Medical and Social Substantiation of the Financial and Economic State of the Kolomyia District Center of Primary Health Care before and after the Implementation of the Hospital District
Authors:   Ivano-Frankivsk Regional Clinical Infectious Diseases Hospital. 66, Hetman Sahaidachny St., Ivano-Frankivsk 76007, Ukraine, Stovban M. P. , Tolstanov O. K. ,   Shupyk National Healthcare University of Ukraine. 9, Dorohozhytska St., Kyiv 04112, Ukraine
Published: November 2022

The relevance of the study is due to the problems of medical care of the population of Ukraine caused by the 2019 pandemic and the war of 2022, which requires prompt, timely and high-quality management of the health care system. The purpose of the study was to evaluate the indicators of the financial condition of the Kolomyia Regional Medical Center after the introduction of the hospital district. To achieve the goal, the following tasks were performed in the course of the study: the peculiarities of the formation of hospital districts and the reorganization of the health care system at the local level were shown, the financial condition of the Kolomyia Regional Medical Center was investigated, and the changes before and after the introduction of the hospital district in the main indicators were shown. Materials and methods. In the course of the study, methods of economic analysis were used, in particular, the method of horizontal and vertical analysis, R-indicators. The method of observation and strengths, weaknesses, opportunities, and threats analysis were also used. Results and discussion. The results of the study showed that the Kolomyia Regional Medical Center is characterized by an unstable financial condition with worsening indicators after the introduction of the hospital district. Improvement of the material and technical base and increase in staff wages are positive factors of the impact of the reforms. The practical significance of the study is due to the definition of the problems of implementing the reform in the health care system and the possibility of adjusting the strategy of development of medical institutions of territorial communities. Conclusion. The introduction of hospital districts became one of the elements of the medical reform, which allows optimizing state and local financial resources in order to use them effectively without threats or risks to the population. Such a reform was carried out in 2017, as a result of which a medical cluster was created in the Kolomyia United Territorial Community. Such a cluster made it possible to optimize the work of medical institutions. According to the results of the analysis of the financial condition of the Kolomyia Regional Medical Center before and after the introduction of the hospital district, it can be concluded that, taking into account the unchanged budget costs for financing the Kolomyia Hospital, its financial condition has changed significantly. In particular, indicators of financial condition, liquidity, turnover and profitability have deteriorated. At the same time, due to the use of ineffective means of optimization, in particular, the reduction of personnel, there was an increase in wages, as well as the release of additional funds for equipment and technical support of the medical institution. Of course, the formation of a hospital district did not solve the problems of medicine, and to some extent even aggravated them, since in general, medical institutions faced issues of staff reduction and reduced funding. However, at the same time, newly created medical clusters are opening up new forms of financing that allow them to provide services on a competitive basis and gain financial autonomy and even independence