Conference abstract
Alternative mechanisms of state public health institutions financing
in Ukraine
Anastasiya Hural, Irena Gryga
BACKGROUND. The main source of state public health
institutions financing in Ukraine is budgetary funding. In order to overcome the
underfunding, the idea of multichannel health financing was proposed in the late
1990s. The main forms of extrabudgetary financial support of public health
institutions in Ukraine are voluntary health insurance, non-profit
self-financing, charity and sponsorship. The study aims to deeper understand the
nature of alternative financing mechanisms of state public health institutions
in Ukraine and peculiarities of their use in practice.
METHODS. The proposed study is exploratory. Case-study was selected as research
method. Nine unstructured interviews were conducted in six health care
facilities that have agreed to participate in the study. All studied facilities
were in-patient.
RESULTS. The sources of financial revenues of the studied institutions were as
follows: reimbursement for treatment of insured patients, reimbursement for
treatment of sickness funds members, payments for services (medical
examinations, counseling, transportation to the hospital), rental of premises,
payment for internship from the students of paid forms of medical education,
charitable contributions, contracts with companies, contracts with private
clinics based in public institutions’ premises (limited liability companies,
private entrepreneurs), sponsorship, grants, gifts, payments for services for
foreigners, and in-kind revenues. Major health facilities expenditures were the
following: salaries (not covered from extrabudgetary revenues; ranged from 70%
to 92% of the funds provided to the institutions from state (municipal,
regional) budget), energy carriers (partially covered from extrabudgetary
funds), patients nutrition, medicines, materials, household expenditures,
reparation of premises, and purchase of equipment (mostly covered from
extrabudgetary revenues). In the studied cases, funds raised by alternative
funding mechanisms amounted from 2% to 22% of the total annual institutions
budgets, depending on the type of facilities and administrative subordination.
CONCLUSIONS. Alternative financing mechanisms (extrabudgetary revenues) help to
support functioning of public healthcare institutions. In the studied cases,
extrabudgetary revenues amounted on average 10% of the annual institutions
budget. Considering that 70-92% of the funds provided to the institutions from
state (municipal, regional) budget were spent on salaries, extrabudgetary funds
significantly help public health institutions to work.
Abstracts (pdf) in English and Ukrainian
