Health Economics and Management Review

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Published by: Sumy State University (10.21272)
Total articles ≅ 56
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, Monika Grabowska
Health Economics and Management Review, Volume 3, pp 86-95; https://doi.org/10.21272/hem.2022.1-09

Abstract:
This article states that the private sector and the government can resolve contradictions and bridge interaction gaps through a public-private partnership due to complementing each other functionally. The study aims to determine the elements of public-private partnership development in healthcare and primary conditions for further forming an effective environment for implementing the principles of public-private partnership in healthcare management. This investigation examined the public-private partnership state worldwide and in Ukraine and the prospects for its development in the context of healthcare reform. It was noted that cooperation between the public and private sectors is becoming increasingly social. However, the current practice does not show effectiveness in achieving certain goals. The properties and differences in realizing social public-private partnership projects were investigated. The risks and problems in the implementation of public-private partnerships in healthcare were identified. The authors developed the structural and target model for ensuring the development of public-private partnerships in healthcare. It was determined that the basic conditions contributing to the successful implementation of public-private partnership projects in healthcare should include the factors as follows: political willpower to promote the development and support of public-private partnership; legislative and regulatory system to attract private sector funding; availability of feasible and effective projects and mechanisms for their selection; availability of information and staff needed for project implementation. The findings substantiated that state budget support is essential in reducing the risks of a private partner at the initial stage of public-private partnership development. The world experience showed that state funding of public-private partnership projects in healthcare might vary depending on the project life cycle stage. Given the importance of improving the funding of public-private partnerships, especially in terms of state budget funding for health projects, key elements and possible areas for improvement were identified.
Veronika Litovtseva, , Paulína Srovnalíková
Health Economics and Management Review, Volume 3, pp 62-75; https://doi.org/10.21272/hem.2022.1-07

Abstract:
The sphere of trust in the health care system, which is actively developing in covid and postcovid conditions, is accompanied by a significant increase in the amount of scientific literature that requires detailed analysis. Accordingly, the primary purpose of this study is to conduct a multilevel bibliometric analysis of publications on trust in the health care system. This will provide a global picture of the phenomenon to determine the dynamic aspects of trends from a statistical point of view, using content-contextual, descriptive, comparative, cluster and evolutionary-temporal analysis. The methodological basis of the study is a set of scientific publications indexed in the scientometric database Scopus, which was analyzed using analytical tools ScopusTools and VOSViewer. A total of 1,134 articles published between 1999 and the second quarter of 2022 were analyzed. The results show a growing trend in the spread of research on trust in the health care system. According to the results, five stages of scientific development of the researched subject were identified, in particular, the last one is characterized by extremely high research interest and covers the period from 2020 to the second quarter of 2022. The geographic center of research is the United Kingdom, and a significant contribution to the development of trust research in the health care system has been made by scientists in the United States, Australia and Canada. The analysis of the sectoral structure of financial sector trust research shows a weak diversification, and a comparative analysis of publications shows a close link between the concepts of trust in the health care system, vaccination and COVID-19. Cluster analysis identified five main groups of research. The results of evolutionary-temporal analysis show that at the beginning of scientific interest, research focused on interpersonal relationships between doctors and patients, and the latest area of research is to study the impact of trust on public decision-making on vaccination and other preventive measures. Thus, the study results showed that trust is one of the most crucial components in ensuring an effective health policy.
, Bozena Kaminska, Volodymyr Boiko
Health Economics and Management Review, Volume 3, pp 25-30; https://doi.org/10.21272/hem.2022.1-03

Abstract:
This study explored the motivational factors of effective management of medical personnel. In this line, the authors highlighted that motivation activates human resources. It is an integral part of the effective management of a medical institution. The main theoretical approaches of foreign and domestic scientists regarding the understanding and interpretation of the personnel management concept were considered. This paper characterized the main employee motivation theories under the procedural, substantive, and behavioral approaches. The authors highlighted the main components of the personnel management system in a medical institution and presented its structure. It was found that motivation is the determinant in the personnel management system. An effectively developed staff motivation system reveals the staff’s potential for achieving the organization’s goals. Besides, it provides an opportunity to meet the needs of the employee. The obtained results identified the main factors of low motivation of medical staff, which lead to a deterioration in the quality of medical care with all the ensuing consequences. The authors concluded that setting surcharges for employees would interest employees in achieving quantitative and qualitative indicators and strengthening responsibility for providing medical services. The findings showed that the most crucial internal motivation factors provide up to an 80% increase in productivity in the organization. The article presents the components of the motivational mechanism of personnel management in a medical institution. The study findings are of practical importance because they could be used to increase the efficiency of the personnel management system and improve social and labor relations between employees and employers, ensure the achievement of quantitative and qualitative indicators, strengthen responsibility for the quality of medical services. The medical institution will be able to receive more profits, consolidate its position in today’s competitive market environment, and create a positive image.
Olena Kolotilina, Vitalii Lomko, Lesya Prasol
Health Economics and Management Review, Volume 3, pp 96-105; https://doi.org/10.21272/hem.2022.1-10

