07.11.2016
The state of medical sphere in Ukraine
- According to a survey conducted by the Rating Group in October 2016, 47% of respondents stated that they use only state-run medical institutions. 26% said that in addition to public health services, they turn to private medicine if their family has extra financial resources. 15% reported that alongside public services they turn to private clinics in cases of serious illness in the family. Only 6% said they primarily prefer private medical institutions over state ones.
- Almost 70% of respondents are dissatisfied with the state medical services they received over the last five years. 24% are satisfied to some degree with the quality of services in public medical institutions. The highest dissatisfaction was recorded in the South (85%). By age and income, dissatisfaction is higher among older people and those with lower incomes.
- 55% stated that over the last two years the overall quality of public healthcare in the country has deteriorated. Only 12% saw improvement. 27% believe nothing has changed, and 6% could not answer.
- At the same time, respondents assessed changes in private medicine quite positively. 25% believe that over the past two years the quality of services in private medical institutions has improved, while only 15% said it has worsened.
- 17% believe no changes occurred, and one third of respondents did not use private medical services at all. The highest share of those who noticed positive changes in private healthcare live in the West, the lowest in the East. By age, younger and middle-aged respondents, mainly those with higher incomes, were most likely to report improvement. Among respondents aged 51 and older, most did not use private medical services at all.
- Only 8% stated that the Ukrainian healthcare system is close to European standards, while 85% believe that the quality of medical care in Ukraine is far from European standards.
- The cost of medical services is one of the key factors when choosing where to seek treatment. 33% said that if money were not an issue, they would turn to private medical institutions, and 31% would go abroad for treatment. At the same time, 27% would still choose state healthcare, even if money were not a constraint.
- Interestingly, younger people are more inclined toward private and foreign healthcare, while older respondents would still entrust their health to state medical institutions, even if they had the money to go private or abroad.
- Among the countries respondents would choose for treatment, Israel (39%), Germany (38%), and Switzerland (21%) lead, followed by the USA (10%) and Belarus (8%). Only 3% would choose Russia.
- 33% of respondents said they consult a doctor or medical specialist less than once a year. 27% do so once a year, 18% at least every six months, 9% at least every three months, and 5% every month.
- 83% believe that treatment for themselves or their family is expensive (39% very expensive). Only 12% consider medical treatment more or less affordable.
- 36% said treatment in state medical institutions is very expensive; 77% in total consider it expensive. Only 16% find public healthcare affordable.
- 86% evaluated the cost of treatment in private clinics as expensive (58% very expensive). Only 3% said the prices are more or less acceptable.
- The perceived cost of treatment is directly linked to how often people seek care. 51% of those who go to doctors monthly say treatment is very expensive, while only one third of those who go once a year say the same. Nevertheless, the vast majority across all groups agree that healthcare in Ukraine is expensive.
- 69% said they were not asked for bribes over the last two years, while 25% reported cases of corruption.
- At the same time, 59% said they felt obliged to give non-cash gifts (alcohol, chocolate, food) to medical staff as a “thank you”. Only one third did not feel such pressure. This feeling was strongest in the West and Center (66%), and weakest in the East (48%). In the South, 42% do not feel any obligation to give such gifts. Women (64%) feel more obligated than men (53%).
- The most common “gratitude” amount demanded was 100–250 UAH (23%). 16% were asked for 250–500 UAH, 14% for 500–1000 UAH, and 16% for more than 1000 UAH. The least common was up to 50 UAH (4%).
- Only 5% said they would refuse to pay any bribe if asked.
- The main sources of information about healthcare are medical workers (67%) and friends and family (45%). About a quarter also rely on the internet, pharmacists, and TV programs.
- Two thirds know who their family doctor or therapist is. Half trust their doctor, 19% do not, and 31% could not answer.
- Trust is highest in the Center (58%) and lowest in the East, where only 38% trust their family doctor and 25% distrust the institution. Trust is higher among older people, women, and rural residents (57%) than urban residents (48%). Every fifth urban resident expresses distrust.
- 83% support childhood vaccination against polio, measles, tuberculosis, hepatitis B, diphtheria, and others. Only 9% oppose it. 77% believe vaccinations should be mandatory, 12% oppose, 11% were undecided.
- 69% support requiring ambulance drivers to complete medical first-aid training rather than just being drivers; 23% oppose this.
- 64% support the creation of a paramedic service like in Western countries, which provides first emergency care before a patient reaches full hospital treatment; 23% oppose it. Among opponents, 66% say paramedics are not doctors, 29% fear it would destroy the traditional ambulance system, 17% fear higher costs, and 10% fear doctors would lose jobs.
- Only 6% have private health insurance; 94% do not. Even among those earning over 5,000 UAH, only 14% are insured.
- 46% believe that private insurance covering real medical costs would best improve the system. 34% believe making the current system work efficiently would help most. Only 12% prefer a medical voucher system.
- 57% support funding hospitals based on the number of patients rather than number of beds; 21% oppose, 22% were undecided. Support is highest in the West (69%) and lowest in the Center (47%).
Methodology
- Audience: residents of Ukraine aged 18 and older. The sample is representative by age, sex, region, and settlement type.
- Total sample: 1,500 respondents.
- Personal formalized interview (face-to-face).
- The margin of error does not exceed 2.5%.
- Fieldwork dates: 13-20 October 2016.
