Ukraine National Health Accounts 2003-2004 Volume 2 by Curatio International Foundation

Ukraine National Health Accounts 2003-2004 Volume 2 April 2006 Prepared by: George Gotsadze, MD, PhD Curatio International Foundation Yuriy Chechulin, MD, MPH Consultant, Abt Associates Inc. Victor Galayda, MD, MA Consultant, the World Bank Valeria Lekhan, MD, PhD Consultant, the World Bank Catherine Chanfreau, MD, MPH Senior HIV/AIDS Technical Adviser Abt Associates Inc. Tania Dmytraczenko, PhD Senior Health Economist, Abt Associates Inc.

Ukraine National Health Accounts 2003-2004 Volume 2: Technical Notes Date: April 2006 Prepared by: George Gotsadze, MD, PhD Curatio International Foundation Yuriy Chechulin, MD, MPH Consultant, Abt Associates Inc. Victor Galayda, MD, MA Consultant, the World Bank Valeria Lekhan, MD, PhD Consultant, the World Bank Catherine Chanfreau, MD, MPH Senior HIV/AIDS Technical Adviser, Abt Associates, Inc. Tania Dmytraczenko, PhD Senior health economist, Abt Associates, Inc.

Ukraine National Health Accounts 2003-2004

Table of Contents for Volume 2 TABLE OF CONTENTS FOR VOLUME 2 ...................................................................................................... 3 ANNEXES ............................................................................................................................................................. 6 Annex 1: National Health Accounts (NHA) Classification for Ukraine and its Comparison with the Ukrainian Budget Classification System....................................................................................................... 7 Introduction................................................................................................................................................................7 Classification of National Health Accounts (NHA) ...................................................................................................8 Financing Sources....................................................................................................................................................11 Financing Agents .....................................................................................................................................................12 Providers ..................................................................................................................................................................13 Functions..................................................................................................................................................................17 Comparison of NHA and budget classifications ......................................................................................................22 Functional budget classification and NHA Providers ..............................................................................................23 Functional budget classification and NHA Functions ..............................................................................................34 Economics budget classification and NHA Functions .............................................................................................43 Use of Program Budget Classification for more detailed allocation of expenditures of the central government budget ......................................................................................................................................................................47 Conclusion ...............................................................................................................................................................52

Annex 2: Methodology for Estimating Health Expenditures on a Household Level for 2004 and 2003..... 53 Introduction..............................................................................................................................................................53 The Survey description ............................................................................................................................................53 Survey Data and Cost Estimates ..............................................................................................................................54 Household level health expenditure by Economic Regions .....................................................................................57 Comparison of Estimates with SSC Data.................................................................................................................57 Addendum 1 COICOP Classificator ........................................................................................................................58

Annex 3: Methodology for Disaggregating Expenditures by Providers .................................................... 59 Public Financing ......................................................................................................................................................59 Private Financing .....................................................................................................................................................63

Annex 4: Methodology for Estimating Private and Non-Budgetary Health Care Facilities...................... 75 Annex 5: Methodology for Estimating Social Security (Social security fund for accidents at work and occupational diseases) ................................................................................................................................ 77 Annex 6: Methodology for Disaggregating Spending by Functions .......................................................... 81 Methodology for estimating public expenditure for each function ..........................................................................81 Methodology for estimating private expenditure for each function .........................................................................97

Annex 7: Methodology for conducting the RH NHA subanalysis in Ukraine ........................................... 108 Annex 8: Methodology for conducting the HIV/AIDS NHA subanalysis in Ukraine ................................ 115 Annex 9: Methodology of mapping NHA HIV/AIDS subanalysis classification to National AIDS Spending Assessments (NASA) classification ........................................................................................................... 131 DETAILED GENERAL NHA TABLES ........................................................................................................ 142 DETAILED NHA RH SUBANALYSIS TABLES ......................................................................................... 231 DETAILED NHA HIV/AIDS SUBANALYSIS TABLES ............................................................................. 258

Technical Notes

List of Tables TABLE 1 BASIC DATA FOR THE SURVEY AND UKRAINE ......................................................................................... 54 TABLE 2 COST ESTIMATES FOR SELF-TREATMENT (DRUGS AND MEDICAL SUPPLIES) HRIVNA ............................... 55 TABLE 3 TOTAL PRIVATE FINANCING ON AN OP LEVEL IN 2004 ........................................................................... 55 TABLE 4 TOTAL HOSPITAL SPENDING IN 2004 (HRIVNA) ...................................................................................... 56 TABLE 5 TYPE OF HOSPITAL PAYMENTS ................................................................................................................ 56 TABLE 6 STRUCTURE OF HOSPITAL PAYMENTS IN 2004........................................................................................ 56 TABLE 7 HOUSEHOLD LEVEL HOSPITAL SPENDING BY TYPE OF HOSPITAL AND ECONOMIC REGION IN UKRAINE 2004 (HRIVNA)............................................................................................................................................. 56 TABLE 8 PRIVATE HEALTH EXPENDITURE IN UKRAINE BY TYPE OF CARE AND ECONOMIC REGION IN 2004 (HRIVNA) ..................................................................................................................................................... 57 TABLE 9 HOSPITAL BEDS AND THEIR DISTRIBUTION BY TYPES OF GENERAL HOSPITALS ........................................ 61 TABLE 10 ESTIMATION OF NUMBER OF BEDS IN STAND-ALONE ONCOLOGY AND STI FACILITIES .......................... 61 TABLE 11 CALCULATIONS OF SPENDING PROPORTION FOR SPECIALTY HOSPITALS NHA CLASSIFICATION CATEGORIES ................................................................................................................................................. 62 TABLE 12 ADJUSTED CALCULATIONS OF SPENDING PROPORTION FOR SPECIALTY HOSPITALS NHA CLASSIFICATION CATEGORIES ................................................................................................................................................. 63 TABLE 13 PHC PROVIDERS IN UKRAINE ................................................................................................................ 63 TABLE 14 PRIVATE FINANCING DISTRIBUTION FOR IP SERVICES ON A HOSPITAL LEVEL IN 2004 ......................... 64 TABLE 15 FURTHER DISTRIBUTION FOR OBLAST LEVEL HOSPITALS ...................................................................... 65 TABLE 16 FURTHER DISTRIBUTION FOR RAYON / MUNICIPAL HOSPITALS ............................................................. 65 TABLE 17 SUMMARY OF PRIVATE FINANCING DISTRIBUTION ON A HOSPITAL LEVEL IN 2004 .............................. 65 TABLE 18 SUMMARY OF PRIVATE FINANCING DISTRIBUTION ON A HOSPITAL LEVEL IN 2004 .............................. 66 TABLE 19 SUMMARY OF PRIVATE FINANCING DISTRIBUTION ON A HOSPITAL LEVEL ADJUSTED FOR DATA ON PRIVATE AND NON-BUDGETARY FACILITIES FROM SSC IN 2004................................................................... 67 TABLE 20 SUMMARY OF PRIVATE FINANCING DISTRIBUTION ON A HOSPITAL LEVEL ADJUSTED FOR DATA ON PRIVATE AND NON-BUDGETARY FACILITIES FROM SSC AND OP SERVICES PROVIDED AT HOSPITAL PROVIDERS IN 2004...................................................................................................................................... 67 TABLE 21 TOTAL PRIVATE FINANCING ON AN OP LEVEL IN 2004 ......................................................................... 68 TABLE 22 OFFICIAL PAYMENTS FOR OP CARE IN 2004.......................................................................................... 68 TABLE 23 PURCHASE OF DRUGS, SUPPLIES AND LAB TESTS ON AN OP LEVEL IN 2004........................................... 68 TABLE 24 CASH PAYMENTS TO PROVIDERS ON AN OP LEVEL IN 2004 .................................................................. 69 TABLE 25 IN-KIND PAYMENTS TO PROVIDERS ON AN OP LEVEL IN 2004 ............................................................... 69 TABLE 26 COMPARISON OF DISTRIBUTION OF PRIVATE SPENDING ON AN OP AND HOSPITAL LEVEL IN 2004 ........ 69 TABLE 27 SUMMARY OF DISTRIBUTION OF PRIVATE SPENDING ON AN OP LEVEL IN 2004 ..................................... 70 TABLE 28 DETERMINING PROPORTION OF DENTAL OP CARE OUT OF TOTAL OP SPENDING BASED ON TYPES OF FACILITIES REPORTED UNDER WB SURVEY ................................................................................................. 70 TABLE 29 MATCHING OUTPATIENT FACILITIES REPORTED UNDER WB 2004 SURVEY WITH NHA CLASSIFICATION CATEGORIES ................................................................................................................................................. 71 TABLE 30 FURTHER DISTRIBUTION FOR HOSPITAL PROVIDERS PROVIDING OP SERVICES: PART 1.......................... 71 TABLE 31 FURTHER DISTRIBUTION FOR HOSPITAL PROVIDERS PROVIDING OP SERVICES: PART 2.......................... 72 TABLE 32 FURTHER DISTRIBUTION FOR GENERAL POLICLINICS ............................................................................. 72 TABLE 33 DISTRIBUTION OF PRIVATE SPENDING ON AN OP LEVEL BY DIFFERENT TYPES OF OP PROVIDERS IN 2004 .................................................................................................................................................................... 72 TABLE 34 DISTRIBUTION OF PRIVATE SPENDING ON AN OP LEVEL BY STAND-ALONE OP PROVIDERS IN 2004 ..... 73 TABLE 35 DISTRIBUTION OF PRIVATE SPENDING BASED ON WB SURVEY IN 2004................................................. 74 TABLE 36 SUMMARY OF PRIVATE FINANCING DISTRIBUTION ADJUSTED FOR ADDITIONAL DATA ON PRIVATE AND NON-BUDGETARY HEALTH CARE FACILITIES FROM SSC ............................................................................. 74 TABLE 37 INCOME AND EXPENSES FOR PRIVATE AND NON-BUDGETARY HEALTH CARE FACILITIES ..................... 75 TABLE 38 ESTIMATING DISTRIBUTION OF EXPENSES BASED ON PROPORTION OF INCOME FOR PRIVATE AND NONBUDGETARY FACILITIES ............................................................................................................................... 75 TABLE 39 MAPPING OF EXPENDITURE LINE ITEMS FOR EMPLOYERS TO NHA CLASSIFICATION CATEGORIES ......... 76 TABLE 40 ESTIMATING SHARE OF OVERHEAD COSTS FOR SOCIAL SECURITY EXPENSES ON HEALTH CARE ............ 77 TABLE 41 DISTRIBUTING SOCIAL SECURITY INCOME RELATED TO HEALTH CARE BY FINANCIAL SOURCES (FS) .. 78 TABLE 42 MAPPING OF SOCIAL SECURITY EXPENSES TO PROVIDERS (HP) AND FUNCTIONS (HC) ....................... 78 TABLE 43 ECONOMIC CHARACTER OF PUBLIC EXPENDITURE BY DIFFERENT TYPE OF HEALTH CARE FACILITIES.... 82 TABLE 44 DISTRIBUTION OF BED DAYS BETWEEN OBSTETRICAL AND GYNAECOLOGICAL BEDS ............................ 83 TABLE 45 BED CAPACITY FOR DAY CASES OF CURATIVE CARE .............................................................................. 83 TABLE 46 FULL-TIME EQUIVALENTS (FTE) FOR RH DOCTORS IN STAND-ALONE POLICLINICS .............................. 86 TABLE 47 ESTIMATION OF PROPORTION OF OP OB & GYN, FP OUT OF ALL OP RH .............................................. 86

Ukraine National Health Accounts 2003-2004

TABLE 48 GENERAL GOVERNMENT FINANCING= HF.1 ......................................................................................... 87 TABLE 49 DISTRIBUTION OF PRIVATE SPENDING ON AN OP LEVEL BY DIFFERENT TYPES OF OP SERVICE PROVIDERS IN 2004...................................................................................................................................... 98 TABLE 50 PRIVATE FINANCING DISTRIBUTION ON A HOSPITAL LEVEL IN 2004..................................................... 99 TABLE 51 PRIVATE FINANCING HF.2 & HF.3...................................................................................................... 100 TABLE 52 ESTIMATION OF PROPORTION OF OP OB & GYN OUT OF ALL OP VISITS IN CENTRAL RAYON HOSPITALS .................................................................................................................................................................. 108 TABLE 53 ESTIMATION OF PROPORTION OF PRIVATE HOUSEHOLD SPENDING ON RH IP SERVICES IN GENERAL HOSPITALS IN 2004.................................................................................................................................... 110 TABLE 54 CURRENT USAGE OF METHODS OF CONTRACEPTION BY WOMEN OF REPRODUCTIVE AGE (15-49 YEARS OLD)*......................................................................................................................................................... 111 TABLE 55 ESTIMATION OF SPENDING FOR ORAL CONTRACEPTIVES, UAH .......................................................... 111 TABLE 56 ESTIMATION OF SPENDING FOR INTRA-UTERUS DEVICE (IUD), UAH ................................................ 112 TABLE 57 ESTIMATION OF PRIVATE HOUSEHOLD SPENDING FOR PHARMACEUTICALS RELATED TO RH ............ 114 TABLE 58 OFFICIAL TREASURY OF UKRAINE DATA EXPANDED BY AD HOC RESEARCH ON CENTRAL AND REGIONAL GOVERNMENTS SPENDING ON HIV/AIDS IN UKRAINE IN 2004.................................................................. 116 TABLE 59 RATIOS AND STAFFING COSTS IN HIV CENTERS IN SAMPLE OBLASTS IN UKRAINE .............................. 117 TABLE 60 ESTIMATING SPENDING ON REGIONAL HIV CENTERS IN UKRAINE ...................................................... 117 TABLE 61 DISTRIBUTION OF HIV BEDS IN UKRAINE IN 2005............................................................................... 118 TABLE 62 SHARE OF HIV BEDS IN TB AND SUBSTANCE ABUSE HOSPITALS ......................................................... 119 TABLE 63 ESTIMATING ANNUAL COST PER BED IN CITY GENERAL HOSPITALS..................................................... 119 TABLE 64 ESTIMATION OF NUMBER OF HIV-POSITIVE PEOPLE IN UKRAINE IN 2003 AND 2004 BASED ON 2005 ESTIMATES* ............................................................................................................................................... 123 TABLE 65 DISTRIBUTIONS BY SEX AND AGE AMONG OFFICIALLY REGISTERED HIV-POSITIVE IDU (INCIDENCE)* .................................................................................................................................................................. 125 TABLE 66 RESULTS OF SENTINEL SURVEILLANCE AMONG CSW IN 2004: DISTRIBUTION BY AGE FOR HIV-POSITIVE CSW*........................................................................................................................................................ 125 TABLE 67 SPENDING ONLY ON IP AND OP SERVICES BY HIV-POSITIVE IDU AND CSW ..................................... 126 TABLE 68 SPENDING ON MEDICINES (OTHER THAN SYRINGES AND CONDOMS) BY HIV-POSITIVE PEOPLE ........... 129 TABLE 69 SPENDING ONLY ON IP AND OP SERVICES BY ALL HIV-POSITIVE (IDU, CSW, GENERAL NON-RISK POPULATION) PEOPLE ................................................................................................................................. 130 TABLE 70 MAPPING NASA TO NHA HIV/AIDS SUBANALYSIS CLASSIFICATION ............................................... 134 TABLE 71 UKRAINE GENERAL NHA 2003: FINANCIAL SOURCES BY FINANCIAL AGENTS ................................... 143 TABLE 72 UKRAINE GENERAL NHA 2003: FINANCIAL AGENTS BY PROVIDERS .................................................. 144 TABLE 73 UKRAINE GENERAL NHA 2003: FINANCIAL AGENTS BY FUNCTIONS.................................................. 150 TABLE 74 UKRAINE GENERAL NHA 2003: PROVIDERS BY FUNCTIONS ............................................................... 159 TABLE 75 UKRAINE GENERAL NHA 2004: FINANCIAL SOURCES BY FINANCIAL AGENTS ................................... 187 TABLE 76 UKRAINE GENERAL NHA 2004: FINANCIAL AGENTS BY PROVIDERS .................................................. 188 TABLE 77 UKRAINE GENERAL NHA 2004: FINANCIAL AGENTS BY FUNCTIONS.................................................. 194 TABLE 78 UKRAINE GENERAL NHA 2004: PROVIDERS BY FUNCTIONS ............................................................... 203 TABLE 79 UKRAINE NHA RH SUBANALYSIS 2003: FINANCIAL SOURCES BY FINANCIAL AGENTS ..................... 232 TABLE 80 UKRAINE NHA RH SUBANALYSIS 2003: FINANCIAL AGENTS BY PROVIDERS .................................... 233 TABLE 81 UKRAINE NHA RH SUBANALYSIS 2003: FINANCIAL AGENTS BY FUNCTIONS .................................... 235 TABLE 82 UKRAINE NHA RH SUBANALYSIS 2003: PROVIDERS BY FUNCTIONS ................................................. 239 TABLE 83 UKRAINE NHA RH SUBANALYSIS 2004: FINANCIAL SOURCES BY FINANCIAL AGENTS ..................... 245 TABLE 84 UKRAINE NHA RH SUBANALYSIS 2004: FINANCIAL AGENTS BY PROVIDERS .................................... 246 TABLE 85 UKRAINE NHA RH SUBANALYSIS 2004: FINANCIAL AGENTS BY FUNCTIONS .................................... 248 TABLE 86 UKRAINE NHA RH SUBANALYSIS 2004: PROVIDERS BY FUNCTIONS ................................................. 252 TABLE 87 UKRAINE NHA HIV/AIDS SUBANALYSIS 2003: FINANCIAL SOURCES BY FINANCIAL AGENTS ......... 259 TABLE 88 UKRAINE NHA HIV/AIDS SUBANALYSIS 2003: FINANCIAL AGENTS BY PROVIDERS ........................ 260 TABLE 89 UKRAINE NHA HIV/AIDS SUBANALYSIS 2003: FINANCIAL AGENTS BY FUNCTIONS ........................ 262 TABLE 90 UKRAINE NHA HIV/AIDS SUBANALYSIS 2003: PROVIDERS BY FUNCTIONS ..................................... 265 TABLE 91 UKRAINE NHA HIV/AIDS SUBANALYSIS 2004: FINANCIAL SOURCES BY FINANCIAL AGENTS ......... 274 TABLE 92 UKRAINE NHA HIV/AIDS SUBANALYSIS 2004: FINANCIAL AGENTS BY PROVIDERS ........................ 275 TABLE 93 UKRAINE NHA HIV/AIDS SUBANALYSIS 2004: FINANCIAL AGENTS BY FUNCTIONS ........................ 277 TABLE 94 UKRAINE NHA HIV/AIDS SUBANALYSIS 2004: PROVIDERS BY FUNCTIONS ..................................... 280

List of Figures FIGURE 1 FLOWCHART FOR PARTITIONING EXPENDITURES INTO FUNCTIONS ON A GENERAL HOSPITAL LEVEL ...... 84 FIGURE 2 FLOWCHART FOR PARTITIONING EXPENDITURES INTO FUNCTIONS ON AN ONCOLOGY HOSPITAL LEVEL 85

Technical Notes

Annexes

Ukraine National Health Accounts 2003-2004

Annex 1: National Health Accounts (NHA) Classification for Ukraine and its Comparison with the Ukrainian Budget Classification System

Introduction National Health Accounts (NHA) is a worldwide-recognized method of summation, description and analysis of the national health system financing. Use of financial information is important to improve health system performance. At this moment, NHA method is used in more than 50 countries. Thus, for example, NHA were calculated in the Russian Federation and Georgia; in many countries of Commonwealth of Independent States the process of active NHA implementation is ongoing. As a part of health reforms, which take place in many countries of the region, the Ukrainian Government and the Ministry of Health of Ukraine could use NHA to estimate process efficiency, and to get more detailed information about health expenditures in the country. NHA can help the Ukrainian government to estimate financial flows in the health system, and also unofficial payments including both in public and private sectors. NHA sub-analyses on HIV/AIDS and reproductive health (RH) allows making better estimation of financial flows in these two priority health spheres, which have great social and strategic state importance. The proposed approach underlines long-term outlook of NHA implementation but not a onetime analysis. Estimation and use of country existing informational flows with the following development of recommendations on their modification (corresponding to NHA needs) will allow to make routine NHA analysis to monitor health financial flows constantly. It will also help in health policy making at the Health Policy Unit on strategic planning and health policy forming. In the given document Ukrainian National Health Accounts classifications are described. These classifications are set up on the basis of International Classification for Health Accounts (ICHA) of the Organization for Economic Co-operation and Development (OECD). Also existing Ukrainian budget classifications (functional and economic) compared with NHA ones are given. Such comparison underlines the approach, which provides the use of existing informational flows that is very important in the process of NHA institutionalization for the routine monitoring of health system well-being. In addition, this document contains recommendations on budget program classification use for more detailed distribution of the expenditures of the central state budget for the purposes of the population of the NHA tables.

Technical Notes

Classification of National Health Accounts (NHA) Introductory provisions NHA methodology takes over the main principles from the System of Health Accounts (SHA) of the Organization for Economic Co-operation and Development (OECD). International Classification of Health Accounts (ICHA) is described in the SHA Manual. All types of health expenditures are divided into categories. SHA classification has become very useful in those countries where health financing is made mostly from one source (as it is done in most countries of OECD). NHA uses ICHA, but at the same time it is divided into subcategories taking into account specific country needs. Such flexibility gives NHA the opportunity to consider the most varied health systems expenditures. Such expenditures are typical for the countries with middle and low income where medical providers can get financing from several sources, and payment can be made to many providers.1 International Classification of Health Accounts (ICHA) describes the main dimensions for health expenditures (for example, financial sources, financial agents, providers and functions) in the context of categories with similar characteristics. For example, financing sources could be divided into the following categories: • National (public) source of financing • Private source of financing • Other sources of financing NHA classification is developed in the framework of ICHA. Each NHA table makes health institution categorization in accordance with ICHA. Since ICHA is internationally accepted standard, it allows conducting comparative health expenditures analysis in the country2.

Defining categories of health care participants In the system of NHA there are four main categories of health care participants: Financing sources (FS) – organizations or other entities that appropriate funds, which are used in the system by Financial Agents. They answer the question “Where does the money come from?” Ministry of Finance, households and donors could be the example of it. Financing Agents (HF) – organizations or other entities that manage funds provided by Financial Sources and use these funds to make payments and purchase results of activities that are considered in the framework of health accounts. Financial agents get funds from financing sources (FS) and use them for financing of medical services, medical goods (e.g. medicines) and activities. It is a very important category because financial intermediary power gives them the possibility to influence the use of funds and to exercise control. This category answers the question “Who manages and organizes funds?” For example, if the Ministry of Finance (source) could assign funds to the Ministry of Health (MOH), MOH for its turn is responsible for actual allocation of received funds in the system of health. That is why MOH is a financial agent (or intermediary, or manager). Other examples are insurance companies and other ministries (e.g. Ministry of Transport).

1 2

Premier for Health Policy Makers. PHRplus. Training Manual on National Health Accounts. PHRplus. 2003.

Ukraine National Health Accounts 2003-2004

Providers of medical services (HP) – entities that get money in exchange of producing results or activities implementation considered in the framework of health accounts. Providers of medical services are the ultimate consumers of health system funds. This participants’ category answers the question “To whom the money go?” Providers are the organizations, which provide medical services. Private and public hospitals, clinics and medical care points could be considered as examples. Health care functions (HC) – types of provided goods, services and fulfilled activities that are included in the framework of Health Accounts. Functions are the services and activities provided by medical service providers in return to received funds. Information of this level answers the question “What kind of service, good or activity was really provided?” The following examples could be indicated: curative care, nursing care, medical goods (e.g. medicines), preventive activities and health management. Main set of NHA tables shows the financial flows between above mentioned categories of health system participants.

Explanation of NHA classification codes In NHA classification ICHA approaches are used. Principal NHA categories start with letter code: 1. “Financial Sources” are appeared as “FS” 2. “Financial Agents” are appeared as «HF» 3. “Medical service providers” are appeared as «HP» 4. “Health care functions” are appeared as «HC» Specific sub-categories within the main category (e.g. financial sources) get letter or numerical code, which is indicated after ICHA title: 1. So, a process of “public funds” coding starts with letter code for the main ICHA category; therefore, “FS” for “Financing sources”. 2. Then a numeral code is following; therefore “FS.1.”. 3. And finally, this subcategory descriptive title is added; therefore, “FS.1. Public funds”. NHA use ICHA classifications, but it is also allowed to add “subcategories” for reflecting country health system. NHA classifications should include specific criteria. They should admit, as far as possible, existing international standards and regulations (i.e. ICHA), but also they have to be flexible to meet defined political needs of country analysis conducting. Therefore, country suitable categories are added, but it is done in the context of defined ICHA categories. For example, ICHA code “HP.1.1 General Hospitals” could be extended due to additional subcategories. Since for Ukraine it is necessary to mark hospitals expenditures in accordance with medical care provision levels, the following subcategories are added: “HP.1.1.1 Oblast general hospitals”, “НР.1.1.2 City general hospitals” est. While adding additional subcategories the first two figures should coincide with ICHA categories. Next figures are new; they mean additional “subcategory” of classification. At the same time each category should be alternative and exhaustive, each financial transaction should correspond to one and only one category. Additional categories have to be feasible; it

Technical Notes

should be possible to get data for this category in the framework of National Health Accounts.3

Training Manual on National Health Accounts. PHRplus. 2003.

Ukraine National Health Accounts 2003-2004

Financing Sources Financing Sources (FS) – organizations or other entities that provide funds used in the system by financing agents. NHA Code* FS.1

Code description (international category)* Public Funds

Code description (literal translation) Общественные средства

Государственные средства Средства Средства сведенного территориального (консолидированного) правительства бюджета Средства центрального Средства центрального правительства государственного (отображает бюджета распределение центральный государственного бюджет для всех министерств и государственных ведомств) Поступления областных Средства местных бюджетов, включая бюджетов Автономной районные и местные Республики Крым, бюджеты (включает 27 областей, городов Киева и регионов, в т.ч. Севастополя Крымскую АР, Киев и Севастополь)

FS.1.1

Territorial government funds

FS.1.1.1

Central government revenues (reflects allocations in central budget for all ministries and state agencies)

FS.1.1.2

Regional and city government budget revenue, including rayon and local budgets revenue (includes 27 Oblasts, Crimea AR, Kiev and Sevastopol) Private Funds Негосударственные (частные) средства Employer funds Средства работодателей Household funds Средства домашних хозяйств Non-profit Средства institutions serving неправительственных households организаций, обслуживающие домохозяйства Other private funds Другие частные средства Rest of the World Весь остальной мир GFATM Глобальный фонд по СПИД, туберкулезу и малярии Other donors Другие доноры Other Rest of the Другие «Весь остальной world мир»

FS.2 FS.2.1 FS.2.2 FS.2.3

FS.2.9 FS. 3 FS.3.1

FS.3.8 FS.3.9

Code Description (Ukrainian adaptation)

Негосударственные (частные) средства Средства работодателей Средства домашних хозяйств Средства неправительственных организаций, обслуживающие домохозяйства Другие частные средства Весь остальной мир Глобальный фонд по СПИД, туберкулезу и малярии Другие доноры Другие «Весь остальной мир»

* In italic font are categories that are added and are extension of standard international categories.

