Substantiates of optimum budget models for the social services providing at the united territorial communities level

Abstract

Background. The importance of creating an affordable, high-quality and efficient Palliative and Hospice Care (PHC) System and Social Care Services for Palliative Care (SCSPC) is growing significantly due to the deep medical-demographic and social changes. In the context of reforms in the Healthcare and Social Care Services System and after the transfer of authority from the Rayon (district) level to the United Territorial Communities (UTC) level the problem of the optimal models of financing (budgeting) of social care services providing, including palliative care, substantiates. The purpose of the study is to analyze and generalize the modern models of PHC and SCSPC providing, to substantiate the social care services providing financing (budgeting) optimal models at the UTC level. Materials and methods. National and international normative-legal documents and literary sources, medical statistics data, methods of system and structural-functional analysis were used in the work. Results. The authors substantiate modern optimal models of social care services financing (budgeting) at the UTC level providing. The transition of the authority to finance the social care services providing from the Rayon (district) level to the UTC level requires the transition from the institution maintenance principle to the financing of the social care services results. The application of the "per capita" standards system is the basis for the introduction of the principle of "money follows a patient/client or service" and the Program-Target Method implementation needs further improvement. It is important to standardize and unify the costs by developing Passports for Social Care Services, as well as increase the amount of financial resources that can be involved in ensuring the social care services implementation, in particular: increasing revenues from the general fund of the UTC local budget, expanding the scope and conditions for the paid services use, the financial grants from donors attraction as an additional source of income, the use of social order mechanisms, etc., the application of the principle of public-private partnership, which has positively established itself in many countries of Eastern Europe. Conclusions. The urgency of the PHC and SCSPC System creating, and the problem of the normative-legal base developing and improving, and the PHC and SCSPC System interagency and inter-sectoral organizational models creating are among the Verkhovna Rada (Parliament) of Ukraine and the Cabinet of Ministers of Ukraine the priority activities directions, as evidenced by the existing legislative and sectoral legal acts. In the context of reforming the Healthcare and Social Care Services System and after the transfer of authority from the Rayon (district) level to the United Territorial Communities level the problem of the optimal models of social care services providing financing (budgeting), including palliative care, requiring a transition from the institution maintenance principle to financing the provided social care services results. Existing practice of the Program-Target Method application needs further improvement, while standardization and unification of expenses by passports of social care services in all types of legislation developing are of great importance. The most significant provision for strengthening the social care services financing in the communities is the expansion of the scope and conditions for the paid services use. Great prospects for the development of social care institutions are related to the principle of public-private partnership application.