007. Факультет охорони здоров`я, соціальної роботи і психології

Permanent URI for this community

https://ekmair.ukma.edu.ua/handle/123456789/28632

Факультет створений у 2023 році.

Browse

Now showing 1 - 20 of 20

Характерні аспекти професійного самовизначення
(2020) Рибалочка, Катерина
Тези доповіді на Науково-практичній конференції "Особистість у просторі проблем ХХІ століття", 5 лютого 2020 р., Київ, Україна.
Надання першої психологічної допомоги в надзвичайних ситуаціях : методичні рекомендації
(Імекс-ЛТД, 2022) Довгань, Н.; Поліщук, Світлана; Духневич, В.
У методичних рекомендаціях представлено практики надання першої психологічної допомоги учасникам освітнього процесу. Описано рекомендовані дії, показання до надання першої психологічної допомоги постраждалим у надзвичайних ситуаціях та інструменти її реалізації. Запропоновано трирівневу систему першої психологічної допомоги. Описано структуру та алгоритми дій психологічної підтримки учасників освітнього процесу. Для психологів системи освіти, викладачів психології закладів вищої освіти, студентів, науковців, соціальних педагогів-практиків і вихователів, фахівців із психології безпеки.
Парадигматичні відношення в термінології державного управління
(2022) Романченко, Алла; Бронікова, Світлана
Національна терміносистема є важливим складником будь-якої мови. Сфера державного управління утворює систему, що складається з лексичних одиниць, які розкривають процеси державного управління, висвітлюють специфіку управлінської діяльності тощо, дефінуючи сутність державного управління як галузі науки й діяльності державних службовців. Досліджувані терміни характеризуються певним ступенем системності. Системні відношення термінолексем висвітлено завдяки аналізу їхніх парадигматичних відношень. Метою розвідки є виявлення семантичної специфіки термінної лексики в галузі державного управління. Основне завдання дослідження передбачає встановлення особливостей семантики цієї лексики, визначення ознак її системності. Обʼєкт спостереження – терміни вказаної галузі, предмет дослідження – семантичні параметри описуваної лексики в парадигматичному аспекті. Низка залучених методів дала змогу здійснити дослідження та вирішити поставлені завдання, зокрема описовий метод забезпечив характеристику термінної лексики щодо семантики, компонентний аналіз сприяв зʾясуванню семантичної структури термінів, дистрибутивний аналіз уможливив встановлення лексико-семантичних відношень в обраній терміносистемі. Джерельною базою для дослідження послугував "Словник термінів і понять з державного управління", де потлумачено понад 660 основних термінів галузі. Увагу зосереджено на таких лексичних мікропарадигмах, як полісеманти, синоніми та антоніми. Зафіксовані полісемічні лексеми номінують осіб, документи, органи влади й становлять 5% від усіх термінів. Лексична синонімія виявляється у 3% термінів та реалізується у вигляді термінів-дублетів, що не відрізняються семантичними чи стилістичними відтінками. Контрастивні відношення, втілювані за допомогою антонімів, є непродуктивними й перебувають на периферії аналізованої терміносистеми (0,8%).
Digital solutions for the development of corporate health programs
(2023) Aleksandrenko, Hlib; Shevchenko, Maryna
Introduction. The article examines the relevance and importance of the health status of employees in modern society. Considering the rapid development of digital technologies, the expediency of their use to improve health and well-being at workplaces is being investigated. Purpose. The purpose of the article is to analyze the current state of development of digital technologies for corporate health programs, as well as to present the results of the developed and implemented digital tool for the implementation of the corporate health program. Materials and methods. The research materials are: 1) regulatory and legal support for the regulation of corporate health of employees of enterprises; 2) information resources of foreign companies that use scientific and practical achievements in the field of digital technology development to preserve and strengthen the corporate health of enterprise employees. In the process of carrying out the research, the following scientific methods were used: theoretical generalization (to characterize corporate health programs and digital applications for tracking the individual corporate health of employees); formalization, analysis and synthesis (to build a model of strengthening corporate health); logical generalization of results (formulation of conclusions). Results. One of the modern trends in the field of personnel management (or, as we call it now, human resources or HR) is the implementation of a holistic approach to the well-being of employees. Companies offer innovative programs to ensure financial well-being, mental health, a healthy lifestyle (in particular, nutrition, physical activity), stress management, etc. It has been becoming a part of both the employer's corporate social responsibility and a strategy crafted to ensure the maintenance of a positive HR brand, attract and retain talents, and increase the level of employee engagement as well as efficiency. It has been confirmed by the results of the Deloitte study. The developed and implemented model of the corporate health program, one of the components of which is the use of digital tools in the form of an automated system of interaction, ensured effective communication and feedback with program participants and prompt response to their needs. Automated distribution of information, support, and personalization were carried out thanks to the proposed algorithm and the possibility of customization through the personal account of each program participant. Thus, we were able to provide a personalized approach to each of them. Discussion. The predicted economic efficiency of this program is estimated for the company's management at approximately $51,000 per year. It has been established that strategies, conditions, or activities carried out in the work environment can motivate employees to make changes that will not only have a positive effect on their health and well-being but also allow for increased productivity at the workplace.
