Analysis of Economic Factors in the Context of Healthcare Reform in Ukraine
Abstract
The study aimed to assess the impact of economic factors on the healthcare system renewal in Ukraine. The study analysed key regulatory documents that affect healthcare financing and management and compares the Ukrainian model with those of other European countries, such as Poland, Germany, the Czech Republic and Switzerland. To obtain the results, data for 2019-2025, including official statistics on sector financing and access to healthcare services, were used. The main findings of the study indicate significant regional disparities in access to healthcare services in Ukraine, which appear to be associated with the uneven distribution of financial resources. The available data suggest that healthcare reform based on the principle of “money follows the patient” has improved funding for healthcare facilities in large cities, while rural facilities tend to remain comparatively underfunded. In addition, the study determined that higher incomes provide better access to healthcare services, while people with lower incomes face financial barriers and informal payments, which worsen access to healthcare. Comparisons with healthcare models in Poland, Germany and the Czech Republic demonstrated that systems with compulsory health insurance provide greater financial stability and equal access to healthcare services. The Ukrainian system requires significant reforms to address regional disparities and improve the efficiency of financing. The findings highlight the need to improve the mechanisms for allocating financial resources, particularly for rural areas, and to attract additional private investment to modernise healthcare facilities.
References
Aliyev, S. T. (2014). Economics of Azerbaijan: Upgrading and implementation of effective instruments. Life Science Journal, 11(5), 321–326. https://doi.org/10.7537/marslsj1105s14.64
Aliyeva, M., Huseynova, L., and Agabekova, G. (2025). The role of investment in the development of smart agricultural technologies in megacities. Scientific Horizons, 28(6), 150–164. https://doi.org/10.48077/scihor6.2025.150
Andriushchenko, K., and Marchuk, S. (2024). The impact of artificial intelligence on the transformation of enterprise business processes. Management and Business, 2(2), 18–31. https://doi.org/10.59214/mb/2.2024.18
Beztelesna, L., Marzec, P., Pliashko, O., Vovk, V., Khomych, S., Kucher, L., and Kucher, A. (2024). Behavioural determinants of the healthcare providers in Ukraine: Focus on competition context. Cleaner and Responsible Consumption, 13, 100192. https://doi.org/10.1016/j.clrc.2024.100192
Bíró, A., and Prinz, D. (2019). Healthcare spending inequality: Evidence from Hungarian administrative data. Health Policy, 124(3), 282–290. https://doi.org/10.1016/j.healthpol.2020.01.006
Breckenkamp, J., Wiskow, C., and Laaser, U. (2007). Progress on quality management in the German health system. Health Research Policy and Systems, 5(1), 7. https://doi.org/10.1186/1478-4505-5-7
Briš, P., Kolářová, E., and Yousaf, M. (2018). Healthcare quality management in Czech Republic. International Journal of Management and Applied Science, 4(10), 69–73. https://www.iraj.in/journal/journal_file/journal_pdf/14-506-154649087569-73.pdf
Clements, B., Coady, D., and Gupta, S. (2012). The economics of public health care reform in advanced and emerging economies. International Monetary Fund.
Czechia: Health system review. (2023). https://eurohealthobservatory.who.int/publications/i/czechia-health-system-review-2023
Denis, J.-L., Ushe, S., and Préval, J. (2023). Health reforms and policy capacity: The Canadian experience. Policy and Society, 42(1), 64–89. https://doi.org/10.1093/polsoc/puac010
Drobyazko, S., Bondarevska, O., Klymenko, D., Pletenetska, S., and Pylypenko, O. (2019). Model for forming of optimal credit portfolio of commercial bank. Journal of Management Information and Decision Sciences, 22(4), 501–506. https://www.abacademies.org/articles/model-for-forming-of-optimal-credit-portfolio-of-commercial-bank.pdf
Durdykulyyeva, M. (2025). The role of the entrepreneurial approach in the development of medical services within the healthcare services market. Economic Forum, 15(3), 73–86. https://doi.org/10.62763/ef/3.2025.73
