More than 37% of medical professionals and nearly 26% of patients negatively assess the state of Ukraine's healthcare system; one of the most pressing issues is staffing shortages.
As Andriy Yeremenko, founder of the sociological company Active Group, reported at a press conference at the Interfax-Ukraine agency on Thursday, this is evidenced by the data of a survey conducted in late May and early June in Ukraine (excluding the occupied regions and the Autonomous Republic of Crimea).
According to the survey data, 9.9% of doctors and 7.2% of patients, in particular, assess the state of the healthcare system as “very poor,” while 48.1% and 54.6%, respectively, assess it as “average.”
At the same time, only 24.4% of surveyed doctors and 24.7% of patients feel that the situation has improved following the medical reforms carried out (for example, the introduction of the National Health Service (NHS) starting in 2018).
A deterioration in the availability of medical services was noted by 40.5% of surveyed medical professionals, while a deterioration in the quality of medical services was reported by 24.2%. Meanwhile, positive changes in the availability of medical services were noted by 25.8% of respondents, while an improvement in quality was reported by 29.2%.
Some 42.7% of medical professionals gave a negative assessment of the reorganization of healthcare institutions aimed at creating an effective network as a whole, while 27.7% assessed these processes as generally positive.
At the same time, 38% of medical workers believe that the relationship between a medical institution and the NHS is completely or largely unpredictable, and 48.3% of surveyed medical workers note constant or frequent unfair decisions regarding medical institutions that have entered into a contract.
Meanwhile, 65.6% of surveyed healthcare professionals and 55.8% of patients expressed a positive attitude toward the idea of mandatory health insurance in Ukraine. Moreover, 39.6% of healthcare professionals believe that mandatory health insurance should be provided by a separate state insurance fund.
Analyzing the assessment of the digitalization processes in the healthcare system, researchers reported that 42.6% of surveyed medical professionals experience inconvenience when using the medical information system and electronic health system due to malfunctions in the latter, while 20.3% see problems in the imperfections of the medical information system.
At the same time, 77.8% of doctors and 75.5% of patients noted the convenience of using electronic prescriptions.
When assessing the staffing levels of the medical institutions where healthcare workers work, 62.8% reported an insufficient supply of doctors, and 65.3% reported a shortage of nursing staff. Furthermore, 70% of healthcare workers and 60.3% of patients cited the outflow of medical personnel as a problem of wartime medicine. A shortage of medications was noted by 6.1% of healthcare workers and 13.4% of patients, while the destruction of infrastructure was noted by 17.8% of healthcare workers and 22.7% of patients.
In Ukraine, 11.9% of surveyed medical professionals said they planned to leave medicine and move to another field of work, while 5.2% said they planned to work outside the country.
Commenting on the survey results, infectious disease specialist and MD Olha Holubovska said that the overwhelming majority of Ukrainian medical professionals are critical of the current state of the healthcare system and do not see positive results from healthcare reform, while more than three-quarters of respondents perceive the National Health Service of Ukraine (NHSU) not as a partner, but as a controlling or punitive body.
"The National Health Service of Ukraine (NHSU) tariffs are the main factor creating an unhealthy environment in healthcare provision. This is a glaring problem. I understand the state is short on funds, but there are things that can be fixed without funding. Where do the NHSU tariffs come from? What formulas and documents are used? How were these tariffs calculated if there are no treatment standards? These tariffs are not objective. Everyone knows this, even at the NHSU," she said.
Holubovska also emphasized the need to reconsider approaches to reforming the healthcare system.
"We're not against the reform—we're for people-centered reforms, but they shouldn't be focused solely on numbers. First and foremost, we need to analyze healthcare reform. We need to know how many doctors and hospitals we have, and what the mortality rate is. We don't have mortality statistics—they're classified. Who's assessing the quality of healthcare right now?" she said.
At the same time, Viktor Serdiuk, president of the All-Ukrainian charitable organization "Council for the Protection of Patients' Rights and Safety," reported that doctors and patients share the same problems: insufficient funding for medicine, the need to pay for part of the treatment out of pocket, and declining access to medical care.
"We hear from patients that it's hard to see a specialist, there aren't enough doctors, they have to buy medications, and it's impossible to get to the hospital. But thanks to this study, we've seen that the problem isn't with doctors — it's with specialists," he said.
"The average age of TB doctors treating tuberculosis is over 60, and the average age of nurses is over 50. They're still working today, but who will be working tomorrow?" he asked.
At the same time, Serdiuk emphasized that the majority of medical workers want the introduction of insurance-based medicine.
"Where does this belief in miraculous insurance come from, and why do they distrust it now? After all, the NHSU is essentially a state-owned insurance company that receives funds from the state and then acts as a regulatory body. The main goal of every insurer is to pay nothing at all. This is ideal for the NHSU – to receive funds and pay nothing. So why is this illusion still actual that some other insurer will come along and everything will be perfect? Global experience suggests the exact opposite," Serdiuk emphasized.
The Active Group study was conducted using an online survey. It was representative of age, geography, medical facility ownership (municipal, state-owned), and type of healthcare delivery (primary, secondary, tertiary). The sample size was 7,249 respondents.
