PUBLIC ADMINISTRATION OF THE FINANCIAL SUSTAINABILITY OF HEALTHCARE INSTITUTIONS UNDER THE CONDITIONS OF MEDICAL FINANCING SYSTEM REFORM

DOI: 10.31673/2786-7412.2026.010988

Abstract

The article examines the mechanisms of public administration aimed at
ensuring the financial sustainability of healthcare institutions under the conditions of
medical financing system reform. The study outlines the conceptual foundations of the
new financing model, which provides for state guarantees of the scope of free medical
care, financial protection of the population in case of illness, socially equitable
distribution of public resources, and minimization of informal payments. It is established
that the financial sustainability of healthcare institutions is formed through the
interaction of centralized state guarantees, municipal support, and the managerial
capacity of institutions for strategic planning.
Laws and regulatory legal acts, in particular Article 3 of the Law of Ukraine «On
State Financial Guarantees of Medical Care for the Population,» define the legal
framework for the functioning of the financial guarantees system and ensure centralized
financing of the medical services package, thereby creating a basic revenue foundation
for healthcare institutions. At the same time, the implementation of public health
programs, anti-epidemic measures, medical and social assessment, and other nationwide
functions is carried out through separate state budget expenditures. An important aspect
is also the financing of local development programs for municipal healthcare institutions,
infrastructure modernization, and staff incentive mechanisms.
The article emphasizes the role of modern financial management instruments,
including the «money follows the patient» system, centralized procurement through
ProZorro and the State Enterprise Medical Procurement of Ukraine, as well as digital
platforms for monitoring and verifying the volume of services provided. It is established that the integration of financial management with the strategic management of healthcare
institutions enables revenue forecasting, expenditure control, and the formation of
liquidity reserves. Particular attention is paid to the assessment of healthcare service
quality, patient satisfaction, and professional staff competence as factors contributing to
the development of intangible capital and stable demand for services.
The study highlights that the implementation of public-private partnership
mechanisms, optimization of the healthcare network, and the application of programbased budgeting contribute to the concentration of resources on priority functions,
improvement of operational efficiency, and long-term financial stability.

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