LEVELS OF ACCESSIBILITY OF PRIMARY MEDICAL SERVICES IN THE CONDITIONS OF THE REFORM OF THE MEDICAL INDUSTRY: A MARKETING APPROACH

Abstract

The reform of the primary medical care link of the health care system became an indicator of changes in the health care system of Ukraine. Considering the fact that the primary link of the medical system was reformed as a priority, the feedback of the population, its assessment of the availability of quality medical care, is important, which will allow determining the consequences and prospects of the reform. The marketing analysis conducted in the article of such three criteria (levels) of the availability of primary medical care services as quality, financial and territorial or temporal availability of medical services in their dynamics for 2018-2020 made it possible to find out positive and negative development trends based on surveys of respondents units of primary medical care. In particular, it was established that during the specified period there is a general tendency to improve the quality of medical services, combined at the same time with an insufficient level of ensuring their financial and territorial or temporal availability. The marketing analysis of the respondents' opinions regarding the main indicators of quality criteria, financial and territorial or time availability made it possible to more objectively assess the consequences of the reform of the primary medical care link. The increase in the quality of medical services, which respondents attributed mainly to the improvement of the attitude of medical staff doctors to patients and the material conditions for the provision of medical services, is actually explained by the socio-psychological factors of the establishment of the "doctor-patient" interaction and the positive effect of the financial independence of medical institutions. The positive trend of increasing the financial availability of medical services, expressed in the survey by indicators of the ability to purchase drugs and receive effective treatment, is due to the practical implementation of the "Affordable Medicines" program, the availability of a significant range of free medical services (under the contract with the National Health Service) and the optimal pricing policy for additional medical services. In the end, the criterion of territorial or temporal availability of medical services, having received a wide range of evaluations (from positive to negative among respondents, testifies, on the one hand, to the positive consequences of the increase in temporal availability and opportunities for patients to choose a doctor, and on the other hand, it demonstrates the unresolved issue of territorial convenience placement of primary care facilities, especially in the conditions of reduction of their network in rural areas. We consider the development of practical recommendations for primary and secondary specialized health care institutions to improve individual indicators of quality, financial and territorial or temporal availability of medical services as a perspective for the study of the problem.