Abstract:
The need to ensure quality and comprehensive healthcare at the world standard level determines the establishment and importance of private medicine in the healthcare system. It forms the task to reform, develop, and implement targets for private medicine. This article aims to investigate the measures by state policy in promoting private medical services. The methodological basis of this study is the dialectical method of scientific knowledge, system approach, and methods of logistic analysis. The empirical research involved retrospective, structural and comparative analyses. To achieve the study goal, the following tasks were solved: 1) determination of the theoretical basis of the state policy in private healthcare based on scientific background; 2) the analysis of the state policy in Ukrainian healthcare; 3) identification of the role of private medicine in the health care system; 4) the comprehensive analysis of the medical institution activities on the example of a private clinic «L-MED Clinic»; 5) determination of the connection between the effectiveness of activities and the marketing activities in promoting medical services. is study determined the importance of private medicine in the healthcare system of Ukraine. Private treatment and prevention facilities relieve the burden on public hospitals and clinics. The main competitive advantages of private healthcare institutions include availability, sufficient admission time, responsibility and organized attitude to the treatment process, quality diagnosis, full-range medical services, courtesy and attentive staff, comfortable and pleasant interior, etc. Based on the findings, the authors provided practical recommendations for improving the state policy, state regulation of private medical activity, and implementing the best world practices of branching out of the health care sector. The obtained results could be useful to the Ministry of Health of Ukraine, the Ministry of Social Policy of Ukraine, the Cabinet of Ministers of Ukraine, and the Verkhovna Rada of Ukraine in state regulation of healthcare reformation in Ukraine.
Health Economics and Management Review, Volume 3, pp 51-61; https://doi.org/10.21272/hem.2022.1-06

Abstract:
Intensive economic development leads to the inevitable consequences of anthropogenic impact on the environment. Air pollution, soil degradation, water pollution and lack of clean drinking water lead to deteriorating human health and increasing the burden on the health care system. Globalization and integration have also become important drivers of the rapid spread of the COVID-19 pandemic. All this leads to the need to transform the health care system and the model of its financing, and adapt it to these challenges. The aim of this work is to identify theoretical (based on bibliometric analysis) and empirical (based on panel data regression modelling) patterns of the impact of health care expenditure on the effectiveness of the COVID-19 combating. The theoretical part of the work involves the implementation of bibliometric analysis based on 262 Scopus publications, in the title, keywords or annotations of which both concepts such as «health expenditure» and «COVID-19» are mentioned. The practical implementation of this task is carried out using VOSviewer v.1.6.17. According to the results of the bibliometric analysis, contextual, geographical and temporal patterns of publishing activity of scientists on certain issues were revealed. The empirical part of the work involves a statistical analysis to identify the relationship between morbidity and mortality due to COVID-19 and the volatility of the share of current health expenditure in GDP and its structure. The task of this stage is to determine the benchmarking model of financial support of the health care system, which demonstrates the greatest resistance to COVID-19. The analysis was conducted on the basis of data for 13 countries in Europe and Asia (Azerbaijan, Belarus, Armenia, Georgia, Estonia, Latvia, Lithuania, Moldova, Poland, Romania, Slovakia, Hungary and Ukraine). According to statistical analysis, the most resistant to COVID-19 is the health care system of Estonia, which is characterized by the volume of health care expenditure at 4-6% of GDP. At the same time, in the structure of the current health care expenditure, 25% is private expenditure and 75% is government expenditure, and external financing is almost non-existent. However, similar proportions of public and private expenditure in other countries do not ensure similar resistance to coronavirus, so this ratio is not a benchmark. A more in-depth analysis using panel regression modelling in Stata 12/SE revealed the positive impact of public, private and external health expenditures on reducing mortality, as well as the positive impact of increasing current health expenditures on life expectancy. The obtained theoretical and practical results can be useful for scientists and government officials in the context of optimizing the financial support of the health care system, taking into account its effectiveness in resisting national and global threats (COVID-19).
Anna Rosokhata, Adam Jasnikowski, Yelizaveta Yatskova, Victoriia Kurylo, Anastasiia Samoilenko
Health Economics and Management Review, Volume 3, pp 39-50; https://doi.org/10.21272/hem.2022.1-05