Dzhedzhula, V., Yepifanova, I., and Shevchuk, D. (2024). The essence and components of the organizational and economic mechanism of healthcare institutions' energy-saving management. Innovation and Sustainability, 4(3), 6–11. https://doi.org/10.31649/ins.2024.3.6.11
Fedotova, I., Shersheniuk, O., Prokopenko, M., Britchenko, I., and Vazov, R. (2021). Management of a viable enterprise on the basis of the approach to management of a “living” organization and the concept of viable systems. In Problems and prospects of development of the road transport complex: Financing, management, innovation, quality, safety – Integrated approach (pp. 63–80). PC Technology Center. https://doi.org/10.15587/978-617-7319-45-9.CH5
Fredriksson, M. (2024). Universal health coverage and equal access in Sweden: A century-long perspective on macro-level policy. International Journal for Equity in Health, 23(1), 111. https://doi.org/10.1186/s12939-024-02193-5
Gulaliyev, M., Abasova, S., Guliyeva, S., Samedova, E., and Orucova, M. (2023). The main problems of building the digital economy of Azerbaijan. WSEAS Transactions on Business and Economics, 20, 1383–1395. https://doi.org/10.37394/23207.2023.20.123
Guo, W., Liu, G., Ma, L., Gao, B., Wang, W., Hu, Z., Tian, Y., Xiao, W., and Qiao, H. (2022). The impact of healthcare reform on the dynamic changes in health service utilization and equity: A 10-year follow-up study. Scientific Reports, 12(1), 3576. https://doi.org/10.1038/s41598-022-07405-y
Habicht, J., Hellowell, M., and Kutzin, J. (2023). Sustaining progress towards universal health coverage amidst a full-scale war: Learning from Ukraine. Health Policy and Planning, 39(7), 799–802. https://doi.org/10.1093/heapol/czae041
Habicht, J., Hellowell, M., and Kutzin, J. (2024). Sustaining progress towards universal health coverage amidst a full-scale war: Learning from Ukraine. Health Policy and Planning, 39(7), 799–802. https://doi.org/10.1093/heapol/czae041
Hasanov, R. I., Vasa, L., Guliyeva, S., Giyasova, Z., and Shakaraliyeva, Z. (2025). Assessing the impact of oil prices and inflation on bank deposits in Azerbaijan. Banks and Bank Systems, 20(1), 11–22. https://doi.org/10.21511/bbs.20(1).2025.02
Hasanova, J., and Najafova, K. (2025). Digitization, automation problems and solutions in small business on the example of Azerbaijan. WSEAS Transactions on Business and Economics, 22, 1358–1369. https://doi.org/10.37394/23207.2025.22.110
Honavar, S. G. (2020). Electronic medical records – The good, the bad and the ugly. Indian Journal of Ophthalmology, 68(3), 417–418. https://doi.org/10.4103/ijo.IJO_278_20
Huriev, V. (2024). Digital technologies as a component of the mechanism for crisis management in regional development. Innovation and Sustainability, 4(3), 151–159. https://doi.org/10.31649/ins.2024.3.151.159
Husereau, D., Drummond, M., Augustovski, F., de Bekker-Grob, E., Briggs, A. H., Carswell, C., Caulley, L., Chaiyakunapruk, N., Greenberg, D., Loder, E., Mauskopf, J., Mullins, C. D., Petrou, S., Pwu, R. F., and Staniszewska, S. (2022). Consolidated health economic evaluation reporting standards 2022 (CHEERS 2022) statement: Updated reporting guidance for health economic evaluations. Journal of Managed Care and Specialty Pharmacy, 28(2), 146–155. https://doi.org/10.18553/jmcp.2022.28.2.146
Ikegami, N. (2024). The economic rationale for healthcare reform. International Journal of Health Policy and Management, 13(1), 1–3. https://doi.org/10.34172/ijhpm.8441
Issayeva, A., Niyazbekova, S., Semenov, A., Kerimkhulle, S., and Sayimova, M. (2024). Digital technologies and the integration of a green economy: Legal peculiarities and electronic transactions. Reliability Theory and Applications, 19(6), 1088–1096. https://doi.org/10.24412/1932-2321-2024-681-1088-1096
Jakovljevic, M., Chang, H., Pan, J., Guo, C., Hui, J., Hu, H., Grujic, D., Li, Z., and Shi, L. (2023). Successes and challenges of China’s health care reform: A four-decade perspective spanning 1985–2023. Cost Effectiveness and Resource Allocation, 21(1), 59. https://doi.org/10.1186/s12962-023-00461-9
Jarvis, T., Smith, R. W., Sandhu, H. S., Mac-Seing, M., O’Neill, M., Rosella, L., Allin, S., and Pinto, A. D. (2023). Promise and peril: How health system reforms impacted public health in three Canadian provinces. Canadian Journal of Public Health, 114(5), 714–725. https://doi.org/10.17269/s41997-023-00785-2
