From 30% to 60% of Ukrainians during the year did not have contact with a family doctor and did not undergo examinations, the state should develop mechanisms for reimbursing studies and analyses within the framework of the Medical Guarantee Program.

The Candidate of Medical Sciences, Master of Public Administration Serhiy Kutsevliak told the Interfax-Ukraine agency this is evidenced by the results of an analysis of monitoring data from the medical information system (MIS), as well as a survey of patients, which was conducted in one of the primary care centers in Kyiv in May-July 2023.

“We analyzed how many patients have never seen their family doctor: no appointment, no referral, no prescription, no sick leave, no certificate, that is, “zero” activity during the year for a person who has a declaration with a family doctor. In the agricultural rural region, we saw about 30% of such patients. And in the central region, we counted up to 60% of people who have never seen a family doctor,” he said.

At the same time, referring to the monitoring of MIS data for 2019-2021, Kutsevliak noted that “many people simply do not turn to family doctors, which logically leads to high mortality rates, in particular from cardiovascular diseases, and high indicators of disability after heart attacks and strokes.”

He said that in one of the primary medical care centers in Kyiv, a pilot project was implemented in the summer of 2023, during which the clinic conducted cardiac examinations and tests on 500 people aged 40-65 years.

“They found 41% of people requiring in-depth attention and corrective therapy. Therefore, now we are talking about the formation of state policy so that the state provides a minimum set of studies for the patient, in order to provide consumables for the study,” he said.

The expert noted that, according to preliminary calculations, the cost of implementing a project to monitor the health status of residents of a city with a population of about 250,000 people could be about UAH 80-90 million.

“We say that the state should introduce reimbursement for examinations in order to be able to motivate and also control the family doctor. It is clear that family medicine will not be able to cope with this at the current level of payment per patient, so the state must shift its emphasis in order to have this opportunity,” he said.

Kutsevliak emphasized that the implementation of projects in the direction of preventive medicine in war conditions is becoming even more urgent.

“Not only does the war affect mortality, but we lose tens of thousands of people at the front, and in the rear we lose hundreds of thousands of people from undiagnosed diseases. Therefore, it is necessary to shift the focus to monitoring the health status of a particular citizen, then an increase in healthcare funding by billions will have an effect and savings of tens of billions throughout the country,” he said.

He clarified that he took the initiative to develop a corresponding state program aimed at enhancing the work of the primary health care system in the direction of preventive medicine, in particular, stimulating primary care doctors to monitor the health status of patients who have declarations with them.

According to the expert, “all government investments over the past 10 years have gone into stands, contrast, angiographs, CT scanners, and other equipment, but timely basic diagnostics and timely identification of risk factors leading to diseases have not occurred.

“The problem of timely diagnosis to identify risk factors remains relevant. High-tech equipment such as CT scanners and angiographs cannot be used effectively without systematic mass screening of working-age residents,” he said.

Kutsevliak noted that many Ukrainians face a lack of regular medical monitoring. At the same time, a shortage of doctors, especially in remote regions, as well as economic and sociocultural factors can cause delays or complete disregard for medical examinations, which becomes especially important for older people and residents of rural areas.

“Today there is a problem with patients in late stages of illness. Unfortunately, the culture of check-ups and regular medical examinations is poorly developed in Ukraine. Doctors have little interest in helping to make a timely diagnosis and begin treatment. We see great prospects for development if the state pays attention to this issue and begins to direct the activities of doctors to work towards preventing diseases,” he concluded.

Kutsevliak noted that “the emphasis should be on efforts at the primary care stage.”

“Family doctors play a key role in timely diagnosis and prevention of diseases. The development of family medicine, advanced training of doctors and intensification of their interaction with patients can contribute to the early detection of risks and diseases,” he said.

In addition, according to Kutsevliak, “it is worth paying attention to educational programs aimed at increasing the medical literacy of the population and awareness of personal responsibility for their own health.”

“An informed patient will be more responsible about their health and undergo regular medical examinations. It is necessary to intensify the work of the primary medical care system and provide citizens with the necessary medical examinations for timely diagnosis. This will help reduce mortality and disability, and will also be economically beneficial for the state. Just reducing the number of strokes by even 5% will give an economic effect of at least UAH 1.5 billion per year and will save the lives and active working condition of 7,500 Ukrainian citizens. The introduction of the principle of continuous monitoring of the health status of citizens should become the basis of state policy,” he said.