The state of healthcare in Rivne region: december 2018

• Only 15% of the polled believe that over the last two years the overall quality of public healthcare services in the region has improved; 14% noted improvement in the overall quality of healthcare services received by them personally. Compared to the last year, the number of those who have not seen any changes in this area has increased (from 41% to 47% respectively). On the personal level, however, the respondents more often reported the worsening of the public healthcare services (from 26% to 32%). In the cities, people are more inclined to notice positive changes as compared to villages. The frequency of visits to doctors also affects the assessment of services: the more frequent the visits to doctors, the better the rates of the doctors’ performance.

 

• Over the year there has been a slight decrease in the number of those who positively assess the activities of state healthcare institutions: 38% of the respondents evaluate the quality of services positively, 46% - negatively. The performance of these institutions was assessed better in the villages, by those who are more likely to visit doctors, and also by those who have children under 18.

 

• At the same time, almost half of the polled could not evaluate the quality of services in the private healthcare institutions; 40% of the respondents assessed it positively, 13% - negatively. Young people, those with higher income, urban residents, and those who are more likely to visit doctors are more likely to assess private healthcare positively.

 

• 46% stated that they had witnessed either reconstruction or capital improvement of the hospitals over the last two years; 32% said the opposite. At the same time, over the last year, the number of those who have noticed positive changes has increased (from 35% to 46%). Urban residents and those who have visited doctors mentioned the hospitals’ premises renovation more often.

 

• Over the last year, about a quarter of the respondents have reported changes in the quality of healthcare services received (45% reported lack of changes). While assessing various quality criteria of the healthcare services, 44% indicated improvement of conditions in which medical services are provided (38% - lack of changes, 12% - worsening). Attitude of the doctors towards the patients, professionalism and competence of doctors, efficiency of treatment have improved in the opinion of 34-39% (43-44% believe that these criteria have not changed, 15-17% stated their deterioration).

 

• Half of the polled noticed changes in the cost of services received (21% believe that there were no any changes). Considering the criteria estimates, opinions vary; thus, the cost of both healthcare services with the use of special equipment and consultations has worsened according to more than 70% of the respondents (14-19% believe it has not changed, 5-6% report an improvement). Almost 90% reported deterioration in the prices for medicines prescribed by a doctor (5% believe that they either have improved or have not changed).

 

• For 11%, territorial and temporal availability of healthcare institutions have changed (65% have not seen such changes). Urban residents and those who are more likely to visit doctors mentioned the changes the most often. More than half of the polled noted an improvement in the possibility of choosing the doctor (27% indicated no changes, 13% - deterioration). Almost 40% positively estimated the changes in the territorial convenience of the medical institution (one-third has not noticed any changes, a quarter reported a deterioration). At the same time, more than 40% have not seen changes in the possibility of applying to the doctor in advance with the right to choose suitable time, waiting time, or doctor's timetable. Along with that, almost one-third of them evaluated these changes positively, 14-18% - negatively.

 

• 6% of the respondents know a lot about the changes proposed by the healthcare reform. 42% stated that they had heard something about it, 29% - know very little about it. Only 21% do not know anything about the reform. A higher level of awareness was recorded among urban residents and those with higher education.

 

• 35% of the polled said they supported the implementation of the healthcare reform in Ukraine, while 43% expressed an opposite opinion. 22% were unable to give any personal estimates of this initiative. The level of support for the healthcare reform implementation is higher among young people, rural citizens, and those who are aware about its implementation.

 

• At the same time, only 17% are convinced that the healthcare system will improve in the next two years as a result of the reform. 28% believe that it will worsen, 38% - that will not change. Compared to the last year, the number of those who are optimistic about the nearest future prospects of the sphere after the reform has somewhat decreased. Worst of all the situation is seen by people over 50 years old. At the same time, in the long run (5-10 years), the respondents are more optimistic about the situation; thus, 52% believe that it will improve (in 2017, 35%), 13% think it will worsen, 14% argue it will not change, 20% could not answer. As in the previous case, the greatest optimists were young people, those with higher education, and rural residents. At the same time, it should be noted that more than half of those who believed that the situation would not change in the next 1-2 years, positively assess it in the longer run.

