INSTRUMENTS OF STATE REGULATION OF THE ECONOMIC EFFICIENCY OF SECONDARY AND TERTIARY HEALTHCARE INSTITUTIONS

DOI: 10.31673/2786-7412.2026.010536

Abstract

The article analyzes and generalizes the instruments of state regulation
aimed at improving the economic efficiency of secondary and tertiary healthcare
institutions under the conditions of transformation of the healthcare system of Ukraine.
It is substantiated that the healthcare sector remains a strategic priority of state policy,
as evidenced by the increase in budget expenditures for 2026 to UAH 258.6 billion, which
exceeds the previous year’s indicator by UAH 38.8 billion. At the same time, it is proven
that a quantitative increase in funding is not a sufficient condition for improving the
performance of the hospital sector, since the determining factor is the effectiveness of
mechanisms for resource allocation and utilization.
The regulatory, legal, and financial-economic foundations of sectoral reform
initiated with the adoption of the Law of Ukraine «On State Financial Guarantees of
Medical Services and Medicines Provision,» which established a payment model based
on actually provided services, are analyzed. The features of the implementation of the
Medical Guarantees Program and the «money follows the patient» principle are
revealed, as they transformed the line-item budgeting model into a contractual system of interaction between the state and healthcare providers. It is demonstrated that the
dependence of financial revenues on the volume and structure of treated cases creates
economic incentives for cost optimization and improvement of healthcare quality.
Organizational instruments of state influence are characterized, including the
formation of hospital districts, the autonomization of healthcare institutions through their
transformation into municipal non-commercial enterprises, and the introduction of
internal financial management systems. The importance of clinical and economic
financing mechanisms, the application of the DRG model, as well as strategic and
centralized procurement of medicines and medical devices ensuring cost standardization
and increased transparency of budget processes are substantiated. Particular attention
is paid to digital regulatory instruments, specifically the functioning of the eHealth
electronic healthcare system, which integrates clinical and financial data and strengthens
control over the use of public funds.
It is summarized that the modern model of state regulation of secondary and
tertiary healthcare institutions is based on a combination of financial, organizational,
and digital mechanisms, within which economic efficiency is defined as a function of
rational resource allocation, standardization of treatment processes, and achievement of
clinical outcomes.

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