• Oleksandr Korniychuk Інститут демографії та соціальних досліджень ім. М.В. Птухи НАН України, Ukraine



health care system, metropolis, innovation, development, directions, ways.


In the article, the structuring of the system tasks of the metropolis's health care, innovative directions and ways to solve them is carried out. Their goal should be to overcome the critical inequality in access to treatment, primarily for the socially vulnerable sections of society. This should be based on ensuring the provision of effective and high-quality medical services and reducing the costs of health care services on the part of households, primarily through the institute of highly qualified family doctors. According to their status, they will have the ability to detect early signs of diseases before the onset of a crisis state of the patient's body. An innovative mechanism is the implementation of the decentralization reform with the transfer of responsibility for the provision of primary medical care to the community, secondary medical care to newly created districts, and tertiary medical care to university clinics in the region

The development of the metropolitan healthcare system will receive a powerful boost after the decentralization process is completed. This will require the regulatory implementation of coordinated actions by the metropolitan authorities and local self-government bodies in three metropolitan gravity zones (the first zone – up to 15 km., the second – up to 60 km., and the third – up to 300 km.). The active metropolises in Ukraine include mm. Kyiv, Kharkiv, Odesa, Dnipro, Lviv.

Pioneering steps should be the humanization of relations between family doctors and narrow specialists, between doctors and nurses, with the granting of the latter the status of autonomous providers of medical services, between medical personnel and patients based on an informed dialogue, the introduction of the priority of preventive care, traditional medicine, ensuring systemic changes in pharmaceutical industry for the production of generics and the introduction of biomedicine.

Reforming the health care system in metropolitan areas and in Ukraine as a whole should be based on modern expert developments, domestic and foreign managers, economists, and the scientific and practicing medical community.


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