Countermeasure policy for chronic noncommunicable diseases in Ukraine
(2023) Yurochko, Tetiana; Kondratiuk, Viktoriia
Background: Noncommunicable diseases (ncd) are main reason for disability and precocious mortality rate in ukraine. they are determining main socio-economic consequences for countrys development and need urgent intervention in political decisions and coordinated actions on all levels. Objective: Comprehensively assess situation of countermeasures, consolidate data from pre-war period about ncd preventive conditions in strategy development of post-war health care system restoration in Ukraine. Methods: The assessment was done accordingly to who methodology "effective treatment of non-communicable diseases: challenges and solutions for the healthcare systems" within the Ukrainian-switzerland project " act for health " Results: The major NCDS are not only part of irreversible losses because of mortality but factors in reducing life expectancy. contribution of ncds is significant, mainly cardiovascular disease, as Ukraines overall disease burden (dalys) which were 8/9 of total years of life lost for women and - for men. There are gaps in primary care in prevention and control of ncds, despite its importance and work done by the system to overcome the epidemy of cardiovascular disease (CVD), diabetes, and oncology diseases in Ukraine. nevertheless, mortality rate from these pathologies remains high, showing a systemic fracture in patient group management system and lack of attention to prevention and financial support. As a result, unhealthy lifestyle practices lead to a high level of CVD spread. the number of neglected cases of diabetes and their complications caused by uncontrolled disease courses remains high. Oncology treatment spending from the government and patient budget remains an acute problem. Conclusions: Results of research show gaps in the pre-war periods activities, which significantly increased due to the destructive impact of war that system passes. Health care system post-war restoration plan development should be based on challenges and barriers depending on populations health condition analysis and pre-war system work.
Вакцинація проти вірусу папіломи людини, як доказовий підхід протидії поширенню раку шийки матки в Україні
(ДВНЗ "Ужгородський національний університет", 2023) Юрочко, Тетяна; Мишко, Андрій
Мета роботи: розкрити необхідність популяризації серед населення України вакцинації проти вірусу папіломи людини, як доказового підходу протидії поширенню раку шийки матки.
Функції мему у сфері громадського здоров'я
(Наукові перспективи, 2023) Бронікова, Світлана; Оганісян, А.
Матеріали доповіді учасників XXX-ої Міжнародної науково-практичної конференції "Сучасні аспекти модернізації науки: стан, проблеми, тенденції", (07 березня 2023 року, м. Гамбург (Німеччина).
Психологічні особливості прояву лідерських якостей у діяльності команди
(Дірект Лайн, 2024) Чорна, Тетяна; Голубєва, Марія
Розділ методичного посібника "Психолого-педагогічний практикум", Ч. 5, 2024.
Психологія реклами, РR та іміджмейкінгу
(Дірект Лайн, 2024) Брик, Оксана
Розділ методичного посібника "Психолого-педагогічний практикум", Ч. 5, 2024.
Практикум із загальної психології
(Дірект Лайн, 2024) Яковенко, Ольга
Розділ методичного посібника "Психолого-педагогічний практикум", Ч. 5, 2024.
Емоції та почуття в діяльності людини
(Дірект Лайн, 2024) Копець, Людмила; Гордієнко, Арсеній
Розділ методичного посібника "Психолого-педагогічний практикум", Ч. 5, 2024.