 

• 31% of the polled consult doctor or healthcare professional about their health status or in order to receive any recommendations on their health less than once a year, 21-22% - every year or every 6 months, 15% - at least every 3 months, and only 11% use this service on the monthly basis.

 

• The vast majority (75%) of the respondents know their family doctor or physician (in 2017, 58%). The level of awareness is higher among women, rural residents, and those who visit doctors more often. Almost 70% of all the polled completely or mostly trust their family doctor (in 2017, 53%). At the same time, women, rural citizens, and those who visit doctors more often reveal greater level of trust in the doctors. It is important that the majority of those who know their family doctor trust him (90%).

 

• The vast majority of the polled (82%) trust healthcare advice provided by medical professionals, 68% - family and friends, 67% - pharmacists. The healthcare advice on the Internet and television, in the press and on the radio is trusted by much lower number of the respondents - 21%, 13%, and 9% respectively. 11% of the polled trust such information received from healers and fortune tellers. Along with that, a high level of trust in the latter source is observed among the elderly people. Young people are more likely to trust information from relatives and friends and from the Internet.

 

• When choosing a healthcare facility, 50% pay the most attention to the professionalism and experience of the doctors, 42% - to the trust in doctors in this institution. Good attitude of doctors and staff towards patients is the most important for 23% of the polled; the possibility of receiving preferential services (consultations, medications) – for 20%, availability of modern medical equipment - 16%. Comfortable conditions of treatment and speed of service at the institution are important for somewhat lower number of the polled (11% each). More attention to the professionalism of doctors is paid by the rural residents, young and middle-aged people, as well as those with higher income. Urban residents and young people often pay attention to the good attitude of doctors and the availability of modern equipment, older people and those with low income – to the trust in doctors, youth and those with higher income - to the speed of service at the facility.

 

• 64% of the respondents indicated that they received healthcare information from doctors, 40% -from friends and family, 29% - pharmacists, 19% - Internet, 16% - TV programs, 3% each - radio and magazines, 2% - healers, and 1% - religious leaders and priests.

 

• 16% of the polled measure arterial blood pressure daily, 28% - several times a month, 11% - every 3 and 6 months, 10% - once a year, 22% - less than once a year.

 

• One-third of the respondents admitted that they had never had problems with arterial blood pressure. 24% face such problems several times a month, 9% and 12% - every 6 and 3 months, 7% - less often than once a year, 7% - every day. Problems with arterial blood pressure are more common for women and older people; thus, they are more likely to check it. The lower the income of the people and the more often they feel stress, the more regularly they face arterial blood pressure problems.

 

• The body weight is measured daily by 10% of the respondents, 22% - several times a month, 10% and 13% - every 3 and 6 months, 17% - once a year, 24% - less than once a year. Young people and women are more likely to measure body weight compared to older people and men.

 

• More than 40% of the polled said that they made an electrocardiogram less than once a year, 25% - every year, 16% - every 6 months, only 7% and 2% - every 3 months or several times a month respectively. Those who often visit doctors or have problems with blood pressure make electrocardiogram more often.

 

• 48% of the respondents check blood sugar level less than once a year, 18% - every year, 13% - every 6 months, 8% - every 3 months, only 4% and 1% - several times a month or each day respectively.

 

• 52% of the polled check blood cholesterol level less than once a year, 15% - every year, 12% - every 6 months, 6% - at least every 3 months, only 2% - several times a month.

