Substantiation of components of availability and integration of primary health care associated with ambulatory care sensitive conditions in Ukraine

The study lists and assesses the impact of the main components of primary care availability and its integration withsecondary care associated with ambulatory care sensitiveconditions that can be used for potentially preventablehospitalizations. Te study showed the directions of prioritization of measures aimed at strengthening the primaryhealth care system in Ukraine. Te results of the study canbe used to develop a specifc action plan for further reformof primary health care, the implementation of which willreduce rates of ambulatory care sensitive hospitalizationsand increase the efcient use of limited resources withina health care system of Ukraine

Global burden of disease due to ambulatory care sensitive conditions, 1990-2019

Disability-adjusted life years (DALYs) due to ACSC over 30 years in Ukraine averaged 5145.4 years per 100,000 population (95% CI 4731.1 -5559.7), which is approximately 14% of DALYs of all reasons without a clear trend of change - compound annual growth rate (CARG) of 0.14%. These five causes – angina pectoris, chronic obstructive pulmonary diseases (COPD), lower respiratory infections, diabetes, and tuberculosis – account for 90% of the disease burden associated with ACSCs. There was an increasing trend in DALYs (CARG varied for different ACSCs in the range of 0.59-1.88%), except for COPD, where the decrease in CARG reached -3.16%. This longitudinal study found a small trend toward increased DALYs due to ACSCs. State measures to influence modified risk factors to reduce the burden of losses from ACSCs proved to be ineffective. To significantly reduce DALYs, a more clear and more systematic healthcare policy regarding ACSCs is needed, which includes a set of primary prevention measures, and organizational and economic strengthening of the primary healt