Public management of healthcare development: international experience, national specificities, and directions for improving efficiency

Andreichenko Andrii
Doctor of Economics, Professor, Head of Economics, Law and Business Management Department, Odesa National Economics University, Odesa, Ukraine, E-mail: a.andreichenko@oneu.ukr.education, ORCID: https://orcid.org/0000-0002-1854-9099

Zhurylo Serhii
candidate of legal sciences, Lecturer at the Department of Economics, Law and Business Administration, Odesa National Economics University, Odesa, Ukraine, E-mail:oneu.sergzhurilo@gmail.com, ORCID: https://orcid.org/0000-0002-4355-5060

Podmazko Alexey
Candidate of Economic Sciences, Senior Lecturer at the Department of Economics, Law and Business Administration, Odesa National Economics University, Odesa, Ukraine, E-mail:ampodmazko@gmail.com, ORCID: https://orcid.org/0009-0003-1495-6046

Cite this article:

Andreichenko A., Zhurylo S., Podmazko A. (2025) Public management of healthcare development: international experience, national specificities, and directions for improving efficiency. Ed.: V.V. Kovalenko (ed.-in-ch.) and others [Publichne upravlinnja rozvytkom sfery ohorony zdorovja: mizhnarodnyj dosvid, nacionalni osoblyvosti ta naprjamy pidvyshhennja efektyvnosti; za red.: V.V. Kovalenko (gol. red.)], Scientific Bulletin of the Odesa National Economic University (ISSN 2313-4569), Odesa National Economics University, Odesa, No. 3 (328), pp.47-54.

Abstract

Research purpose is to conduct a comprehensive theoretical and applied study of public governance mechanisms in healthcare development in Ukraine, considering international experience and national characteristics to substantiate scientific and practical recommendations for improving managerial approaches in this sector. Research methodology is based on a systematic analysis of the institutional structure of public healthcare governance, including the horizontal-vertical dimension of interaction between the three branches of government, comparative study of international models of healthcare systems organization, critical assessment of domestic reform outcomes, and synthesis of adaptive improvement mechanisms. Methods of theoretical generalization, documentary analysis, and structural-functional modeling were used to develop a holistic understanding of healthcare system development directions. Research findings revealed structural imbalances in the domestic healthcare system, including limited access to services due to financial and infrastructural barriers, insufficient quality of medical care, and a significant share of out-of-pocket payments by patients. The American market model with dominant private financing, European solidarity systems with mandatory health insurance, and the Japanese mixed model with a four-level institutional architecture were analyzed. The main stage of the transformation of Ukraine's medical sector has been identified, along with current challenges of functioning under martial law conditions, which have complicated the implementation of planned reforms. Practical significance lies in developing scientifically grounded recommendations for improving public healthcare governance, including: creating a comprehensive financing system with an optimal combination of budget funds, mandatory health insurance, and public-private partnerships; modernizing infrastructure through promoting healthcare facility autonomy; expanding local authorities' powers with consideration of regional characteristics; enhancing preventive medicine development by increasing funding for vaccination programs and educational campaigns; expanding the use of electronic systems to optimize budget expenditures and increase transparency; and developing objective indicators for evaluating the effectiveness of state healthcare policy.

Keywords

public governance, public authorities, local self-government, healthcare, financing, international experience, public- private partnership, decentralization of medical services, digitalization.

JEL classification:I180; H510; H750; P410; O570;DOI: https://doi.org/10.32680/2409-9260-2025-3-328-47-54

UD classification:351.77:614.2:005.591.6

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