 

• Half of the respondents state that when they last tested their pressure, it was normal; one-third mentioned that it was above the norm, 9% - below the norm. 70% state that when they last measured their body weight, it was normal, 19% - above the norm, only 2% - below the norm. Two-thirds of the respondents say that during the last measurement of the blood sugar level, it was within the norm limits, 27% could not say anything about it, 8% reported above the norm level. The level of blood cholesterol was normal referring 55% of the polled, 36% did not provide an answer, 7% stated that it was elevated.

 

• 48% of the polled said they had never applied for medical services related to cardiovascular diseases. 13% had such an experience several years ago, 12% - a year ago and more, 17% - several months ago, 7% - several weeks ago, and 3% - recently. Among those who have applied for such services over the recent months, the number of urban residents is higher as compared to rural population, and the number of women is higher as compared to men (34% vs. 17%); also, the number of elderly people among them is almost three times higher than the number of young people (41% vs. 14%).

 

• More than 60% of the polled do not take medicines to normalize arterial blood pressure, 37% - do take them. 90% do not take medications to normalize the level of sugar and cholesterol in the blood. Among those who have problems with arterial blood pressure at least every 6 months, 70% take medications to normalize pressure, 10% and 9% - to normalize the blood sugar and cholesterol.

 

• When detecting the arterial blood pressure problems, one-third of the respondents take medications recommended by their doctor, and 27% - based on their own knowledge and experience. 10% each - either use traditional medicine or immediately appeal to a doctor. 5% do nothing at all in this situation. Taking medications recommended by the doctor or based on one’s own experience is more popular among older people and women. Urban residents and young people are more likely to trust in traditional medicine. Women, rural residents, and middle-aged and elderly people are more likely to appeal to the doctor immediately.

 

• 80% are used to take a walk in the fresh air every day, 17% - several times a week, 2% and 1% - several times or once a month, respectively. Rural citizens spent in the fresh air much more time.

 

• 50% of the respondents indicated that they consumes fresh fruits and vegetables daily, 34% - several times a week, 13% - several times a month, 2% - once a month or less, 1% - never.

 

• One-third of the polled indicated that they ate meat every day, 50% - several times a week, 13% - several times a month, 4% - once a month or less, 1% - never. Naturally, the number of men who eat meat products daily is somewhat higher compared to women. In its turn, rural citizens and young people consume meat more often than urban residents and elderly people.

 

• Almost 30% of the respondents consume confectionery and pastries daily (the number of young and middle-aged people among them is higher), 38% - several times a week, 20% - several times a month, 10% - once a month or less, 4% - never. Relatively more often confectionery products are consumed by rural residents compared to urban.

 

• 19% of the polled confessed that they ate fried, greasy food every day, 38% - several times a week, 21% - several times a month, 15% - once a month or less, 7% - never. Among those who consume such food daily, the number of males is higher as compared to females. Young people are also more likely to eat such food everyday as compared to older ones. Relatively more frequent consumption of fried food is also recorded among rural residents as compared to urban.

 

• 10% stated daily use of non-alcoholic carbonated drinks, 19% - several times a week, 25-27% - several times a month or once a month and less, 19% - never. The latter are mostly women and older people.

 

• Almost 40% of the respondents drink alcohol once a month or less, 21% - several times a month, 8% - several times a week, 3% - every day. Almost a quarter (29%) of the polled does not consume alcohol at all - among them more women than men and almost twice as much of elderly people than youth. In the villages, alcohol is relatively more often consumed than in the cities.

 

• Only 18% of the polled practice physical exercises and sports daily, 21% - several times a week, 9% - several times a month, 11% - once a month or less. 39% of the polled do not go in for sports at all – the number of such is higher among middle-aged and elderly people and rural residents.

 

• 75% of the polled do not smoke: 62% of them have never smoked, 13% - used to but have quitted. Among those who smoke, 5% smoke 1-5 cigarettes per day, 7% - 6-12 cigarettes, 8% - 13-20, 5% - more than 20. The number of smokers is twice as much higher among young and middle-aged people as compared to people aged 51 and over; among men this figure is almost five times higher than among women. People with low incomes and those with blood pressure problems are less likely to smoke.