Abstract:
In the EU, palliative care is a comprehensive system of patient support: social, psychological, spiritual and, of course, medical care. How it works in other countries and what the experience should be applied so that children in Ukraine can not only adequately anesthetize, but also not violate their rights. These and a number of other issues and challenges today are highlighted in this study. The object of research is palliative and hospice care.The research was preceded by the following questions: to analyze current problems of palliative and hospice care in Ukraine and the world; to analyze the regulatory and legal support for palliative care in Ukraine; to study statistical data on the need for palliative and hospice care in Ukraine and local communities; to conduct a survey of residents of the united territorial communities on their awareness of palliative and hospice care and its needs in communities; develop recommendations for the implementation of modern methods of palliative care for residents of united territorial communities. The analysis examined the experience of European countries in this issue and the challenges facing Ukraine. The legal framework governing the provision of palliative care to terminally ill patients in Ukraine was analyzed. A representative survey was conducted on public awareness of the provision of palliative and hospice care to patients among the population of Sumy region. 150 respondents took part in the survey: 33% of women and 67% of men. According to the results of the research, hypotheses about the problems and needs of hospice and palliative care were confirmed. It has been found that the elderly and people with incurable diseases need it the most, and most agree that such people should be cared for in special institutions that need to be formed at the level of territorial communities. Which in turn has a significant impact on the place brand formation due to the stakeholders involvement. As a result of the study, proposals were presented to address current issues of palliative and hospice care in Ukraine, using the experience of EU countries and the implementation of it through the efforts of local communities, which in turn forms the brand of the place.
Stanislav Kotenko,
Health Economics and Management Review, Volume 3, pp 31-38; https://doi.org/10.21272/hem.2022.1-04

Abstract:
This article aims to examine the impact of the pandemic on competition in the medical services market of the Sumy region, which is ranked among the Ukrainian regions with small medical personnel and low socio-economic development. This study involved marketing research methods (surveys and content analysis), statistical methods for information processing, factor analysis, and alternatives analysis. The results unveiled the intense competition for patients and medical staff in the healthcare market of the Sumy region. The organization’s competitiveness before the pandemic was assessed by factors such as «the doctors’ treatment of patients and their qualifications» and «the availability of necessary medical services». During the pandemic, the essential factor in choosing a medical institution was «patient safety, reducing the risk of coronavirus». Before the pandemic, the competition between medical organizations was most influenced by the population paying capacity and the shortage of qualified medical personnel. Private clinics ranked below public clinics in delivering a wide range of medical services because of the lack of medical specialists. However, the pandemic has strengthened the position of private clinics through two factors. First, private clinics have expanded their range of services through narrow specialists who have moved from public institutions to private clinics. Second, private clinics have provided a higher level of client safety through a tight filter for patients with symptoms of coronavirus infection. Besides, using remote technologies by medical organizations has become a competitive advantage. The authors noted that remote technologies in healthcare are not common in the Sumy region and Ukraine in general, as patients distrust this service. This study is of practical value because it allows assessing the impact of global challenges on healthcare development in the regions to assess private medicine competitiveness changes. In addition to its practical value, private market research, especially in times of pandemic threat, confirms or rejects some theoretical hypotheses aimed at analyzing the performance of the private sector in health care facilities. This work opens new avenues for a deeper study of the similarities between private and public health facilities, especially in the face of legal and pandemic constraints.
, Regina Veckalne, Inna Balahurovska, Nataliia Khrin
Health Economics and Management Review, Volume 3, pp 19-24; https://doi.org/10.21272/hem.2022.1-02

