Comparative analysis of indicators that determine the effectiveness of the implementation of socio-economic determinants of health in Europe and Ukraine
DOI:
https://doi.org/10.15587/2519-4852.2021.235787Keywords:
socioeconomic determinants, financing of healthcare and pharmaceutical provision, comparative analysis, Ukraine, European regionAbstract
The introduction of national strategies aimed at improving the well-being of the population of the country is one of the current approaches to reforming the public policies of the countries of the world. It is the socioeconomic determinants of health that determine the conditions in which people are born, grow, live and getting old, as well as the spheres of influence on these conditions, such as public policy, state of economic development, demographic trends, etc.
The aim. In this way, our research has focused on a comparative analysis of macroeconomic indicators that determine the effectiveness of socioeconomic determinants of healthсare in Europe and Ukraine, that are used to provide scientific justification for the construction of humanistic models for the provision of pharmaceutical care to the population in the context of the rapid stratification of Ukrainian society according to socioeconomic indicators.
Materials and methods. The research methodology is based on the principles of systems analysis and an interdisciplinary scientific and systemic approach. The study used the empirical method, the method of comparative analysis and synthesis of statistical data, the graphical method.
Results. A comparative analysis of the socioeconomic determinants of health in the countries of the European region and in Ukraine was carried out on three levels of indicators: the level of health-care expenditure, the structure of health-care expenditure and expenditure on medicines.
The analysis revealed that in 2019, the average health expenditure of the countries analyzed was 8.2 % of GDP. Only two of the 34 countries - Ukraine and Turkey - have a rate below the 5 % that recommended by WHO.
Public health financing schemes and compulsory health insurance are the main funding mechanisms in all countries, with the exception of Cyprus. Ukraine, Russia, Greece, Latvia and Bulgaria have the largest share of direct costs to patients as a source of health care financing.
The results of the analysis of the medicine expenditure indicator as a proportion of total health expenditure showed that the highest level was in Bulgaria (35.4 %), the lowest in Denmark (6.4 %). Overall, five countries have high levels of pharmaceutical expenditures.
In most European countries, the cost of purchasing medicines has been found to range from 346 to 619 USD per person per year. The highest value of this indicator from the European region is in Switzerland (894 USD per person), and the lowest is in Ukraine (73 USD).
Based on the results of the comparative analysis, the countries were grouped according to key indicators into three categories - high, medium and low.
Conclusions. A comparative analysis of key indicators of the socio-economic determinants of health in the country of the European region has been carried out
References
- The WHO strategy on research for health (2012). World Health Organization. Available at: https://www.who.int/phi/WHO_Strategy_on_research_for_health.pdf
- Developing a national health financing strategy (2017). World Health Organization, 37. Available at: https://www.who.int/publications/i/item/9789241512107
- Implementing Health Financing Reform: Lessons from countries in transition (2017). World Health Organization. Available at: https://www.who.int/publications/i/item/implementing-health-financing-reform-lessons-from-countries-in-transition
- World Health Assembly. 62. Reducing health inequities through action on the social determinants of health (2009). World Health Organization. Available at: https://apps.who.int/iris/handle/10665/2257
- Alderwick, H., Gottlieb, L. M. (2019). Meanings and Misunderstandings: A Social Determinants of Health Lexicon for Health Care Systems. The Milbank Quarterly, 97 (2), 407–419. doi: http://doi.org/10.1111/1468-0009.12390
- Commission on Social Determinants of Health. Closing the gap in a generation: Health equity through action on the social determinants of health. CSDH final report (2008). Geneva: WHO. Available from: https://www.who.int/social_determinants/final_report/csdh_finalreport_2008.pdf
- Rasanathan, K., Diaz, T. (2016). Research on health equity in the SDG era: the urgent need for greater focus on implementation. International Journal for Equity in Health, 15 (1). doi: http://doi.org/10.1186/s12939-016-0493-7
- Marmot, M., Allen, J., Bell, R., Bloomer, E., Goldblatt, P. (2012). WHO European review of social determinants of health and the health divide. The Lancet, 380 (9846), 1011–1029. doi: http://doi.org/10.1016/s0140-6736(12)61228-8
- Closing the gap: policy into practice on social determinants of health (2011). World Health Organization. Available at: https://apps.who.int/iris/bitstream/handle/10665/44731/9789241502405_eng.pdf?sequence=1&isAllowed=y
- European action plan for strengthening public health capacities and services (2012). WHO Regional Office for Europe. Available at: https://www.euro.who.int/en/health-topics/Health-systems/public-health-services/publications/2012/european-action-plan-for-strengthening-public-health-capacities-and-services
- Samborskyi, O., Slobodyanyuk, M., Panfilova, Н. (2020). Comparative analysis of the dynamics of healthcare expenditures from country GDP and cash payments of families to medical and pharmaceutical support in Ukraine, CIS countries and ЕU. ScienceRise: Pharmaceutical Science, 3 (25), 20–27. doi: http://doi.org/10.15587/2519-4852.2020.206569
- Proskurova, I. O., Kubarieva, I. V., Yevsieieva, L. V., Boldar, G. E. (2019). Analysis of handling practice with unused medicines in home first aid kits of the Ukrainian households. Journal of Advanced Pharmacy Education & Research, 9 (3), 123–127.
- Houlihan, J., Leffler, S. (2019). Assessing and Addressing Social Determinants of Health: A Key Competency for Succeeding in Value-Based Care. Primary Care: Clinics in Office Practice, 46 (4), 561–574. doi: http://doi.org/10.1016/j.pop.2019.07.013
- Machledt, D. (2017). Addressing the Social Determinants of Health Through Medicaid Managed Care. Issue Brief (Commonw Fund), 1–9.
- Health at a Glance: Europe 2018: state of health in the EU cycle (2018). OECD/European Union. Available at: https://ec.europa.eu/health/sites/health/files/state/docs/2018_healthatglance_rep_en.pdf
- Thornton, R. L. J., Glover, C. M., Cené, C. W., Glik, D. C., Henderson, J. A., Williams, D. R. (2016). Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health. Health Affairs, 35 (8), 1416–1423. doi: http://doi.org/10.1377/hlthaff.2015.1357
- OECD. Pharmaceutical spending (indicator). Available at: https://www.oecd-ilibrary.org/social-issues-migration-health/pharmaceutical-spending/indicator/english_998febf6-en
- OECD. Health spending (indicator). Available at: https://www.oecd-ilibrary.org/social-issues-migration-health/health-spending/indicator/english_8643de7e-en
- Soboliev, V. M., Chala, T. H., Korepanov, O. S. et. al.; Soboliev, V. M. (Ed.) (2017). Ekonomichna statystyka. Kharkiv: KhNU imeni V. N. Karazina, 388.
- Bush, M. (2018). Addressing the Root Cause: Rising Health Care Costs and Social Determinants of Health. North Carolina Medical Journal, 79 (1), 26–29. doi: http://doi.org/10.18043/ncm.79.1.26
- Hosseini Shokouh, S. M., Arab, M., Emamgholipour, S., Rashidian, A., Montazeri, A., Zaboli, R. (2017). Conceptual Models of Social Determinants of Health: A Narrative Review. Iranian Journal of Public Health, 46 (4), 435–446.
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