Technical Notes

Financing Agents Financing Agents (HF) – organizations or other entities that manage funds provided by financing sources and use these funds to pay for or acquire the results of activities accounted for in the framework of health accounts

HF.A HF.1.1

Code description (international category)* Public Sector Territorial government

HF.1.1.1 HF.1.1.1.1

Central government Ministry of Health

HF.1.1.1.2 HF.1.1.1.3

Ministry of Transport Ministry of Internal Affairs

HF.1.1.1.4 HF.1.1.1.5

Ministry of Defence Ministry of Labor and Social Policy Academy of Medical Sciences Other ministries Oblast/City/Local governments Social security funds

NHA Code*

HF.1.1.1.6 HF.1.1.1.9 HF.1.1.2 HF.1.2 HF.1.2.1

Social security fund for accidents at work and occupational diseases

HF.B HF.2.2

Nonpublic Sector Other private VOLUNTARY insurance

HF.2.3

Private households' payments Non-profit Institutions serving households (other than social insurance)

HF.2.4

HF.2.5

Private firms and corporations (other than health insurance, this includes all private/public factories that also have their health care provision facilities)

Code description (literal translation) Общественный сектор Территориальное правительство Центральное правительство Министерство здравоохранения Министерство транспорта Министерство внутренних дел Министерство обороны Министерство труда и социальной политики Академия Медицинских Наук

Code Description (Ukrainian adaptation) Государственный сектор Не применимо Центральное правительство Министерство здравоохранения Министерство транспорта Министерство внутренних дел Министерство обороны Министерство труда и социальной политики Академия Медицинских Наук

Другие министерства Областные бюджеты/ Местное правительство Фонды социального страхования Фонд социального страхования от несчастных случаев на производстве и профессиональных заболеваний Негосударственный сектор Другое частное ДОБРОВОЛЬНОЕ страхование Расходы частных домохозяйств Неправительственные организации, обслуживающие домохозяйства (другие, чем социальное страхование) Частные фирмы и корпорации (другие, чем медицинское страхование, это включает все частные/общественные фабрики, которые имеют свои собственные медицинские учреждения)

* In italic font are categories that are added and are extension of standard international categories.

Ukraine National Health Accounts 2003-2004

Providers Providers (HP) – entities that get the money in exchange of the results of activities or for performing activities that are accounted for in the framework on health accounts. NHA Code* HP.1 HP.1.1 HP.1.1.1 HP.1.1.1.1 HP.1.1.1.2 HP.1.1.1.9 HP.1.1.2 HP.1.1.2.1 HP.1.1.2.2 HP.1.1.2.9 HP.1.1.3 HP.1.1.4 HP.1.1.5 HP.1.1.6 HP.1.1.9 HP.1.2 HP.1.2.1

HP.1.2.2 HP.1.3

HP.1.3.1 HP.1.3.2 HP.1.3.3 HP.1.3.4 HP.1.3.9

Code description (international category)* Hospitals General hospitals Oblast hospitals Oblast general hospitals Children oblast general hospitals Other oblast general hospitals City Hospitals City general hospitals Children city general hospitals Other city general hospitals Central Rayon Hospitals Rayon Hospitals Dilnichni Hospitals Maternity houses Other hospitals Mental health and substance abuse hospitals Mental health hospitals and dispensers Substance abuse hospitals and dispensers Specialty (other than mental health and substance abuse) hospitals Oncology hospitals and dispensers AIDS clinics and centers Tuberculosis hospitals and dispensers STI clinics and dispensers Other specialty hospitals

HP.2

Nursing and residential care facilities

HP.2.1

Nursing care facilities

Technical Notes

Code description (literal translation)

Code Description (Ukrainian adaptation)

Больницы Больницы общего профиля Областные больницы Областные больницы общего профиля Детские областные больницы общего профиля Другие областные больницы общего профиля Городские больницы Городские больницы общего профиля Детские городские больницы общего профиля Другие городские больницы общего профиля Центральные районные больницы Районные больницы Участковые больницы Родильные дома Другие больницы Психиатрические и наркологические больницы Психиатрические и психоневрологические больницы и диспансеры Наркологические больницы и диспансеры Специализированные больницы (кроме психиатрических больниц для лечения алкогольной или наркотической зависимости) Онкологические больницы и диспансеры Клиники и центры ВИЧ/СПИД Туберкулезные больницы и диспансеры Кожно-венерологические клиники и диспансеры Другие специализированные больницы Сестринские/врачебные учреждения длительного пребывания больных (по уходу) Учреждения сестринского ухода

NHA Code* HP.2.2

Code description (international category)* Residential mental retardation, mental health and substance abuse facilities

HP.2.2.1

Residential substance abuse facilities

HP.2.2.2

Residential mental retardation and mental health facilities Community care facilities for the elderly Rehabilitation centers

HP.2.3 HP.2.4

HP.2.9 HP.2.9.1 HP.2.9.9 HP.3

HP.3.1

All other residential care facilities Hospice Sanatoriums Providers of ambulatory health care

HP.3.1.1 HP.3.1.2 HP.3.1.3 HP.3.1.4 HP.3.1.5

Offices of physicians and policlinics Adults Policlinics Children's Policlinics Women consultations Mixed polyclinics Village doctor posts

HP.3.1.6

Feldsher-midwife posts

HP.3.1.9

All other not described in the above groups Offices of dentists

HP.3.2 HP.3.3 HP.3.4

Offices of other health practitioners Outpatient care centres

HP.3.4.1 HP.3.4.2

Family planning centres Outpatient mental health and substance abuse centres

HP.3.4.3

Free-standing ambulatory surgery centres Dialysis care centres All other outpatient multi-specialty and cooperative service centres

HP.3.4.4 HP.3.4.5

HP.3.4.9

All other outpatient community and other integrated care centres

Code description (literal translation)

Code Description (Ukrainian adaptation)

Учреждения по уходу за умственно отсталыми, психиатрическими больными и лечения алкогольной или наркотической зависимости Учреждения для лечения алкогольной или наркотической зависимости Учреждения по уходу за умственно отсталыми и психиатрическими больными Дома престарелых

Реабилитационные центры (больницы восстановительного лечения) Все прочие учреждения по уходу Хоспис Санатории Организации, предоставляющие амбулаторные медицинские услуги Врачебные кабинеты и поликлиники Взрослые поликлиники Детские поликлиники Женские консультации Смешанные поликлиники Сельские врачебные амбулатории Фельдшерско-акушерские пункты Все остальное не включенное в других категориях Стоматологические кабинеты (отделения) Кабинеты (отделения) других работников здравоохранения Центры амбулаторного лечения Центры планирования семьи Амбулаторные учреждения для лечения психиатрических заболеваний и алкогольной и наркотической зависимости Отдельные центры амбулаторной хирургии Центры диализа Все прочие амбулаторные многопрофильные центры по предоставлению комбинированных медицинских услуг Все прочие амбулаторные и интегрированные медицинские центры по уходу

Ukraine National Health Accounts 2003-2004

NHA Code* HP.3.5 HP.3.6

Code description (international category)* Medical and diagnostic laboratories Providers of home health care services

HP.3.7 HP.3.9

Private clinics Other providers of ambulatory health care

HP.3.9.1 HP.3.9.2 HP.3.9.3

Ambulance services Blood and organ banks Alternative or traditional practitioners All other ambulatory health care services Retail sale and other providers of medical goods

HP.3.9.9 HP.4

HP.4.1

Dispensing chemists

HP.4.2

HP.6.2

Retail sale and other suppliers of optical glasses and other vision products Retail sale and other suppliers of hearing aids Retail sale and other suppliers of medical appliances (other than optical glasses and hearing aids) All other miscellaneous sale and other suppliers of pharmaceuticals and medical goods Provision and administration of public health programmes General health administration and insurance Government administration of health Social security funds

HP.6.3

Other social insurance

HP.6.4 HP.6.9

Other (private) insurance All other providers of health administration All other industries (rest of the economy) Establishments as providers of occupational health care services

HP.4.3 HP.4.4

HP.4.9

HP.5

HP.6

HP.6.1

HP.7 HP.7.1

Technical Notes

Code description (literal translation)

Code Description (Ukrainian adaptation)

Медицинские и диагностические лаборатории Организации, предоставляющие медицинские услуги на дому Частные клиники Прочие организации, предоставляющие амбулаторные медицинские услуги Скорая помощь Банки крови и органов Службы альтернативной или традиционной медицины Все прочие амбулаторные медицинские услуги Розничная продажа и прочие организации, предоставляющие медицинские товары Розничная продажа фармацевтической продукции Розничная продажа и прочие поставщики очков и различной продукции для органов зрения Розничная продажа и прочие поставщики слуховых средств Розничная продажа и прочие поставщики медицинских приборов (кроме оптических очков и слуховых приборов)

Продажа прочей продукции и прочие поставщики фармацевтических или медицинских товаров Обеспечение и управление программами общественного здоровья Общее управление здравоохранением и медицинское страхование Государственное управление здравоохранением Фонды социального страхования Прочее социальное страхование Прочее (частное) страхование Все прочие организации управления здравоохранением Все прочие сектора экономики Учреждения, предоставляющие услуги по охране здоровья на производстве

NHA Code* HP.7.3

Code description (international category)* All other industries as secondary producers of health care

HP.8

Institutions providing health-related services

HP.8.1 HP 8.2

Research institutions Education and training institutions Other institutions providing health-related services

HP.8.3

HP.9 HP.nsk

Rest of the world Provider not specified by kind

Code description (literal translation)

Code Description (Ukrainian adaptation)

Все прочие отрасли промышленности как организации, предоставляющие вторичные медицинские услуги Учреждения, предоставляющие услуги, связанные со здравоохранением Исследовательские институты Учреждения образования и обучения Прочие учреждения, предоставляющие услуги, связанные со здравоохранением Остальной мир Провайдеры, не определенные по типу

* In italic font are categories that are added and are extension of standard international categories.

Ukraine National Health Accounts 2003-2004

Functions Functions (HC) – types of provided goods and services and performed activities that are accounted for in the framework of health accounts. NHA Code* HC.1 HC.1.1 HC 1.1.1 HC 1.1.1.1 HC 1.1.1.2 HC 1.1.1.2.1 HC 1.1.1.2.1 HC 1.1.2 HC 1.1.2.1 HC 1.1.2.2 HC 1.1.6 HC 1.1.9 HC.1.2 HC.1.3 HC.1.3.1 HC.1.3.2

Code description (international category)* Services of curative care Inpatient curative care Obstetrics & Gynecology Obstetrics Gynecology Abortion Other Gynecology Oncology Gynecology Oncology Other Oncology Sterilization Other Inpatient curative care Day cases of curative care Outpatient curative care Basic medical and diagnostic services Outpatient dental care

HC.1.3.3

All other specialized medical services

HC.1.3.3.1

TB Services

HC.1.3.3.2 HC.1.3.3.3

STI Management OI Treatment Monitoring

HC.1.3.3.4 HC.1.3.3.5

ARV Treatment Voluntary Counseling & Testing (VCT)

HC.1.3.3.6 HC.1.3.3.7

Post Exposure Prophylaxis (PEP) Psychosocial support

HC.1.3.3.8

OB & Gyn OP care

HC.1.3.3.9 HC.1.3.3.99

Replacement therapy All other

HC.1.3.4

All other outpatient curative care Services of curative home care Services of rehabilitative care Sanatorium services

HC.1.4 HC.2 HC.2.1

Technical Notes

and

Code description (literal translation) Услуги по лечению Стационарное лечение Акушерство и гинекология Акушерство Гинекология Аборты Другая гинекология Онкология Гинекологическая онкология Другая онкология Стерилизация мужчин и женщин Другое стационарное лечение Лечение в дневном стационаре Амбулаторное лечение Основные медицинские и диагностические услуги Амбулаторное стоматологическое лечение Все прочие специализированные медицинские услуги Услуги, связанные с туберкулезом Менеджмент БППП Лечение и мониторинг оппортунистических инфекций АРВ лечение Добровольное консультирование и тестирование (ДКТ) Пост-контактная профилактика Психосоциальная поддержка Амбулаторные акушерскогинекологические услуги Заместительная терапия Другие специализированные медицинские услуги Все прочее амбулаторное лечение Услуги лечения на дому

Code Description (Ukrainian adaptation) Услуги по лечению Стационарное лечение Акушерство и гинекология Акушерство Гинекология Аборты Другая гинекология Онкология Гинекологическая онкология Другая онкология Стерилизация мужчин и женщин Другое стационарное лечение Лечение в дневном стационаре Амбулаторное лечение Основные медицинские и диагностические услуги Амбулаторное стоматологическое лечение Все прочие специализированные медицинские услуги Услуги, связанные с туберкулезом Менеджмент БППП Лечение и мониторинг оппортунистических инфекций АРВ лечение Добровольное консультирование и тестирование (ДКТ) Пост-контактная профилактика Психосоциальная поддержка Амбулаторные акушерскогинекологические услуги Заместительная терапия Другие специализированные медицинские услуги Все прочее амбулаторное лечение Услуги лечения на дому

Услуги реабилитационного лечения Санаторные услуги

NHA Code* HC.2.9 HC.3 HC.3.1

HC.3.2 HC.3.3 HC.4 HC.4.1 HC.4.2

Code description (international category)* All other services of rehabilitative care Services of long-term nursing care Inpatient long-term nursing care Day cases of long-term nursing care Long-term nursing care: home care Ancillary services to medical care Clinical laboratory Diagnostic imaging

HC.4.3

Patient transport emergency rescue

HC.4.9

All other miscellaneous ancillary services

HC.5

Medical goods dispensed to outpatients

HC.5.1

Pharmaceuticals and other medical nondurables

HC.5.1.1 HC.5.1.1.1 HC.5.1.1.2

Prescribed medicines ARV Drugs OI Drugs

HC.5.1.1.3 HC.5.1.1.9

Oral contraceptives Other prescribed medicines

HC.5.1.2

Over-the-counter medicines

HC.5.1.2.1 HC.5.1.2.9

Spermicides and prenatal vitamins Other OTC medicines

HC 5.1.3

Other medical nondurables

HC.5.1.3.1 HC.5.1.3.9

Condoms Other medical nondurables

HC.5.2

Therapeutic appliances and other medical durables

HC.6

Prevention and public health services Maternal and child health; family planning and counselling PMTCT

HC.6.1

HC.6.1.1

and

Code description (literal translation) Все другие услуги реабилитационного лечения Услуги долгосрочного медсестринского ухода Стационарный долгосрочный сестринский уход Долгосрочный сестринский уход в дневном стационаре Долгосрочный сестринский уход на дому Вспомогательные услуги для медицинского лечения Клиническая лаборатория Радиологическая диагностика Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях Все прочие виды дополнительных услуг для медицинского лечения Предоставление медицинских товаров амбулаторным пациентам Фармацевтические и прочие медицинские товары недлительного пользования Рецептурные медикаменты Препараты АРВ Препараты ОИ (оппорт. инф.) Оральные контрацептивы Другие рецептурные медикаменты Нерецептурные медикаменты Спермициды и пренатальные витамины Другие нерецептурные медикаменты Прочие медицинские товары недлительного пользования Презервативы Другие прочие медицинские товары недлительного пользования Терапевтические приборы и прочие медицинские товары длительного пользования Профилактические услуги и услуги по охране здоровья Здоровье матери и ребенка; планирование семьи и семейные консультации Профилактика вертикальной трансмиссии от матери к ребенку

Code Description (Ukrainian adaptation) Все другие услуги реабилитационного лечения Услуги долгосрочного медсестринского ухода Стационарный долгосрочный сестринский уход Долгосрочный сестринский уход в дневном стационаре Долгосрочный сестринский уход на дому Вспомогательные услуги для медицинского лечения Клиническая лаборатория Радиологическая диагностика Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях Все прочие виды дополнительных услуг для медицинского лечения Предоставление медицинских товаров амбулаторным пациентам Фармацевтические и прочие медицинские товары недлительного пользования Рецептурные медикаменты Препараты АРВ Препараты ОИ (оппорт. инф.) Оральные контрацептивы Другие рецептурные медикаменты Нерецептурные медикаменты Спермициды и пренатальные витамины Другие нерецептурные медикаменты Прочие медицинские товары недлительного пользования Презервативы Другие прочие медицинские товары недлительного пользования Терапевтические приборы и прочие медицинские товары длительного пользования Профилактические услуги и услуги по охране здоровья Здоровье матери и ребенка; планирование семьи и семейные консультации Профилактика вертикальной трансмиссии от матери к ребенку

Ukraine National Health Accounts 2003-2004

HC.6.1.9

Code description (international category)* Other maternal and child health; family planning and counselling

HC.6.2

School health services

HC.6.3

Prevention of communicable diseases Blood Safety Info. Educ. Communic. Prog. (IEC) STI Prevention Program

NHA Code*

HC.6.3.1 HC.6.3.2 HC.6.3.3 HC.6.3.4 HC.6.3.5

Needle Exchange Program Condom distribution programs

HC.6.3.6

Prevention programs for specific groups

HC.6.3.9

Other prevention communicable diseases

HC.6.4

Prevention of noncommunicable diseases

HC.6.5

Occupational health care

HC.6.9

All other miscellaneous public health services Health administration and health insurance

HC.7

HC.7.1

General government administration of health

HC.7.1.1

General government administration of health (except social security)

HC.7.1.2

Administration, operation and support of social security funds Health administration and health insurance: private

HC.7.2

HC.n.s.k

HC expenditure specified by kind

HC.R.1–5

Health-related functions

HC.R.1

Capital formation for health care provider institutions

HC.R.2

Education and training of health personnel

Technical Notes

not

Code description (literal translation) Другие услуги здоровья матери и ребенка; планирование семьи и семейные консультации Медицинские услуги в школах Профилактика инфекционных заболеваний Безопасность крови Информационно-образоват. кампании Программа профилактики БППП (IEC) Программа обмена шприцев Программа распространения презервативов Программы по профилактике для специфических групп Другие услуги по профилактике инфекционных болезней Профилактика неинфекционных заболеваний Охрана здоровья на производстве Все прочие различные услуги по охране здоровья Управление здравоохранением и медицинское страхование Общее государственное управление здравоохранением Общее государственное управление здравоохранением (за исключением социального обеспечения) Управление, проведение и поддержка фондов социального обеспечения Управление здравоохранением и медицинское страхование: частное Расходы здравоохранения, не определенные по типу услуг

Code Description (Ukrainian adaptation) Другие услуги здоровья матери и ребенка; планирование семьи и семейные консультации Медицинские услуги в школах Профилактика инфекционных заболеваний Безопасность крови Информационно-образоват. кампании Программа профилактики БППП (IEC) Программа обмена шприцев Программа распространения презервативов Программы по профилактике для специфических групп Другие услуги по профилактике инфекционных болезней Профилактика неинфекционных заболеваний Охрана здоровья на производстве Все прочие различные услуги по охране здоровья Управление здравоохранением и медицинское страхование Общее государственное управление здравоохранением Общее государственное управление здравоохранением (за исключением социального обеспечения) Управление, проведение и поддержка фондов социального обеспечения Управление здравоохранением и медицинское страхование: частное Расходы здравоохранения, не определенные по типу услуг

Деятельность, связанная со здравоохранением Привлечение капитала для учреждений, предоставляющих медицинские услуги Образование и обучение медицинского персонала

NHA Code* HC.R.3 HC.R.4

Code description (international category)* Research and development in health Food, hygiene and drinking-water control

HC.R.5 HC.R.nsk

Environmental health HC.R expenditure specified by kind

AD. AD.1

Addendum Items HIV/AIDS Mitigation

AD.1.1

Social support services

AD.1.1.1 AD.1.1.2 AD.1.1.3

Support to widows In-kind benefits to PLWHA Psychosocial support to families Non-health services to orphans and vulnerable children School fees (AIDS orphans) Psychosocial support to orphans and vulnerable children Grants to families taking care of orphans & vulnerable children Policy advocacy Policy advocacy (Includes support to national strategic plan for HIV/AIDS (lobbying))

AD.1.2

AD.1.2.1 AD.1.2.2

AD.1.2.3

AD.2 AD.2.1

not

AD.2.2

Policy advocacy for RH

AD.3

Non-health IEC (Includes social stigma reduction campaigns)

AD.3.1

Non-health IEC in HIV

AD.3.2

Non-health IEC in RH

AD.4

Empowerment organization (Includes services) Empowerment organization in HIV Empowerment organization in RH

AD.4.1 AD.4.2

and legal and and

Code description (literal translation) Исследования и разработки в здравоохранении Контроль за продуктами питания, правилами гигиены и питьевой водой Экологическое здоровье Расходы HC.R, не определенные по типу

Code Description (Ukrainian adaptation) Исследования и разработки в здравоохранении Контроль за продуктами питания, правилами гигиены и питьевой водой Экологическое здоровье Расходы HC.R, не определенные по типу

Дополнительные статьи Уменьшение последствий ВИЧ/СПИД Социальные услуги поддержки Поддержка вдовам Натуральная помощь ЛЖВС Психо-социологическая поддержка семьям Немедицинское обслуживание сирот и уязвимых детей Плата за обучение в школе (сироты СПИДа) Психо-социологическая поддержка сиротам и уязвимым детям Гранты семьям, заботящимся о сиротах и уязвимых детях Политическая адвокация Политическая адвокация (Включает поддержку национальному стратегическому плану по ВИЧ/СПИД (лоббирование)) Политическая адвокация для РЗ Не связанные со здравоохранением просветительные кампании (Включает кампании по уменьшению социальной стигмы) Не связанные со здравоохранением просветительные кампании по ВИЧ Не связанные со здравоохранением просветительные кампании в РЗ Усиление и организация (Включает юридические услуги) Усиление и организация по ВИЧ Усиление и организация в РЗ

Ukraine National Health Accounts 2003-2004

NHA Code* AD.5

AD.5.1

AD.5.2

Code description (international category)* Monitoring and evaluation and operations research / Оценка и мониторинг и операционные исследования HIV specific surveillance activities (including second generation surveillance activities)

RH specific activities

surveillance

Code description (literal translation)

Code Description (Ukrainian adaptation)

деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) деятельность по эпиднадзору, специфическая для РЗ

* In italic font are categories that are added and are extension of standard international categories.

Technical Notes

Comparison of NHA and budget classifications Introductory provisions Existing Ukrainian budget classifications (functional and economic) are described below. They are compared with NHA classifications. Such comparison underlines the approach, which provides use of existing informational flows that are very important in NHA institutionalization process for the routine monitoring of financial health system well-being. Also recommendations on budget program classification use are given. It is done for more detailed allocation of central national budget expenditures during population of the NHA tables. Proposed approach underlines long-term outlook of NHA implementation, but not a one-time analysis. Estimation and use of existing country informational flows with the following recommendationsâ&#x20AC;&#x2122; development on their modification for NHA needs compliance will allow conducting routine NHA analysis for continuous health financial flows monitoring. It will also assist in health policy development at the Health Policy Unit on strategic planning and it will help in forming health policy. Comparison tables are made on the following principle: the first column contains a code of one or another budget classification; the second column has a description of corresponding code, the third one contains corresponding NHA classification category, the fifth one is a description of NHA category, and the final column includes comments or remarks for further discussion on possible budget classifications modification or peculiarities on their use in NHA.

Ukraine National Health Accounts 2003-2004

Functional budget classification and NHA Providers Budget Functional Code / Функциональный бюджетный код 0700

0710

NHA HP Code / Код НСЗ Провайдеров

Code Description / Описание кода Health care Здравоохранение Medical goods equipment Медицинская продукция оборудования

Comment / Комментарий

/ and / HP.4 и

HP.4.1

HP.4.2

Technical Notes

NHA Description / Описание кода НСЗ

Retail sale and other providers of medical goods / Розничная Existing budget code 0710 / продажа и прочие организации, Существующий бюджетный предоставляющие медицинские функциональный код 0710 товары Recommended budget code 0711 in accordance to Government Finance Statistics (GFS) IMF/ Dispensing chemists / Розничная Рекомендованный бюджетный продажа фармацевтической функциональный код 0711 в продукции соответствии с Государственной Финансовой Статистикой (ГФС) МВФ Recommended budget code 0713 in Retail sale and other suppliers of accordance to Government Finance (GFS) IMF / optical glasses and other vision Statistics бюджетный products / Розничная продажа и Рекомендованный прочие поставщики оптических функциональный код 0713 в очков и различной продукции для соответствии с Государственной органов зрения Финансовой Статистикой (ГФС) МВФ

Budget Functional Code / Функциональный бюджетный код

Code Description / Описание кода

NHA HP Code / Код НСЗ Провайдеров

NHA Description / Описание кода НСЗ

HP.4.3

Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

HP.4.4

Retail sale and other suppliers of medical appliances (other than optical glasses and hearing aids) / Розничная продажа и прочие поставщики медицинских приборов (кроме оптических очков и слуховых приборов)

HP.4.9

All other miscellaneous sale and other suppliers of pharmaceuticals and medical goods / Продажа прочей продукции и прочие поставщики фармацевтических или медицинских товаров

Comment / Комментарий Recommended budget code 0713 in accordance to Government Finance Statistics (GFS) IMF / Рекомендованный бюджетный функциональный код 0713 в соответствии с Государственной Финансовой Статистикой (ГФС) МВФ Recommended budget code 0712 in accordance to Government Finance Statistics (GFS) IMF / Рекомендованный бюджетный функциональный код 0712 в соответствии с Государственной Финансовой Статистикой (ГФС) МВФ Recommended budget code 0712 in accordance to Government Finance Statistics (GFS) IMF / Рекомендованный бюджетный функциональный код 0712 в соответствии с Государственной Финансовой Статистикой (ГФС) МВФ

Ukraine National Health Accounts 2003-2004

Budget Functional Code / Функциональный бюджетный код

0720

0721

Code Description / Описание кода

NHA HP Code / Код НСЗ Провайдеров

Policlinics and ambulatories, ambulance and emergency / HP.3 Поликлиники и амбулатории, быстрая и неотложная помощь

HP.3.1.2

Children's Policlinics / Детские поликлиники

HP.3.1.3

Women consultation

HP.3.1.9

Technical Notes

Specialized policlinics / HP.3.4.1 Специализированные

Взрослые

Adults Policlinics поликлиники

General Policlinics and HP.3.1.4 ambulatories / Поликлиники общего HP.3.1.5 профиля и амбулатории

Comment / Комментарий

Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги

HP.3.1.1

HP.3.1.6

0722

NHA Description / Описание кода НСЗ

Mixed polyclinics/Смешанные поликлиники Village doctor posts / Сельские врачебные амбулатории This category under the budget functions is coded as 0725 / Данная Feldsher-midwife posts / категория в бюджетном Фельдшерско-Акушерские пункты функциональном классификаторе закодирована как 0725 All other not described in the above groups / Все остальное не включенное выше Family planning centres / Центры планирования семьи

Budget Functional Code / Функциональный бюджетный код

NHA HP Code / Код НСЗ Провайдеров

Code Description / Описание кода поликлиники

HP.3.4.2

HP.3.4.3

HP.3.4.4

HP.3.4.5

HP.3.4.9

0723

Dentist policlinics Стоматологические поликлиники

/ HP.3.2

NHA Description / Описание кода НСЗ

Comment / Комментарий

Outpatient mental health and substance abuse centres / Амбулаторные учреждения для лечения психиатрических заболеваний и алкогольной и наркотической зависимости Free-standing ambulatory surgery This category not required in Ukraine / centres / Отдельные центры Эта категория не нужна для НСЗ в амбулаторной хирургии Украине This category not required in Ukraine / Dialysis care centres / Центры Эта категория, возможно, не нужна диализного лечения для НСЗ в Украине All other outpatient multi-specialty and cooperative service centres / Все прочие амбулаторные многопрофильные центры по предоставлению комбинированных медицинских услуг All other outpatient community and other integrated care centres / Все прочие амбулаторные и интегрированные медицинские центры по уходу Offices of dentists / Стоматологические кабинеты (отделения)

Ukraine National Health Accounts 2003-2004

Budget Functional Code / Функциональный бюджетный код 0724

0725

0730

0731

Code Description / Описание кода

NHA HP Code / Код НСЗ Провайдеров

Comment / Комментарий

Ambulance and emergency / Станции HP.3.9.1 быстрой и неотложной помощи

Ambulance помощь

Feldsher-Midwife posts / Фельдшерсько- HP.3.1.6 акушерські пункты

The category coded under General ambulatory services 0721 as a subcategory according to NHA / Эта Feldsher-midwife posts / категория закодирована под Фельдшерско-Акушерские пункты Общими амбулаторными услугами 0721 как суб-категория в соответствии с НСЗ

Hospitals and sanatoriums / Больницы и HP.1 санаторно-курортні учреждения General hospitals / HP.1.1 Больницы общего профиля HP.1.1.1 HP.1.1.1.1

HP.1.1.1.2

Technical Notes

NHA Description / Описание кода НСЗ

services

Скорая

Hospitals / Больницы General hospitals / Больницы общего профиля Oblast hospitals / Областные больницы Oblast general hospitals / Областные больницы общего профиля Children oblast general hospitals / Детские областные больницы общего профиля

Budget Functional Code / Функциональный бюджетный код

Code Description / Описание кода

NHA HP Code / Код НСЗ Провайдеров HP.1.1.1.9 HP.1.1.2 HP.1.1.2.1 HP.1.1.2.2

HP.1.1.2.9 HP.1.1.3 HP.1.1.4 HP.1.1.5 HP.1.1.6 HP.1.1.9 0732

Specialized hospitals and other specialized HP.1.2.1 facilities / Специализированные HP.1.2.2 больницы и другие специализированные HP.1.3.1 учреждения

NHA Description / Описание кода НСЗ

Comment / Комментарий

Other oblast general hospitals / Другие областные больницы общего профиля City Hospitals / Городские больницы City general hospitals / Городские больницы общего профиля Children city general hospitals / Детские городские больницы общего профиля Other city general hospitals / Другие городские больницы общего профиля Central Rayon Hospitals / Центральные районные больницы Rayon Hospitals / Районные больницы Dilnichni Hospitals / Участковые больницы Maternity houses / Родильные дома Other hospitals / Другие больницы Mental health hospitals / Психиатрические и психоневрологические больницы Substance abuse hospitals / Наркологические больницы Oncology hospitals / Онкологические больницы Ukraine National Health Accounts 2003-2004

Budget Functional Code / Функциональный бюджетный код

NHA HP Code / Код НСЗ Провайдеров

Code Description / Описание кода

HP.1.3.2

HP.1.3.3

HP.1.3.9 0733

Technical Notes

Maternity houses Родовые дома

HP.1.1.6

NHA Description / Описание кода НСЗ

Comment / Комментарий

AIDS clinics / Клиники ВИЧ/СПИД Expenses on Prison Hospitals in Ukraine are coded as 0340 and counted along with penitentiary system expenditures. Such approach does not allow separating TB spending from prison expenditure. Suggestion is to code this spending under healthcare 07 / Расходы на тюремные больницы в Tuberculosis hospitals / Украине закодированы как 0340 и Туберкулезные больницы учитываются вместе с расходами на пенитенциарную систему. Такой подход не дает возможность выделить расходы на ТБ среди общих затрат пенитенциарной системы. Предлагается изменить этот код на код расходов на здравоохранение 07. Other specialty hospitals / Другие специализированные центры Maternity houses / Родильные дома

Budget Functional Code / Функциональный бюджетный код

0734

0740

0750

NHA HP Code / Код НСЗ Провайдеров

Code Description / Описание кода

Sanatoriums Санаторно-курортні учреждения

HP.2.9.9

Public Health Services / Санитарнопрофилактическое и HP.5 противоэпидемическое мероприятия и учреждения R&D in Health / Исследование и HP.8 разработки в сфере здравоохранения

Comment / Комментарий 1. It is better to move these providers as a subcategory of 0760 in order to make Ukraine data comparable / Лучше переместить этих провайдеров в суб-категорию под 0760, чтобы украинские данные были сопоставимы. 2. Current NHA classification category is used temporarily to keep HP.nsk spending at minimum / Данная классификационная категория НСЗ используется временно, для того, чтобы свести к минимуму расходы по категории HP.nsk.