Abstract:
The organization’s management performance is essential for modern managers who strive for positive work results and achievements in public life. The authors have emphasized that healthcare reformation requires the selection of effective management staff since changes in healthcare are designed to create conditions for the operation of patient-oriented medical institutions. This paper aims to study the issues related to the development of Ukrainian management in current conditions. The authors unveiled the effective interaction between the manager and subordinates in the view of healthcare peculiarities. The methodological basis of this research involved a systematic approach to investigating the theoretical aspects of management. The method of scientific literature analysis in healthcare management was applied. Tabular modeling is used to visualize the study results. The comparison method was used to explore the international management models. The study confirmed that effective communication between the manager and team is an essential management element. The principles of democratic leadership style to build an effective management model in health care institutions of Ukraine were analyzed. To better understand the peculiarities of health care, this paper considered the basic concepts of the study area (medicine, medical activities, and health care) and identified a logical connection between them. The study described the importance and specificity of healthcare for each member of society and the state. The findings showed that the main criteria for evaluating the efficiency of managers in healthcare institutions rest on their understanding of the need to provide quality medical services and develop leadership qualities. This study analyzed the domestic and foreign approaches to developing leadership qualities. The authors provided insight into the democratic style principles in the interaction between the leader, staff, and the business environment. The differences in Japanese, American, and European management models were analyzed. Based on the obtained results, this study proposed the theoretical management model in Ukrainian healthcare institutions to promote the development of organizations.
Oladayo Nathaniel Awojobi
Health Economics and Management Review, Volume 3, pp 8-18; https://doi.org/10.21272/hem.2022.1-01

Abstract:
The author of the paper investigates the issue of Indigenous health inequalities. The main purpose of the research is to assess the causes of health inequalities among Indigenous people and policy options to reduce the health gaps. Systematization of the literary sources shows that there are health disparities between Indigenous people and non-Indigenous people and approaches for solving the problem come in different forms. The methodological basis of this study is a comparative analysis that used secondary data to capture health inequalities among the Indigenous populations in Australia, Canada, and the United States. These countries have adopted different policy options to reduce these inequalities. The paper presents the results of a comparative analysis that contributes to knowledge by articulating what is not known about Indigenous health inequalities and social determinants of health and policy response. The study contributes to understanding by articulating what is not known about Indigenous health inequalities and social determinants of health and policy response. Aside from the study being useful to policymakers, politicians, development experts and the academic environments, the study provides the opportunity to assess some of the policy interventions. When necessary, it provides ample opportunity if there is a need to reform the social and health policies meant to reduce health inequalities among Indigenous populations. The author found that both grey and academic studies have examined policy options and governance meant to reduce health inequalities among Indigenous people in Australia, Canada, and the U.S. However, there is a lack of quality studies that have evaluated these policy options, limiting the strength to determine achievement associated with such policy options and governance. Further, there is limited information on whether these policy options are suitable for the Indigenous population to enhance their health status. With these limitations, future studies need to assess the effectiveness of these policy options and determine if the policy options are culturally suitable to reduce Indigenous people’s health inequalities.
Oleh Skorba,
Health Economics and Management Review, Volume 3, pp 76-85; https://doi.org/10.21272/hem.2022.1-08

Abstract:
The healthcare reformation focuses on improving public health since public health is one of the state policy priorities. The systematization of scientific background showed the growing academic interest in the reformation of the secondary medical service market, determining the study’s relevance. This study aims to substantiate ways to improve the organization and management of health services in the secondary market of health services. To achieve the research goal, the authors analyzed the theoretical approaches to defining the concept of quality of medical services. They considered the development of the Ukrainian medical services market and determined the quality of medical care. This study examined the functioning of the admission department of the central district hospital. The methodological basis of the study involved the methods of statistical analysis, systematic approach, analysis, and synthesis. The findings showed no fatalities in the analyzed hospital from 2013 to 2015, thanks to an insignificant discrepancy in outpatient and inpatient diagnoses and ambulance diagnoses. The authors emphasized the necessity to transfer the information about the patient’s condition for treatment in the outpatient department to improve the quality of medical services. Within the study framework, the authors found that doctors use new treatment methods in their medical activities in the admission department, which allows stating a high percentage of recovery and improvement of the general condition of patients. Much attention is paid to personal, social, and health education to prevent the emergence of difficult medical situations in the admission department. The above is essential for providing quality medical care by doctors and junior medical staff. The authors concluded that the improvement of the current medical care requires the efficient use of material and human resources; improvement of the communication between ambulance, polyclinic, and inpatient facilities to provide the validity and timeliness of hospitalization; improving the interaction between separate medical institution’s services and its structural subdivisions to timely examine and hospitalize in inpatient departments, etc. The results of this study could elevate the quality of medical services in the admission department and prevent complex medical cases in the treatment of patients.
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