Професійна підготовка медіаторів у ЗВО України
(Дірект Лайн, 2024) Жарук, Ірина; Голубєва, Марія
Розділ методичного посібника "Психолого-педагогічний практикум", Ч. 5, 2024.
Основи соціально-психологічного тренінгу
(Дірект Лайн, 2024) Кочаровський, Мстислав
Розділ методичного посібника "Психолого-педагогічний практикум", Ч. 5, 2024.
Barriers and facilitators to viral hepatitis testing in Uzbekistan: scoping qualitative study among key stakeholders, healthcare workers, and the general population
(2024) Mazhnaya, Alyona; Geurts, Brogan; Brigida, Krestina; Bakieva, Shokhista; Sadirova, Shakhlo; Witzigmann, Annika; Musabaev, Erkin; Brandl, Michael; Weishaar, Heide; Dudareva, Sandra; El Bcheraoui, Charbel
Introduction In the World Health Organization European Region, an estimated 14 million people live with a chronic hepatitis B virus infection (HBV), and 12 million are affected by a hepatitis C virus infection (HCV). Uzbekistan bears a major burden of HBV and has one of the highest HCV prevalence in the region. Following a presidential decree in May 2022, significant funds were allocated to the viral hepatitis (VH) elimination program in Uzbekistan. The program expands VH testing to reach 500,000 people annually during 2022–2025 as part of the VH elimination strategy that includes the provision of free testing and affordable treatment. Exploring the existing barriers and facilitators to VH testing is pivotal for informing these interventions. Methods This study uses a cross-sectional qualitative design to identify and explore the barriers and facilitators to VH testing among the general population in Uzbekistan. We collected data during October-November 2022 through semi-structured interviews with 12 key informants (KIs) and 7 focus group discussions with two target populations: the general population and healthcare workers (HCW) in Tashkent, Uzbekistan. Results Following the capability-opportunity-motivation-behavior model (COM-B model) as a framework for the analysis, we identified major capability barriers to VH testing primarily linked to low health literacy and limited knowledge about VH types, symptoms, transmission, testing and treatment. Physical opportunity barriers included the time and financial costs associated with testing, diagnostics, and treatment. Sociocultural opportunity barriers involved anticipated negative reactions and stigmatization, particularly affecting women. Motivational barriers included a reluctance to be tested when asymptomatic and a general fear of receiving positive test results. The involvement of healthcare workers in promoting VH awareness and motivating the general population emerged as a facilitator. Conclusions A multi-pronged approach is recommended to achieve VH testing goals among the general population, focusing on raising awareness and health literacy and creating an enabling environment that ensures easy accessibility and minimizing VH testing-associated costs.
Using a chatbot as a digital tool at the primary health care level
(2024) Aleksandrenko, Hlib; Shevchenko, Maryna
Aim: To analyze the feasibility of utilizing a digital tool such as a chatbot at the primary health care level as part of a health program. Materials and Methods: With the involvement of a general practitioner and the use of a digital tool, a chatbot, a three-month health program was conducted for employees of an IT company. The chatbot was used to collect information, monitor the health status of participants and provide personalized health recommendations. To evaluate the program’s effectiveness survey was conducted to compare participants answers before and after using standardized evaluation scales. A questionnaire based on the Evaluation and Management Services Guide was created to collect medical information on the health status of participants before and after the program. Results: After the program, the average total score of participants’ health complaints and symptoms decreased (from 27.1 to 16.1, p=0.019). The average severity of the chief complaint on a scale of 0 to 10 decreased from 5.08 to 2.27, or by 55.3% (p=0.00676). The frequency of individual complaints such as eye pain, decreased concentration, increased fatigue and irritability also dropped. Conclusions: The chatbot enabled the primary care physician to respond promptly to participants’ health complaints. The results demonstrated the potential of chatbots as innovative and accessible digital tools at the primary health care level for providing recommendations, monitoring health, and contacting a primary care physician in a timely manner.
Current challenges in accessibility to ophthalmological care in Ukraine
(2024) Skrypnikova, Olena; Yurochko, Tetiana
Aim: The purpose of the study is to identify challenges in the organization and access to ophthalmic services through the analysis of expert opinion of practitioners and government officials. Materials and Methods: Materials developed during expert interviews with practitioners and government officials were used in the study. We also used materials worked out within the project ID 22120107 supported by Visegrád Fund. Conclusions: Despite all the challenges in access to high-quality ophthalmology services, practitioners and government officials have common opinions on how to improve the organization of eye services, how to make care more inclusive and effective, so that the development of blindness and visual impairment does not cause a burden on the state and society.