HP.8.1

NHA Description / Описание кода НСЗ

Sanatoriums / Санатории

Provision and administration of public health programmes / Обеспечение и управление программами общественного здоровья Institutions providing health-related services / Учреждения, предоставляющие услуги, связанные со здравоохранением Research institutions / Исследовательские институты

Ukraine National Health Accounts 2003-2004

Budget Functional Code / Функциональный бюджетный код

Code Description / Описание кода

NHA HP Code / Код НСЗ Провайдеров

HP.8.2

HP.8.3

0760

Technical Notes

NHA Description / Описание кода НСЗ

Comment / Комментарий

Under Ukrainian budget classification all medical educational expenditures are coded as 0950, 0942, 0990 and counted under educational system. This issue needs to be visited and considered, how Ukraine would like to account for this / Согласно Education and training institutions / украинской бюджетной Учреждения образования и классификации эти расходы на обучения медицинское образование учитываются как коды 0950, 0942, 0990 и учитываются в образовательной системе. Эту ситуацию необходим рассмотреть и обсудит, как Украина желает учитывать данные расходы. Other institutions providing healthrelated services / Прочие учреждения, предоставляющие услуги, связанные со здравоохранением

Other activities in health care / Другая деятельность в сфере здравоохранения

Budget Functional Code / Функциональный бюджетный код

Code Description / Описание кода

Дома

0761

Orphanages ребребенка

0762

Blood Banks / Станции HP.3.9.2 переливания крови

0763

Other agencies and services in Health Care / Другие учреждения и HP.6 мероприятия в сфере здравоохранения

NHA HP Code / Код НСЗ Провайдеров

???????

NHA Description / Описание кода НСЗ

Comment / Комментарий Classified under health care in Ukraine needs re-classification under different budget code / Классифицированы под здравоохранением в Украине, необходимо переклассифицировать под другой бюджетный код.

???????

Blood and organ banks / Банки крови и органов General health administration and insurance / Общее управление здравоохранением и медицинское страхование (частично)

HP.6.1

Government administration of health / Государственное управление здравоохранением

HP.6.2

Social security funds / Фонды социального страхования

No separation between general administration and social security administration / Нет распределения между общей администрацией и администрированием социального страхования. Also all expenditures for central national programs e.g. HIV/AIDS, Oncology, Diabetes etc are coded under this code. / Также все центральные национальные программы, например, ВИЧ/СПИД, онкология, диабет, и т.д. закодированы под этим кодом.

Ukraine National Health Accounts 2003-2004

Budget Functional Code / Функциональный бюджетный код

Code Description / Описание кода

NHA HP Code / Код НСЗ Провайдеров

HP.7

Technical Notes

NHA Description / Описание кода НСЗ

Comment / Комментарий

Includes treatment of Ukrainians All other industries (rest of the abroad in the budget classification / economy) / Все прочие сектора Включает лечение украинцев экономики заграницей согласно бюджетной классификации.

Functional budget classification and NHA Functions Budget Functional Code / Функциональный бюджетный код 0700

0710

NHA HC Code / Код НСЗ Функций

Code Description / Описание кода Health care Здравоохранение Medical goods equipment Медицинская продукция оборудования

Comment / Комментарий

and / HC.5 и

HC.5.1

HC.5.1.1

NHA Description / Описание кода НСЗ

In Ukraine medical goods dispensed not only to OP, but IP patients as well due to Medical goods dispensed to under financing of hospitals / В Украине outpatients / Предоставление медицинские товары предоставляются медицинских товаров не только амбулаторным, но и амбулаторным пациентам стационарным пациентам в виде недостаточного бюджетного финансирования больниц. Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1.1 ARV Drugs / Препараты АРВ HC.5.1.1.2 OI Drugs / Препараты ОИ (оппорт. инф.) Prescribed medicines / Рецептурные HC.5.1.1.3 Oral contraceptives / медикаменты Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты

Ukraine National Health Accounts 2003-2004

Budget Functional Code / Функциональный бюджетный код

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций

HC.5.1.2

HC 5.1.3

HC.5.2

0720

0721

Technical Notes

NHA Description / Описание кода НСЗ

Comment / Комментарий

HC.5.1.2.1 Spermicides and prenatal vitamins / Спермициды и пренатальные Over-the-counter medicines / витамины Нерецептурные медикаменты HC.5.1.2.9 Other OTC medicines / Другие нерецептурные медикаменты HC.5.1.3.1 Condoms / Презервативы Other medical nondurables / Прочие HC.5.1.3.9 Other medical nondurables / медицинские товары недлительного Другие прочие медицинские товары пользования недлительного пользования Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования

Policlinics and ambulatories, ambulance and emergency / Поликлиники и амбулатории, быстрая и неотложная помощь

General Policlinics and ambulatories / Поликлиники общего профиля и амбулатории

Basic medical and diagnostic services HC.1.3.1 / Основные медицинские и диагностические услуги HC.1.4 part / Services of curative home care / часть Услуги лечения на доме HC.4.1 part / Clinical laboratory / Клиническая часть лаборатория HC.4.2 part / Diagnostic imaging / часть Радиологическая диагностика

Budget Functional Code / Функциональный бюджетный код 0722

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций

Specialized policlinics / Специализированные HC.1.3.3.1 поликлиники

NHA Description / Описание кода НСЗ

Comment / Комментарий

TB Services / Услуги, связанные с туберкулезом

STI Management / Менеджмент БППП OI Treatment and Monitoring / HC.1.3.3.3 Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение Voluntary Counseling & Testing HC.1.3.3.5 (VCT) / Добровольное консультирование и тестирование (ДКТ) Post Exposure Prophylaxis (PEP) / HC.1.3.3.6 Пост-контактная профилактика Antenatal and postnatal care / HC.1.3.3.8 Антенатальное и постнатальное лечение All other / Другие HC.1.3.3.99 специализированные медицинские услуги HC.1.4 part / Services of curative home care / часть Услуги лечения на доме HC.4.1 part / Clinical laboratory / Клиническая часть лаборатория HC.4.2 part / Diagnostic imaging / часть Радиологическая диагностика HC.1.3.3.2

Ukraine National Health Accounts 2003-2004

Budget Functional Code / Функциональный бюджетный код

0723

0724

0725

0730

0731

Technical Notes

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций

NHA Description / Описание кода НСЗ

Comment / Комментарий

Maternal and child health; family planning and counselling / Здоровье HC.6.1 матери и ребенка; планирование семьи и семейные консультации PMTCT / Профилактика вертикальной трансмиссии вот HC.6.1.1 матери к ребенку Outpatient dental care / Амбулаторное стоматологическое Dentist policlinics / HC.1.3.2 лечение Стоматологические поликлиники HC.4.2 part / Diagnostic imaging / часть Радиологическая диагностика Patient transport and emergency Ambulance and rescue / Транспортировка пациентов emergency / Станции HC.4.3 и спасение жизни в чрезвычайных быстрой и ситуациях неотложной помощи Feldsher-Midwife All other outpatient curative care / Все posts / Фельдшерсько- HC.1.3.4 прочее амбулаторное лечение акушерські пункты Hospitals and sanatoriums / Больницы и санаторно-курортні учреждения General hospitals / Other Inpatient curative care / Другое HC 1.1.9 Больницы общего стационарное лечение профиля HC.1.2 part / Day cases of curative care / Лечение в часть дневном стационаре

Budget Functional Code / Функциональный бюджетный код

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций HC.4.1 part / часть HC.4.2 part / часть HC 1.1.1.1 part / часть HC 1.1.1.2

0732

0733

HC 1.1.1.2.1 Specialized hospitals and other specialized facilities / HC 1.1.2 Специализированные больницы и другие HC 1.1.6 специализированные учреждения HC.1.2 part / часть HC.4.1 part / часть HC.4.2 part / часть HC 1.1.1.1 part / часть Maternity houses / HC.1.2 part / Родовые дома часть HC.4.1 part / часть

NHA Description / Описание кода НСЗ

Comment / Комментарий

Clinical laboratory / Клиническая лаборатория Diagnostic imaging / Радиологическая диагностика Obstetrics / Акушерство Gynecology / Гинекология Abortion / Аборты HC 1.1.2.1 Gynecology Oncology / Гинекологическая онкология HC 1.1.2.2 Other Oncology / Другая онкология

Oncology / Онкология Sterilization / Стерилизация мужчин и женщин Day cases of curative care / Лечение в дневном стационаре Clinical laboratory / Клиническая лаборатория Diagnostic imaging / Радиологическая диагностика Obstetrics / Акушерство Day cases of curative care / Лечение в дневном стационаре Clinical laboratory / Клиническая лаборатория

Ukraine National Health Accounts 2003-2004

Budget Functional Code / Функциональный бюджетный код 0734

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций

Sanatoriums / Санаторно-курортні HC.2.1 учреждения HC.R.4

0740

Public Health Services / СанитарноHC.6.3.9 профилактическое и противоэпидемическо е мероприятия и учреждения HC.6.4

HC.6.9

0750

0760

0761

Technical Notes

R&D in Health / Исследование и HC.R.3 разработки в сфере здравоохранения Other activities in health care / Другая деятельность в сфере здравоохранения Orphanages ребребенка

Дома

NHA Description / Описание кода НСЗ

Comment / Комментарий

Sanatorium services / Санаторные услуги Food, hygiene and drinking-water control / Контроль за продуктами питания, правилами гигиены и питьевой водой Other prevention of communicable diseases / Другие услуги по профилактике инфекционных болезней Prevention of noncommunicable diseases / Профилактика неинфекционных заболеваний All other miscellaneous public health services / Все прочие различные услуги по охране здоровья Research and development in health / Исследования и разработки в здравоохранении

Should be counted outside of health care / Необходим учитывать вне здравоохранения

Budget Functional Code / Функциональный бюджетный код 0762

0763

1012 part / часть

1020 part / часть

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций

Blood Banks / Станции HC.6.3.1 переливания крови

NHA Description / Описание кода НСЗ

Comment / Комментарий

Blood Safety / Безопасность крови

All expenditures for central national programs e.g. HIV/AIDS, Oncology, Other agencies and General government administration of Diabetes etc are coded under this code. / services in Health Care / HC.7.1 part / центральные национальные health / Общее государственное Все Другие учреждения и часть программы, например, ВИЧ/СПИД, мероприятия в сфере управление здравоохранением онкология, диабет, и т.д. закодированы здравоохранения под этим кодом. Only proportion of spending related to Residential care facilities direct health care costs should be attributed for young handicapped / HP.2.1 part / Nursing care facilities / Учреждения to this category in the NHA / Только Дома-интернаты для часть сестринского ухода часть расходов, связанная с прямыми малолетних инвалидов затратами на здравоохранение, должна быть отнесена к этой категории в НСЗ Residential care facilities for elderly and Only proportion of spending related to handicapped of the social direct health care costs should be attributed security system / ДомаCommunity care facilities for the to this category in the NHA / Только HP.2.3 интернаты elderly / Дома престарелых часть расходов, связанная с прямыми (пансионаты) для затратами на здравоохранение, должна пожилых людей и быть отнесена к этой категории в НСЗ инвалидов системы социальной защиты

Ukraine National Health Accounts 2003-2004

Budget Functional Code / Функциональный бюджетный код

1020 part / часть

0825 part / часть

0826 part / часть

0942 part / часть

Technical Notes

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций

Other residential care facilities for the elderly and handicapped / Другие дома интернаты для пожилых людей и инвалидов Medical library / Функционирование HC.R.2 Государственной научной медицинской библиотеки Medical museum and medical history / Сохранение и популяризация истории медицины, музей медицины Medical education and training / Подготовка и повышения квалификации медицинских и фармацевтических, научных и научнопедагогических кадров высшими учебными заведениями ІІІ и ІV уровней аккредитации

NHA Description / Описание кода НСЗ

Comment / Комментарий

It should be decided if medical library and Education and training of health medical history, museums should be personnel / Образование и обучение included or excluded from NHA / медицинского персонала Необходим обсудит и принять решение во включении или исключении медицинских библиотек и популяризации истории медицины и медицинских музеев из НСЗ

Budget Functional Code / Функциональный бюджетный код

0950 part / часть

0990 part / часть

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций

NHA Description / Описание кода НСЗ

Comment / Комментарий

Medical education and training / Повышение квалификации медицинских и фармацевтических кадров и подготовка научных и научнопедагогических кадров в сфере здравоохранения Medical education and training / Методическое обеспечение деятельности медицинских (фармацевтических) высших учебных заведений и заведений последипломного образования

Ukraine National Health Accounts 2003-2004

Economics budget classification and NHA Functions Budget Economics Code / Экономический бюджетный код 1000 1100 1110

1111 1112 1113 1120 1130

1131

1132

Technical Notes

Code Description / Описание кода Current expenses / Текущие расходы Expenses on goods and services / Расходы на товары и услуги Payment for work of workers of budgetary establishments / Оплата труда работников бюджетных учреждений Salary / Заработная плата Monetary support of military personnel / Денежное удержание военнослужащих Code excluded / Код исключен Salary add-ons / Начисление на заработную плату Procurement of goods and materials, payment for services other expenses / Приобретение предметов снабжения и материалов, оплата услуг и другие расходы Goods, materials, equipment and inventory / Предметы, материалы, оборудование и инвентарь Drugs and bandages / Медикаменты и перевязочные материалы

NHA HC Code / Код НСЗ Функций

HC.5.1

NHA Descriptor / Описание кода НСЗ

Comment / Комментарий

Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования

Budget Economics Code / Экономический бюджетный код 1133 1134 1135

1136 1137

1138 1139 1140 1150

1160 1161 1162 1163 44

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций

NHA Descriptor / Описание кода НСЗ

Comment / Комментарий

Food / Продукты питания Soft inventory and special clothing / Мягкий инвентарь и обмундирования Transport services expenses and maintenance of transport (vehicles) / Оплата транспортных услуг и удержание транспортных средств Rent / Аренда Current maintenance of equipment, inventory and buildings; technical service of equipment / Текущий ремонт оборудования, инвентаря и зданий; техническое обслуживание оборудования Communication services / Услуги связи Payment for other services and other expenses / Оплата других услуг и другие расходы Business trip expenses / Расходы на командировку Materials, inventory, building, capital renovation and special purpose activities that have countrywide government importance / Материалы, инвентарь, строительство, капитальный ремонт и мероприятия специального назначения, которые имеют общегосударственное значение Payment for utilities and energy / Оплата коммунальных услуг и энергоносителей Payment for heating / Оплата теплоснабжения Payment for water and water supply / Оплата водоснабжения и водоотвод Payment for electricity / Оплата электроэнергии Ukraine National Health Accounts 2003-2004

Budget Economics Code / Экономический бюджетный код 1164 1165 1166 1170

1171

1172

1200

1300

Technical Notes

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций

NHA Descriptor / Описание кода НСЗ

Comment / Комментарий

Payment for natural gas / Оплата природного газа Payment for other utilities / Оплата других коммунальных услуг Payment for other energy sources / Оплата других энергоносителей Research and development, expenses of state (regional) importance / Исследование и разработки, расходы государственного (регионального) значения Research and development, separate development activities on realization of state (regional) programs / Исследование и разработки, отдельные мероприятия развития по реализации государственных (региональных) программ Separate activities on realization of state (regional) programs, that are not included as development activities / Отдельные мероприятия по реализации государственных (региональных) программ, не отнесенные мероприятий развития Payment of percentage (income) in accordance to borrowing agreements / Выплата процентов (дохода) за обязательствами Subsidies and current transfers / Субсидии и текущие трансферты

Budget Economics Code / Экономический бюджетный код 2000

Code Description / Описание кода

NHA HC Code / Код НСЗ Функций

Capital expenses / Капитальные расходы HC.R.1

3000

Undivided расходы

expenses

NHA Descriptor / Описание кода НСЗ

Comment / Комментарий

Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги

Нераспределенные

Ukraine National Health Accounts 2003-2004

Use of Program Budget Classification for more detailed allocation of expenditures of the central government budget Program budget classification code / Код программной бюджетной классификации 0301220

2101080

Corresponding functional budget classification code / Соответствующий Program description / Описание код программы функциональной бюджетной классификации 0763 Centralized purchase of very expensive equipment and medicines for medical and sanitary institutions of the Public Administrative Department 0260 Medical treatment and medical services for the Ukrainian armed forces staff

2101090

0260

Financial support of health resorts and maintenance of rehabilitation centers which belong to the Ministry of Defense.

2301280

0763

Centralized purchase of heart pacemakers, implants and single medical goods.

Technical Notes

Comments / Комментарии

It is expedient to divide capital outlays and medicines costs on different programs.

1. Functional code 0260 should be replaced to the corresponding public health code (07….) 2. It is expedient to identify separate programs for in-patient and out-patient treatment of military men with the correspondent functional codes (0731 and 0721). 1. Functional code 0260 should be replaced to the corresponding public health code (07….) 2. It is expedient to identify sanatoriums separately from rehabilitation centers. Rehabilitation centers are in the structure of NHA; sanatoriums should be replaced to the additional categories. Functional code 0763 should be replaced to the functional code 0710 in accordance with the Government Financial Statistics (GFS) of International Monetary Fund (IМF)

Program budget classification code / Код программной бюджетной классификации 2301290

2301600 2301100 2501170

2507090

3201080

Corresponding functional budget classification code / Соответствующий Program description / Описание Comments / Комментарии код программы функциональной бюджетной классификации 0763 Centralized purchase of very expensive 1. It is necessary to divide central programs on equipment equipment for health facilities purchaser (capital outlay) into medical help levels (in-patient, out-patient). 2. General code of central programs (0763) could be specified by the corresponding functional codes while program’s level division. 0763 Actions to control TB and AIDS It is necessary to divide the program into two parts to trace TB epidemics. and AIDS costs (accordingly) more precisely. 0731 In-patient medical service for water General hospitals should not be financed by the central budget transport and oil-refining industry staff. in accordance with the Budget Code. 1010 Development of new kinds of prosthetic Functional code 1010 – social support in case of disablement – devices and invalids’ service in in- should consist of dollar adjustment, in-kind aid, etc. patient departments which belong to Development of new kinds of prosthetic devices related to prosthetic factories. public health and it has to be coded like 0750. 1010 Providing invalids with prosthetic and Functional code 1010 – social support in case of disablement – orthopaedic devices, vehicles and should include dollar adjustment, in-kind aid, etc. Purchase of rehabilitation facilities. medical rehabilitation facilities and prosthetic devices is related to public health, it should be coded like 0710. 1070 Medical service benefits for people Functional code 1070 – social support in case of other social suffered from Chernobyl catastrophe. exposure – should include dollar adjustment, in-kind aid, etc. Special benefits for public health are related to public health; they have to be coded like 0700, also they could be presented in more detailed layout concerning public health.

Ukraine National Health Accounts 2003-2004

Program budget classification code / Код программной бюджетной классификации 3201110

6071060

6071600

6521050

6561080

Technical Notes

Corresponding functional budget classification code / Соответствующий Program description / Описание Comments / Комментарии код программы функциональной бюджетной классификации 1070 Recovery of people suffered from Functional code 1070 – social support in case of other social Chernobyl catastrophe. exposure – should include dollar adjustment, in-kind aid, etc. People recovery in sanatoriums concerns additional items. Today it is coded like 0734 (though it needs further revision and allocation in separate additional category beyond health care). 0340 Support of a special contingent and a TB Functional code 0340 belongs to the general penitentiary patient in the facilities of criminal- system; given program has to be coded like 0731. executive system. 0763 Actions to control TB and AIDS It is necessary to divide the program into two parts to trace TB epidemics in the facilities of criminal- and AIDS expenditures (accordingly) more precisely. executive system 0734 Medical service and recovery of For this moment the code 0734 should be replaced to the Ukrainian Security Service staff. general code of public health 0700. The optimal decision will be to provide in-patient and out-patient service, etc. For example, in the budget for 2003 the given program is divided into medical help and sanatorium recovery. 0763 Centralized purchase of very expensive 1. It is expedient to divide capital outlays and medicines costs equipment and medicines for the clinics on different programs. of scientific-research institutions which 2. Functional code 0763 should be replaced to the functional belong to the Academy of Medical code 0710 in accordance with the Government Financial Science of Ukraine. Statistics (GFS) of International Monetary Fund (IМF)

Program budget classification code / Код программной бюджетной классификации 6561120

2301390

2301380

2301370

2301010 2302010

2301340

Corresponding functional budget classification code / Соответствующий Program description / Описание Comments / Комментарии код программы функциональной бюджетной классификации 0763 Set up of modern regional rehabilitation In a number of cases rehabilitation centers are taken into medical centers for people of moderate account with sanatoriums. Even such separation of means. rehabilitation centers by code 0763 could be insufficient. It is necessary to consider them with another functional code, or allocate them in a separate program at the least. 0763 Supplying of medical arrangements It is possible to use the given program for the category NHA under the state program “Oncology” «HP.1.3.1 Oncology hospitals and dispensaries / Онкологические больницы и диспансеры» 0763 Programs and centralized actions on It is possible to use the given program for the category NHA AIDS prevention and treatment. «HP.1.3.2 AIDS clinics and centers / Клиники и центры ВИЧ/СПИД» 0763 Programs and centralized actions to It is possible to use the given program for the category NHA control TB. «HP.1.3.3 Tuberculosis hospitals and dispensaries / Туберкулезные больницы и диспансеры» 0763 Supervision and management in the It is possible to use the given program for the category NHA sphere of public health «HP.6.1 Government administration of health / 0763 Supervision and management in the Государственное управление здравоохранением» sphere of quality assurance, safety control, medicines and medical goods (devices) manufacturing control. 0763 Government control of medicines quality

Ukraine National Health Accounts 2003-2004

Program budget classification code / Код программной бюджетной классификации 2301350

2301360

2304020

0301740 2301290 2301460 2301470 2301810

Technical Notes

Corresponding functional budget classification code / Соответствующий Program description / Описание Comments / Комментарии код программы функциональной бюджетной классификации 0763 Set up and regulation of institutions’ activity. Single actions in the system of public health. 0763 Treatment of Ukrainian citizens abroad. It is possible to use the given program for the category NHA «HP.7.3 All other industries as secondary producers of health care / Все прочие отрасли промышленности как организации, предоставляющие вторичные медицинские услуги» 0763 Financial support of Ukrainian Red It is possible to use the given program for the category NHA Cross service and fees to the «HP.8.3 Other institutions providing health-related services / International Federation of Red Cross Прочие учреждения, предоставляющие услуги, связанные Society. со здравоохранением» 0763 Capital outlays on the centralized At this moment, the given programs are in the NHA category programs are not specified by specific «HP.nsk Provider not specified by kind / Провайдеры, не categories. определенные по типу». In the future, it will be expedient to classify clearly given programs by the proper functional classification codes (levels of medical help provision, types of help, est.)

Conclusion Conducting of regular National Health Accounts estimation and use of NHA classification based on international standards will promote not only better health financing estimation in the country but also conduct comparative international analysis. Implementing recommendations dealing with the modification of existing functional budget classification and more efficient use of codes concerning program budget classification of central government budget expenditures will allow informing National Health Accounts more precisely. NHA production is one of the top-priority tasks for successful informed reforming of health system financing. It will result in more efficient use of funds and the health system as a whole.

Ukraine National Health Accounts 2003-2004

Annex 2: Methodology for Estimating Health Expenditures on a Household Level for 2004 and 2003

Introduction The State Statistical Committee of Ukraine (SSC) carries out quarterly Household Budget Surveys (HBS) in order to estimate private consumption at the household level and its contribution to the national economy. Consumption structure is classified according to Classification of Individual Consumption by Purpose Adapted to the Needs of Household Budget Surveys (COICOP/HBS)4, which groups HH monthly health expenditure in two broad categories: A. Expenditure for Services and B. Expenditure for drugs and medical items HBS data is published annually in the statistical yearbooks and is used for estimating Total Health Expenditure along with public spending. Analysis of the SSC reported data and consultations with representatives from SSC and experts from academia reveal that HBS could possibly underestimate private health expenditures. The purpose of this document is to evaluate the validity of this assumption using the 2004 World Bank financed a national representative household survey, which looked into details of household level expenditures for health5. If this assumption proves correct, the SSC HBS survey data can be adjusted for 2004 and 2003 to better estimate and reflect household level health expenditure for these years.

