Implementation of patient-centered care in primary medical care reform in Ukraine 2018-2020: an exploratory study of stakeholder perceptions in Kiev and Ivano-Frankivsk

Abstract

The Master’s Thesis is focused on the perceptions of patient-centered care by different stakeholders on the primary health care level in Ukrainian two cities, Kiev and Ivano-Frankivsk. To improve the quality of primary health care services in Ukraine, population health in general and make sure that the citizens are provided with equal access to health care services at all levels, the new health care reforms were implemented by the Ministry of Health in late 2017. An essential role in these reforms is the focus on the patient, the so called, patient-centered care (PCC), which should improve the quality of care, make the primary care level more reliable and leave satisfied patients and doctors. This is a comparatively new approach for Ukraine, as before there was a doctor-centered model where the patient’s point of view was not required, as the healthcare sector worked just as a system and for the system. There is evidence that doctors are not ready for this new approach as they were always considered as the center of the system and were in charge of the patient’s health. Therefore, the aim of the research is first of all to find out the main objectives of the PCC approach and understand the perception of PCC from different stakeholders' viewpoints, because the literature review demonstrated that there should be the same understanding of the certain element of the reform by all stakeholders in order to have a successful reform implementation. Last but not least, it is also important to find out how PCC contributes to the quality of care. It is also important to compare and contrast the findings from both cities and to see how the reform is implemented and whether there are different understandings of the PCC approach. The research contributes to the understanding of the PCC approach in health care not only in Ukraine but to the literature regarding PCC. The researcher also identified policy implications that can be introduced for improving the reform implementation process in Ukraine. Additionally, the research findings may have useful applications in other countries who still suffer from the doctor-centered or system-centered healthcare system and wish to implement another approach in health care. The framework may be also useful for conducting similar research.