Environmental competencies for healthcare management at a 2nd education level as a component of strategic management
(2024) Turianytsia, Solomiia; Yurochko, Tetiana; Balashov, Kostyantyn; Hulchiy, Olesya
Aim: To present the results of the analysis of educational standards and curricula of the second educational level of training of specialists, who may be managers of healthcare, on the content of the environmental component as an element of strategic management. Materials and Methods: Content analysis 24 educational standards of the Ministry of Education and Science of Ukraine for 6 fields of knowledge and 200 master’s curricula from 87 institutions of higher education of Ukraine. Conclusions: There is a distribution of basic leadership and management competencies both by types of these competencies and between specialties. The requirements for the inclusion of the environmental component in the framework documents are poorly expressed. The content of environmental issues in the curricula is insufficient.
How much can we learn from each other? Polish and Hungarian good practices in financing ophthalmology care as a proposal for implementation in Ukraine
(2024) Więckowska, Barbara; Byszek, Katarzyna; Rękas, Marek; Yurochko, Tetiana; Shevchenko, Maryna; Skrypnikova, Olena; Dozsa, Csaba; Toth, Melanie
The article aims to compare payment schemes for cataract, glaucoma, vitrectomy, cornea transplantations, DME, and AMD across Hungary, Poland, and Ukraine, and to identify implementable practices in Ukraine within the context of ongoing healthcare reforms.
Bridging gaps: improving the access of primary health care in rural Ukraine through mobile health units
(2024) Suzyma, Valentyna; Yurochko, Tetiana
Rural healthcare is an integral part of the Ukrainian healthcare system. However, access to healthcare for the rural population is uneven due to poor development of medical infrastructure and staffing. The problem of access to medical care in rural areas has been exacerbated by the full-scale war. The objective: to study and analyze the current state of accessibility of primary health care in rural areas in Ukraine, followed by a discussion of promising areas for the introduction of mobile health units as a tool for implementing the "Medical Guarantees" program in hard-to-reach regions of Ukraine. Materials and methods. The study included data from official statistical reports, regulatory documents and scientific sources. The methodology includes bibliosemantic, medical and statistical methods and the method of structural logical analysis. Results. It has been established that the low level of access to primary health care for the rural population of Ukraine has been significantly exacerbated by the devastating impact of the war on medical and transport infrastructure, especially in the frontline and recently de-occupied rural areas, and by migration processes. The situation is complicated by the fact that most patients in rural areas are elderly people who are physically unable to use public transportation, even if it is available. The analysis of international practice has shown that mobile health units can be introduced into the public healthcare system as a temporary measure to meet the urgent needs of the Ukrainian population, especially in rural areas. Integration of mobile health units into the state program "Medical Guarantees" can effectively address the urgent health care needs to increase access to health care for the rural population of Ukraine. State regulation of the division of these units will eliminate problems such as duplication and uneven service delivery and will create a transparent system of remuneration for the staff included in these units. Conclusions. The results of the study suggest that the practice of mobile medical units should be introduced as a tool for implementing the "Medical Guarantees" program for regions/locations of Ukraine with low access to medical infrastructure, namely remote rural areas and areas that have been devastated by the war. Mobile medical units will ensure the stability of access to primary health care services and contribute to improving the health of the population.