The Survey description The World Bank 2004 survey looked at the following aspects of health spending: 1. Outpatient service utilization and cost of accessing care broken down into the following categories: a. Official payments at OP facility/doctor (NB This could include cost of services as well as supplies/medicines); b. Purchase of medicines/medical supplies and payment for lab tests (N.B. not separated but lumped together); c. Cash payments (gifts and/or informal fees) to medical provider; d. In-kind payments/gifts to medical providers; e. The place/provider for the outpatient care provision (e.g. Hospital outpatient department, or polyclinic or ambulatory, etc.) 2. Hospitalizations and cost of care for inpatient treatment that is broken down into following categories: a. Official payments at the hospital;

See details of the classificatory in the Addendum 1 or on the web http://unstats.un.org/unsd/cr/registry/regcs.asp?Cl=4&Lg=1&Co=07 5 Analytical Report on Results of the Implementation of Project “HEALTH AND EDUCATION” Module Sample Survey, “Statinformconsulting” Information and Analytic Agency, Kiev 2004

Technical Notes

b. Purchase of medicines/medical supplies and payment for lab tests (N.B. not separated but lumped together); c. Cash payments (gifts and/or informal fees) to medical provider; d. In-kind payments/gifts to medical providers; e. The provider for the inpatient care provision by the type of the hospital; 3. Self-treatment mainly representing costs of drug/medical supply purchase. Access to primary data file was not provided, thus the report and the data from the report was used for the presented estimates, which should be interpreted cautiously as some categories used by the survey were overlapping as well as the methodology of such estimates has its own implicit weaknesses.

Survey Data and Cost Estimates In total 10,238 households with 26,729 residents participated in the survey and represented all oblasts of Ukraine including cities of Kiev and Sevastopol. Thus, household level estimates and per capita estimates are based on these data (see Table 1). Table 1 Basic data for the survey and Ukraine Economic region Eastern Donetsky Prydniprovsky Prychornomorsky Podilsky Central Karpatsky Polisky Total

Population 5,718,900 7,193,500 6,495,500 7,203,700 4,263,900 5,805,400 6,161,800 4,779,700 47,622,400

Total HHs 1000 2,180 2,732 2,529 2,639 1,573 2,259 1,983 1,739 17,634

Average HH Size Surveyd HHs 2.62 2.63 2.57 2.73 2.71 2.57 3.11 2.75 2.62

1,206 1,326 1,295 1,669 1,007 1,082 1,384 1,269 10,238

Surveyed Individuals 3,039 3,352 3,194 4,374 2,621 2,670 4,129 3,350 26,729

Self-treatment The share of those who embarked on a self-treatment during the 30 day period prior to the survey was 33.2% (8,874 individuals) and on average they spent 30.7 HRV, which translates to 10.19 HRV per capita monthly spending or 26.61 HRV per household per month. These estimates are different for different economic regions of Ukraine and they allow deriving per capita and per HH monthly spending for self-treatment, which helps estimating total expenditure on a national level for 2004. An implicit assumption for these estimates is that monthly spending per household is constant from month to month and is not subject to seasonal fluctuations. Thus, the total amount spent in 2004 by all households for self-treatment is estimated at 5.917 Mln. Hrivnas. This amount has been treated as an expenditure on Medical products, appliances and equipment, because self-treatment does not entails visit to a medical provider and affiliated costs of service provision.

Ukraine National Health Accounts 2003-2004

Table 2 Cost estimates for self-treatment (drugs and medical supplies) Hrivna

Economic region

Share who self treated & bought drugs

Eastern Donetsky Prydniprovsky Prychornomorsky Podilsky Central Karpatsky Polisky Total

38.4 37.0 32.5 30.9 35.3 37.2 28.3 30.3 33.2

1,165 1,238 1,036 1,350 923 992 1,167 1,013 8,884

Average Cost in Total Monthly Hrivnas per Spending Month for Those among who fce this Surveyd expenditure 29.1 33,843 27.1 33,537 30.7 31,847 31.6 42,674 34.0 31,373 37.7 37,418 27.0 31,497 29.7 30,096 30.7 272,739

Per Capita Monthly Spending

Per HH Monthly Spending

Total Spending on Self-Treatment in 2004

11.1 10.0 10.0 9.8 12.0 14.0 7.6 9.0 10.4

28.1 25.3 24.6 25.6 31.2 34.6 22.8 23.7 28.0

764,249,407 863,668,607 777,181,654 843,366,507 612,454,883 976,304,946 564,050,127 515,286,987 5,916,563,118

Out-Patient Care and Affiliated Costs The survey offered detailed information about the patients that utilized outpatient care services and the share of those who faced payments and the average fee per economic region. These data allowed estimating per capita monthly household spending on an outpatient level, which helped to estimate national spending for 2004 (See Table 3 for details). Table 3 Total Private Financing on an OP level in 2004 Economic region Eastern Donetsky Prydniprovsky Prychornomorsky Podilsky Central Karpatsky Polisky Total

The share of population, which applied for out-patient 12.3 12.0 9.7 11.8 12.5 13.6 10.1 12.8 11.8

Share Who Paid for Services

374 402 310 516 328 363 417 429 3139

44.0 40.8 43.2 41.5 32.4 31.4 42.8 39.0 39.5

165 164 134 214 106 114 178 167 1240

Mean Total Monthly Amount Paid Spending among in Hrivnas Surveyd 48.9 62.3 72.2 63.6 56.8 147.1 57.9 45.2 66.3

8,044 10,210 9,672 13,624 6,036 16,762 10,328 7,557 82,218

Per Capita Monthly Spending 2.65 3.05 3.03 3.11 2.30 6.28 2.50 2.26 3.18

Total Spending on OP Care in 2004 181,642,941 262,931,765 236,027,087 269,246,179 117,838,831 437,353,864 184,959,766 129,392,489 1,819,392,921

For further details of methodological partitioning of private spending on OP level see Annex 3 â&#x20AC;&#x153;Methodology for Disaggregating Expenditures by Providersâ&#x20AC;?.

Hospital Care and Affiliated Costs The survey captured 1,887 cases of hospitalization among 26,729 individuals and over the course of 12 month period prior to the survey, which brings hospitalization rate to 7.1 per 100 population that is much lower then reported by the SSC 21.16. It is hard to validate which rate reflects the reality, because 12 month recall could underestimate the hospital rate and bias the findings towards lower end and implicit motivation of the provider to over-report7 could bias the findings towards upper end. However the survey allows estimating that hospital care related costs that will most probably be underestimated. Available data in the survey allows estimating total hospital costs for the given economic regions (see Table 4). The table shows that per capita hospital level spending varies significantly between economic regions. Besides, this amount can be partitioned into various parts also based on the information available in the survey.

6 7

Health Care Facilities and Morbidity in Ukraine in 2004. Statistical Bulletin SSC 2005 Kiev. (in Ukrainian) This comment was made by experts during private interviews

Technical Notes

Table 4 Total Hospital Spending in 2004 (Hrivna) Economic region

Total Hospital Spending in 2004

Per Capita Spending

Eastern Donetsky Prydniprovsky Prychornomorsky Podilsky Central Karpatsky Polisky Total

1.28 1.13 0.87 1.27 1.70 1.29 0.95 1.41 1.21

88,176,366 97,880,763 67,725,932 110,204,344 87,169,366 89,734,541 70,478,901 81,138,061 692,508,271

Table 5 shows that patients mainly pay for drugs, medical supplies and lab tests, which comprise 83% of total hospital level payments. Using SSCâ&#x20AC;&#x2122;s data for goods and services (like in the case of out-patient treatment) we partitioned payments for the drugs and lab tests into two categories and the results are presented in the Table 6. Table 5 Type of hospital payments Typae of Hospital Payments Official payments for Hospital Services Expenditure on drugs, medical supplies and lab tests on a hospital level Cash payments to providers on a hospital level In-kind payments to providers on a hospital level Total Hospital Payments

Total Amount 71,157,370 572,066,889 43,739,812 5,544,202 692,508,271

Per Cent 10% 83% 6% 1% 100%

Table 6 Structure of Hospital Payments in 2004

Type of Expenditure

Hrivna in 2004

Total Hospital Level Care

692,508,271

General hospital services Medical products and appliances Laboratory tests

120,441,383 333,899,212 238,167,676

Besides estimating total hospital expenditures and its structure, the survey also helped in partitioning hospital spending by types of hospitals in each economic region. The assumption underlying this partitioning is following that case of hospitalization by type of hospital does not vary within the given region. This separation will be helpful to use this data and populate National Health Accounts tables by different types of providers (see Table 7). Table 7 Household level hospital spending by type of hospital and economic region in Ukraine 2004 (hrivna) Type of Hospital Facility Clinic / hospital attached to the Research Institute, University or Academy Hospitals of oblast, republic level Rayon / municipal hospitals Local rural hospital Maternity hospital Departmental clinics / hospitals Sanatorium-and-spa institutions Private clinic / hospital Specialized narcological dispensary Specialized T.B. prophylactic centre Specialized dermatovenerologic dispensary Other specialized dispensary Other healthcare institutions Total

Eastern

Donetsky

Prydniprovsky

Prychornomorsky

Podilsky

Central

Karpatsky

Polisky

Total Hosp Costs

3,359,100

1,709,708

352,739

878,122

1,089,617

10,206,772

1,740,220

1,394,125

20,730,403

18,055,161 49,966,607 2,939,212 5,458,537 1,259,662 2,099,437 1,679,550 419,887 419,887

16,669,650 58,984,914 1,282,281 5,556,550 2,564,561 4,701,696 0 427,427 427,427

10,229,438 44,092,403 1,763,696 5,643,828 2,116,435 1,058,218 0 352,739 352,739

26,782,729 58,834,191 4,390,611 7,464,039 1,756,245 5,707,795 0 0 878,122

17,797,079 54,844,059 2,905,646 2,905,646 2,542,440 2,542,440 363,206 0 726,411

8,505,644 45,079,911 2,126,411 4,678,104 8,930,926 7,229,797 0 0 0

18,562,344 33,934,285 2,030,256 9,281,172 1,450,183 1,160,147 0 0 580,073

14,498,897 44,611,992 5,018,849 8,085,924 2,509,425 2,230,600 0 557,650 278,825

131,100,941 390,348,364 22,456,962 49,073,799 23,129,877 26,730,129 2,042,756 1,757,703 3,663,485

427,427

850,564

290,037

1,568,028

2,099,437 419,887 88,176,366

3,419,415 1,709,708 97,880,763

1,763,696 0 67,725,932

1,756,245 1,756,245 110,204,344

726,411 726,411 87,169,366

1,275,847 850,564 89,734,541

1,160,147 290,037 70,478,901

1,115,300 836,475 81,138,061

13,316,497 6,589,327 692,508,271

Ukraine National Health Accounts 2003-2004

Household level health expenditure by Economic Regions Finally the estimates for health care expenditure and health care utilization data from each region allowed partitioning total private health spending by regions. Table 8 Private Health Expenditure in Ukraine by type of care and economic region in 2004 (hrivna) Economic region Eastern Donetsky Prydniprovsky Prychornomorsky Podilsky Central Karpatsky Polisky Total

Total Spending on Self- Total Spending on Total Hospital Treatment in 2004 OP Care in 2004 Spending in 2004 764,249,407 863,668,607 777,181,654 843,366,507 612,454,883 976,304,946 564,050,127 515,286,987 5,916,563,118

181,642,941 262,931,765 236,027,087 269,246,179 117,838,831 437,353,864 184,959,766 129,392,489 1,819,392,921

88,176,366 97,880,763 67,725,932 110,204,344 87,169,366 89,734,541 70,478,901 81,138,061 692,508,271

Total 1,034,068,714 1,224,481,134 1,080,934,672 1,222,817,030 817,463,080 1,503,393,351 819,488,794 725,817,537 8,428,464,311

Comparison of Estimates with SSC Data According to SSC HBS data8 private health care consumption estimates for 2003-2004 were following: 2003 Health Care Health Care Goods Services

Monthly Spending per HH 18.11 10.84 7.72

Total 3,827,657,160 2,291,099,040 1,631,668,320

Per cent Distribution 100% 60% 40%

2004 Health Care Health Care Goods Services

Monthly Spending per HH 22.17 12.94 9.23

Total 4,691,296,152 2,738,176,464 1,953,119,688

Per cent Distribution 100% 58% 42%

Our estimates for 2004 were 1.7966 times higher then reported in HBS. This coefficient can be used to adjust the estimates for 2003 and it will amount to 6,876,768,854 Hrivna in current prices. As for the ratio between goods and services they will remain as calculated per respective years.

Statistical Yearbook 2003 and 2004, State Statistics Committee of Ukraine, Kiev

Technical Notes

Addendum 1 COICOP Classificator COICOP Classification of individual consumption by purpose Adapted to the Needs of Household Budget Surveys Code

Name

Division: 06

Health

Group: 06.1

Medical products, appliances and equipment

Class: 06.1.1

Pharmaceutical products (ND)

Class: 06.1.2

Other medical products (ND)

Class: 06.1.3

Group: 06.2

This group covers medicaments, prostheses, medical appliances and equipment and other health-related products purchased by individuals or households, either with or without a prescription, usually from dispensing chemists, pharmacists or medical equipment suppliers. They are intended for consumption or use outside a health facility or institution. Such products supplied directly to outpatients by medical, dental and paramedical practitioners or to inpatients by hospitals and the like are included in outpatient services (06.2) or hospital services (06.3). Medicinal preparations, medicinal drugs, patent medicines, serums and vaccines, vitamins and minerals, cod liver oil and halibut liver oil, oral contraceptives. Excludes: veterinary products (09.3.4); articles for personal hygiene such as medicinal soaps (12.1.3). Clinical thermometers, adhesive and non-adhesive bandages, hypodermic syringes, first-aid kits, hot-water bottles and ice bags, medical hosiery items such as elasticated stockings and knee supports, pregnancy tests, condoms and other mechanical contraceptive devices.

Therapeutic appliances and equipment (D)

Corrective eyeglasses and contact lenses, hearing aids, glass eyes, artificial limbs and other prosthetic devices, orthopaedic braces and supports, orthopaedic footwear, surgical belts, trusses and supports, neck braces, medical massage equipment and health lamps, powered and unpowered wheelchairs and invalid carriages, "special" beds, crutches, electronic and other devices for monitoring blood pressure, etc.; - repair of such articles. Includes: dentures but not fitting costs. Excludes: hire of therapeutic equipment (06.2.3); protective goggles, belts and supports for sport (09.3.2); sunglasses not fitted with corrective lenses (12.3.2).

Outpatient services

This group covers medical, dental and paramedical services delivered to outpatients by medical, dental and paramedical practitioners and auxiliaries. The services may be delivered at home, in individual or group consulting facilities, dispensaries or the outpatient clinics of hospitals and the like. Outpatient services include the medicaments, prostheses, medical appliances and equipment and other health-related products supplied directly to outpatients by medical, dental and paramedical practitioners and auxiliaries. Medical, dental and paramedical services provided to in-patients by hospitals and the like are included in hospital services (06.3).

Class: 06.2.1

Medical services (S)

Class: 06.2.2

Dental services (S)

Class: 06.2.3

Explanatory note This division also includes health services purchased from school and university health centres.

Paramedical services (S)

Consultations of physicians in general or specialist practice. Includes: services of orthodontic specialists. Excludes: services of medical analysis laboratories and x-ray centres (06.2.3); services of practitioners of traditional medicine (06.2.3). Services of dentists, oral hygienists and other dental auxiliaries. Includes: fitting costs of dentures. Excludes: dentures (06.1.3); services of orthodontic specialists (06.2.1); services of medical analysis laboratories and x-ray centres (06.2.3). Services of medical analysis laboratories and x-ray centres; - services of freelance nurses and midwives; - services of freelance acupuncturists, chiropractors, optometrists, physiotherapists, speech therapists, etc.; - medically prescribed corrective-gymnastic therapy; - outpatient thermal bath or sea-water treatments; - ambulance services; - hire of therapeutic equipment. Includes: services of practitioners of traditional medicine.

General Hospital services (S)

Hospitalization is defined as occurring when a patient is accommodated in a hospital for the duration of the treatment. Hospital day-care and home-based hospital treatment are included as are hospices for terminally ill persons.Hospital services comprise the provision of the following services to hospital in-patients: - basic services: administration; accommodation; food and drink; supervision and care by nonspecialist staff (nursing auxiliaries); first aid and resuscitation; ambulance transport; provision of medicines and other pharmaceutical products; provision of therapeutic appliances and equipment; - medical services: services of physicians in general or specialist practice, of surgeons and of dentists; medical analyses and x-rays; paramedical services such as those of nurses, midwives, chiropractors, optometrists, physiotherapists, speech therapists, etc. This group covers the services of general hospitals

Class: 06.3.2

Specialized Hospital Services (S)

This group covers services of specialized hospitals e.g. TB, Neurology, Orthopedy, Mental heallth, etc.

Class: 06.3.3

Maternity Hospital Services (S)

This group covers the services of maternity hospitals

Nursing and convalescent home services (S)

This group covers the services of nursing homes and convalescent homes which chiefly provide inpatient health care, the services of institutions serving old people in which medical monitoring is an essential component and the services of rehabilitation centres providing in-patient health care and rehabilitative therapy where the objective is to treat the patient rather than to provide long-term support. It does not includes the services of retirement homes for elderly persons, institutions for disabled persons and rehabilitation centres providing primarily long-term support (12.4).

Group: 06.3

Class: 06.3.1

Class: 06.3.4

Hospital services

Abbreviations used:

Source: http://unstats.un.org/unsd/cr/registry/regcs.asp?Cl=4&Lg=1&Co=07

(ND) - non-durable goods (SD) - semi-durable goods (D) - durable goods (S) - services

Ukraine National Health Accounts 2003-2004

Annex 3: Methodology for Disaggregating Expenditures by Providers

Public Financing Budget functional classification in Ukraine allows allocating funds to the major provider groups mainly level 1 and 2 under Ukraineâ&#x20AC;&#x2122;s NHA classification. Thorough evaluation of budget functional classification leads to the specific proposals for changes (See table on the page 23) that will be helpful for deriving better quality and more detailed data under the Government Finance Statistics System. Meanwhile, further disaggregating of public funds by providers, necessary for the health care financing policy analysis, needs elaboration of the methodological approach, which is described below. The health care financing system of Ukraine informs and guides data partitioning methodology for public financing. Ukraine employees input based budget financing of medical institutions/providers using staffing norms and government established rules and regulations for in and outpatient facilities and bed capacity for hospital financing. Thus number of staff can be used as a proxy to partition the data for outpatient facilities and bed capacity as a proxy for hospital sector data partitioning. In addition different levels of the government (national, oblast and rayon) have responsibility to finance different types of facilities/providers described under the budget code of Ukraine (see Box 1). Thus, statistical reports about the staffing levels and bed capacity by type of facilities provides data for determining proxy coefficients and distributing financial data to lower levels of NHA classification of the providers.

Technical Notes

Box 1. Distribution of health expenditures covered by different level of government budgets The State: ● Primary health care, outpatient, and inpatient care (multi-specialty hospitals and polyclinics performing specific national functions according to the list approved by the Cabinet of Ministers of Ukraine) ● Specialized, highly specialized outpatient and inpatient care (clinics of research institutes, specialized hospitals, centres, leprosarium, hospitals for Second World War invalids, specialized health posts, specialized polyclinics, specialized dental polyclinics according to the list approved by the Cabinet of Ministers) ● Sanatorium and rehabilitation care (nationwide sanatoria for tuberculosis patients, children, and adolescents, war veterans) ● Sanitary and epidemiological surveillance (sanitary and epidemiological stations, disinfecting stations, control interventions) ● Other health programs of nationwide function according to the list approved by the Cabinet of Ministers Villages, towns and amalgamations thereof: Primary health care, outpatient and inpatient care (catchment area hospitals, outpatient departments, feldshermidwife aid posts) Districts, cities and towns in the Crimea Autonomous Republic and oblast-level cities and towns: Primary health care, outpatient and inpatient care (multi-specialty hospitals, maternity hospitals, accident and emergency care stations, polyclinics and outpatient aid posts, general dental polyclinics), health educational programs (municipal and district health centers, health educational interventions). Crimea Autonomous Republic and oblast budgets: Primary health care, outpatient and inpatient care; specialized outpatient and inpatient care (specialized hospitals, polyclinics including dental facilities, health centers, follow-up centers, hospitals for war invalids, orphanages, blood transfusion stations); sanatoria and health resorts (tuberculosis patients, children and young adults, rehabilitation); other state programs in medical and sanitary aid (socio-medical expert commissions, forensic expertise, centers for medical statistics, bases of special health services, centers of health and health educational interventions, other programs and interventions). Borrowed from Lekhan V. et all 2004

General (HP.1.1) and Specialty (HP.1.2, HP.1.3) Hospitals Disaggregating HF.1.1.1 Central government financing by providers presents challenging task as the proxies for those providers that are funded from central government sources are hard to obtain. Current statistical reports do not provide information either about bed capacity or staffing. Thus the data can only be presented as aggregates. As for HF.1.1.2 the data is available to separate funds by different providers. Assuming that government allocates same amount per hospital bed in any given oblast9, the statistical data available in the country allows disaggregating between the adult and children general hospitals. Using similar approach further partitioning of the data is possible for city, rayon and district hospitals.

If Ukraine has the state defined standards (norms) of budget estimation for different types of hospital facilities, then these norms could be used to determine the weights and use the number of beds along with weights to allocate the funds.

Ukraine National Health Accounts 2003-2004

Table 9 Hospital beds and their distribution by types of general hospitals 2003 2004 Hospital beds # % # Oblast Hospitals (adult) 21 142 7% 20 922 Children Oblast Hospitals 11 302 4% 11 302 City Hospitals (adult) 110 707 39% 108 002 Children City Hospitals 14 253 5% 14 253 Central Rayon Hospitals 104 012 36% 102 754 Rayon Hospitals 12 173 4% 12 164 Dilnichni hospitals 11 987 4% 11 047 Total 285 576 100% 280 444 Source MoH Statistics 2004

% 7% 4% 39% 5% 37% 4% 4% 100%

Official medical statistics on number of beds by types of medical providers (Statistical form #47-zdorov) of MoH capture distribution of beds between different types of specialized hospitals, but not all (some reported together). It should be noted that Center for Medical Statistics at MoH reports on types of beds in all facilities but it does not allow distribution within providers as many specialized beds are in joint hospitals (oblast, rayon, etc.). As it was noted in the above paragraph, statistical form #47 on facilities does not capture all details for specialized hospitals. However, it is important for NHA and especially for NHA sub-analyses to estimate spending for STI and oncology clinics. Understanding considerable weakness of the following assumption, we assume that distribution among stand-alone STI and oncology facilities is the same as total number of STI and oncology beds in the country. Estimations for stand-alone oncology and STI facilities shown in the Table 10. Summarizing available information it is possible to construct the distribution for the necessary NHA categories described in the Table 11. Table 10 Estimation of number of beds in stand-alone Oncology and STI facilities Center for med stat Per cent for Form 47 (types of distribution (facilities)* beds) 8 942 58,6% 2 582 Oncology beds 6 327 41,4% 1 827 STI beds 15 269 100,0% 4 409 Total *Estimated in blue font

Technical Notes

Table 11 Calculations of spending proportion for specialty hospitals NHA classification categories Number of % Beds in Distribution 2004* HP.1.2.1 Mental health hospitals and dispensers / Психиатрические больницы и диспансеры AND HP.1.3.9 Other specialty hospitals / Другие специализированные больницы (including neurologic; minus onco, TB, STI / включая неврологич.; минус онко, ТБ, ИППП учреждения) HP.1.2.2 Substance abuse hospitals and dispensers / Наркологические больницы и диспансеры HP.1.3.1 Oncology hospitals and dispensers / Онкологические больницы и диспансеры HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы и диспансеры HP.1.3.4 STI clinics and dispensers / Кожновенерологические клиники и диспансеры Total *Estimated in blue font

49 893

83,9%

478

0,8%

2 582

4,3%

4 703

7,9%

1 827

3,1%

59 483

100,0%

As it can be seeing in the above table, there is a further need to separate “HP.1.2.1 Mental health hospitals and dispensers” and “HP.1.3.9 Other specialty hospitals”. Special considerations for this distribution will be described in this paragraph. If medical statistics on number of beds is used, then 86.2% out of this joint category (taken as 100%) should be allocated to mental health hospitals, which, of course, would be a considerable overestimation of mental health spending and underestimation of other specialty hospitals. Indeed, it is highly unlikely that a mental health bed as expensive as cardio-surgery or other highly specialized bed. Recent study10 that looked at public spending on mental health services in seven oblasts of Ukraine suggests that total spending for mental health accounts for 6.5% of total regional public health spending. If per capita expenditure for mental health for different oblasts follows this ration, then we can apply these estimates for the whole Ukraine. The study also estimated that proportion of in-patient services is 92.8% and for outpatient services is 7.2% out of total public mental health spending. Applying these estimates to 2004 NHA data, we can conclude that mental health services would amount to 564 355 662 UAH, or 51.6% out of total joint category we are estimating (“HP.1.2.1 Mental health hospitals and dispensers” and “HP.1.3.9 Other specialty hospitals”). Fully adjusted distribution is shown in Table 12.

Study of psychiatry services in Ukraine, 2004, WHO (unpublished data).

Ukraine National Health Accounts 2003-2004

Table 12 Adjusted calculations of spending proportion for specialty hospitals NHA classification categories % Distribution HP.1.2.1 Mental health hospitals and dispensers / Психиатрические 43,3% больницы и диспансеры HP.1.3.9 Other specialty hospitals / Другие специализированные больницы (including neurologic; minus onco, TB, STI / включая неврологич.; минус 40,6% онко, ТБ, ИППП учреждения) HP.1.2.2 Substance abuse hospitals and dispensers / Наркологические больницы и диспансеры HP.1.3.1 Oncology hospitals and dispensers / Онкологические больницы и диспансеры HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы и диспансеры HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры Total

0,8% 4,3% 7,9% 3,1% 100,0%

HP.3 Providers of ambulatory health care HP.3.1 Offices of physicians and policlinics Number of doctors working in the PHC facilities and described in the Table 13 can be used as a proxy to distribute the funds among the Offices of physicians and policlinics per NHA classification defined for Ukraine. The data about the number of doctors employed in a different type of facilities is routinely available from the medical statistics office and can be used for these calculations. Table 13 PHC providers in Ukraine PHC providers (doctors) Dilnichni Therapists Dilnichni Paediatricians Doctors in Village Doctor Ambulatories Total

2003 # 11 652 7 043 5 772 24 467

% 48% 29% 24% 100%

2004 # 11 044 6 733 5 916 23 693

% 47% 28% 25% 100%

Private Financing Private payments for health care are composed of two parts services and goods (drugs, medical appliances etc.). Available data about household spending (with some in-depth surveys) allows partitioning the data among these two groups. Further partitioning for goods becomes problematic due to lack of the information; however, desegregation of data for services is possible using either: a) detailed household survey findings or b) official statistical reports of health services utilization. It should be noted that for any distribution of private households financing where adult versus children health care facilities (either OP or IP) financing distribution based on health services utilization is concerned, we understand the weakness of assumption that private spending in adult and children facilities is equally proportional. As it was discussed with a national health system expert in a private interview, private spending in children facilities is generally lower than in adult facilities, since government regulations restrict charging official medical fees in children facilities, as well as “under-the-table” payments are also deemed to be lower. Factors Technical Notes

contributing to the last statement (“under-the-table” payments) could vary, but may include lower “offer” of unofficial payments by parents, or children providers being more cautious to accept those11. However, it is almost impossible to come up with any proxy for allocation of the funds between children and adult facilities, besides health services utilization data. We used for our calculations general approach in this situation, citing as above its potential weakness. Hospital level The World Bank financed survey 2004 allows more detailed separation of HP.1 in subcategories using the weights derived from the dataset. See the details in the document “Methodology for Estimating Health Expenditures on a Household Level for 2004”. It is possible to produce the following matching and perform desegregation in accordance with NHA classification categories (see Table 14). Table 14 Private Financing Distribution for IP Services on a Hospital level in 2004 Hospital Per Cent Type of Hospital Facility Services Distribution Clinic / hospital attached to the Research 3 605 442 3,0% Institute, University or Academy

NHA Code HP.1.3.9

Hospitals of oblast, republic level

22 801 141

18,9%

Rayon / municipal hospitals

67 889 582

56,4%

3 905 726 8 534 939 4 022 760 4 648 917

3,2% 7,1% 3,3% 3,9%

HP.1.1.1.1 HP.1.1.1.2 HP.1.1.2.1 HP.1.1.2.2 HP.1.1.3 HP.1.1.4 HP.1.1.5 HP.1.1.6 HP.1.1.9 HP.2.9.9

355 277

0,3%

HP.3.7

305 701 637 155

0,3% 0,5%

HP.1.2.2 HP.1.3.3

272 712

0,2%

HP.1.3.4

1,9% 1,0% 100,0%

HP.1.3.9 HP.n.s.k

Local rural hospital Maternity hospital Departmental clinics / hospitals Sanatorium-and-spa institutions Private clinic / hospital Specialized narcological dispensary Specialized T.B. prophylactic centre Specialized dermatovenerologic dispensary Other specialized dispensary Other healthcare institutions Total Source WB Survey 2004

2 316 012 1 146 019 120 441 383

Assuming that private spending for Rayon / Municipals and Oblast level hospitals was equally distributed among different types of facilities in these categories based on the utilization (number of bed-days), it is possible to disaggregate Rayon / Municipal hospitals further into corresponding NHA classification categories. For this partitioning we will use inpatient bed-day as a proxy for private expenditure, because it is assumed that the longer the patient stay in the hospital more expenses they will face.

