Public administration of the process of autonomy of medical institutions in the context of health care reform

Abstract

The main mechanisms of state management of the process of autonomy in the field of health care are considered in the article; the legislative provision of autonomy of medical institutions in Ukraine is investigated; the mechanism of transformation of CHC from a budgetary institution into a municipal non-profit enterprise is considered; an analysis of the financing of the health care system of Ukraine was conducted; directions of improvement of the state management of process of autonomy of medical establishments in the conditions of reforming of system of public health services are developed. Proposals for improving public administration in the process of autonomy of medical institutions are formed in three areas: improving public administration in the organizational and legal direction; improvement of public administration in the direction of personnel policy of autonomous medical institutions; improvement of public administration in the direction of resource provision through the introduction of public-private partnership. In the organizational and legal direction, a model of state management of the process of autonomy of medical institutions has been developed, the main stakeholders of the process and their role at each stage of autonomy have been identified. In the direction of personnel policy, changes and updated requirements for the management and medical staff of health care facilities have been identified. The main vectors of professional development of medical staff have been formed, which are a mandatory requirement in the conditions of reforming the medical sector. In the context of health care reform and the autonomy of medical institutions, cooperation between state and municipal medical institutions and business is important. The current practice of interaction between the state and business is reviewed, forms of cooperation with different degrees of private sector involvement are proposed. The state partner bears subsidiary liability for the obligations of such enterprise or business company in accordance with the agreement concluded within the framework of public-private partnership.