Perceptions of quality and satisfaction with primary healthcare in Ukraine : dissertation to obtain the degree Doctor at Maastricht University
(2024) Anufriyeva, Valentyna
This dissertation focuses on the perceptions of healthcare quality in primary care in Ukraine. Healthcare services in Ukraine, as in other countries, aim to ensure accessible and affordable healthcare of the highest possible quality. This makes quality of healthcare one of the most essential values of the health system. Good quality of healthcare services in terms of healthcare that is effective, safe and patient-centered, and that is accessible and affordable for all, is a known predictor of population health. Quality is a major component of health system performance and quality improvement is an important aim of health policy. To ensure this, health policies at all levels (national, regional, and facility) need adequate instruments to measure, maintain and improve healthcare quality. Chapter 1 of this dissertation describes the concepts of healthcare quality and satisfaction as well as gives the aim and objectives of the studies included in the dissertation. As explained in the chapter, healthcare quality determines satisfaction with healthcare services, the latter being the driving force of decisions and behaviors as well as a known predictor of healthcare utilization and an influencing factor of health outcomes. Apart from being an element of quality, patient-satisfaction measures are an important tool to gain insight into the aspects of healthcare that patients truly value. There is little evidence on the perception of healthcare quality in Ukraine. Quality assurance procedures, though legally well-developed, are somewhat chaotic and formal. At the same time, Ukraine is experiencing a transition from central budgeting to capitation financing, from the Semashko model of healthcare organization to more managerial autonomy and free choice of healthcare provider. Therefore, the central aim of this dissertation is to obtain new knowledge on the perception of healthcare quality by different stakeholders as well as insights on self-reported satisfaction with primary healthcare, specifically, on general satisfaction with primary healthcare in Ukraine. In Chapter 2, the method of systematic literature review is used to study the psychometric properties of self-reported satisfaction with healthcare as a measure of quality. The aim of this chapter is to systematize the evidence on the validity and reliability of subjective measurements of satisfaction with healthcare. In this systematic literature review, we searched for relevant publications in PubMed and JSTOR databases. The key inclusion criteria were: (a) original research articles in peer-reviewed journals; (b) year of publication from 2008 onward; (c) English language publications. We applied directed qualitative content analysis to the publications included in the review. Overall, 1167 publications are found and screened. Of these, 39 publications that focus on the psychometric properties of the measurement of patient satisfaction, are included. The majority of the studies validate already existing instruments adapted to different contexts; the rest describe psychometric properties of self-developed tools. Psychometric properties are assessed by means of reliability and validity assessment. Reliability assessment is performed via Cronbach alpha and test-retest reliability. In total, 94.9% of studies find that the satisfaction measures are reliable. Validation is performed by a variety of different methods, among which the most applicable are face validity and factor analysis. Overall, 71.8% of studies find that the satisfaction measures are valid. Thus, we identified tools to measure quality, which were adapted to different contexts and self-developed, and we systematized evidence on their psychometric properties, specifically, on their validity and reliability. We find that quality measurement tools exist in a great variety depending on their purpose, context, resources, and others. Adaptive subjective measures prevail, which might be explained by their long-term usage, effectiveness as shown by the number of studies, as well as positive experience of usage of the measurements' results on micro- (organizational) and macro- (national) levels. At the same time, the growing number of studies measuring psychometric properties of self-developed patient satisfaction assessment tools shows the desire to have as exact an instrument as possible for the specific domains and specific healthcare facilities. Because of the complexity of the studies, we could not make strong recommendations on the application of self-reported satisfaction measures. We recommended the following key strategies: (1) developing a unified standard for satisfaction measurement; and (2) identifying a combination of tools to routinely measure satisfaction. We also suggested further research on the issue of subjectivity reduction. In Chapter 3, a combination of qualitative and quantitative data analysis is presented. This chapter provides new insights into primary care managers' perceptions of healthcare quality in Ukraine. Ukraine is reforming its health system to improve healthcare quality. Insight into how primary healthcare managers perceive quality is important for the ongoing reform as well as for the improvement of medical services. Data were gathered in an online survey, which was conducted as part of the UkrainianSwiss project "Medical Educational Development" in April-May 2019. A mixture of sampling methods was used: a total population sampling method and a convenience sampling method. The sampling was based on the contact list of USAID project "Health Reform Support", and additionally on the database of the National Health Service of Ukraine and other channels. Data were analyzed using descriptive statistics and qualitative data analysis. In total, 302 healthcare managers took part in the study. We identified fifteen groups of quality attributes important to primary healthcare managers. We also investigated quality assessment practices used by primary healthcare managers. The majority of primary healthcare managers perceive quality in healthcare as process quality. The