Information obtained in a private interview with a national health system expert.

Ukraine National Health Accounts 2003-2004

Table 15 Further distribution for Oblast level Hospitals NHA Code and Description

Number of Bed-Days in 2004

Per Cent

7 201 418

66,3%

3 654 182

33,7%

10 855 600

100,0%

HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.1.2 Children oblast general hospitals / Детские областные больницы общего профиля Total Table 16 Further distribution for Rayon / Municipal Hospitals NHA Code and Description

Number of Bed-Days in 2004

HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.2.2 Children city general hospitals / Детские городские больницы общего профиля HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы HP.1.1.4 Rayon Hospitals / Районные больницы Total

Per Cent

37 024 177

46,5%

4 466 715

5,6%

33 946 148

42,7%

4 106 012

5,2%

79 543 052

100,0%

Summarizing the above three tables, it is possible to construct following private spending distribution table for hospital services: Table 17 Summary of Private Financing Distribution on a Hospital level in 2004 NHA code and Description HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля

Per Cent 12,56%

HP.1.1.1.2 Children oblast general hospitals / Детские областные больницы общего профиля

6,37%

HP.1.1.2.1 City general hospitals / Городские больницы общего профиля

26,24%

HP.1.1.2.2 Children city general hospitals / Детские городские больницы общего профиля

3,17%

HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы

24,06%

HP.1.1.4 Rayon Hospitals / Районные больницы

2,91%

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

3,24%

HP.1.1.6 Maternity houses / Родильные дома

7,09%

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

3,34%

HP.1.2.2 Substance abuse hospitals / Наркологические больницы

0,25%

HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы и диспансеры

0,53%

HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры

0,23%

HP.1.3.9 Other specialty hospitals / Другие специализированные больницы

4,92%

HP.2.9.9 Sanatoriums / Санатории

3,86%

HP.3.7 Private clinics / Частные клиники *

0,29%

HP.nsk

0,95% Total

100,00%

Because in Ukraine laboratory and other ancillary services are almost always integrated into hospital providers, and assuming that private spending for these ancillary services was distributed proportionally to payments for hospital services, we can produce the following Table 18 for Private financing distribution for hospital and ancillary services in 2004. Note: private spending for laboratory services amounted 238 167 677 hrivnas in 2004 (see details in Annex 2 “Methodology for Estimating Health Expenditures on a Household Level for 2004 and 2003”), therefore total private spending at hospital level for hospital services and lab tests was 358 609 059 hrivnas.

Technical Notes

It should be noted that in accordance to the data from State Statistics Committee on private and non-budgetary health care facilities private households spending for sanatoriums and private clinics was under-estimated in the WB survey (please see Annex 4 “Methodology for Estimating Private and Non-Budgetary health care facilities”). Spending for sanatoriums services by private households was 307 197 477 hrivnas and for private clinics services it was 116 640 597 hrivnas in 2004. One additional assumption for further desegregation: all expenditures at private clinics will be considered as OP level spending and all private clinics are moved to OP provider category. This assumption has also some additional grounds, as quite a lot of private providers in Ukraine providing only OP services, and proportion of those providing IP services is relatively smaller. Additional justification for this assumption: private clinics pure OP spending captured by the WB survey is 45 times higher than hospital level spending. Table 18 Summary of Private Financing Distribution on a Hospital level in 2004 NHA code and Description HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.1.2 Children oblast general hospitals / Детские областные больницы общего профиля HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.2.2 Children city general hospitals / Детские городские больницы общего профиля

Detailed Distribution (Hospital Services and Lab tests) 45 036 672 22 852 749 94 087 476 11 351 014

HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы

86 265 453

HP.1.1.4 Rayon Hospitals / Районные больницы

10 434 379

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

11 629 132

HP.1.1.6 Maternity houses / Родильные дома

25 412 417

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

11 977 595 910 211

1 897 102

HP.1.3.9 Other specialty hospitals / Другие специализированные больницы

17 630 875

HP.2.9.9 Sanatoriums / Санатории

13 841 952

HP.3.7 Private clinics / Частные клиники *

1 057 822

HP.nsk

3 412 222 Total

811 989

358 609 059

* In order to avoid double counting, private clinics are accounted under OP providers (see explanations in the text).

The following Table 19 demonstrates the new distribution for private households financing at the hospital level.

Ukraine National Health Accounts 2003-2004

Table 19 Summary of Private Financing Distribution on a Hospital level adjusted for data on private and non-budgetary facilities from SSC in 2004 NHA code and Description

Detailed Distribution (Hospital Services and Ancillary services)

HP.1.1.1 Oblast hospitals / Областные больницы

45 036 672

HP.1.1.2 City Hospitals / Городские больницы

94 087 476

HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы

86 265 453

HP.1.1.4 Rayon Hospitals / Районные больницы

10 434 379

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

11 629 132

HP.1.1.6 Maternity houses / Родильные дома

25 412 417

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

11 977 595

HP.1.2.2 Substance abuse hospitals / Наркологические больницы HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы и диспансеры HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры HP.1.3.9 Other specialty hospitals / Другие специализированные больницы HP.2.9.9 Sanatoriums / Санатории

910 211 1 897 102 811 989 17 630 875 307 197 477

HP.nsk

3 412 222 Total

650 906 762

As it will be discussed in details in the following section “OP level spending”, a lot of hospital providers in Ukraine provide both IP and OP services. Adding OP services portion to hospital providers allows constructing the following Table 20 (for calculations of OP spending at hospital level please see section “OP level”). Table 20 Summary of Private Financing Distribution on a Hospital level adjusted for data on private and non-budgetary facilities from SSC AND OP Services provided at hospital providers in 2004 NHA code and Description HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.1.2 Children oblast general hospitals / Детские областные больницы общего профиля HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.2.2 Children city general hospitals / Детские городские больницы общего профиля HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы HP.1.1.4 Rayon Hospitals / Районные больницы

Fully Adjusted Distribution 62 562 121 32 585 443 189 461 830 29 168 012 169 671 405 19 030 325

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

79 774 492

HP.1.1.6 Maternity houses / Родильные дома

25 412 417

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

11 977 595

1 897 102 811 989 17 630 875 307 197 477

HP.nsk

5 683 734 Total

Technical Notes

910 211

953 775 029

Outpatient level The WB survey offered detailed information about the patients that utilized outpatient care services and the share of those who faced payments and the average fee per economic region. These data allows estimating per capita monthly household spending on an outpatient level, which helped to estimate national spending for 2004 (See Table 21 for details). Table 21 Total Private Financing on an OP level in 2004 Economic region Eastern Donetsky Prydniprovsky Prychornomorsky Podilsky Central Karpatsky Polisky Total

The share of population, which applied for out-patient 12.3 12.0 9.7 11.8 12.5 13.6 10.1 12.8 11.8

Mean Total Monthly Amount Paid Spending among in Hrivnas Surveyd

Share Who Paid for Services

374 402 310 516 328 363 417 429 3139

44.0 40.8 43.2 41.5 32.4 31.4 42.8 39.0 39.5

165 164 134 214 106 114 178 167 1240

48.9 62.3 72.2 63.6 56.8 147.1 57.9 45.2 66.3

8,044 10,210 9,672 13,624 6,036 16,762 10,328 7,557 82,218

Per Capita Monthly Spending 2.65 3.05 3.03 3.11 2.30 6.28 2.50 2.26 3.18

Total Spending on OP Care in 2004 181,642,941 262,931,765 236,027,087 269,246,179 117,838,831 437,353,864 184,959,766 129,392,489 1,819,392,921

The survey also provides information on the following four categories under the total OP spending: • Official Payments for Outpatient Care (Table 22); • Purchase of drugs, supplies and lab tests (Table 23); • Cash Payments to Providers (Table 24); • In-kind payments to providers (Table 25). Table 22 Official Payments for OP care in 2004 Economic Regions Eastern Donetsky Prydniprovsky Prychornomorsky Podilsky Central Karpatsky Polisky Total

N 374 402 310 516 328 363 417 429 3139

The share of respondents, who effected this type of payment (among those, who applied for the healthcare) 24,5 20 27,6 25,3 13,5 19,2 12,1 18,6 20,1

Mean Official Payments

Per Capita Monthly Spending

7,2 8,69 12,79 13,73 6,13 31 6,05 4,62 11,16

0,22 0,21 0,34 0,41 0,10 0,81 0,07 0,11 0,29

Total Payments in 2004 14 898 180 17 992 574 26 705 471 35 424 102 5 298 944 56 373 069 5 466 644 6 311 743 168 470 727

Table 23 Purchase of drugs, supplies and lab tests on an OP level in 2004 Economic Regions Eastern Donetsky Prydniprovsky Prychornomorsky Podilsky Central Karpatsky Polisky Total

N 374 402 310 516 328 363 417 429 3139

The share of respondents, who effected this type of payment (among those, who applied for the healthcare) 28,5 29,7 32,1 27,9 24,0 14,1 27,9 29,4 26,8

Mean Payment 11,6 11,6 17,7 9,3 8,3 10,1 12,4 12,3 11,5

Per Capita Monthly Spending 0,41 0,41 0,55 0,31 0,25 0,19 0,35 0,46 0,37

Total Payments in 2004 27 993 630 35 789 280 42 958 932 26 460 311 12 816 586 13 541 470 25 814 013 26 474 768 211 848 992

Ukraine National Health Accounts 2003-2004

Table 24 Cash Payments to Providers on an OP level in 2004 Economic Regions Eastern Donetsky Prydniprovsky Prychornomorsky Podilsky Central Karpatsky Polisky Total

N 374 402 310 516 328 363 417 429 3139

The share of respondents, who effected this type of payment (among those, who applied for the healthcare) 10,3 6,8 2,9 9,9 3,9 5,4 18,2 3,1 7,9

Mean Payment 2,1 3,4 0,5 2,9 3,3 3,6 5,3 0,6 2,7

Per Capita Monthly Spending 0,03 0,03 0,00 0,03 0,02 0,03 0,10 0,00 0,03

Total Payments in 2004 1 800 704 2 386 449 100 920 2 887 414 829 083 1 830 988 7 257 594 125 233 17 218 384

Table 25 In-kind payments to providers on an OP level in 2004 Economic Regions Eastern Donetsky Prydniprovsky Prychornomorsky Podilsky Central Karpatsky Polisky Total

N 374 402 310 516 328 363 417 429 3139

The share of respondents, who effected this type of payment (among those, who applied for the healthcare) 6,0 6,5 3,6 3,0 4,8 3,0 4,7 2,2 4,1

Mean Payment 0,6 1,5 0,3 0,5 0,6 1,4 1,0 0,2 0,8

Per Capita Monthly Spending 0,00 0,01 0,00 0,00 0,00 0,01 0,00 0,00 0,00

Total Payments in 2004 314 179 1 016 094 68 087 159 086 196 705 394 952 343 957 32 318 2 525 379

If these four categories are summed the total is only 400,063,482, which does not correspond to the first WB Survey assessment on total OP private spending estimated at 1,819,392,921. This difference could be explained by some bias in the assessment. The total OP spending assessment presumably is a more rigorous estimation, and the same could be said about the three detailed spending categories (Official Payments, Cash Payments to Provides and In-kind payments to Providers). The distribution falls very closely to the one that is observed for hospital care: Table 26 Comparison of distribution of private spending on an OP and Hospital level in 2004 Category Hospital Care Per Cent OP Care Per Cent Official Payments 71 157 370 10,3% 168 470 727 9,3% Cash Payments to Providers 43 739 812 6,3% 17 218 384 0,9% In-kind payments to providers 5 544 202 0,8% 2 525 379 0,1% Remaining part (Purchase of drugs, supplies and lab tests) 572 066 889 82,6% 1 631 178 432 89,7% Total 692 508 271 100,0% 1 819 392 921 100,0%

Taking into the consideration the common knowledge that the majority of private spending is for drugs, medical supplies (that are not available in most cases in the hospitals and clinics due to budget constrains) and often laboratory tests (providers need to cover purchase of test reagents and other consumable), as well as looking at Private spending for Hospital care, we can assume that Private Spending on OP level for purchase of drugs, supplies and lab tests was 1,631,178,432. Using the same methodology as described in Hospital level part to disaggregate drugs and supplies from lab tests (see Annex 2 â&#x20AC;&#x153;Methodology for Estimating Health Expenditures on a Household Level for 2004 and 2003â&#x20AC;?) we can come to the following disaggregating for private spending on an OP level (Table 27). Technical Notes

Table 27 Summary of distribution of private spending on an OP level in 2004

Type of Expenditure Total Outpatient Care

Hrivna in 2004 1,819,392,921

General medical services Medical products and appliances Laboratory tests

188,214,490 952,072,570 679,105,861

WB Survey captured per cent distribution among respondents who applied for OP care to different types of OP practitioners. Because dental care is almost always integrated into different types of health care providers, as a first step for disaggregating OP spending we take dental care out of all other OP spending (Table 28). We take out dental services based on practitioners (versus facilities as we do further) to ensure that we capture this type of service provision (as it can be seen further, place of rendering of OP services does not capture this type of services, while dental care account for considerable part of private spending). Table 28 Determining proportion of dental OP care out of total OP spending based on types of facilities reported under WB Survey

Type of OP practitioner

Dentist All other OP practitioners Total

Per Cent Distribution among respondents who applied for OP care 12,7% 87,3% 100,0%

NHA Code

HP.3.2 All Other

WB survey also allows distributing further general OP medical services private spending into corresponding NHA classification provider categories, assuming that private spending was distributed equally between different types of OP providers based on the volume of services provided (number of OP cases/contacts for OP care).

Ukraine National Health Accounts 2003-2004

Table 29 Matching outpatient facilities reported under WB 2004 Survey with NHA classification categories Health Care Provider

% Distribution

NHA Provider Code

No reply

0,3%

HP.n.s.k

Stations of obstetric care. aid posts

11,8%

HP.3.1.1 (RH)

Public out-patients’ clinic / outpatients’ healthcare or diagnostic institution

38,2%

HP.3.1.1 HP.3.1.2

Local rural hospital

9,0%

Rayon municipal hospital

27,1%

Hospital of oblast. republic level

3,6%

Specialized healthcare institution / dispensary

1,6%

HP.1.1.5 HP.1.1.2.1 HP.1.1.2.2 HP.1.1.3 HP.1.1.4 HP.1.1.1.1 HP.1.1.1.2 HP.3.4

Private hospital / healthcare or diagnostic institution or private doctor

5,3%

HP.3.7

Other institutions

1,6%

HP.3.9.9

The healthcare was rendered not in the healthcare institution

1,5%

HP.3.9.9

In order to separate further spending for provider categories aggregated in the WB Survey, it is possible to use medical statistics provided by Center for Medical Statistics of MoH on number of visits, assuming that private spending is proportionate to the utilization rate (Table 30 and Table 31). Unfortunately, it was not possible to obtain data on number of visits in adult versus children policlinics, therefore, number of doctors was used, understanding that input proxy is not appropriate for private financing (Table 32). Supporting consideration is that number of doctors in the country is determined by the number of the covered corresponding population, and assuming that rate of the sickness for adult and children population is similar it can support the above usage of the doctors proxy. Table 30 Further distribution for hospital providers providing OP services: part 1 Health Care Provider

Number of OP visits

% Distribution

HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля

4 437 924

64,3%

HP.1.1.1.2 Children oblast general hospitals / Детские областные больницы общего профиля

2 464 585

35,7%

Total

6 902 509

100,0%

Technical Notes

Table 31 Further distribution for hospital providers providing OP services: part 2 Number of OP visits

Health Care Provider HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.2.2 Children city general hospitals / Детские городские больницы общего профиля HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы

111 701 698

HP.1.1.4 Rayon Hospitals / Районные больницы Total

11 512 149 274 805 740

% Distribution

127 730 419

46,5%

23 861 474

8,7% 40,6% 4,2% 100,0%

Table 32 Further distribution for general policlinics

Health Care Provider

HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.2 Children's Policlinics / Детские поликлиники Total

Number of Doctors (Dilnichni Therapists or Paediatricians) 11 044 6 733 17 777

% Distribution 62,1% 37,9% 100,0%

Based on the distribution described in Table 29 through Table 32 it is possible to produce the following private spending distribution on an OP level for different types of OP providers under NHA classification categories (Table 33). Because ancillary services in most cases are integrated in the structure of health care providers in Ukraine, both direct health services payments and laboratory tests payments captured by the WB Survey are used for total provider distribution of private spending. Table 33 Distribution of Private Spending on an OP level by different types of OP providers in 2004 % Distribution

Health Care Provider

HP.1.1.1 Oblast hospitals / Областные больницы HP.1.1.2 City Hospitals / Городские больницы

Total OP Curative Care and Ancillary Services

2,02%

17 525 449

1,12%

9 732 695

11,00%

95 374 354

2,05%

17 816 998

HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы

9,62%

83 405 953

HP.1.1.4 Rayon Hospitals / Районные больницы

0,99%

8 595 946

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

7,86%

68 145 360

HP.3.1.1 Adults Policlinics / Взрослые поликлиники

20,72%

179 690 480

HP.3.1.2 Children's Policlinics / Детские поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники (Reproductive Health - Репродуктивное здоровье) HP.3.2 Offices of dentists / Стоматологические кабинеты (отделения)

12,63%

109 548 714

10,30%

89 346 139

12,70%

110 149 685

Ukraine National Health Accounts 2003-2004

Health Care Provider HP.3.4 Outpatient care centres / Центры амбулаторного лечения HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги HP.3.7 Private clinics HP.n.s.k

% Distribution

Total OP Curative Care and Ancillary Services

1,40%

12 114 731

2,71%

23 472 291

4,63%

40 130 045

0,26%

2 271 512

Total 100,00% 867 320 351 Note: Yellow highlighting represents OP level spending at hospital providers, green highlighting shows reproductive health services spending reported separately in the WB survey at OP level.

As it was already mentioned in the previous section, private spending for private clinics was under-estimated based on data provided by SSC (SSC reports 116 640 597 UAH in 2004). To conclude private financing distribution for stand-alone OP providers Table 34 was constructed. Table 34 Distribution of Private Spending on an OP level by stand-alone OP providers in 2004 Health Care Provider HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.2 Children's Policlinics / Детские поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники (Reproductive Health Репродуктивное здоровье) HP.3.2 Offices of dentists / Стоматологические кабинеты (отделения) HP.3.4 Outpatient care centres / Центры амбулаторного лечения HP.3.7 Private clinic HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги Total

Total OP Curative Care and Ancillary Services 179 690 480 109 548 714 89 346 139 110 149 685 12 114 731 116 640 597 23 472 291 640 962 636

Note: Green highlighting shows reproductive health services spending reported separately in the WB survey at OP level.

Self-treatment Self-treatment estimates methodology is described in the “WB Survey HH Methodology Estimates” document, and private spending for 2004 for self-treatment (drugs and medical supplies) was estimated at 5,916,563,118 hrivnas. Summary of Private Financing Distribution Summarizing described above information for private financing on different levels based on WB Survey it is possible to produce the following distribution for major categories (Table 35).

Technical Notes

Table 35 Distribution of private spending based on WB Survey in 2004 Type of spending Amount Hospital Spending 692 508 271 General Medical Services 120 441 383 Medicines and medical supplies 333 899 212 Laboratory tests 238 167 677 OP Spending 1 819 392 921 General Medical Services 188 214 490 Medicines and medical supplies 952 072 570 Laboratory tests 679 105 861 Self-treatment drugs and medical supplies 5 916 563 118 Total 8 428 464 311

Per Cent 8,2% 1,4% 4,0% 2,8% 21,6% 2,2% 11,3% 8,1% 70,2% 100,0%

Using similar weights private spending for 2003 could be separated into sub-categories. It should be noted that the above table does not account for OP spending at hospital level. Due to the fact that additional data from State Statistics Committee on private and nonbudgetary health care facilities shows that the WB 2004 Survey under-estimated private household spending for sanatoriums and private clinics this distribution and total amounts needs to be adjusted (see Annex 4 “Methodology for Estimating Private and Non-Budgetary Health Care Facilities” for details). It is shown in the following Table 36. In order to come up with final estimates for private spending, SSC data on private clinics and sanatoriums (423 838 074 UAH in 2004) was added to the total amount reported under WB Survey, and then WB-captured spending on private clinics and sanatoriums (55 029 820 UAH in 2004 – see details in Table 18 and Table 33) was subtracted to avoid double counting. Table 36 Summary of Private Financing Distribution Adjusted for Additional Data on Private and NonBudgetary health care facilities from SSC

Total

Amount in 2004

Amount in 2003

8 797 272 566

7 174 537 772

Ukraine National Health Accounts 2003-2004

Annex 4: Methodology for Estimating Private and Non-Budgetary Health Care Facilities State Statistics committee provided the following data on private and non-budgetary health care facilities (see Table 37): Table 37 Income and Expenses for Private and Non-budgetary health care facilities Code Item 2003 % 2004 Income 845 821 500 100% 996 482 400 Income from households 342 667 649 41% 423 838 074 Income from employers and other sources* 503 153 851 59% 572 644 326 Expenditures 845 821 500 996 482 400 General and Specialized health 85.11.1 facilities 42 060 700 56 499 100 85.11.2 Maternity and Child Care 91 500 82 900 85.11.3 Sanatoriums and spa 629 256 500 722 249 600 85.12.0 Medical practice 94 765 400 117 500 500 85.13.0 Dentistry 47 266 600 54 357 000 Paramedical services outside of 85.14.1 facilities 15 361 700 23 313 000 85.14.2 Ambulance 17 019 100 22 480 300

% 100% 43% 57%

* Other sources account for small proportion of income for private and non-budgetary health care facilities (around 7%)

Assuming that structure of expenses is the same for different types of sources of income for private and non-budgetary health care facilities, it is possible to build the following table that would allow distribution of the expenses by different NHA classification categories. Table 38 Estimating distribution of expenses based on proportion of income for private and nonbudgetary facilities 2003 Code

85.11.1 85.11.2 85.11.3 85.12.0 85.13.0 85.14.1 85.14.2

Item Per cent distribution of income Expenditures General and Specialized health facilities Maternity and Child Care Sanatoriums and spa Medical practice Dentistry Paramedical services outside of facilities Ambulance

Total 100% 845 821 500 42 060 700 91 500 629 256 500 94 765 400 47 266 600 15 361 700 17 019 100

Households 41% 342 667 649 17 040 051 37 069 254 930 674 38 392 305 19 149 117 6 223 485 6 894 948

2004 Employers and other sources* 59% 503 153 851 25 020 649 54 431 374 325 826 56 373 095 28 117 483 9 138 215 10 124 152

Total 100% 996 482 400 56 499 100 82 900 722 249 600 117 500 500 54 357 000 23 313 000 22 480 300

Households 43% 423 838 074 24 031 001 35 260 307 197 477 49 976 985 23 119 893 9 915 817 9 561 641

Employers and other sources* 57% 572 644 326 32 468 099 47 640 415 052 123 67 523 515 31 237 107 13 397 183 12 918 659

* Other sources account for small proportion of income for private and non-budgetary health care facilities (around 7%)

This data provides very important information for the NHA allowing indirectly estimating employers expenses on health care. Employer expenses on health care together with some other sources (which are around 7% of the total) amount for 503 million hrivnas in 2003 and 573 million hrivnas in 2004. Additionally it can be concluded that spending by private households on sanatoriums and private clinics were underestimated in the WB 2004 Survey. The survey captured only 4 648 917 hrivnas of private household spending on sanatoriums, while based on the data from SSC on the private and non-budgetary facilities it can be estimated that private spending for sanatoriums was 307 197 477 hrivnas in 2004. The survey also reports only 355 277 hrivnas Technical Notes

spent by private households on private clinics in 2004, while data in the Table 38 clearly shows that this spending accounted for 116 640 597 hrivnas in 2004 (total household spending minus spending for sanatoriums). The above mentioned under-estimation in the part of private out-of-pocket expenses on sanatoriums and private clinics by the WB Survey could be explained in part by the fact that any household survey, especially quarterly SSC survey, and in less part, but still is subject to, WB survey, covers poorer population. While spending on private clinics and sanatorium and spa services could be afforded by richer population. It can be clearly seen with the reliable and robust data from SSC on private and non-budgetary health care facilities. The following table provides mapping of expenditures line items by employers and some other sources (other sources account only for a small proportion) to the NHA classification categories. It should be noted that in order to avoid putting curative care into “nsk” category, it was decided to keep curative care in the outpatient private facilities. This assumption has also some additional grounds, as quite a lot of private providers in Ukraine providing only OP services, proportion of those providing IP services relatively smaller. Table 39 Mapping of expenditure line items for employers to NHA classification categories NHA HP Code NHA HC Code and Item 2003 and Decription Description General and HC.1.3.4 All other outpatient 25 020 649 Specialized curative care / Все прочее health facilities амбулаторное лечение Maternity Child Care

HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги

and

HC.1.3.1 Basic medical and diagnostic services / Основные медицинские и диагностические услуги HC.1.3.2 Outpatient dental care / Амбулаторное стоматологическое лечение HC.4.9 All other miscellaneous ancillary services / Все прочие виды дополнительных услуг для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях

Medical practice

Dentistry

HP.3.7 Private clinics / Частные клиники

Paramedical services outside of facilities

Ambulance

Sanatoriums and spa

HP.2.9.9 Sanatoriums Санатории

HC.2.1 Sanatorium services / Санаторные услуги

2004 32 468 099

54 431

47 640

56 373 095

67 523 515

28 117 483

31 237 107

9 138 215

13 397 183

10 124 152

12 918 659

374 325 826

415 052 123

Ukraine National Health Accounts 2003-2004

Annex 5: Methodology for Estimating Social Security (Social security fund for accidents at work and occupational diseases) Information on income and expenses for the Social security fund for accidents at work and occupational diseases contains in the standard report by Ministry of Labor and Social Policy. Analysis of income and expense records from the above report allows disaggregating social security money by Financial Sources, Providers and Functions.

Estimating income of Social security related to health care Because expenses of the Social security fund for accidents at work and occupational diseases related to health care account only for part of the total expenses of the fund it is necessary to estimate share of overhead costs of the fund related to expenses on health care. We assume that overhead costs related to health care are proportionate to the distribution of the program expenses by the fund (Table 40). Table 40 Estimating share of overhead costs for Social Security expenses on health care 2003 2004 Item Amount, UAH % Amount, UAH Expenses related to health care Expenses not related to health care Total program expenses Overhead costs Overhead costs related to health care Total expenses related to health care

45 609 800 1 142 888 900 1 188 498 700 84 717 900 3 251 132 48 860 932

4% 96% 100%

49 973 300 1 439 645 200 1 489 618 500 100 690 200 3 377 926

% 3% 97% 100%

53 351 226

Since income from sources other than employers accounts for only 0.3% of total income, all Social Security income would be considered as coming from employers. Data from State Statistics Committee on average salary of employees working in the government and private sectors, number of employees allows distributing income of social security by different types of Financial Sources (FS), assuming that contributions to the social security are proportionate to the total salary paid in the given sector (Table 41).

