28.08.2017
The state of medical sector in Ukraine
- According to a survey conducted by Rating Group in July–August 2017, 47% of respondents said that over the past two years the overall quality of public healthcare in the country had worsened, while only 10% reported improvement. One third (34%) said that the quality had not changed, and 9% were unable to answer.
- The overwhelming majority of respondents (71%) trust advice on treatment and healthy lifestyles from relatives and friends. Almost the same high level of trust is shown toward medical professionals: ambulance doctors are trusted by 68%, qualified nurses by 66%, pharmacists and pharmacy staff by 65%, and family doctors and therapists by 63%. Half of respondents (51%) trust advice from medical lecturers, and almost as many (46%) from athletes. Priests and clergy are trusted by 31%, while 15% listen to folk healers and psychics. Only 4% trust advice from members of parliament on health and treatment.
- Trust patterns vary across groups. Relatives and friends are trusted most in the South, among older people and those with lower incomes. Medical professionals are trusted most in the East, among older people, women, and those with medium or high incomes. Medical lecturers and athletes are trusted more by youth and middle-aged people, especially men and higher-income respondents. Clergy are trusted more in the West, among older people and women. Folk healers are trusted more in the East, among middle-aged and older people, and more by women than men.
- Almost half of respondents (46%) do not trust homeopathy as a system of treatment. At the same time, 30% do trust it, especially in the East, among women and older people, while 24% were undecided.
- 57% know their family doctor or therapist. Awareness is highest in the East, among city residents, women, and older people.
- The vast majority of respondents (93%) do not have private health insurance; only 7% do. Even among respondents with relatively high incomes (more than 5,000 UAH), only 11% have insurance. More than half said that even if they had insurance, they would visit doctors in the same way as before; one third said they would go more often, and 6% less often.
- The share of people who say treatment is very expensive for them and their families has increased sharply — from 39% last October to 61% now. This concern is strongest in the Center and South, among older people, low-income respondents, and those without insurance. Only 13% say treatment is more or less affordable. Even half of those with insurance say healthcare is very expensive.
- Among government healthcare initiatives, respondents are most aware of the free or low-cost provision of medicines for diabetes, asthma and cardiovascular diseases by prescription (77%) and the introduction of national health insurance (61%). About half know about raising doctors’ salaries through contracts and tight control over charitable funds for the Okhmatdyt hospital (54% and 50%), both much higher than in May 2017.
- More people do not know than know about reference pricing of medicines, patient–doctor contracts, public health centers, hospital districts, subsidies for internally displaced persons, and standardized treatment protocols based on evidence-based medicine. Nevertheless, public awareness of healthcare reforms has grown over the past three months.
- Support for reforms is very high. The most supported initiatives are free or low-cost medicines by prescription and control over Okhmatdyt funds (91% and 89%). Public health centers and reference pricing are supported by 77%, medical subsidies for IDPs by 71%, national health insurance by 69%, standardized treatment protocols and doctors’ salary reform by 67%, patient–doctor contracts by 57%, and hospital districts by 44%.
- Overall, 72% support the healthcare reform bills, 15% oppose them, and 12% are undecided. Support is higher in the West, among women, young and middle-aged people, higher-income groups, and families with medical workers, and lowest in the East.
- Regarding financing, 53% support the principle “money follows the patient”, while 20% support funding based on the number of hospitals and beds; 27% are undecided or reject both models. 58% prefer international standardized treatment protocols, while 20% prefer domestic ones.
- Nearly all respondents (97%) believe healthcare should be provided regardless of a person’s income. Large majorities support transparency of medical donations (84%), a 70/30 state–patient cost split (83%), priority funding for ATO veterans (82%), tax exemptions for medical donations (81%), money following the patient (80%), tax benefits for employers who insure workers (79%), and a special fund for ATO veterans (79%).
- The least supported ideas are allowing doctors to work as entrepreneurs with lower taxes (51%) and denying state-funded treatment to people who neglect their health (44%).
- Vaccination is supported by 84%; 75% believe it should be mandatory.
- 56% say they were not asked for bribes in the past year, 20% experienced corruption, and 22% did not visit doctors.
- 73% support co-payment for medical services, especially if it helps eliminate bribes. 78% would support cost-sharing if it reduced corruption.
- 63% support organ donation after death, 80% support medical training for ambulance drivers, and 85% support creating a paramedic service.
- The share of people who see the Ministry of Health as important for their families increased from 49% to 57% between May and August 2017.
Methodology
- Respondents: residents of Ukraine aged 18 and older. The sample is representative in terms of age, sex, region, and place of residence.
- Total sample: 1200 respondents.
- Personal formalized interview (face-to-face).
- The margin of error does not exceed 2,8%.
- Fieldwork dates: 26 July - 2 August 2017
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