frequency of mentioning the "compliance to standards" and "indicators" attributes confirms the traditional focus of the Ukrainian approach to quality and shows the lack of association of quality with integrated care. Primary healthcare managers prefer to assess outcome quality via a system of indicators and feedback. We find a high number of unclear descriptions of measurement tools given by the participants of our survey. This may have two major explanations. Primary healthcare managers do not distinguish between quality assessment (as a process) and the quality level in their facilities. Or the formulation of the question was unclear for the participants. There appears to be a lack of consensus about healthcare quality. Furthermore, most Ukrainian primary healthcare managers who took part in our survey do not recognize the multidimensionality of quality. This may be due to a lack of awareness of the national strategy for better quality of healthcare service. The absence of a clear consensus about quality complicates the discussion about quality and how to measure quality in healthcare. This appears to be one of the obstacles to systemwide quality improvement. The data used in the studies described in Chapter 4 and Chapter 5 were collected by means of repeated cross-section household surveys via face-to-face interviews by trained interviewers. The survey had a sample size of over 10,000 participants per wave. Based on these data in Chapter 4, we explored perceptions of outpatient care quality among healthcare users in Ukraine by identifying and comparing attributes important to outpatient healthcare users as well as by comparing any changes in their importance over a four-year period (2016 - 2019). We also explored changes in the importance of quality attributes that might have been provoked by the reform, which started in 2017. Evidence on healthcare users' perceptions of quality is important for future system changes. Data were analyzed using descriptive statistics as well as binary regression analysis. Healthcare quality in Ukraine is mostly associated by users with "effectiveness of treatment (the correct diagnosis, adequate treatment)" and "qualified medical personnel using modern and safe treatment methods". Both aspects are predisposed by socio-demographic characteristics. The "effectiveness of treatment (the correct diagnosis, adequate treatment)" aspect is predisposed by gender (more important for female respondents), low income and good self-reported health status. And "qualified medical personnel using modern and safe treatment methods" is predisposed by specialized education and low income. The perceptions of outpatient care users about attributes connected with payment policies and general management of the facility have changed over time. At the same time, quality is least associated with such aspects of quality as "the possibility to stay close to family members of patients" and "respect, trust and empathy to the patient". Whereas the "the possibility to stay close to family members of patients" aspect is not predisposed by socio-demographic characteristics included in the analysis and "respect, trust and empathy to the patient" is predisposed by gender, health status, occupation and type of settlement (less important to female respondents and respondents with average self-reported health status but more important for employed and urban inhabitants). Our analysis showed an increase in the importance (it more than doubled) of all the quality attributes in 2019 in comparison with other years. The reason behind this increase require further investigation. This chapter provides new insights into the importance of healthcare quality attributes for outpatient healthcare users in Ukraine, showing the need to develop a national policy on quality and a national quality strategy for healthcare that incorporates quality aspects important to patients. This will help to make the health system more responsive to the needs and expectations of healthcare users. Based on the same data in Chapter 5, we examined the general satisfaction with primary healthcare services in Ukraine among service users and nonusers before and after the implementation of the capitation reform in 2017-2020. We compared primary care users and non-users over a five-year period before and after the reform. Effects were estimated using difference-in-differences methods based on matched samples. Our findings show that in general, respondents are "rather satisfied" with the services of district/family doctors and pediatricians. Users of primary healthcare in our study rated their satisfaction with the family doctor and satisfaction with pediatrician higher than nonusers. In total, 72.1 % (users) and 69.2% (nonusers) were satisfied with their family doctor in 2016. This was 75.3% and 71.9% in 2020. For pediatrician services, these shares were 73.6% (users) and 71.1% (nonusers) in 2016; and 74.7% and 70.2% in 2020, respectively. The study in this chapter also revealed an increase in satisfaction with the district/family doctor over time. However, this does not seem to be due to the reform. The results for pediatrician services were mixed. Why satisfaction with primary care is fairly high and slightly increasing over time is unclear. However, we offer several possible explanations, such as low expectations of primary healthcare, subjective perception of healthcare quality, improved access and affordability, and general improvements in primary healthcare settings not directly linked to the reform. Other confounding variables included in our analysis, such as age, gender, education, type of settlement, self-reported health status, and the number of persons in the household, also showed an influence on satisfaction among users. However, only gender and selfreported health status had statistical significance over the years (2016-2020). Whereas age showed no statistical significance, and other variables were statistically significant three years out of five included in the analysis. Thus, the results of our analysis confirm the results of previous analyses described in the literature. At the same time, the reason why some of the variables had an effect in certain years could not be identified in the study. The