ORGANIZATIONAL AND MANAGERIAL INNOVATIONS IN PROVIDING SPECIALIZED MEDICAL CARE UNDER MARTIAL LAW

DOI: 10.31673/2786-7412.2025.040709

Abstract

The article analyzes organizational and managerial innovations in
ensuring specialized medical care under martial law. It is established that the reform of
the healthcare system requires updating the regulatory framework and improving
management processes to increase the efficiency of medical service delivery. It was found
that the Resolution of the Cabinet of Ministers of Ukraine № 97 of February 4, 2023,
ensured the unification of terminology and optimization of the structure of medical care
provision, contributing to a systemic approach to management. It is emphasized that the
adopted changes reflect the evolution of state policy, ensuring the effectiveness and
quality of medical services, especially under martial law. The Resolution of the Cabinet
of Ministers of Ukraine № 174 of February 28, 2023, is highlighted as forming a capable
hospital network, optimizing the territorial organization of medical infrastructure, and
increasing the resilience of the healthcare system to external challenges.
At the regional level, the practical implementation of state decisions takes place
through the creation of interregional clusters of specialized medical institutions,
particularly in the Lviv region, where a decentralized management model with digitalized
processes is applied. It is determined that the Law of Ukraine № 2347-IX of July 1, 2022,
contributes to greater transparency in healthcare institutionsʼ activities, more efficient
use of budget funds, and enhanced public oversight.
It is noted that digital tools – including electronic referrals and telemedicine
services – ensure the continuity of medical care and the promptness of response under
conditions of limited access to infrastructure. The effectiveness of implementing
managerial innovations is confirmed through the introduction of mobile medical clinics,
modernization of material and technical resources, and the development of rehabilitation
services, which ensure comprehensive patient recovery.
The results of the budget program 2301110 demonstrate a significant expansion
of healthcare facilities, an increase in bed capacity and medical personnel, and improved
treatment performance. It is concluded that the developed model of public administration
in the healthcare sector is characterized by high adaptability, responsiveness, and the
ability to maintain resilience and continuity in providing specialized medical care to the
population even in crisis conditions of martial law.

