The potential of the national healthcare system in a context of integration into the European medical space

Abstract

The conducted study of an analysis of a healthcare system in Ukraine demonstrates a long-term trend toward a reduction of human and infrastructural potential of the national healthcare system, which began in the 1990s and intensified amid military actions after 2014. In particular, the total number of doctors and mid-level medical personnel has decreased threefold, especially in frontline regions. A personnel crisis became most acute after 2020, coinciding with the pandemic and the war. A number of hospitals and hospital beds between 1990 and 2023 decreased almost threefold, reflecting a shift from the Soviet model to an outpatient-oriented system; however, this simultaneously threatens to create shortages in access to inpatient care. At the same time, the number of outpatient and polyclinic institutions has gradually increased, indicating an implementation of principles of primary healthcare reform. Healthcare financing has shown an overall increase, particularly through the Medical Guarantees Program, which in 2024 accounts for more than 50 % of a sectoral budget. However, emergency medical care and infrastructure in combat zones remain underfunded. The increase in expenditures for drug reimbursement indicates strengthening of a social component of healthcare policy aimed at supporting vulnerable population groups. Despite positive changes in a financial support of the sector, a situation with medical personnel and infrastructure requires urgent strategic decisions to preserve and restore resource potential, especially under wartime conditions and during post-war reconstruction.