 

• Stress or similar feelings are felt daily by 18% of the respondents, 21% - several times a week, 32% - several times a month; 29% of the polled have never felt stressed. Women and urban residents are more likely to be stressed than men and those residing in rural areas. Also, those who have problems with blood pressure at least once every six months are more likely to feel stress.

 

• 74% are aware of the high arterial blood pressure symptoms, 65% - are aware of the treatment methods in this case (referring low blood pressure – 69% and 61% respectively).

 

• 22% have received information on the prevention of cardiovascular and blood circulation diseases recently from the family doctor, 16% - from stands/announcements at the medical facilities, 11% - from family and friends, 8% - television or radio, 6% - Internet , 3% - newspapers and magazines. In comparison with the last year, the number of those who have received such information from TV and radio has decreased 2.5 times. 50% have not received such information at all recently - most of them are young people and rural residents.

 

• 29% of the respondents give positive rates to the quality of healthcare services related to cardiovascular diseases in their own place of residence, 13% - rate the quality of these services negatively. At the same time, 49% of the polled have not applied to the relevant institutions at all. Compared to the last year, the positive assessment has decreased (from 37% to 29%). The urban population assesses the quality of service better compared to rural residents. Better rates are also more likely to be provided by older people, those with higher income, and also those who visit doctors more often.

 

• 21% of the polled assess the quality of cardiovascular diseases treatment at the regional level as positive, 6% - negative; along with that, the number of those who have not applied for such treatment is two-thirds. Among those who assess this aspect positively, the number of those who apply to a doctor more often is higher. 74% of the respondents have not applied for this type of services in other cities of Ukraine. 8% rated the quality of these services positively, 2% - negatively. In general, over the year, the number of positive rates of such healthcare services has decreased both at regional level and in other cities.

 

• One-third of the respondents in case of problems with the cardiovascular system address to the city/district healthcare facility, 17% - to the family doctor (dispensary), 8% - Rivne oblast clinical hospital, 6% each - Rivne oblast clinical medical and diagnostic center of V.Polyschuk or paramedical and midwifery point, 4% - emergency service, 3% - private healthcare institution. 46% said they had no blood pressure problems.

 

• Better rates of the quality of healthcare in cardiology departments were given to the city/district hospitals, polyclinics - 32%; family doctor - 26%, Rivne oblast clinical medical and diagnostic center of V.Polyschuk, Rivne oblast clinical hospital, and emergency - 13% each, paramedical and midwifery points - 11%, private healthcare institutions - 8%.

 

• 30% of the polled believe that there are plenty of institutions involved in cardiovascular diseases treatment in their place of residence; half thinks there are not enough of them. The last thesis is shared by 62% of the rural residents and by 40% of the urban population.

 

• As in the previous year, the majority of the respondents (81%) know nothing about the fact that Rivne region is a participant of the joint project of the World Bank and the Ministry of Health of Ukraine «Serving People, Improving Health», which involves increasing the effectiveness of treatment and prevention of circulatory system diseases. 12% - have heard something about it, and only 7% are well aware. At the same time, the vast majority (76%) of the polled consider this project implementation to be important. Only 4% disagree with this. Among those who know about the project, more than 90% consider it to be very important.

 

• According to more than half of the respondents, the introduction of this project will improve the overall situation with cardiovascular diseases in the region, 23% think that the situation will not change, only 3% argue that it will worsen. 22% could not answer this question. Among those who are aware about the project, 57% believe that the situation will improve.

 

 

Audience: residents of Rivne region aged 18 and older. The sample if representative in terms of age, gender, and settlement type. Total sample: 800 respondents. Personal formalized interview (face-to-face). The margin of error does not exceed 3.5%. Period of the survey: November, 29 – December, 11, 2018