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

National health expenditure trends, 2000 to 2019

The aim: To assess the lo n g-term dynam ics o f health spending in Ukraine from the standpoint o f readiness to m ake progress in the universal health coverage (UHC) Materials and methods: Data from the Global Health Expenditure D atabase, European H ealth for All database, World Bank Open Data, collected du rin g 2 000-2019 were used. The research w as conducted using bibliosem antic, historical m ethods and benchm arking. Results: All indicators o f health spending in Ukraine show ed som e gro w th: total and governm ent health spending o f % Gross D om estic Product (GDP) by 3 4 % (9 5 % CI 13-55) and 2 8 % (9 5 % CI 8 -4 8 ), total and governm ent health sp en d in g per capita in US $ by 7.1 and 6.5 tim es and in Purchasing pow er parity (PPP) - by 4 and 3.8 tim es. Growth was interrupted during the glo b al (2008) and national (2017-2019) financial crises. O u t-of-pocket sp en d in g in Ukraine grew and am ounted to 5 1 .1 % in 2019, w h ich is by 2.1 tim es m ore than in the European region - 2 4 .0 % (15.5; 36.6). In 2019 Ukraine ranked am o n g 1 0 % o f the countries w ith the worst com bination o f governm ent health spending per share o f GDP and share o f OOPS in total health spending. Conclusions: The study found an u nsustainable upw ard dyn am ic in health spen d in g. In the last decade, there has been a clear trend tow ards an increase % OOPS in total health sp en d in g a gain st low, aim ed at reducing governm ent health sp en d in g as % o f GDP, w h ich could n egatively affect UHC