Школа управління в охороні здоров'я

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https://ekmair.ukma.edu.ua/handle/123456789/28639

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Browsing Школа управління в охороні здоров'я by Subject "informal practices"

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    Just informal patient payments are not enough, 'personal connections' and knowledge of the 'rules' are also required: a logistic regression analysis of informal practices in health care in Ukraine
    (2025) Levenets, Olena; Stepurko, Tetiana; Polese, Abel; Pavlova, Milena; Groot, Wim
    In Ukraine, patients and their family members face numerous barriers to health care services. In response, they use coping strategies, that are manifold and complex activities aimed at overcoming these barriers, the financial burden of the treatment, and the poor quality of health care services. These activities include formal and informal practices. Based on representative survey data from 2015 (N = 2,022), we identify patterns in the use of coping strategies, specific coping strategies used to secure good quality consultation and treatment, and analyse opinions and actions towards coping practices. We further analyse the factors associated with the last experience of coping and look at patterns of connection building. We find that the chances of using both money and connection as a coping strategy are higher for people with incomplete higher and highest levels of education. The size of this effect increases with the level of education. Older people, people with better health, and people with a higher opinion of the state use informal practices less, while women are more active in developing connections. The closer the relationship is with a medical doctor, the higher is the chance that such connection will be used in case of health service consumption.
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    Navigating cancer care in Ukraine: patient’s coping strategies to ensure access and quality
    (2025) Levenets, Olena; Chernysh, Tetiana; Pavlova, Milena; Groot, Wim
    Purpose This study investigates how socio-economic and healthcare factors shape the coping strategies of patients diagnosed with cancer in Ukraine, including the decision to forego treatment. The focus is on how these variables influence patients’ strategies to gain access to services, ensure better treatment quality, and decrease treatment costs. Methods Data were collected in 2021 through structured interviews in three oncological dispensaries and an online questionnaire among patients diagnosed with cancer in Ukraine (632 patients in total). Sequential logistic regression analyses were applied to identify patterns in selecting specific coping strategies. Results The results show that socio-economic characteristics, the perception of service quality, financial resources, and the availability of support influence the choice of coping strategies. Older patients and women are more likely to use informal payments than connections. Patients, who perceive service quality as (very) bad and those finding it hard to afford treatment, are more likely to deploy coping strategies. Higher education and urban residency also impact the coping strategy applied. Conclusion The study highlights significant disparities in the choice of coping strategy regarding cancer treatment in Ukraine. Coping strategies, including informal payments and connections, are crucial for accessing and ensuring better treatment. These findings underscore the need for evidence-informed policies to support the most vulnerable cancer care patients in Ukraine.