Technical Notes

Table 41 Distributing Social Security income related to health care by Financial Sources (FS) Per cent Avera Number Total distributi Social Social ge of Financial estimated Security in Security in on of Source salary employees salary 2003 2004 total * * salary FS.1.1.1 Central government revenue / 351 702 200 246 472 200 5% 2 410 787 2 632 337 Центральное правительство FS.1.1.2 Regional and city government budget revenue, including rayon and local budgets 351 3 039 300 1 066 794 300 21% 10 434 499 11 393 424 revenue / Областные бюджеты, включая районные и местные бюджеты FS.2.1 462 7 970 000 3 682 140 000 74% 36 015 646 39 325 465 Employer funds / Работодатели 11 711 500 4 995 406 500 100% 48 860 932 53 351 226 Total

*All sectors of economy. Source: Labor 2003, State Statistics Committee

Mapping of Social security expenses to NHA classification categories Report on the Social security fund for accidents at work and occupational diseases by the Ministry of Labor and Social Policy provides detailed line item description for the expenses, which allows mapping of these line items to the NHA classification categories (see Table 42). Table 42 Mapping of Social Security Expenses to Providers (HP) and Functions (HC) Item

NHA HP Code and Description

NHA HC Code and Description

2003

2004

Prophylaxis of accidents at work and occupational diseases / Профилактика несчастных случаев на производстве и профессиональных заболеваний

HP.7.1 Establishments as providers of occupational health care services / Учреждения, предоставляющие услуги по охране здоровья на производстве

HC.6.5 Occupational health care / Охрана здоровья на производстве

15 455 000

10 016 500

30 154 800

39 956 800

Medical rehabilitation of injured at work / Медицинская реабилитация пострадавших на производстве

Ukraine National Health Accounts 2003-2004

Item Expenses on treatment of injured at work in medical institutions / затраты на лечение пострадавших на производстве в лечебнопрофилактических учреждениях Expenses on sanatorium treatment of handicapped / затраты на приобретение путевок для санаторно-курортного лечения инвалидов Expenses on orthopedic devices / затраты на приобретение протезное ортопедических изделий Expenses on orthopedic dentistry / затраты на протезирование зубов Expenses on purchase of special handicapped trolleys / затраты на приобретения специальных средств передвижения (коляски)

Expenses on orthopedic ophthalmology and glasses / затраты на протезирования глаз и приобретение очков

Expenses on hearing devices / затраты на слуховые аппараты

Expenses on medical goods and drugs / затраты на изделия медицинского, медикаментозного назначения и медицинские препараты

Technical Notes

NHA HP Code and Description

NHA HC Code and Description

HP.nsk Provider not specified by kind / Провайдеры, не определенные по типу

HC.1 Services curative care Услуги лечения

HP.2.9.9 Sanatoriums Санатории

HC.2.1 Sanatorium services / Санаторные услуги

HP.4.4 Retail sale and other suppliers of medical appliances (other than optical glasses and hearing aids) / Розничная продажа и прочие поставщики медицинских приборов (кроме оптических очков и слуховых приборов) HP.4.2 Retail sale and other suppliers of optical glasses and other vision products / Розничная продажа и прочие поставщики очков и различной продукции для органов зрения HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции

of /

HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования

2003

2004

4 687 500

8 390 100

11 174 800

13 173 500

3 337 600

3 670 900

27 700

17 100

577 500

6 600

9 600

27 800

50 800

3 410 900

5 221 500

Item

NHA HP Code and Description

NHA HC Code and Description

Expenses on special nursing care / затраты на специальный медицинский уход Expenses on continuos residential care / затраты на постоянный посторонний уход

HP.2.1 Nursing care facilities / Учреждения сестринского ухода

HC.3 Services of long-term nursing care / Услуги долгосрочного медсестринского ухода

HP.6.2 Social security funds / Фонды социального страхования

HC.7.1.2 Administration, operation and support of social security funds / Управление, проведение и поддержка фондов социального обеспечения

Share of overhead costs on Fund activities related to health care / Доля накладных расходов на деятельность Фонда, связанную со здравоохранением

2003

2004

2 337 000

2 749 500

5 144 900

6 096 300

3 251 132

3 377 926

Ukraine National Health Accounts 2003-2004

Annex 6: Methodology for Disaggregating Spending by Functions In order to disaggregate NHA spending by functions and produce Providers x Function and Financing Agents x Functions tables it is proposed to use different approach for the public expenditure and private expenditure. Using Financing Agents X Providers NHA estimates allows mapping various functions by providers and Financing Agents (See Table 48). Close look at this table shows that cells where only ONE function is mapped per provider do not require specific calculations, because estimates are already available from the Financing Agent x Provider (NHA Table No. 2) tables. Methodology for disaggregating should be elaborated only for those cells, where several functions are listed per provider and/or financing agent. Analysis of the Table 48 identifies following needs: 1. For various hospitals there is a need to separate: a. Hospital capital expenditures HC.R.1 from the total expenditure for a given provider; b. Separate remaining funds by the type of hospitals; c. Under each type of a hospital partition service provision costs between four major functions a) Inpatient curative HC.1.1; b) day cases of curative care HC.1.2; c)outpatient curative care HC.1.3; and d) ancillary services to curative care HC.4; 2. Within maternity houses in addition to inpatient/outpatient separation there is a need to separate inpatient services into OB & gynaecology. 3. Separation of functions listed under HP.1.3.2 AIDS clinics and centres will be dealt in the methodology for NHA HIV/AIDS Sub-analysis; 4. And for HP.3.1.5 Village doctor posts and HP.3.1.6 Feldsher-midwife posts there is a need to separate their services into curative (personal care services) HC1.3 and in the services that they offer to the groups of individuals and fall under HC.6 Prevention and public health. In order to address these needs following has been proposed: 他 Use different approaches for public spending distribution and different for the private expenditure, because capital expenditures are largely borne by public purchasers; 他 Service provision financing differs between public financiers and households. Public financing is input driven while private expenditures are output driven. Thus input variables could serve as a proxy to distribute the public health expenditure and utilization variables to estimate private expenditures by functions.

Methodology for estimating public expenditure for each function A. Separating Service provision costs from capital expenditures

1. The first step is to separate service provision costs from capital expenditures by type of facilities (including inpatient and outpatient service providers). The treasury data for government spending allows obtaining expenditures by budget functional (i.e. types of facilities) and economic codes. Economic codes help differentiating economic character of the public spending. Based on the treasury data from 2004 economic character of the public expenditures by different types of facilities was following (see Table 43). Using the levels of capital expenditures by types of the facilities it is possible to partition public Technical Notes

spending for e.g. general hospitals between services provision costs (=95%) and capital expenditure costs (=5%) or for the specialized hospitals were capital spending amounts to 11% of total public spending (see details in the Table 43). Table 43 Economic character of public expenditure by different type of health care facilities Per-Cent Out of recurrent Expenses Type of Facility

Policlinics and ambulatories, ambulance and emergency General Policlinics and ambulatories Specialized policlinics Dentist policlinics Ambulance and emergency Feldsher-Midwife posts Hospitals and sanatoriums General hospitals (adult and children) Specialized hospitals and other spec. fac. Maternity houses Sanatoriums Public Health Services Other activities in health care Orphanages Blood Banks Other agencies and services in Health Care Average for the health care sector

Recurrent Expenses

Capital Expenses

95%

Cost of Labour

Cost of other direct inputs and services

Utility Costs

Other

76%

19%

95%

76%

19%

87% 95% 98% 96% 94%

13% 5% 2% 4% 6%

65% 73% 79% 83% 67%

30% 21% 19% 10% 23%

5% 6% 2% 6% 10%

1% 4% 0% 1% 1%

95%

69%

21%

10%

89%

11%

59%

30%

10%

95% 95% 94% 83% 92% 94%

5% 5% 6% 17% 8% 6%

67% 52% 58% 58% 70% 52%

21% 33% 35% 36% 22% 38%

12% 14% 4% 4% 8% 9%

0% 2% 4% 4% 1% 1%

78%

22%

56%

40%

93%

68%

23%

Source: Calculated from Treasury of Ukraine data, 2004

B. Separating Service provision costs by types of hospital facilities

2. Calculated service provision costs, which amounts to 95% of total expenditure on general hospitals and maternity homes 95%, needs to be further partitioned according to the Figure 1. The level 1 on the Figure 1 requires partitioning general hospital expenditures between reproductive and non-reproductive functions. The data from the State Statistics Committee (SSC) provides detailed breakdown of the national bed capacity by type of beds. Based on this data 11% of total bed capacity is represented by obstetrical and gynecology (reproductive health) beds, which includes abortion beds. We assume that this distribution is uniform country-wide and use the bed capacity as a proxy to separate spending between Reproductive Health functions and General Care Function on a hospital level. 3. The next step is to separate Reproductive Health functions into three parts: a) maternity services (delivery and pregnancy complications); b) Gynecology function (not including abortions); c) abortion. For these purposes we will use total bed days as a proxy, with the exception of abortions (see Level 2 in the Figure 1). 4. According to the Center for Medical Statistics of Ukraine 1% of total RH beds are represented by the abortion beds, thus 1% of total spending for RH beds will be allocated for abortion function. In order to distribute the remaining funds between obstetrics and gynecology we use total bed days as a proxy for distribution, which is provided in the Table 44.

Ukraine National Health Accounts 2003-2004

Table 44 Distribution of bed days between obstetrical and gynaecological beds Type of Beds Obstetrics & gynaecology Obstetrics Gynaecology

2004 Total bed days 13,536,458

Distribution % 100.0%

6,165,328 7,542,609

45.5% 54.5%

Source: Center for Medical Statistics, Ukraine 2005

C. Separating Service provision costs by functions within the hospitals

5. The next step is to move to level 3 on the Figure 1 and separate each estimate from the previous sections into four critical functions, which are offered to the population by hospitals. We assume that all general hospitals in the country offer: a) inpatient curative care; b) day cases of curative care; c) outpatient curative care; and d) ancillary services to curative care which includes diagnostic tests, radiology etc. 6. The first step is to separate expenditures for all outpatient services from hospital expenditures. Based on the study carried out in Ukraine12, approximately 18-22% of total hospital expenditure (in oblast, city and rayon hospitals) is used to finance outpatient curative care provision, thus we take out from each type of hospital expenditure 20% for outpatient services offered on a hospital level. 7. From the remaining amount we separate estimates for the day cases of curative care = HC.1.2. We assume that day cases of curative care only occur on a hospital level (which is not exactly true for Ukraine) the share of expenditure does not differ between general and RH hospitals. For these estimates we use total bed days as a proxy to estimate percentage distribution between inpatient curative care HC.1.1 and day cases of curative care HC.1.2. According to the Center for Medical Statistics in 2003 only 1.6% of total bed days were used for day cases of curative care and in 2004 - 1.8% (see Table 45). These percentages allow estimating and subtracting the amounts used for the day cases of curative care and the remaining amount will represent the expenditure levels for inpatient curative care and ancillary services. Table 45 Bed capacity for day cases of curative care No. of Beds

Type of Beds 2003 HC.1.1 Inpatient curative care HC.1.2 Day cases of curative care Share of HC.1.2 in HC.1.1 (%)

419,679 55,320

Total Bed days 2004 412,606 59,152

2003 114,615,385 1,823,914 1.6%

2004 114,099,961 2,068,975 1.8%

Source: Center for Medical Statistics, Ukraine 2005

8. Unfortunately the available data from Ukraine does not provide sufficient details to separate expenditures for ancillary services to curative care within the hospital facilities. Due to this reason estimates for inpatient curative care HC.1.1 include these expenditures HC.4. For future it will be necessary to plan and carry out special study to estimate expenditures for these functions HC.4. 9. After estimating volumes of expenditure for all functions within the hospital on the level 3 from Figure 1 finally we group similar functional expenditures and reflect it in the appropriate cell of the Table 48 on page 87 for General Government financing. This table is the working table that allows constructing providers by functions and financial agents by function tables.

O.V. Lyulko, V.N. Lekhan et al. â&#x20AC;&#x153;Scientific justification for organization and management of primary health care for urban population under insurance medicineâ&#x20AC;?, Dnepropetrovsk State Medical Academy, 1995.

Technical Notes

D. Separating costs by functions within the children hospitals

10. The procedure for estimating expenditure levels by different functions within the children hospitals resembles the methodology described above with the exception that we would skip separating RH expenditures from the general hospital spending. E. Separating expenditures by functions within the maternities

11. For separating expenditures by functions within the maternities we should follow the steps 3,4 described on the page 82 and in the section C. F. Separating expenditures by functions within oncology hospitals

12. We assume that all oncology services are rendered out of oncology hospitals thus in order to separate the expenditures by the functions we have to follow the flowchart provided in the Figure 2. 13. First we separate capital expenses from the total expenditure spent on an oncology hospital level per Table 43. The remaining funds have to be separated between RH oncology and non-RH oncology services offered on a hospital level. For this purposes we use share of those patients (male and female) that have RH oncology diseases13. According to Center for Medical Statistics (CMS) in 2003 and 2004 share of those (males and females) that had RH oncology diseases amount to 4.9% out of total oncology patients. We use this share to estimate RH related oncology expenditure on a hospital level. Figure 1 Flowchart for partitioning expenditures into functions on a general hospital level

General Hospital Services (Oblast and city level) General Hospital Services

Level 1

Level 2

RH Hospital Services

89% of Total Expenditure

11 % of Total Expenditure

Distribution by bed capacity as a proxy

The distribution methodology described in the text

Inpatient Curative Care Day Cases of Curative Care Outpatient Curative Care Ancillary services to Curative Care Level 3

95% of Total Expenditure

Sum of detailed Expenditure

Inpatient Curative Care Day Cases of Curative Care Outpatient Curative Care Ancillary services to Curative Care

Maternity Services

Gyn. Services

Inpatient Curative Care Day Cases of Curative Care Outpatient Curative Care Ancillary services to Curative Care

Use of the No of patient instead of actual hospital utilization is determined by the fact that this is the only data routinely reported in the national statistics. On the other hand oncology facility provide in as well as outpatient services to the population thus the number of patients could be good proxy for RH oncology estimates.

Ukraine National Health Accounts 2003-2004

Figure 2 Flowchart for partitioning expenditures into functions on an oncology hospital level Oncology Hospitals

11 % of Total Expenditure

Level 1

Level 2

Level 3

Capital Expenses

Oncology Hospitals Services

89 % of Total Expenditure

Distribution by bed capacity as a proxy 4.9 % of Total Expenditure

Sum of detailed Expenditure

Inpatient Curative Care Day Cases of Curative Care Outpatient Curative Care Ancillary services to Curative Care

RH related Oncology Services

Other Oncology Services

Inpatient Curative Care Day Cases of Curative Care Outpatient Curative Care Ancillary services to Curative Care

14. Further steps will be similar to steps 5 through 9 on the page 83. G. Separating expenditures by functions for AIDS

15. AIDS expenditure detailed breakdown will be described in the methodology for HIV/AIDS sub-analysis. H. Separating expenditures by functions for other specialty hospitals

16. For specialty hospitals to separate capital expenses from total expenditure we use data from Table 43 and estimate capital expenses at 11% of total spending on this level. 17. Further steps will be similar to steps 5 through 9. Special considerations will be applicable to mental health hospitals (see reference to functional distribution of financing for mental health hospitals in the Annex on estimating spending by providers). I. Separating expenditures by functions for Outpatient facilities

18. Available data does not allow disaggregating OP expenditures in much detail. However, it is possible to separate capital expenditures from recurrent expenditures based on data from the Treasury by economics classification (see Table 43). In accordance to this information, HC.R.1 Capital formation for health care provider institutions accounts for 5% in general and dentist policlinics and for 13% in specialized OP facilities. 19. Regardless of the lack of the information for properly disaggregating expenditures for stand-alone adult OP facilities, it is important to separate RH functions for NHA subanalysis. Medical Statistics office at MoH provides information on number of doctors FTE (Full-time equivalents) for OB & Gyn doctors and doctors-genetics (family planning function) â&#x20AC;&#x201C; see Table 46. It also gives number of visits per one Ob & Gyn doctor FTE at women consultations within maternity houses (4,050 annual visit per doctor); assuming that number of visits for RH doctors is similar across different types of medical facilities it is possible to estimate number of RH visits in stand-alone adult OP facilities. At the

Technical Notes

same time State Statistics Committee14 gives total number of OP visits for stand-alone MoH policlinics. It allows constructing Table 47 to estimate spending proportions for RH and other OP functions within general policlinics. Applying these proportions to OP current expenditures part (remaining after capital formation is taken out), it is possible to separate Ob & Gyn, FP and other OP functions for general OP facilities. Table 46 Full-time equivalents (FTE) for RH doctors in stand-alone policlinics Types of Medical Providers

Full-time equivalents

OB & Gyn doctors in policlinics Doctors-genetics in policlinics

6 341 201 Total 6 542 Source: Health status of women population in Ukraine in 2002 (Center for Medical Statistics of MoH) Table 47 Estimation of proportion of OP Ob & Gyn, FP out of all OP RH Types of Visits Number

OB & Gyn OP visits 25 681 050 13,3% FP visits 814 050 0,4% All other OP visits in stand-alone MoH OP facilities 167 184 615 86,3% Total OP visits in stand-alone MoH OP facilities* 193 679 715 100,0% *Source: Medical Facilities and Health Status of Population in 2004 (State Statistics Committee)

J. Separating expenditures by functions for Village Doctor and Feldsher-Midwife posts

20. For the purposes of NHA village doctor and Feldsher-Midwife posts are treated equally. Capital expenses for these types of facilities are estimated at 4% of total expenditure. And the remaining of funds are separated into outpatient curative care HC1.3 and prevention and public health and preventive services HC.6. 21. Public health and preventive services are estimated to consume â&#x2030;&#x2C6;14-15%15 of the staff time, thus the expenditure for public health and preventive services HC.6 should amount of 14-15% of total expenditure on these facilities (less capital expenses). 22. Next step is to separate RH function out of all OP spending (after taking out preventive services in the previous step). Assuming that structure of RH and other OP visits is similar to those in general OP policlinics (Table 47) we can separate RH OP functions out of other OP spending.

Medical Facilities and Health Status of Population in 2004, State Statistics Committee. These percentages are author estimates and derived on the basis of the data from the Decree No. 1000 of the Ministry of Health of the Soviet Union

Ukraine National Health Accounts 2003-2004

Table 48 General Government financing= HF.1 HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство Providers / Поставщики (провайдеры) медицинских услуг (HP)

HF.1.1.1.1 Ministry of Health

HF.1.1.1.2 Ministry of Transport

HF.1.1.1.3 Ministry of Internal Affairs

HF.1.1.1.4 Ministry of Defence

HF.1.1.1.9 Other ministries

HF.1.1.2 Oblast/City/Local /Municipal governments (27)

HP.1 Hospitals / Больницы

HP.1.1 General hospitals / Больницы общего профиля

HC.1.1

HP.1.1.1 Oblast hospitals / Областные больницы

Higher category HC 1.1.1.1 HC 1.1.1.2.1 HC 1.1.1.2.9 HC1.1.9 HC.1.2 HC.1.3 HC.4.1 HC.4.2 HC.R.1 HC.1.1 HC.1.2 HC.1.3 HC.4.1 HC.4.2 HC.R.1

HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля

HP.1.1.1.2 Children oblast general hospitals / Детские областные больницы общего профиля

HP.1.1.1.9 Other oblast general hospitals / Другие областные больницы общего профиля HP.1.1.2 City Hospitals / Городские больницы

Technical Notes

HC.1.1

This is higher category, in the HPxHC table it will not be broken down (sum of lower items)

THIS CATEGORY IS NOT NEEDED Higher category

HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.1.1.2.1 City general hospitals / Городские больницы общего профиля

HP.1.1.2.2 Children city general hospitals / Детские городские больницы общего профиля

HF.1.1.1.1 Ministry of Health

HF.1.1.1.2 Ministry of Transport

HF.1.1.1.3 Ministry of Internal Affairs

HF.1.1.1.4 Ministry of Defence

HF.1.1.1.9 Other ministries

HF.1.1.2 Oblast/City/Local /Municipal governments (27) HC 1.1.1.1 HC 1.1.1.2.1 HC 1.1.1.2.9 HC1.1.9 HC.1.2 HC.1.3 HC.4.1 HC.4.2 HC.R.1 HC.1.1 HC.1.2 HC.1.3 HC.4.1 HC.4.2 HC.R.1

HP.1.1.2.9 Other city general hospitals / Другие городские больницы общего профиля

HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы

HC 1.1.1.1 HC 1.1.1.2.1 HC 1.1.1.2.9 HC1.1.9 HC.1.2 HC.1.3 HC1.4 HC.4.1 HC.4.2 HC.R.1

Ukraine National Health Accounts 2003-2004

HP.1.1.4 Rayon Hospitals / Районные больницы

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

HP.1.1.6 Maternity houses / Родильные дома

HF.1.1.1.1 Ministry of Health

HF.1.1.1.2 Ministry of Transport

HF.1.1.1.3 Ministry of Internal Affairs

HF.1.1.1.4 Ministry of Defence

HF.1.1.1.9 Other ministries

HF.1.1.2 Oblast/City/Local /Municipal governments (27) HC 1.1.1.1 HC 1.1.1.2.1 HC 1.1.1.2.9 HC1.1.9 HC.1.2 HC.1.3 HC1.4 HC.4.1 HC.4.2 HC.R.1 HC.1.1 HC.1.2 HC.1.3 HC.1.4 HC.4.1 HC.4.2 HC.R.1 HC 1.1.1.1 HC 1.1.1.2.1 HC 1.1.1.2.9 HC1.3 HC.1.4 HC.4.1 HC.4.2 HC.R.1

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля HP.1.2 Mental health and substance abuse hospitals / Психиатрические больницы для лечения алкогольной или наркотической зависимости

HC.1.1 HC.1.3.3 HC.4 HC.R.1

HP.1.2.1 Mental health hospitals / Психиатрические и психоневрологические больницы

Technical Notes

HP.1.2.2 Substance abuse hospitals / Наркологические больницы

HF.1.1.1.1 Ministry of Health

HF.1.1.1.2 Ministry of Transport

HF.1.1.1.3 Ministry of Internal Affairs

HF.1.1.1.4 Ministry of Defence

HF.1.1.1.9 Other ministries

HF.1.1.2 Oblast/City/Local /Municipal governments (27) HC.1.1 HC.1.2 HC.1.3.3.3 HC.4.1 HC.4.2 HC.R.1

HP.1.3 Specialty (other than mental health and substance abuse) hospitals / Специализированные больницы(кроме психиатрических больниц для лечения алкогольной или наркотической зависимости)

HP.1.3.1 Oncology hospitals and dispensers / Онкологические больницы и диспансеры

HP.1.3.2 AIDS clinics and centers / Клиники и центры ВИЧ/СПИД

HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы и диспансеры

HC.1.1.2.1 HC.1.1.2.2 HC.1.2 HC.1.3.3 HC.4.1 HC.4.2 HC.R.1 HC.1.1 HC.1.3.3.3 HC.1.3.3.4 HC.1.3.3.5 HC.1.3.3.6 HC.1.3.3.7 HC.2 HC.4.1 HC.4.2 HC.5.1.3.1 HC.6.1.1 HC.R.1 HC.1.1 HC.1.2 HC.1.3.3.1 HC.4.1 HC.4.2 HC.R.1

Ukraine National Health Accounts 2003-2004

HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры

HP.1.3.9 Other specialty hospitals / Другие специализированные больницы

HF.1.1.1.1 Ministry of Health

HF.1.1.1.2 Ministry of Transport

HF.1.1.1.3 Ministry of Internal Affairs

HF.1.1.1.4 Ministry of Defence

HF.1.1.1.9 Other ministries

HF.1.1.2 Oblast/City/Local /Municipal governments (27) HC.1.1 HC.1.2 HC.1.3.3.2 HC.4.1 HC.4.2 HC.R.1 HC.1.1 HC.1.2 HC.1.3.3.3 HC.4.1 HC.4.2 HC.R.1

HC.3

HP.2.2 Residential mental retardation, mental health and substance abuse facilities / Учреждения по уходу за умственно отсталыми, психиатрическими больными и лечения алкогольной или наркотической зависимости HP.2.2.1 Residential substance abuse facilities / Учреждения для лечения алкогольной или наркотической зависимости HP.2.2.2 Residential mental retardation and mental health facilities / Учреждения по уходу за умственно отсталыми и психиатрическими больными HP.2.3 Community care facilities for the elderly / Дома престарелых

HC.3

HP.2.4 Rehabilitation centers / Реабилитационные центры

HC.2

HP.2.9 All other residential care facilities / Все прочие учреждения по уходу

Technical Notes

HF.1.1.1.1 Ministry of Health

HF.1.1.1.2 Ministry of Transport

HF.1.1.1.3 Ministry of Internal Affairs

HF.1.1.1.4 Ministry of Defence

HF.1.1.1.9 Other ministries

HF.1.1.2 Oblast/City/Local /Municipal governments (27)

HP.2.9.1 Hospice / Хоспис HC.2.1 Sanatorium services

HP.2.9.9 Sanatoriums / Санатории HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги

Higher category HC.1.3 HC.R.1

HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники

HC.1.3 HC.R.1

Higher catogory HC.1.3.3.8 HC.6.1.9 HC.1.3.4 HC.4 HC.R.1 HC.1.3 HC.4 HC.R.1

HP.3.1.1 Adults Policlinics / Взрослые поликлиники

HP.3.1.2 Children's Policlinics / Детские поликлиники HP.3.1.3 Women consultations / Женские консультации HP.3.1.4 Mixed polyclinics / Смешанные поликлиники

HC.1.3.3.8 HC.1.3.4 HC.6 HC.R.1 HC.1.3.3.8 HC.1.3.4 HC.6 HC.R.1

HP.3.1.5 Village doctor posts / Сельские врачебные амбулатории

HP.3.1.6 Feldsher-midwife posts / Фельдшерско-акушерские пункты HP.3.1.9 All other not described in the above groups / Все остальное не включенное в других категориях HP.3.2 Offices of dentists / Стоматологические кабинеты (отделения)

HC1.3.2

HC.1.3.2 HC.R.1

Ukraine National Health Accounts 2003-2004

HF.1.1.1.1 Ministry of Health

HF.1.1.1.2 Ministry of Transport

HF.1.1.1.3 Ministry of Internal Affairs

HF.1.1.1.4 Ministry of Defence

HF.1.1.1.9 Other ministries

HF.1.1.2 Oblast/City/Local /Municipal governments (27)

HP.3.3 Offices of other health practitioners / Кабинеты (отделения) других работников здравоохранения HP.3.4 Outpatient care centres / Центры амбулаторного лечения

HC.1.3 Minus HC1.3.2

HC.1.3.1

HP.3.4.1 Family planning centres / Центры планирования семьи

HC.1.3.3 HC.4 HC.R.1 HC.6.1

HP.3.4.2 Outpatient mental health and substance abuse centres / Амбулаторные учреждения для лечения психиатрических заболеваний и алкогольной и наркотической зависимости

HC.2

HP.3.4.5 All other outpatient multi-specialty and cooperative service centres / Все прочие амбулаторные многопрофильные центры по предоставлению комбинированных медицинских услуг

HC.1.3.3.99

HP.3.4.9 All other outpatient community and other integrated care centres / Все прочие амбулаторные и интегрированные медицинские центры по уходу HP.3.5 Medical and diagnostic laboratories / Медицинские и диагностические лаборатории

HC.4.1

HP.3.6 Providers of home health care services / Организации, предоставляющие медицинские услуги на дому HP.3.9 Other providers of ambulatory health care / Прочие организации, предоставляющие амбулаторные медицинские услуги HP.3.9.1 Ambulance services / Скорая помощь HP.3.9.2 Blood and organ banks / Банки крови и органов

Technical Notes

HC.4.3 HC.6.3.1

HC.6.3.1

HF.1.1.1.1 Ministry of Health

HF.1.1.1.2 Ministry of Transport

HF.1.1.1.3 Ministry of Internal Affairs

HF.1.1.1.4 Ministry of Defence

HF.1.1.1.9 Other ministries

HF.1.1.2 Oblast/City/Local /Municipal governments (27)

HP.3.9.3 Alternative or traditional practitioners / Службы альтернативной или традиционной медицины

HC.nsk

HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги

HC.1.3

HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары

HC.5

HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции

HC.5.1

HP.4.2 Retail sale and other suppliers of optical glasses and other vision products / Розничная продажа и прочие поставщики очков и различной продукции для органов зрения

HC5.2

HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

HC5.2

HP.4.9 All other miscellaneous sale and other suppliers of pharmaceuticals and medical goods / Продажа прочей продукции и прочие поставщики фармацевтических или медицинских товаров

HC.5

HP.5 Provision and administration of public health programmes / Обеспечение и управление программами общественного здоровья

HC.6

Ukraine National Health Accounts 2003-2004

HF.1.1.1.1 Ministry of Health

HF.1.1.1.2 Ministry of Transport

HF.1.1.1.3 Ministry of Internal Affairs

HF.1.1.1.4 Ministry of Defence

HF.1.1.1.9 Other ministries

HF.1.1.2 Oblast/City/Local /Municipal governments (27)

HC.7.1.1

HP.6.2 Social security funds / Фонды социального страхования

HC.7.1.2

HP.6.3 Other social insurance / Прочее социальное страхование HP.6.4 Other (private) insurance / Прочее (частное) страхование HP.6.9 All other providers of health administration / Все прочие организации управления здравоохранением HP.7 All other industries (rest of the economy) / Все прочие сектора экономики

HC.7.1.1

?????