Ketners, K., Jarockis, A., and Petersone, M. (2024). State budget system improvement for informed decision-making in Latvia. Scientific Bulletin of Mukachevo State University. Series Economics, 11(3), 86–99. https://doi.org/10.52566/msu-econ3.2024.86
Kovalchuk, S., Morokhova, V., Bondarenko, O., Mohylova, A., Dankevych, A., and Liu, J. (2024). Creative economy and value creation through marketing analytics: New approaches and opportunities. Pakistan Journal of Life and Social Sciences, 22(2), 9812–9824. https://doi.org/10.57239/PJLSS-2024-22.2.00741
Kussainova, A., Rakhimberdinova, M., Denissova, O., Taspenova, G., and Konyrbekov, M. (2018). Improvement of technological modernization using behavioral economics. Journal of Environmental Management and Tourism, 9(7), 1470–1478. https://doi.org/10.14505/jemt.v9.7(31).11
Lakbaev, K. S., Uakasov, D. A., and Tusupbekov, K. R. (2017). About economic basics and social consequences of extremism and terrorism. Man in India, 97(20), 365–371. https://serialsjournals.com/abstract/95760_ch_33_f_-_lakbaev_327118.pdf
Lavrukhina, K., Tytok, V., Biloshchytskyi, A., Tormosov, R., Kalinin, O., and Mostovenko, O. (2025). Research on the prospects and risks of digital economic transformation: Positive impact, key threats, and the role of clusters in the transformation of Ukraine's national economy. In SIST 2025 – 2025 IEEE 5th International Conference on Smart Information Systems and Technologies. IEEE. https://doi.org/10.1109/SIST61657.2025.11139283
Law of Ukraine No. 2168-VIII “On state financial guarantees of medical service to the population.” (2018). https://zakon.rada.gov.ua/laws/show/2168-19?lang=en#Text
Leontyev, A., and Ketners, K. (2023). The improvement of decision-making in the Latvian tax system. Intellectual Economics, 17(2), 322–343. https://doi.org/10.13165/IE-23-17-2-04
Leshchenko, K., and Leshchenko, S. (2023). Determining priorities for Ukraine’s post-war reconstruction in the conditions of preparation for EU membership. Economics of Development, 22(3), 42–51. https://doi.org/10.57111/econ/3.2023.42
Moskalenko, O., Yeleussinova, A., Panjieva, N., Tkachenko, A., and Yakovlev, O. (2025). Role of tax and legal incentives in attracting foreign capital in the context of international investment policy. International Journal of Accounting and Economics Studies, 12(2), 381–391. https://doi.org/10.14419/jbzc6c96
Mudge, G. H., Vilenskyi, A., Kumar, U., and Kohli, M. (2025). The future of Ukrainian healthcare: The digital opportunity. Journal of Global Health, 15, 03039. https://doi.org/10.7189/jogh.15.03039
Murphy, A., and Kovtoniuk, P. (2025). Three years into Russia’s full-scale invasion, Ukraine offers a model of health system resilience. BMJ, 388, r377. https://doi.org/10.1136/bmj.r377
Musayeva, N., Aliyeva, M., Gasimova, L., and Bayramova, G. (2025). The role of blockchain technology in ensuring transparency, trust, and auditing in financial markets. Operations Research Forum, 6(4), 167. https://doi.org/10.1007/s43069-025-00578-y
National strategy for building a new healthcare system in Ukraine for the period 2015–2025. (2014). https://healthsag.org.ua/wp-content/uploads/2014/11/Proekt-Strategiyi-reformi_OZ.pdf
Nitsenko, V., Dankevych, A., Dzoba, O., Ustenko, A., and Bashynska, Y. (2024). Ethical and social incentives for the transformation of the business model of enterprise management. Naukovyi Visnyk Natsionalnoho Hirnychoho Universytetu, 4, 172–179. https://doi.org/10.33271/nvngu/2024-4/172
Niyazbekova, S., Zverkova, A., Sokolinskaya, N., and Kerimkhulle, S. (2023). Features of the “green” strategies for the development of banks. E3S Web of Conferences, 402, 08029. https://doi.org/10.1051/e3sconf/202340208029
Nurusheva, S. S., Abisheva, S. T., Abisheva, A. B., Rutskaya-Moroshan, K. S., and Shaimerdenov, S. A. (2024). Late post-COVID syndrome: Clinical complications beyond 12 weeks. Journal of Clinical Medicine of Kazakhstan, 21(1), 9–13. https://doi.org/10.23950/jcmk/14268
Order of the Cabinet of Ministers of Ukraine No. 1013-p “On approval of the concept of reform of the financing of the healthcare system.” (2016). https://cis-legislation.com/document.fwx?rgn=92696
Panchenko, A., Voloshina, A., Kiurchev, S., Titova, O., Onopreychuk, D., Stefanov, V., Safoniuk, I., Pashchenko, V., Radionov, H., and Golubok, M. (2018). Development of the universal model of mechatronic system with a hydraulic drive. Eastern-European Journal of Enterprise Technologies, 4(7-94), 51–60. https://doi.org/10.15587/1729-4061.2018.139577
