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Состояние медицинской сферы в Украине

The state of medical sphere in Ukraine

Date posted: 07.11.2016 Print Full version
According to the results of the survey conducted by the Sociological group "Rating" in October 2016, 47% of respondents declared use of state medical institutions services only. 26 % stated that except state medical institutions services they apply to private medical institutions in case there are additional funds in a family. 15% declared that alongside with state services they do appeal to private establishments in case of serious illness in a family. Only 6% prefer mainly private medical establishments over the state.
Almost 70% of respondents are not content with state medical services they have been provided with during the last five years. 24% of respondents are more or less content with the level of services in state medical establishments. The biggest number of those who are dissatisfied with the field lives in the South (85%). Considering age and property cuts, the worst rates were given by elderly people and those with low incomes. 
55% of respondents declared that for the last two years the common quality of state medical services in the country has become worse. Only 12% of respondents saw the improvements in the field. 27% consider that nothing has changed regarding state medical services quality. 6% were not able to answer this question.
At the same time, respondents marked changes in the field of private medicine positively enough. 25% of respondents consider that for the last two years quality of services has improved within private medical establishments, and only 15% mentioned that it has worsened.
17% consider that there have not been changes in the field for the last two years. One-third of respondents did not use services in this field of medicine at all. Most of those who noticed positive quality changes in the field of private medicine live in the West, least – in the East.
Considering age cut, improvements in the private medicine field were marked by young and middle age respondents, mainly people with relatively high profits. At the same time, among respondents 51 years older majority did not use services of private medicine at all.
Only 8% mentioned that Ukrainian medical sphere is close to the European standards, 85% consider that quality of medical services in Ukraine is pretty far from the European standards.
The cost of medical services is one of the determinatives of respondents’ choice when it comes to the decision where exactly to get medical care. Thus, 33% of respondents declared that if to ignore money matters they would appeal for a necessary medical help to private medical establishments, 31% would even go abroad to be treated. At the same time, however, 27% seemed to be ready to appeal for help to state medicine services even on such conditions.
Interestingly, young people are more likely to use private and foreign medical services; at the same time, elder respondents would still entrust their health to state medical institutions, even presuming they have money on private or foreign medicine.
Among the countries which could be chosen for treatment, the leaders are Israel (39%), Germany (38%), and Switzerland (21%). Also, the USA (10%) and Belorussia (8%). Only 3% would choose Russia.
33% of respondents declared that they have been consulted on their state of health or received relevant recommendations from a doctor or any medical specialist rarer than once per year. 27% are being advised on this occasion every year, 18% - at least each 6 months, 9% - at least each 3 months, and 5% apply for consultation each month.
83% of respondents consider that treatment for themselves or their family members occurred to be expensive (39% - very expensive). Only 12% of respondents marked that treatment was more or less affordable.
36% of respondents marked that treatment in state medical establishments was very expensive. Generally, the high cost of medical services in these establishments was stated by 77% of respondents. Only 16% of respondents estimated the cost of medical services in state institutions as affordable.
86% of respondents generally estimated the cost of treatment in private establishments as expensive (58% - as very expensive). Only 3% of respondents declared that the treatment price seemed to be more or less normal there.
The treatment cost estimation correlates directly with the frequency of appeals for medical services. 51% of respondents applying for medical consultations monthly mark that treatment appear to be very expensive for them. Instead, only one-third of those who applies for services once per year agree that treatment is very expensive. Regardless of this fact, the absolute majority of respondents, despite the frequency of their appeals to medical establishments, agree on the fact that treatment costs in Ukraine are high.
The majority (69%) declared that they have not been asked for a bribe for treatment or medical services during the last two years. At the same time, 25% of respondents mentioned the corruption facts.
In its turn, 59% of respondents declared that they felt obliged to give a medical worker not a monetary gift (alcohol, chocolate, food) to thank for treatment. Only one-third did not feel such obligations. The most of those who felt an obligation «to thank» a doctor was recorded in the West and in the Center (66%), the least – in the East (48%). At the same time, it should be noted that in the South there is a relatively high level of imperception of the «gratitude» phenomenon regarding medical worker – 42% do not feel any obligations. More obliged in terms of a gift to a doctor are women (64%) as compared to men (53%).
The most widespread sum of «gratitude» which was required for treatment or medical services was 100-250 UAH (23%). In 16% the required sum was from 250 to 500 UAH, in 14% – 500-1,000 UAH, in 16% – more than 1,000 UAH. The least widespread sum of «gratitude» – up to 50 UAH (4%). 
Only 5% declared that would pay no bribes if they were asked to pay treatment fees.
The basic source of information on treatment and services is presented by medical workers (67%) and friends, family members (45%). Also, about one-fourth gets information from the Internet, from chemists, from TV shows.
The two-thirds of respondents know their family doctor or therapist. The half of respondents trusts their doctor, 19% - do not trust. 31% were not able to answer this question.
The greatest level of trust in family doctor is observed among respondents in the Center (58%). Instead, in the East, there are only 38% of those who trust their family doctor, and one-fourth of respondents do not trust this institution at all. Trust in family doctor is higher among elder people and women. In the rural territories, trust is stronger (57%) as compared to the cities (48%). Every fifth respondent in the cities expresses mistrust in family doctors’ institution.
83% support the children’s vaccination against such illnesses as poliomyelitis, measles, tuberculosis, hepatitis B, diphtheria, etc. Only 9% do not support this type of preventive measures. 77% consider that vaccination must be obligatory, 12% – do not support this idea, 11% were not determined with an answer for this question.
69% of respondents declared their support for the initiative to oblige the first-aid drivers to pass first-aid and help for injury medical courses, instead of being just drivers. 23% – do not support this idea.
64% support initiative to create medical assistants’ service following the Western countries example - their services are used to deliver first medical aid in case of traumatic situations to rescue patient’s life until he gets valuable and independent treatment at the first-aid department. 23% stand against such an idea. Respondents named the principal reasons for such an initiative imperception: medical assistants are not equal to licensed doctors (66%), medical assistants’ service will destroy traditional first-aid service (29%), 17% are afraid that it will increase charges or will leave first-aid doctors out of employment (10%).
Only 6% of respondents have private medical insurance, 94% - do not have. It should be noted that even among those with more or less high profits (more than 5,000 UAH) only 14% do have medical insurance.
46% of respondents consider that providing every citizen with private insurance to cover real costs on medical care quality would help to improve the Ukrainian healthcare system the most. 34% consider that the most helpful in terms of the Ukrainian healthcare system improvement would be existent state medical system effective operation. Only 12% would prefer such improvement mechanism as the introduction of the certain money sum medical voucher to be used monthly and filled up due to salary. 
57% of respondents support the principle of state budgetary means allocation for medical establishments depending on a number of patients, but not on the basis of hospital beds’ amount. 21% stand against such an initiative, 22% were not able to answer this question. The most of those who estimated initiative positively is in the West (69%), the least – in the Center (47%).
Audience: residents of Ukraine aged 18 and older. The sample is representative by age, sex, region, and settlement type. Total sample: 1,500 respondents. Personal formalized interview (face-to-face). The margin of error does not exceed 2.5%. Period of the survey: 13-20 October 2016.

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