HC.6.5

HP.7.3 All other industries as secondary producers of health care / Все прочие отрасли промышленности как организации, предоставляющие вторичные медицинские услуги HP.8 Institutions providing health-related services / Учреждения, предоставляющие услуги, связанные со здравоохранением

HC.n.s.k

HP.8.1 Research institutions / Исследовательские институты

HC.R.3

HP 8.2 Education and training institutions / Учреждения образования и обучения

HC.R.2

Technical Notes

HP.8.3 Other institutions providing health-related services / Прочие учреждения, предоставляющие услуги, связанные со здравоохранением

HF.1.1.1.1 Ministry of Health

HF.1.1.1.2 Ministry of Transport

HF.1.1.1.3 Ministry of Internal Affairs

HF.1.1.1.4 Ministry of Defence

HC.R.nsk

HF.1.1.1.9 Other ministries

HF.1.1.2 Oblast/City/Local /Municipal governments (27)

HC.R.nsk

HP.9 Rest of the world / Остальной мир HP.nsk Provider not specified by kind / Провайдеры, не определенные по типу

??????

????????

HC.n.s.k.

HC.R.1

Ukraine National Health Accounts 2003-2004

Methodology for estimating private expenditure for each function 23. In order to estimate private expenditures for each function Table 51 has been developed. 24. Analysis of this table reveals the need to separate private spending on a hospital level among following functions: HC.1.1 Inpatient curative care HC.1.3 Outpatient curative care HC.4 Ancillary services to medical care HC.5 Medical goods dispensed to outpatients 25. And private expenditures on an outpatient level among following functions: HC.1.3 Outpatient curative care HC.4 Ancillary services to medical care HC.5 Medical goods dispensed to outpatients 26. The world bank survey that has been used to estimate most of private spending offers good insight how the private funds are spend for different functions and at different health care providers. Please refer to the document “Methodology to Disaggregate Data for Providers” (see Annex 3) for the sequential steps for disaggregating private spending for different health care providers. The following tables reflect this sequence as described in Annex 3, adding the breakdown for curative services and ancillary services. As it was described in Annex 2 “Methodology for Estimating Health Expenditures on a Household Level for 2004 and 2003”, WB Survey lumped together drugs and ancillary services, however proportional breakdown based on State Statistics Committee household survey was used to disaggregate these two categories. Assuming that ancillary services utilization is proportional to hospital / OP services utilization, we can distribute ancillary services as well among different types of health care providers.

Technical Notes

Table 49 Distribution of Private Spending on an OP level by different types of OP service providers in 2004 Health Care Provider

Distribution

HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.1.2 Children oblast general hospitals / Детские областные больницы общего профиля HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.2.2 Children city general hospitals / Детские городские больницы общего профиля

Total OP Curative Care and Ancillary Services

HC.1.3 Outpatient Curative Care

HC.4 Ancillary services to medical care

2,02%

17 525 449

3 803 143

13 722 306

1,12%

9 732 695

2 112 062

7 620 633

11,00%

95 374 354

20 696 892

74 677 462

2,05%

17 816 998

3 866 411

13 950 587

HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы HP.1.1.4 Rayon Hospitals / Районные больницы

9,62%

83 405 953

18 099 666

65 306 286

0,99%

8 595 946

1 865 379

6 730 566

HP.1.1.5 Dilnichni Hospitals Участковые больницы

7,86%

68 145 360

14 788 012

53 357 348

HP.3.1.1 Adults Policlinics / Взрослые поликлиники

20,72%

179 690 480

38 994 072

140 696 408

HP.3.1.2 Children's Детские поликлиники

12,63%

109 548 714

23 772 826

85 775 889

10,30%

89 346 139

19 388 727

69 957 411

12,70%

110 149 685

23 903 240

86 246 444

1,40%

12 114 731

2 628 980

9 485 751

2,71%

23 472 291

5 093 649

18 378 642

4,63%

40 130 045

8 708 496

31 421 549

0,26%

2 271 512

492 934

1 778 578

867 320 351

188 214 490

Policlinics

HP.3.1.1 Adults Policlinics / Взрослые поликлиники (Reproductive Health Репродуктивное здоровье) HP.3.2 Offices of dentists / Стоматологические кабинеты (отделения) HP.3.4 Outpatient care centres / Центры амбулаторного лечения HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги HP.3.7 Private clinics / Частные клиники HP.n.s.k Total

100,00%

679 105 861

Ukraine National Health Accounts 2003-2004

Table 50 Private Financing Distribution on a Hospital level in 2004 Detailed Distribution (Hospital Services and Ancillary services)

Hospital Services

Ancillary services

12,56%

15 125 884

29 910 788

45 036 672

6,37%

7 675 257

15 177 492

22 852 749

26,24%

31 599 943

62 487 533

94 087 476

3,17%

3 812 318

7 538 696

11 351 014

24,06%

28 972 861

57 292 592

86 265 453

2,91%

3 504 460

6 929 919

10 434 379

HP.1.1.5 Dilnichni Hospitals / Участковые больницы HP.1.1.6 Maternity houses / Родильные дома

3,24% 7,09%

3 905 726 8 534 939

7 723 406 16 877 477

11 629 132 25 412 417

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

3,34%

4 022 760

7 954 835

11 977 595

NHA code and Description

Per Cent

HP.1.2.2 Substance abuse hospitals / Наркологические больницы HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы и диспансеры

0,25%

305 701

604 510

910 211

0,53%

637 155

1 259 947

1 897 102

HP.1.3.4 STI clinics and dispensers / Кожновенерологические клиники и диспансеры

0,23%

272 712

539 277

811 989

HP.1.3.9 Other specialty hospitals / Другие специализированные больницы HP.2.9.9 Sanatoriums / Санатории HP.3.7 Private clinics / Частные клиники * HP.nsk

4,92% 3,86% 0,29% 0,95%

5 921 454 4 648 917 355 277 1 146 019

11 709 421 9 193 035 702 545 2 266 203

17 630 875 13 841 952 1 057 822 3 412 222

100,00%

120 441 383

238 167 677

358 609 059

Total

27. Adjustment for data on private clinics and sanatoriums spending from State Statistics Committee allows constructing final distribution of private spending (see Annex 3 “Methodology to Disaggregate Data for Providers”) 28. Functional distribution for private clinics spending by employers is described in Annex 4 “Methodology for Estimating Private and Non-Budgetary Health Care Facilities”

Technical Notes

Table 51 Private Financing HF.2 & HF.3

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HF.2.2 Other private VOLUNTA RY insurance

HF2 Private Financing Agents HF.2.4 NonHF.2.5 profit Private firms HF.2.3 Institutions and Private serving corporations households' households (other than out-of pocket (other than health payment social insurance, insurance) /

HF.2.6 Hospital kassa

HF.3The Rest of the World

HP.1 Hospitals / Больницы HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 Oblast hospitals / Областные больницы

HC.1.1 HC.1.3 HC.4 HC.5

HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.1.2 Children oblast general hospitals / Детские областные больницы общего профиля HP.1.1.1.9 Other oblast general hospitals / Другие областные больницы общего профиля HP.1.1.2 City Hospitals / Городские больницы

HC.1.1 HC.1.3 HC.4 HC.5

HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.2.2 Children city general hospitals / Детские городские больницы общего профиля HP.1.1.2.9 Other city general hospitals / Другие городские больницы общего профиля

100

Ukraine National Health Accounts 2003-2004

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы

HP.1.1.4 Rayon Hospitals / Районные больницы

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

HP.1.1.6 Maternity houses / Родильные дома

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

HF.2.2 Other private VOLUNTA RY insurance

HF2 Private Financing Agents HF.2.4 NonHF.2.5 profit Private firms HF.2.3 Institutions Private and serving corporations households' households out-of pocket (other than (other than health payment social insurance, insurance) / HC.1.1 HC.1.3 HC.4 HC.5 HC.1.1 HC.1.3 HC.4 HC.5 HC.1.1 HC.1.3 HC.4 HC.5 HC.1.1.1 HC.1.3 HC.4 HC.5 HC.1.1 HC.1.3 HC.4 HC.5

HF.2.6 Hospital kassa

HF.3The Rest of the World

HP.1.2 Mental health and substance abuse hospitals / Психиатрические больницы для лечения алкогольной или наркотической зависимости HP.1.2.1 Mental health hospitals / Психиатрические и психоневрологические больницы HP.1.2.2 Substance abuse hospitals / Наркологические больницы

HC.1.1

Technical Notes

101

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HF.2.2 Other private VOLUNTA RY insurance

HF.2.6 Hospital kassa

HF.3The Rest of the World

HP.1.3.1 Oncology hospitals and dispensers / Онкологические больницы и диспансеры HP.1.3.2 AIDS clinics and centers / Клиники и центры ВИЧ/СПИД

HC.5.1.1.1

HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы и диспансеры

HC.1.1

HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры

HC.1.3

HP.1.3.9 Other specialty hospitals / Другие специализированные больницы

HC.1.1

HP.2 Nursing and residential care facilities / Сестринские/врачебные учреждения длительного пребывания больных (по уходу) HP.2.1 Nursing care facilities / Учреждения сестринского ухода HP.2.2 Residential mental retardation, mental health and substance abuse facilities / Учреждения по уходу за умственно отсталыми, психиатрическими больными и лечения алкогольной или наркотической зависимости HP.2.2.1 Residential substance abuse facilities / Учреждения для лечения алкогольной или наркотической зависимости HP.2.2.2 Residential mental retardation and mental health facilities / Учреждения по уходу за умственно отсталыми и психиатрическими больными HP.2.3 Community care facilities for the elderly / Дома престарелых

102

Ukraine National Health Accounts 2003-2004

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HF.2.2 Other private VOLUNTA RY insurance

HF.2.6 Hospital kassa

HF.3The Rest of the World

HP.2.4 Rehabilitation centers / Реабилитационные центры HP.2.9 All other residential care facilities / Все прочие учреждения по уходу HP.2.9.1 Hospice / Хоспис HP.2.9.9 Sanatoriums / Санатории HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники

HC.1.3 HC.4 HC.5

HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.2 Children's Policlinics / Детские поликлиники HP.3.1.3 Women consultations / Женские консультации HP.3.1.4 Mixed polyclinics / Смешанные поликлиники HP.3.1.5 Village doctor posts / Сельские врачебные амбулатории HP.3.1.6 Feldsher-midwife posts / Фельдшерско-акушерские пункты HP.3.1.9 All other not described in the above groups / Все остальное не включенное в других категориях HP.3.2 Offices of dentists / Стоматологические кабинеты (отделения)

HC.1.3.2

Technical Notes

HC.1.3 HC.4 HC.5

103

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HF.2.2 Other private VOLUNTA RY insurance

HF.2.6 Hospital kassa

HF.3The Rest of the World

HP.3.4.1 Family planning centres / Центры планирования семьи HP.3.4.2 Outpatient mental health and substance abuse centres / Амбулаторные учреждения для лечения психиатрических заболеваний и алкогольной и наркотической зависимости HP.3.4.5 All other outpatient multi-specialty and cooperative service centres / Все прочие амбулаторные многопрофильные центры по предоставлению комбинированных медицинских услуг HP.3.4.9 All other outpatient community and other integrated care centres / Все прочие амбулаторные и интегрированные медицинские центры по уходу HP.3.5 Medical and diagnostic laboratories / Медицинские и диагностические лаборатории

HC.4

HP.3.6 Providers of home health care services / Организации, предоставляющие медицинские услуги на дому

HP.3.7 Private clinics / Частные клиники

HP.3.9 Other providers of ambulatory health care / Прочие организации, предоставляющие амбулаторные медицинские услуги

HC.1.3.1 HC.1.3.2 HC.1.3.3.8 HC.1.3.4 HC.4.3 HC.4.9 HC.1.3 HC.4

HP.3.9.1 Ambulance services / Скорая помощь HP.3.9.2 Blood and organ banks / Банки крови и органов

104

Ukraine National Health Accounts 2003-2004

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HF.2.2 Other private VOLUNTA RY insurance

HP.3.9.3 Alternative or traditional practitioners / Службы альтернативной или традиционной медицины

HC.R.n.s.k

HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги

HC.1.3.4

HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары

HC.5

HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции

HF.2.6 Hospital kassa

HF.3The Rest of the World

HC.5

HP.4.2 Retail sale and other suppliers of optical glasses and other vision products / Розничная продажа и прочие поставщики очков и различной продукции для органов зрения HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

Technical Notes

105

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.5 Provision and administration of public health programmes / Обеспечение и управление программами общественного здоровья

HF.2.2 Other private VOLUNTA RY insurance

HF.2.6 Hospital kassa

HF.3The Rest of the World

HC.6.3.2 HIV/AIDS

HP.6 General health administration and insurance / Общее управление здравоохранением и медицинское страхование HP.6.1 Government administration of health / Государственное управление здравоохранением HP.6.2 Social security funds / Фонды социального страхования HP.6.3 Other social insurance / Прочее социальное страхование HP.6.4 Other (private) insurance / Прочее (частное) страхование HP.6.9 All other providers of health administration / Все прочие организации управления здравоохранением HP.7 All other industries (rest of the economy) / Все прочие сектора экономики

HP.7.1 Establishments as providers of occupational health care services / Учреждения, предоставляющие услуги по охране здоровья на производстве HP.7.3 All other industries as secondary producers of health care / Все прочие отрасли промышленности как организации, предоставляющие вторичные медицинские услуги HP.8 Institutions providing health-related services / Учреждения, предоставляющие услуги, связанные со здравоохранением HP.8.1 Research institutions / Исследовательские институты

106

Ukraine National Health Accounts 2003-2004

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HF.2.2 Other private VOLUNTA RY insurance

HF.2.6 Hospital kassa

HF.3The Rest of the World

HP 8.2 Education and training institutions / Учреждения образования и обучения

HP.8.3 Other institutions providing health-related services / Прочие учреждения, предоставляющие услуги, связанные со здравоохранением HP.9 Rest of the world / Остальной мир HP.nsk Provider not specified by kind / Провайдеры, не определенные по типу

Technical Notes

HC.n.s.k

HC.n.s.k.

HC.n.s.k

107

Annex 7: Methodology for conducting the RH NHA subanalysis in Ukraine Estimating Major Categories for Reproductive Health NHA Subanalysis Major categories for the Reproductive Health NHA Subanalysis were estimated and explained in detail in the general NHA methodologies annexes. National Health Accounts classifications and analysis are comprehensive and exhaustive, and all spending related to reproductive health is part of the general NHA. To construct the reproductive health subanalysis tables, major reproductive health categories (at the functional and provider levels) are identified in the general NHA tables. Several categories for the RH subanalysis were not detailed in the general NHA (though they remain integral part of it) and will be discussed in this Annex.

Reproductive Health versus HIV/AIDS NHA Subanalyses Boundary Considerations As agreed with the NHA Working Group in Ukraine, STI management and STI clinics spending will be considered as part of RH spending. IEC campaigns targeting prevention of STIs (and, in most cases, simultaneously HIV or vice versa) will be considered under the HIV/AIDS subanalysis.

Estimating Public Spending for Reproductive Health Ambulatory Services, Day Cases and Capital Formation in General Hospitals For the purposes of the reproductive health subanalysis it is important to estimate RH OP public spending that occurs in general joint hospitals. The Center for Medical Statistics of the MoH provides information on the number of Full-Time Equivalents (FTE) for obstetricians/ gynecologists and doctors-genetics16 in Central Rayon Hospitals (typical joint hospital providers)17. There were 6,053 FTE in 2002. It was also reported that the number of OP visits per FTE for women consultations within maternity houses was 4,050. Assuming that the number of OP visits is the same per FTE of obstetricians/ gynecologists in both types of RH ambulatory facilities, we can estimate total number of RH visits in Central Rayon Hospitals in 2004. The State Statistics Committee reports on the number of total OP visits in Central Rayon Hospitals18, which allows for estimating the portion of total spending in Central Rayon Hospitals that can be attributed to RH visits (see Table 52). Table 52 Estimation of proportion of OP ob & gyn out of all OP visits in Central Rayon Hospitals Types of Visits Number % Ob & gyn OP visits 13 846 950 12,4% All other OP visits in Central Rayon Hospitals 97 854 748 87,6% Total OP visits in Central Rayon Hospitals* 111 701 698 100,0% *Source: Medical Facilities and Health Status of Population in 2004 (State Statistics Committee)

This share can be applied to other joint general hospitals (city general hospitals, etc.).

Doctor-genetics is a physician specialty in Ukraine, mainly responsible for family planning services, prediction of birth defects, etc. 17 Health Status of Women Population in 2002, Center for Medical Statistics at MoH 18 Medical Facilities and Health Status of Population in 2004, State Statistics Committee.

108

Ukraine National Health Accounts 2003-2004

Mirroring how day cases were estimated in the general NHA methodology, it was assumed that public spending for day cases related to RH is proportional to spending for IP RH services. Thus, 11% of spending for all day cases are allocated to RH, assuming that number of day cases beds is proportional to the number of regular beds of a given specialty (in this case – RH beds). For the purposes of the NHA RH subanalysis we will assume that the proportion of capital formation related to RH in a given type of health providers is the same as proportion of spending for RH relative to all other health care services. For example, for Central Rayon Hospitals (and other joint general hospitals) the proportion of capital formation related to RH will be 13.5% out of total spending for capital formation: 11% (IP RH) + (20% (Total OP) * 12.4% (OP RH out of Total OP)) = 13.5%.

Estimating Public Spending for Reproductive Health Ambulatory Services, Day Cases and Capital Formation in Oncology Hospitals As was described in the general NHA methodology document “Methodology for Estimating Spending by Functions”, RH oncology IP spending accounts for 4.9% of IP services spending for oncology hospital services. This proportion, 4.9%, was based on proportion of people (men and women) who have RH cancers of the reproductive system. It is reasonable to assume that spending structure for other oncology hospitals line items would resemble this proportion. Therefore, we will take 4.9% of total OP services, day cases and capital formation for RH sub-analysis as well.

Estimating Spending for Sanatoriums Related to Reproductive Health Spending on sanatorium services accounts for a significant proportion of total healthcare spending (7% in 2004). It was already recommended in the discussion section of the document on National Health Accounts classifications in Ukraine (see general NHA methodological documents) that sanatoriums should eventually be excluded from total healthcare spending. However, sanatoriums have been included in the current estimate of THE because they are an integral part of the current Ukrainian health care system. Hence, an effort is made to identify the portion of health service delivery in sanatoriums that is directly related reproductive health sickness while recognizing that the extent to which sanatorium services lead to improvements in health is questionable. The reason for this is that, otherwise, RH subanalysis would considerably underestimate any proportional RH assessment out of total health care spending (e.g., per cent of RH spending out of total healthcare expenditures (THE)). As there is neither statistics for RH service utilization in sanatoriums nor other suitable proxies—such as RH beds—an arbitrary share of 12% is utilized because it falls in the range for the RH share of IP and OP spending, which are 11 and 13 percent respectively.

Estimating Public Spending for Reproductive Health Capital Formation in General Adult OP Facilities It was assumed that proportion of capital formation related to reproductive health in general adult OP facilities is the same as proportion of OP RH services spending out of total OP services spending (estimated in general NHA methodology documents). For both obstetrics & gynecology and FP functions a share of 13.7% was used. It should be noted that we do not apportion capital outlays that are not known for what they went (almost all Central budget spending), but we apportion only capital investment in general hospitals / OP facilities with known number of RH beds / offices (OP visits). If we would have not accounted for capital outlays for existing ob & gyn departments and separate offices in the structure of the given health facilities, it would underestimate public spending for RH. This issue was brought up at the WG meeting and an agreement was reached on taking this approach. Technical Notes

109

Estimating Private Households Spending for Reproductive Health Services in General Hospitals When estimating private household spending for general hospitals all services were estimated together (without separating RH). For the RH subanalysis it is necessary to estimate the share of household spending attributable to RH. Center of Medical Statistics of the MoH provides information on total number of bed-days for all specialties, including obstetric & gynecology. Utilization figures can be used for estimating the proportion of private household spending on RH IP services. Assuming that structure of national bed-days represents the structure of beddays in general hospitals we can separate private household spending for RH services in general hospitals (See Table 53). In the absence of unit cost information, this is the best we can do and as better cost data becomes available the validity of these estimates needs to be assessed and revised if necessary. Table 53 Estimation of Proportion of Private Household Spending on RH IP Services in General Hospitals in 2004 Type of Service

Average days per bed*

Number of Beds*

Obstetrics 260,9 Gynecology (excluding abortions) 345,01 Abortions 345,01 All diseases 334,88 *Source: Center for Medical Statistics at MoH, 2005

Annual Bed days for the Service

% Distribution

23 631

6 165 328

4,46%

21 365 497 412 606

7 371 130 171 478 138 173 497

5,33% 0,12% 100,00%

It was already estimated above (Table 52) that based on the structure of OP visits, RH services OP visits account for 12.4% out of total OP visits in general hospitals. We will use this proxy to separate private household spending for OP RH services in general hospitals. Indeed, it is the only proxy available at the moment, otherwise we would had to keep all spending in a lump sum without any distribution.. Private spending in the general NHA included expenditures on ancillary services. To estimate the RH share of ancillary services, the IP RH proportion is applied to IP ancillary services and OP RH proportion is applied to OP ancillary services.

Estimating Oral Contraception Spending A survey conducted by POLICY project â&#x20AC;&#x153;Willingness and Ability to Pay for Contraceptionâ&#x20AC;? provides figures on usage of different types of contraception in Ukraine by women of reproductive age (15-49 years old). See Table 54. It can be seen from the table that all methods of contraception account for 52.6%, while estimated 47.4% of reproductive age women do not use any method. This table is not used at all to allocate any spending. It is source information for methodology described further and only number of women 15-49 years old who use a given service is being estimated out of it.

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Ukraine National Health Accounts 2003-2004

Table 54 Current usage of methods of contraception by women of reproductive age (15-49 years old)* Method Per Cent Oral contraceptives 5,1% IUD 13,0% Condoms 17,6% Other barrier methods 0,1% Spermicides 2,0% Women sterilization 0,5% Method of lactation amenorrhea 0,2% Interrupted sexual intercourse 6,8% Calendar method 5,2% Abstention of sexual intercourse 0,2% Syringing 2,2% Other methods 0,0% All Methods 52,6% * Source: Willingness and Ability to Pay for Contraception study, POLICY project, 2005

Estimation of private and public spending for oral contraception is described in Table 55. The bottom line in the table shows estimated annual government spending for oral contraception, including donor contributions. However, it is known that donor provision of oral contraceptives occurred primarily through 1999, though distribution continued through 2001 from remaining stockpiles. In 2003 and 2004, donor assistance for oral contraceptives was very small19. This means that the government paid for almost all â&#x20AC;&#x153;free-of-chargeâ&#x20AC;? oral contraceptives. We understand the weakness of the assumption that the cost of one oral contraception cycle for the government is the same as for private purchases; most likely, it was lower. However, because we were not able to obtain any estimates of prices paid by the government, private median cost of one cycle was used. Hence government spending for oral contraceptives is likely to be overestimated. It should be noted that spending associated with medical consultations for the administration of oral contraception was captured in the total amount for reproductive health services (both public and private) and is described in detail in the general NHA methodology. Table 55 Estimation of Spending for Oral contraceptives, UAH 2004 2003 Number of women 15-49 years old* 12 516 747 12 488 947 Percent of women 15-49 years old using oral contraception** 5,1% 5,1% Estimated women 15-49 year old using oral contraception 638 354 636 936 Median cost of purchasing oral contraceptives for one cycle** 21 21 Average annual cost of purchasing oral contraceptives 319 319 Percent of women who pay out-of-pocket** 93,3% 93,3% Estimated annual private spending for oral contraceptives 190 214 759 189 792 287 Estimated annual government (including donor contributions) 13 659 581 13 629 243 spending for oral contraceptives Estimated total annual spending for oral contraceptives 203 874 340 203 421 530 * Source: Health Status of Women population in 2003 and 2004, Center for Medical Statistics at MoH ** Source: Willingness and Ability to Pay for Contraception study, POLICY project, 2005

It should be noted that in accordance to the official statistics by Center for Medical Statistics at MoH the total number of women who are using oral contraception is much higher (1,721,523 in 2004, and 1,554,719 in 2003). We consider the Willingness and Ability to Pay

Information obtained in private interview with a RH national expert.

Technical Notes

111

for Contraception survey by the POLICY Project as a representative one (confirmed by independent international organizations) and used their estimate of the number of women of reproductive age who use oral contraception. In addition, CDC Reproductive Health Survey conducted in 1999 showed only 3% current usage of oral contraceptives. It is well-known that, in Ukraine, official medical statistics are artificially inflated; medical facilities have an incentive to do so, otherwise their staffing / number of beds could be reduced and, as a result, their financing, too (as financing is input based). Also there could be a registration bias. Women who stop attending FP consultations after their oral contraception start-up visit may continue to be categorized as oral contraceptive users, though they may have switched to another method of contraception or abandoned contraception all together. Yet another triangulation that leads us to have greater confidence on the lower survey figures is that, if official statistics are true, then—given the price of oral contraceptives—private spending for oral contraceptives would have been around 512,974,044 in 2004, which accounts for 7.12% of total estimated private spending for pharmaceuticals. Given the relatively higher price of other non contraceptive drugs (antibiotics, pain relievers, etc.) and overall rather low socioeconomics status of population of Ukraine, it is unlikely that contraceptive would account for such a large proportion of household spending on pharmaceuticals.