Panteghini, P. M. (2000). Tax evasion and entrepreneurial flexibility. Public Finance Review, 28(3), 199–209. https://doi.org/10.1177/109114210002800303
Panteghini, P. M. (2006). S-based taxation under default risk. Journal of Public Economics, 90(10–11), 1923–1937. https://doi.org/10.1016/j.jpubeco.2005.12.004
Peredalo, Kh. S., Oherchuk, Yu. V., and Libenko, Yu. S. (2019). Behavioral economy and possibilities of its influence techniques application in modern organizations. Efficient Economy, 12, 1–10. https://doi.org/10.32702/2307-2105-2019.12.94
Reddy, K., Gharde, P., Tayade, H., Patil, M., Reddy, L. S., and Surya, D. (2023). Advancements in robotic surgery: A comprehensive overview of current utilizations and upcoming frontiers. Cureus, 15(12), e50415. https://doi.org/10.7759/cureus.50415
Resolution of the Cabinet of Ministers of Ukraine No. 410. On approval of the procedure for the implementation of state guarantees of medical care for the population.(2018). https://zakon.rada.gov.ua/laws/show/410-2018-п
Schusselé Filliettaz, S., Berchtold, P., Koch, U., and Peytremann-Bridevaux, I. (2021). Integrated care in Switzerland: Strengths and weaknesses of a federal system. International Journal of Integrated Care, 21(4), 10. https://doi.org/10.5334/ijic.5668
Shafa, A. (2021). Historical aspects of economic thought in Azerbaijan. Voprosy Istorii, 8(2), 148–155. https://doi.org/10.31166/VoprosyIstorii202108Statyi41
Shahini, E., and Shahini, E. (2025). The economic and political legacy of Trump’s first term: Implications for the second presidency. Politics and Policy, 53(5), e70066. https://doi.org/10.1111/polp.70066
Shtal, T., Ptashchenko, O., Rodionov, S., and Kurtsev, O. (2023). Implementation of modern marketing tools in entrepreneurial activity. Economics of Development, 22(4), 53–63. https://doi.org/10.57111/econ/4.2023.53
Smarżewska, D., Wereda, W. S., and Jończyk, J. A. (2022). Assessment of the health care system in Poland and other OECD countries using the Hellwig method. International Journal of Environmental Research and Public Health, 19(24), 16733. https://doi.org/10.3390/ijerph192416733
Sorum, P. C., Stein, C., and Moore, D. L. (2023). “Comprehensive healthcare for America”: Using the insights of behavioral economics to transform the U.S. healthcare system. Journal of Law, Medicine and Ethics, 51(1), 153–171. https://doi.org/10.1017/jme.2023.52
Sparkes, S. P., Bump, J. B., Özçelik, E. A., Kutzin, J., and Reich, M. R. (2019). Political economy analysis for health financing reform. Health Systems and Reform, 5(3), 183–194. https://doi.org/10.1080/23288604.2019.1633874
Sparkes, S. P., Campos Rivera, P. A., Jang, H., Marten, R., Rajan, D., Robb, A., and Shroff, Z. C. (2022). Normalizing the political economy of improving health. Bulletin of the World Health Organization, 100(4), 276–280. https://doi.org/10.2471/BLT.21.286629
The National Council for the Recovery of Ukraine from the Consequences of the War. (2022). Draft Ukraine recovery plan. https://www.kmu.gov.ua/storage/app/sites/1/recoveryrada/eng/health-care-eng.pdf
Vazova, T., Vazov, R., and Radev, V. (2025). Active aging among the elderly and its economic and social consequences in Bulgaria. Jurnal Ilmiah Ilmu Terapan Universitas Jambi, 9(3), 1037–1054. https://doi.org/10.22437/jiituj.v9i3.42957
World Bank Group. (2025a). Population ages 65 and above (% of total population) – Ukraine, Poland, Czechia, Germany, Switzerland. https://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS
World Bank Group. (2025b). GDP per capita (current US$) – Ukraine. https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?locations=UA
World Health Organization. (2024). Health financing in Ukraine: Reform, resilience and recovery. https://iris.who.int/server/api/core/bitstreams/e4c96bd2-aee5-4367-865f-99090ab8500e/content
World Health Organization. (2025). Unlocking investment for the transformation of Ukraine’s health-care network. https://iris.who.int/server/api/core/bitstreams/aa1fbe72-e0e6-487b-bd00-45fe0eae1ec5/content
Yaremko, I., and Dumych, N. (2025). The essence and modern features of attraction and management of foreign investment in Ukraine. Economic Forum, 15(3), 56–72. https://doi.org/10.62763/ef/3.2025.56
Zaporizhzhia City Council. (2025). Medical reform. https://zp.gov.ua/uk/page/medichna-reforma
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