STRATEGIC MANAGEMENT OF SPECIALIZED HEALTHCARE DEVELOPMENT UNDER DECENTRALIZATION

Abstract

The article provides a comprehensive substantiation of the theoretical
foundations and practical instruments of strategic management of specialized healthcare
development under the conditions of decentralization of public authority in Ukraine. The
study analyzes the legislative framework for the financial provision of specialized
healthcare, in particular the provisions of the Law of Ukraine «On State Financial
Guarantees of Medical Care for the Population,» according to which the implementation
of the Medical Guarantees Program serves as a basic instrument for contracting and
financing healthcare services from the State Budget of Ukraine. It is substantiated that
the strategic orientation of specialized healthcare development requires the coordination
of state financial guarantees with regional healthcare programs and local plans for
modernizing healthcare infrastructure, taking into account the demographic and spatial
characteristics of particular territories. It is demonstrated that the decentralization
reform has contributed to expanding the managerial powers of territorial communities
while simultaneously increasing the need to strengthen their institutional and financial
capacity. It is established that inter-community cooperation, medium-term planning,
resource audits of healthcare facilities, and the concentration of high-technology
interventions within hospital districts constitute the basis for improving clinical outcomes
and rationalizing budget expenditures. Particular attention is paid to the cluster
approach to organizing a capable healthcare network, which ensures the functional
specialization of healthcare facilities and prevents duplication of costly technologies. The
strategic directions of institutional strengthening of the healthcare system are analyzed,
including the development of the electronic healthcare system, centralized procurement,
mechanisms for monitoring the quality of healthcare services, and the introduction of
performance indicators for healthcare facility managers. The importance of supervisory
boards as an instrument for enhancing transparency, accountability, and public oversight
under the conditions of transferring powers to the local level is substantiated.

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