final Chapter 6 outlines and discusses the main findings presented in the dissertation. The main findings of the studies included in this dissertation are presented in the form of five statements. Statement 1: Satisfaction with healthcare measures aspects of quality that are not measured by clinical quality measurement tools. This dissertation supports the importance of valid and reliable self-reported satisfaction with healthcare as a measure of quality. Including satisfaction in quality measures helps to measure the aspects of healthcare that healthcare users truly value. The discussion of this statement reveals a vague understanding of quality assessment tools and practices among healthcare managers in Ukraine. Thus, at the research level, there is a need to further study the routine application of measurement tools in healthcare management practice in Ukraine. At the policy level, there is a need to revise quality assessment practices on the levels of the system and facility. Statement 2: The healthcare financing reform of 2017-2020 has changed the discussion on the quality and satisfaction with healthcare in Ukraine. With the healthcare financing reform 2017-2020, Ukraine experienced dramatic change not only in financing principle and managerial freedom but more importantly in views and perceptions of healthcare professionals and users on the health system in general and on quality in particular. The discussion of this statement revealed a long history of top-down practices as well as paternalistic views on healthcare, leaving no place for providers' and patients' views on quality. Rapid health system changes and lack of data on quality perceptions lead to the recommendation that at the research level, it is important to collect and analyze repeated cross-sectional data on views and satisfaction of healthcare stakeholders (policy makers, healthcare providers and healthcare users) on quality. At the policy level, it is important to maintain the dialogue between the stakeholders, take into consideration their views and expectations, and to develop a working quality strategy. Statement 3: Primary healthcare managers and patients in Ukraine perceive quality mostly as process quality. The attention to outcome quality is limited. The discussion of this statement shows that both healthcare professionals (managers, medical doctors and nurses) and healthcare users in Ukraine perceive quality mostly as process quality. At the same time, attention to outcome is limited. This also explains the lack of attention to patient satisfaction. This means that at the policy level, health system responsiveness should be improved by raising awareness of important attributes of structure (like tangibles) or outcome (patient satisfaction) among healthcare professionals and users. At the research level, we did not find other studies of healthcare managers' perceptions of quality in Ukraine. We perceive the findings of Chapter 3 to be the baseline of such kind. Thus, healthcare managers' perceptions of quality in Ukraine require further study. Also, system responsiveness studies are rare in Ukraine and require further elaboration. Statement 4: A clear consensus about quality assessment and how to measure it is needed in Ukraine. The discussion of this statement shows little consensus about quality among Ukrainian healthcare managers as well as an unclear understanding of quality assessment. Education and clear messages on quality in healthcare from the Ministry of Health of Ukraine are important in developing a clear consensus about quality assessment and how to measure it. To achieve this at the policy level, the development and promotion of a national policy on quality and a national quality strategy for healthcare should become one of the priorities of the healthcare sector. Up-to-date quality education should be a part of clinical training as well as continuous professional development programs for medical doctors and nurses. At the research level, the perception of healthcare quality among healthcare managers, medical doctors, and nurses, as well as the routine application of measurement tools in healthcare management practice, require further study. Statement S: Paradoxically in Ukraine, satisfaction with primary care is high, although the health system does not perform well. The discussion of this statement reveals that the reasons behind high and increasing over time satisfaction are unclear and seem not to be directly linked to the reform. Healthcare users in Ukraine tend to express satisfaction with the services received on a facility level and relocate their satisfaction with primary healthcare services onto the health system in general. This implies that at the policy level, healthcare reforms should be strengthened by quality improvements in healthcare settings. At the same time, the principles of health system functioning should be well communicated to healthcare users. At the research level, further research is needed to fully understand the drivers of satisfaction, the extent to which responses are affected by adaptation bias and scale of reference bias, and to assess the impact of healthcare financing reforms on the quality and accessibility of primary care. During the work on this dissertation, the Ukrainian health system was rapidly changing. Healthcare financing reforms launched changes in managerial and educational practices, triggering different healthcare discussions. In general, healthcare stakeholders became more open and willing to be a part of discussions that had the ability to reshape the health system. Thus, quality perceptions and satisfaction with healthcare services gained more importance. The findings of the studies included in this dissertation will be relevant to policy makers, who could use our analysis to improve health system performance. Our analysis will also be beneficial for healthcare providers, who can use it to improve their quality assessment practices and strengthen the loyalty of their patients. Our findings will also be interesting to the countries with similar health system, experiencing similar transition.

Browse

Browsing 007. Факультет охорони здоров`я, соціальної роботи і психології by Issue Date

Results Per Page

Sort Options