REFERENCES
1. Myroniuk, I. S., Slabkyi, H. O., Shcherbinska, O. S., & Bilak-Lukianchuk, V. Y.
(2022). Naslidky viiny z rosiiskoiu federatsiieiu dlia hromadskoho zdorovia
Ukrainy [Consequences of the war with the Russian Federation for public health
in Ukraine]. Reproduktyvne zdorovia zhinky – Reproductive Health of Women, 8,
26–31 [in Ukrainian].
2. Maksymovych, M. I., & Lytvyn, N. A. (2022). Aktualni problemy dostupu do
medytsyny pid chas voiennoho stanu [Current problems of access to medicine
during martial law]. Yurydychnyi naukovyi elektronnyi zhurnal – Legal Scientific
Electronic Journal, 9, 330–332 [in Ukrainian].
3. Rudoi, K., & Udrenas, H. (2025). Osoblyvosti nadannia medychnoi dopomohy
pid chas voiennoho stanu [Features of providing medical care during martial law].
In Mizhnarodne humanitarne pravo ta osnovy bezpeky u period zbroinykh
konfliktiv – International humanitarian law and fundamentals of security during
armed conflicts. Proceedings of the International Scientific and Practical
Conference (Kyiv, February 6, 2025) (pp. 275–279). Kyiv: Kyiv Institute of the
National Guard of Ukraine [in Ukrainian].
4. Kvasnii, L. H., Balanda, N. O., Senakh, P. N., & Petsukh, A. O. (2024). Vplyv
viiny na systemu upravlinnia yakistiu medychnykh posluh [Impact of war on the
medical services quality management system]. Filosofiia ta upravlinnia –
Philosophy and Management, 3–4, 53–61 [in Ukrainian].
5. Bohuslavska, S. I., Podolynnyi, S. O., & Vilivchenko, P. A. (2024). Problemy
orhanizatsii derzhavnoi polityky nadannia likuvalnykh posluh pervynnoiu lankoiu
medychnoi dopomohy v Ukraini [Problems of organizing state policy for the
provision of medical services by primary healthcare in Ukraine]. Ekonomichnyi
prostir – Economic Space, 194, 13–17 [in Ukrainian].
6. Cabinet of Ministers of Ukraine. (2023). Pro vnesennia zmin do deiakykh
postanov Kabinetu Ministriv Ukrainy shchodo orhanizatsii nadannia
spetsializovanoi medychnoi dopomohy [On amendments to certain resolutions of
the Cabinet of Ministers of Ukraine regarding the organization of specialized
medical care]. Resolution № 97 (February 4, 2023). Retrieved from
https://zakon.rada.gov.ua/laws/show/97-2023-%D0%BF#Text [in Ukrainian].
7. Lviv Regional State Administration. (2024). Lvivshchyna pidsumuvala
dosiahnennia u sferi okhorony zdorovia za 2024 rik [Lviv region summarized
achievements in the field of healthcare in 2024]. Retrieved from
https://loda.gov.ua/news/127569 [in Ukrainian].
8. Verkhovna Rada of Ukraine. (2022). Pro vnesennia zmin do deiakykh
zakonodavchykh aktiv Ukrainy shchodo udoskonalennia nadannia medychnoi dopomohy [On amendments to certain legislative acts of Ukraine on improving
medical care]. Law of Ukraine № 2347-IX (July 1, 2022). Retrieved from
https://zakon.rada.gov.ua/laws/show/2347-20#Text [in Ukrainian].
9. Ministry of Health of Ukraine. (n.d.). «Ambulatorii na kolesakh»: 19 oblastei
otrymaly spetsialni mobilni medychni avto dlia vyizdiv ta diahnostyky u
hromadakh [“Clinics on wheels”: 19 regions received special mobile medical
vehicles for outreach and diagnostics in communities]. Retrieved from
https://moz.gov.ua/uk/ambulatoriyi-na-kolesah-19-oblastej-otrimali-specialnimobilni-medichni-avto-dlya-viyizdiv-ta-diagnostiki-u-gromadah [in Ukrainian].
10. eHealth Ukraine. (2025). Yak pratsiuie e-napravlennia na medychnu posluhu v
Ukraini? [How does an electronic referral for a medical service work in Ukraine?].
Retrieved from https://ehealth.gov.ua/2025/06/13/yak-pratsyuye-e-napravlennyana-medychnu-poslugu-v-ukrayini [in Ukrainian].
11. Ministry of Health of Ukraine. (2022). Pro zatverdzhennia pereliku medychnoho
obladnannia dlia zabezpechennia potreb sfery okhorony zdorovia v umovakh
voiennoho stanu [On approval of the list of medical equipment to meet the needs
of the healthcare sector under martial law]. Order № 761 (May 9, 2022). Retrieved
from https://zakon.rada.gov.ua/rada/show/v0761282-22#n9 [in Ukrainian].
12. Ministry of Health of Ukraine. (n.d.). Yak prokhodyt telemedychne
konsultuvannia dlia liudei u pryfrontovykh ta viddalenykh naselenykh punktakh
[How telemedicine consultations are provided for people in frontline and remote
settlements]. Retrieved from https://moz.gov.ua/uk/jak-prohodit-telemedichnekonsultuvannja-dlja-ljudej-u-prifrontovih-ta-viddalenih-naselenih-punktah-#!
[in Ukrainian].
13. Ministry of Health of Ukraine. (2025). Pasport biudzhetnoi prohramy na 2025 rik
[Passport of the budget program for 2025]. Order № 262 (February 14, 2025).
Retrieved from https://moz.gov.ua/storage/uploads/abdd833d-7679-4196-8e58-
18bb9eafe2d3/dn_262_14022025_dod.pdf [in Ukrainian].
14. Ministry of Health of Ukraine. (2024). Pasport biudzhetnoi prohramy na 2024 rik
[Passport of the budget program for 2024]. Order № 254 (February 15, 2024).
Retrieved from https://moz.gov.ua/storage/uploads/7ebf65e4-3f36-4465-bd5ced361d08ffda/dn_2053_09122024_dod.pdf [in Ukrainian].