Abstract
The aim: to conduct a comparative analysis of the dynamics of health expenditures from GDP, cash expenditures of families and public expenditures on health in Ukraine, Poland and the countries of the WHO European Region.
 Materials and methods. The object of the research was the data of the WHO European Office. Historical, analytical-comparative, systemic, logical, graphic, mathematical-statistical and other research methods were used.
 Research results. It was found that all indicators of the analysis in Ukraine had an unstable character of changes in the years dynamics. Since 1995, Poland and European countries have seen a systematic increase in total health spending (%) of the country's GDP. The indicator of out-of-pocket expenses of families on medical and pharmaceutical support in Ukraine was significantly higher than in Poland and European countries, and its average values in Ukraine were 1.5 times higher than in Poland. In 2014, this indicator reached its maximum (46.2 %) against the background of an increase in government spending (%) of total health spending (from 11.9 % to 12.7 %). In 2014, this indicator exceeded similar values in Poland by 2.0 times and 1.7 times in European countries. In contrast, in Poland, the out-of-pocket expenses of families on medical and pharmaceutical support have been steadily decreasing from 30.0 % to 22.1 %, and since 2010 they have been lower than in European countries. According to government spending as a percentage of total health spending in Europe and Poland, there was a trend towards a gradual increase from 11.0 % to 13.2 % (European countries) and from 8.2 % to 10.7 % (Poland). The corresponding Ukrainian data were higher than in Poland and lower than in European countries (from 10.8 % to 11.4 %). Against the background of the unstable nature of the dynamics of changes in indicators characterizing the participation of the state in financing health care in Ukraine, since 2005, there has been an increase in the cash expenditures of Ukrainian families for relevant needs. As a result of systemic transformations in Poland, on the threshold of its accession to the EU (May 1, 2004), since 2005, there has been a decrease in the out-of-pocket expenditures of families against the background of a slight increase in % of public spending on health care.
 Conclusions. The unstable nature of the dynamics of changes in domestic indicators, in comparison with similar data that was observed in Poland and the countries of the WHO European Region, suggests the need to introduce more decisive actions, which should lead to a reformatting of the role of the state in financing the health system
Highlights
In any country, the issue of providing affordable medical and pharmaceutical care to the population appears as one of the most important areas of public policy in accordance with the objectives of the National Medical Policy [1, 2]
The aim of the work is to conduct a comparative analysis of the dynamics of health care expenditures from the GDP of countries, cash expenditures of families and government expenditures on health care in Ukraine, Poland and the countries of the WHO European Region
There was no country that has reformed its national health systems has taken this path painfully, as it is both a socially sensitive and a financially attractive sector of the country’s macroeconomic complex [38]. These processes are especially difficult in countries that are experiencing a system of crisis or are in a state of internal and external conflict [39]
Summary
The issue of providing affordable medical and pharmaceutical care to the population appears as one of the most important areas of public policy in accordance with the objectives of the National Medical Policy [1, 2]. At the same time, according to the literature, the issue of shortage of funds in the health care system is common to all countries, regardless of their level of economic development [7, 8]. This problem is relevant for health care systems, which differ in the type of funding and organizational and administrative structure [9, 10]. Particular successes in solving this problem have been achieved by countries moving towards the introduction of socially oriented forms and methods of serving the population with low and relatively low incomes in society [13, 14]
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