Зарубіжні моделі управління системами охорони здоров’я: можливості та виклики для територіальних громад України

Abstract

This article explores international models of healthcare system governance and healthcare delivery, with a focus on their adaptation to the conditions of territorial communities in Ukraine. The research is based on an interdisciplinary approach that combines comparative, systemic, case-study, and prognostic methods for analyzing healthcare management models. Its purpose is to study foreign practices in the organization of healthcare systems and to determine the possibilities for their adaptation to Ukrainian conditions during the war and reconstruction period. It examines the fundamental governance models (Beveridge, Bismarck, single-payer and “out-of pocket”) and identifies integrated care approaches (such as HMO, PPO, IDS, ACO, PCMH and others), particularly considering the experiences of the United Kingdom, the United States of America, Finland, Brazil and India. This article emphasizes the shift in the role of communities from service recipients to service purchasers, as well as the use of contracting mechanisms, key performance indicators, and health cluster management. It has been proven that the methodology for researching public policy management in the field of healthcare at the local community level requires comprehensive analysis and interdisciplinary discussion in order to develop an adaptive model suitable for countries in the process of transformation, in particular Ukraine in the context of war. An interdisciplinary approach to analyzing governance in healthcare is proposed, incorporating institutional, social, and economic factors. The study identifies the potential for integrating international experience in health system governance at the level of territorial communities in the context of decentralization and war in Ukraine. The results are of practical importance for the formation of an effective model of healthcare management at the level of local communities in Ukraine, taking into account international experience.