Estimating IUD Contraception Spending Estimations for spending for Intra Uterine Devices (IUD) are described in Table 56. In order to estimate the annual cost of purchasing IUD devices, official reported number of IUD insertions by Center for Medical Statistics at MoH was used. Official numbers were used for IUD insertions (182 783 в 2004 году и 185 728 в 2003 году). As IUDs can be inserted only in a medical facility, it was thought that the official number of insertions is the most reliable. Number of women who use IUD as a method of contraception is considerably higher (1 629 070 in 2004 and 1 625 452 in 2003 in accordance to POLICY project survey on willingness and ability to pay for contraception (13% of women of reproductive age); 1 847 459 in 2004 and 1 812 219 in 2003 in accordance to official statistics by MedStat at MoH). In terms of estimations of volume of financial flow only actual annual insertions of IUD matter. It is known that the government provides a certain amount of IUD devices free-of-charge to women, though the exact amount of subsidization is not known. It was assumed that government subsidization for IUDs is the same as its subsidization of oral contraception, an amount that can be derived from the willingness and ability to pay for contraception study. It should be noted that medical service cost associated with insertion of IUDs and related consultations were captured in the total amount for reproductive health services (both public and private) and are described in detail in the general NHA methodology. Table 56 Estimation of Spending for Intra-Uterus Device (IUD), UAH 2004 2003 Number of inserted IUD* 182 783 185 728 Median cost of one IUD device** 50 50 Percent of Women who pay out-of-pocket*** 93,3% 93,3% Estimated annual private spending for purchase of IUD devices 8 526 827 9 286 400 Estimated annual government spending for purchase of IUD 612 323 622 189 devices Estimated total annual spending for purchase of IUD devices 9 139 150 9 908 589 * Source: Resources of Health Care System and Their Usage in 2003 and 2004; Center for Medical Statistics at MoH ** Source: Willingness and Ability to Pay for Contraception study, POLICY project, 2005 *** Based on assumption that per cent of women who pay out-of-pocket as the same as for oral contraception

112

Ukraine National Health Accounts 2003-2004

Estimating Other Methods of Contraception Spending The survey conducted by the POLICY Project on willingness and ability to pay for contraception was able to capture current usage of different methods of contraception by women of reproductive age (see Table 54). However, it is a challenging task to estimate spending for methods of contraception other than oral contraceptives and IUDs. It is known that usage of methods such as condoms (reported as a method of contraception by 17,6% of women, or 2,198,701 in 2004) and spermicides (reported by 2,0% of women, or 244,346 in 2004) usually is sporadic and frequency of use of these methods by women may vary considerably from woman to woman. The POLICY Project survey captured the median cost of purchasing one pack of three condomsâ&#x20AC;&#x201D;4 UAH. However, it is extremely difficult or almost impossible to extrapolate this information into actual annual total spending for those methods of contraception. Condoms will be dealt with in particular in the NHA HIV subanalysis. Capturing the share of condoms that are used purely for family planning (reproductive health) purposes versus condoms that are used for prevention of HIV and STIs is difficult and, probably, somewhat artificial. Further, such figures would have little relevance to health policy. Concerning the remaining methods of contraception, they account only for a small proportion and no details are available to allow for estimating related spending.

Estimating Private Households Spending for Pharmaceuticals Related to RH (other than Oral Contraceptives and IUDs) In Ukraine, private households spending comprises the biggest proportion of spending for pharmaceuticals, since public financing is not capable of covering pharmaceuticals costs in most cases. There is a dearth of statistics on drugs purchased for treatment and care related to reproductive health (other than spending for oral contraceptives and IUDs). There could be a multitude of drugs used for RH, from antibiotics to vitamins, and most drugs have multiple purposes. Using proxies derived from medical statistics on incidence of RH diseases would not be helpful as severity of diseases and variance in pharmaceuticals prices would lead to considerably variations in treatment cost across illnesses. However, not taking into consideration private households spending for RH drugs (other than oral contraceptives and IUDS) in the RH subanalysis would considerably underestimate any proportional RH assessment out of total health care spending (e.g., percent of RH spending out of total healthcare expenditures (THE)). For that reason, despite imperfect information, a proportion of private spending on pharmaceuticals will be attributed to RH. Our previous estimates show that proportion of RH spending out of other health care services ranges from 11% for IP RH services to 13% for OP RH services (with the exception of oncology RH, where it accounts only for 4.9%). Assuming that spending for drugs is proportional to services utilization, for the purposes of RH subanalysis, we will take arbitrary 12% out of total private households spending for pharmaceuticals. This amount includes spending for oral contraceptives and IUDs (because RH services utilization includes contraception / family planning services) and that were estimated according to the method previously described. Therefore, private household spending for drugs for reproductive health, other than oral contraceptives and IUDs, would be estimated at 665,562,602 UAH in 2004. Please see for details Table 57. It is well understood that the approach used is an oversimplification and that ideally we would like to have better data, but that for now this is all that can be done with existing data.

Technical Notes

113

Table 57 Estimation of Private Household Spending for Pharmaceuticals Related to RH Item 2004 2003 7 202 534 901 5 876 535 255 Total private spending for drugs 864 304 188 705 184 231 Proportion of private spending for drugs for RH (12%) Total private spending for oral contraceptives and 198 741 586 199 078 687 purchase of IUDs 190 214 759 189 792 287 Private spending for oral contraceptives 8 526 827 9 286 400 Private spending for purchase of IUDs Private spending for drugs for RH other than oral 665 562 602 506 105 543 contraceptives and IUDs

Estimating Spending of Social Security Fund for Accidents at Work and Occupational Diseases between different Financial Sources We assume that spending of Social Security Fund for Accidents at Work and Occupational Diseases for RH is proportionally distributed between the three contributing Financial Sources (Central Government, Regional Government and Private Employers) in accordance to their total contributions to the social security fund (see methodology for general NHA).

114

Ukraine National Health Accounts 2003-2004

Annex 8: Methodology for conducting the HIV/AIDS NHA subanalysis in Ukraine Introduction The expenditure on HIV/AIDS in Ukraine is by Central and Regional/Local governments, private households, non-profit institutions serving households (e.g. Olena Franchuk Foundation) and donor funds. Response to the emerging HIV/AIDS epidemic is mainly funded from external resources. At present, GFATM and USAID grants and loan from the World Bank finance significant share of HIV/AIDS, however, in the long term, public financing is expected to replace these funds. Though, it may become a challenging task for the government to handle, without adequate tracking system of the resources (government, private and donor) that flows into the sector and for HIV/AIDS. Attempts to compile reliable data for national health spending and HIV/AIDS have not offered expected results as of yet, because the government tracking system lacks capacity to determine source and purpose of fund flows. Information on expenditures from donors and non-profit institutions serving households is available from the survey funded by the World Bank20, as well as from donor questionnaires administered by “National Health Accounts in Ukraine” PHRplus project that also offers data on spending by functions/interventions. The following sections of this Annex describe developed methodology for estimating Central and Regional/Local governments and private households spending on HIV/AIDS.

Estimating Central Budget Public Spending for HIV/AIDS Estimating Central Government Public Spending for HIV/AIDS basically follows estimation of the UNGASS (United Nations General Assembly Special Session on HIV/AIDS) indicator #1 “Amount of national funds disbursed by governments in low- and middle income countries” calculations,21 that were performed by the National Health Accounts project in response to the request from the Ministry of Health. Mr. Didenko (Ministry of Finance) endorsed correctness of these calculations. However, this indicator omits the majority of regional spending. A methodology for estimating regional spending is described later in this Annex. Estimates of regional spending should be included in future calculations of the UNGASS indicator #1, in order to ensure its comprehensiveness and completeness. United Nations General Assembly Special Session on HIV/AIDS proposed general framework for monitoring the Declaration of Commitment on HIV/AIDS. One of the core indicators is “Amount of national funds disbursed by governments in low- and middle income countries”. PHRplus project received a request from the Ministry of Health to provide technical assistance to the Government of Ukraine in estimation of the above indicator.

Socio-economics impact of HIV/AIDS epidemic in Ukraine, survey funded by the World Bank. Calculations of the indicator are performed as part of the PHRplus project “National Health Accounts in Ukraine” and provided to the Government of Ukraine on special request from the Ministry of Health (letter dated 23.06.2005 #482).

Technical Notes

115

The following information is available on Central and Regional governments funds disbursed on HIV/AIDS in 200422: Table 58 Official Treasury of Ukraine data expanded by ad hoc research on central and regional governments spending on HIV/AIDS in Ukraine in 2004 Item

Central government budget execution Ministry of Health of Ukraine Programs and centralized activities in prophylaxis and treatment of AIDS Purchase of HIV test systems for pregnant women Purchase of HIV test systems other than for pregnant women Purchase of drugs for HIV treatment Support to HIV-infected children Activities to fight epidemics of TB and AIDS (WB loan) - only AIDS part of the program State Department of Ukraine of the Penitentiary System Activities to fight epidemics of TB and AIDS (WB loan) - only AIDS part of the program

Program Code

Functional Code

Amount, UAH

Amount, USD23

0763

17 473 715

3 285 027

3 225 400

606 369

4 959 300

932 339

8 272 300

1 555 177

1 016 715

191 141

0763

1 556 597

292 637

0763

246 134

46 273

0763

1 655 983

311 322

20 932 429

3 935 259

2300000 2301380

2301600 6070000

6071600

Regional budget execution Programs and centralized activities for HIV/AIDS prevention

Total

Similar calculations were performed for 2003. There were also special considerations for Central level spending on TB services related to TB/HIV co-infection, which is described in detail in the next section Regional Level Public Spending for HIV/AIDS. Estimated central level public spending for TB/HIV co-infection totaled 3,183,072 UAH in 2004 and 3,227,486 UAH in 2003.

Estimating Regional Level Public Spending for HIV/AIDS Ukraine regulations determine the types of expenditures that have to be paid by local budgets for HIV/AIDS. This includes:

Central government and regional budget execution reports data is provided by Ministry of Finance and Treasury; details of the programs â&#x20AC;&#x201C; by respective responsible ministries and agencies. 23 Exchange rate: 1 USD = 5,3192 UAH (Statistical Year Book 2004, State Statistics Committee of Ukraine).

116

Ukraine National Health Accounts 2003-2004

a. Funding for HIV/AIDS Centers (staff salaries, drug and other input costs, recurrent costs and capital formation), which includes outpatient treatment as well as inpatient treatment in those centers that have beds. b. General provider network, where some beds are allocated for HIV/AIDS patients and/or OP treatment is provided for HIV/AIDS patients. c. TB patients with HIV that are treated on TB beds. d. Drug users with HIV that are treated on substance abuse beds. e. Expenditure on HIV-positive pregnant women treated within maternities. f. HIV tests not financed from the Central budget and/or donor funds g. Quarantine blood banks for HIV prevention within blood transfusion stations. Methodological separation of each of these costs out of total expenditure of regional financing agents requires different approaches that are described in this document. Estimating funding for HIV/AIDS centers

Data on financing of HIV/AIDS centers in the country is limited or not available. The system of government financing does not have the functional code to account for HIV/AIDS expenditure, thus a methodology needs to be developed to account for expenditure from regional budgets on AIDS centers in the regions. The National HIV Center provides statistics on distribution of regional HIV centers and their staffing level (doctors) for each region (oblast). As of August 2004, there were 328.75 HIV doctors FTE (full-time equivalents) in 28 regional HIV Centers. Sample oblasts that were studied during the subanalysis implementation showed the expenditures ratios presented in Table 59. Table 59 Ratios and staffing costs in HIV Centers in sample oblasts in Ukraine 2003 2004 Share of Payroll in Annual Budget (average) 54% 67% Oblast 1 78% 83% Oblast 2 72% 74% Oblast 3 52% 65% Oblast 4 14% 46% 18,5 23,4 Payroll Annual Cost per Doctor FTE ('1,000 UAH) 18,3 24,0 Oblast 1 19,3 23,4 Oblast 2 17,5 23,5 Oblast 3 18,8 22,8 Oblast 4

2005 75% 89% 82% 68% 59% 37,3 35,6 38,9 38,7 36,0

This data makes it possible to estimate total staffing costs for each regional HIV center as well as total costs spend from regional budgets on HIV/AIDS centers (using the staff cost to total budget ratio estimate). These estimates would include expenditure for in- and outpatient services (Table 60). Table 60 Estimating spending on regional HIV Centers in Ukraine 2003 2004 2005 Total HIV doctors FTE* 328,75 328,75 384 Estimated annual staffing costs, UAH 6 066 634 7 698 344 14 322 449 Total estimated annual expenditures on HIV Centers, UAH 11 200 021 11 467 207 19 206 914 *Note: no nation-wide data is available on number of HIV doctor FTE in HIV Centers in 2003; therefore, 2004 data was used.

Technical Notes

117

Presented estimates are lower-end as the sample oblasts AIDS centers had no IP beds. It is known that out of 28 HIV Centers there are eight HIV Centers that in 2004 had total 201 beds. This estimation is the best that can be done with available data. Ideally, for future estimates, it would be advisable to either carry out a nationwide study to estimate regional budget spending on AIDS centers or, alternatively, under the budget functional classification a separate code would be assigned for all HIV/AIDS related expenditures. Sample oblasts show that the average spending on capital formation out of total AIDS center expenditure was 11.36%. When performing functional allocation of the remaining 88.64% out of total regional government representing current expenditures for HIV Centers, there is a need to distribute these amounts mainly between HC.1.1 Inpatient curative care function and HC.1.3.3.3 OI Treatment and Monitoring function (ARV treatment is paid for either by Central government or donors). There should be one doctor FTE per 20 IP beds in HIV Centers24. Knowing the total number of IP beds (total 201 beds) in HIV Centers in 2004, it can be estimated that there should be 10 doctor FTE for these beds, or 10 / 328.75 = 3.04% out of all doctor FTE. Since our calculations for HIV Centers spending extrapolation utilizes doctor FTE as a proxy, we can take 3.04% out of total current expenditures for HIV Centers for IP function. Estimating regional budgets expenditures on general provider network

Usually beds for treating HIV patients that are not in AIDS Centers are allocated within infectious disease hospitals, TB dispensaries, substance abuse hospitals and potentially other hospitals. Unfortunately, we do not know the precise distribution of beds that are in facilities other than HIV Centers for 2003 and 2004. However, data from National HIV Center for 2005 shows that there were 301 beds in HIV Centers and 929 beds in the other health facilities (Table 61). Table 61 Distribution of HIV beds in Ukraine in 2005 HIV Centers TB Hospitals Substance abuse hospitals The other facilities Total HIV beds *Source: National HIV Center data.

HIV beds 310 235 124 570 1239

The number of IP beds in the HIV/AIDS Centers is growing on an annual basis, which reflects the policy of opening IP beds within AIDS Centers that enacted by the government (for example, in 2004 there were only 201 total beds in AIDS Centers). Unfortunately, state statistics do not report the total number of HIV/AIDS beds nor its distribution between AIDS centers and general provider network. Only 2005 detailed data was made available and as a result, estimates for 2003-2004 are based on the assumption that number of beds allocated in the general provider network for HIV was constant throughout 2003-2004. Based on the information obtained in the private interview with a national HIV expert, number of beds in the general provider network should not have changed very much over these years. For future estimates, it will be important to modify medical statistical reporting forms and separately request information about HIV/AIDS beds from providers/regions.

â&#x20AC;&#x153;Staffing norms in HIV/AIDS centersâ&#x20AC;?, Addendum #52 to Order of MoH #33 as of February 2000.

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Ukraine National Health Accounts 2003-2004

This assumption allows for estimating the share of regional budgets spent on HIV in TB and substance abuse hospitals based on the proportion of HIV beds versus all beds in these facilities (Table 62). This proportion will be applied to the estimate of total spending on TB and substance abuse hospitals from the general NHA, keeping the same percentage functional distribution across IP, OP, etc. as in the general NHA. Because Central government provides considerable funding for TB services (including centralized procurement of all TB drugs provided for free to all TB patients25), we will take the same identified proportion for TB hospitals from total MoH spending on TB program. Table 62 Share of HIV beds in TB and substance abuse hospitals

TB Hospitals Substance abuse hospitals *Source: State Statistics Committee data **Source: National HIV Center data

All beds* 4 338 478

HIV beds** 235 124

% of HIV beds 5,42% 25,94%

In order to estimate regional budget spending in remaining facilities (other than HIV Centers, TB or substance abuse hospitals), we will calculate the annual cost per bed in the city general hospitals (to be conservative and use the best available estimates, we assume that amounts spent by local governments for HIV/AIDS beds equal to those in city general hospitals) . The annual cost per bed will be applied to the number of HIV beds known to be allocated for HIV in these facilities (Table 61 and Table 63). Table 63 Estimating annual cost per bed in City general hospitals 2004 Estimated NHA regional budgets spending 1 939 560 903 Number of beds 108 002 Annual cost per one bed 17 959

2003 1 679 069 561 108 002 15 547

According to this approach, HIV/AIDS spending in “Other Facilities” will be: 570 * 17 959 = 8 861 592 UAH in 2003 and 570 * 15 547 = 10 236 382 UAH in 2004. For the purposes of NHA HIV subanalysis, we will attribute this expenditure to category to “HP.1.3.9 Other specialty hospitals”. Unfortunately, reliable statistics on number of OP visits by HIV patients in facilities other than HIV Centers is not known; thus, it is very difficult to assess the OP share attributable to HIV in the general provider network attributable. However, taking the approach described above (using number of beds as a proxy for total spending in those facilities) we are accounting for OP spending as well, since those are joint providers (providing both IP and OP services), thus presented estimates include both IP and OP spending. It should be noted that OP spending in facilities other than HIV Centers would be underestimated with this approach, due to the fact that HIV is a chronic condition requiring more OP visits per patient than may be found in general (non-chronic) patients. When better medical statistics on HIV becomes available in the future, it will be possible to make better estimates for HIV spending by function in facilities other than HIV Centers. Estimating HIV/AIDS related spending within maternity services for HIV-infected women

This situation in TB is opposite to spending on pharmaceuticals in other sectors of health care (with exception of few) where drug costs are borne fully by private households (see general NHA methodology).

Technical Notes

119

Official statistics on HIV testing results among pregnant women by the National HIV Center shows that there were 0.28% of HIV-positive pregnant women in 2003, and 0.34% in 2004 accordingly. These estimates may be not very precise, but the best available. Only since 2005 correct information is available for this indicator (0.51% of HIV-positive women in 2005), because only since 2005 the official statistics distinguishes performed first and repeated HIV tests (sometimes testing is done twice for the same women and all performed tests versus identified HIV-positive women were reported before 2005, not allowing for estimating true prevalence of HIV among pregnant women). At the same time, the overwhelming majority of pregnant women agreed to do VCT at least once in both analysis years as reported by National HIV Center. Noting that the future estimates (from 2005 onwards) will be more precise, these proportions were used to separate HIV/AIDS expenditure from general NHA estimates on HC.1.1.1.1 Obstetrics functions. Thus in 2003 expenditure on HIV infected pregnant women amounted to 707 207 UAH and 1 005 540 UAH in 2004. The need for specific acknowledgement of this public spending for HIV-pregnant women comes from the fact that HIV specialized observation departments and delivery operating rooms are allocated in the structure of maternity health services in Ukraine, as well as PMTCT is being administered there as well26. HIV Tests

According to HIV/AIDS sero-epidemiologic monitoring total number of HIV tests conducted in the country during 2003 was 2.46 million and in 2004 2.5 million. Out of this amount, 1.88 million in 2003 and 1.91 million in 2004 were conducted among blood donors and pregnant and supposedly were financed by the central budget. In addition, tests among prisoners (17,782 in 2003 and 25,638 in 2004) were probably paid from central public resources and/or donors. The remaining amount of HIV tests (559 698 in 2003 and 568 565 in 2004) was supposedly financed by local budgets and households. Unfortunately, no data is available to assess what proportion of these remaining tests was paid by the government versus by households in the form of private out-of-pocket payments. It is known that tests under the code 107 - official references on HIV status for emigrants, etc. - (76 022 tests in 2005) are always paid by households. However, other groups of people may also pay out-of-pocket, either through official charges, so-called “charitable donations” or unofficially (under-the-table). These limitations prevent precise assessment of regional spending on HIV tests. However, the remaining tests (besides donors, pregnant women and prisoners) could serve as a reasonable proxy for estimating regional public spending on HIV tests. Average cost of one HIV test system (only kit, additional supplies such as pipits, cotton are not accounted for, but are known to be very cheap) is estimated at ≈4.29 UAH (when purchased in bulk by government27). Thus regional budget financing for these years was estimated at 2 402 271 UAH in 2003 and 2 440 329 UAH in 2004. Estimating Spending on HIV-specific Quarantine Blood Banks at Blood Transfusion Stations

In many blood transfusion stations in Ukraine special quarantine blood banks were created (blood and its products are being preserved for six months, then testing of a donor is repeated to account for the sero-negative HIV “window”). In accordance to corresponding MoH 26

Note: costs of drugs for PMTCT are recorded under HIV Centers due to centralized provision of these drugs through HIV Centers that distribute them as necessary. 27 This price was paid per one test by Central government for HIV tests under their jurisdiction (pregnant women and donors). Central government pays only for the kit, all salary and other associated costs are borne by regional/local budgets spending.

120

Ukraine National Health Accounts 2003-2004

rulings all donor blood should undergo this six-month quarantine, however, in reality it does not happen in all cases28 due to insufficient currently infrastructure (freezing cameras, preservation tanks, etc.). Unfortunately, no statistics or operational data exists on these quarantine blood banks; therefore, it is very difficult to assess what proportion of total spending on Blood transfusion stations is being consumed by these banks. Information obtained in a private interview with a representative of administration of a regional blood transfusion station revealed that the major expenditures attributable to quarantine blood banks include sufficient capital infrastructure (-30 0C freezing cameras), related electricity costs and special preservation tanks (cost per tank for one donor sample of 300 â&#x20AC;&#x201C; 400 ml ranges from 30 UAH for a tank for manual centrifuges to 160 UAH for a tank for automatic centrifuges). This particular regional blood transfusion station covering a region with about 5.1% of total population in Ukraine produces about 3 tons of plasma per year, which should all potentially go through quarantine. Calculations that should be taking with great cautiousness would bring the cost for preservation tanks alone (taking 30 UAH cost of a tank per 400 ml of blood and its products) to 4.4 millions UAH per year nationwide. Total regional spending on blood transfusions stations was 70.98 million UAH, therefore, estimated spending on preservation tanks would account for about 6.2 % out of total spending. Additional information for consideration is that the new ruling of MoH requires usage of -30 0C freezing cameras while before this requirement was only -20 0C, thus requiring undergoing costly replacement of freezing cameras and corresponding capital outlays. While special tanks and freezing cameras are required for long preservation of blood and its products to cover HIV sero-negative window, it does not mean that blood would not have been preserved otherwise if there would be no HIV in the country (though less costly tanks could have been used and cameras could be with a higher temperature for shorter preservation). In reality, the expenditure on quarantine blood banks cannot be estimated until better information becomes available because there is no basis for attributing a certain proportion of spending on blood banks to quarantine blood banks. Special research is required. For health policy purposes to address existence of such banks we will take arbitrary 1% of total spending on Blood transfusion stations for spending on Quarantine blood banks. It is not an actual calculation, and it is done only to ensure that this existing type of spending is reflected in the NHA HIV tables.

International comparisons provide the following information on spending on HIV-specific blood banks as a proportion out of total expenditures on HIV/AIDS: Rwanda - 0.02%, Kenya - 0.01% (NHA subanalysis data); Mexico - 5%, Belize - 0.9%, Chile - 6.14%, Ghana - 0.51%, Guatemala - 0%, Haiti - 0%; Paraguay - 4.95%, Trinidad and Tobago - 2.41% (SIDALAC data). In Ukraine this spending would amount to 1.6% out of THE on HIV/AIDS in 2004 (again, this is an arbitrary amount only, taken for policy purposes). Spending on sanatoriums

As it was noted in the methodological Annex for RH NHA subanalysis, a certain proportion was taken from sanatoriums spending and attributed to RH (for details please see the corresponding Annex). In case of HIV-positive people there is no government subsidized or other specific referral system to sanatorium services (no specialized HIV sanatoriums exist, and health care providers do not refer their HIV-positive patients to sanatoriums)29. Therefore, no public funds will be allocated to sanatorium services.

Private interviews with HIV experts show range anywhere between 50% and 100% of blood and its products go through quarantine. 29 Information obtained in a private interview with a Head of a Regional HIV Center.

Technical Notes

121

Estimating Private Households Spending for HIV/AIDS Ukraine is a country with a concentrated epidemic of HIV/AIDS with 1.28% estimated adult prevalence of HIV (15-49 years), or 307,000 HIV-infected people (all ages) in 200530. Risk groups represent the majority of HIV-infected people, key of them being Injecting Drug Users (IDU) and Commercial Sex Workers (CSW). In accordance to recent estimates, there are 381,600 IDU (estimated range is from 338,500 to 424,700 with a recommendation to use the average when a single point estimate is needed) and 226,550 CSW (estimated range is from 202,800 to 250,300 with a recommendation to use the average when a single point estimate is needed) in 2005 in Ukraine31. HIV sentinel surveillance among risk groups conducted by National HIV Center showed 34.85% average prevalence of HIV among IDU and 23.25% among CSW in 2005, which brings the estimated number of HIV-positive IDU to 133,001 and HIV-positive CSW to 52,670 in 2005. However, there is a clear trend of the epidemic moving to the general population. For example, out of all officially registered HIVpositive people there were 71.85% IDU as of December 2003, 69.52% IDU as of December 2004, and 67.8% as of October 200532; HIV prevalence among pregnant women, considered as an indicator of HIV prevalence trends in the general population, is also increasing over the years33. Therefore, estimating private spending within IDU and CSW risk groups will allow estimating the bulk of private spending for HIV in the country. Special techniques can be used for estimating HIV private spending by the rest of HIV-infected people represented by general (non-risk group) population. Since NHA HIV subanalysis is performed for 2003 and 2004, there is a need to come up with HIV prevalence estimates for these years based on nationally agreed estimates for 2005. In order to estimate total number of all HIV-positive people and number of HIV-positive IDU in 2003 and 2004, official statistics on total number of registered all HIV-positive people and number of officially registered HIV-positive IDU was used as a proxy34..For example, to estimate the total number of HIV positive persons in Ukraine who are IDU in 2003, the ratio of the number of officially registed HIV positive IDU persons in 2003 to the number in 2005 was computed. This ratio was then multiplied by the known estimated total number of HIV positive IDU persons in 2005. Unfortunately, no similar ratios can be constructed for HIVpositive CSW due to lack of data for this risk group. Therefore, the ratios computed for HIV positive IDU persons were used to compute the estimates for CSW in 2003 and 2005.35 Detailed calculations presented in the table below (Table 64).

National Consensus Meeting on Estimates of HIV prevalence and ART Needs, November 28, 2005, Kiev, Ukraine. These results differ from data previously published in Ukraine (“UNAIDS report on the global epidemic, 2004”, presenting UNAIDS/WHO estimates for the end of 2003 in Ukraine: 360,000 HIV-positive people). However, the new estimates agreed during the National Consensus Meeting are considered valid and currently the best available HIV/AIDS estimates for Ukraine. 31 Analytical report on the research “Estimation of sizes of high risk groups for HIV infection in Ukraine”, 2005, International HIV Alliance in Ukraine. 32 Official Statistics, National HIV Center data 33 Results of sero-epidemiologic monitoring, National HIV Center. 34 Official statistics in accordance to Form-2 AIDS, National HIV Center. 35 There is certain support to usage of this proxy: due to employed techniques for estimating sizes of risk groups in Ukraine and the fact that CSW and IDU groups in reality are overlapping, there are 25% of IDU among total CSW estimated population as it was estimated in Ukraine and described in the Report on estimation of sizes of the risk groups. Our comnibed analysis sample (HIV-positive and HIV-negative CSW) of 446 people resembles this pattern very well: there are 109 or 24.44% of CSW who are IDU.

122

Ukraine National Health Accounts 2003-2004

Table 64 Estimation of number of HIV-positive people in Ukraine in 2003 and 2004 based on 2005 estimates* 2005 2004 2003 Number of all officially registered HIV-positive people

62 936

54 815

47 348

Decrease co-efficient (base year 2005) Estimations for 2003 and 2004 based on 2005 data on estimated total number of all HIV-positive people in Ukraine

1,0000

0,8710

0,7523

307 000

267 386

230 962

Number of officially registered HIV positive IDU

36 773

33 700

30 503

Decrease co-efficient (base year 2005)

1,0000

0,9164

0,8295

Estimations for 2003 and 2004 based on 2005 data on estimated total number of HIV-positive IDU in Ukraine Estimations for 2003 and 2004 based on 2005 data on estimated total number of HIV-positive CSW in Ukraine *Input numbers are in bold font and described in the text.

133 001

121 887

110 324

52 670

48 269

43 689

Second generation HIV/AIDS surveillance survey36 was expanded in 2004 to include questions that allow estimating major NHA HIV subanalysis expenditure categories for private spending among two key risk groups for HIV in Ukraine: IDU and CSW. Data was analyzed using The SAS 9.1.2 System for Windows. Private spending for HIV/AIDS IP and OP services is estimated only for those that are either HIV-positive or have developed AIDS. Estimations for spending on syringes by IDU, condoms and HIV tests are discussed in the following chapters of this Annex. Estimates for HIV-positive IDU and CSW for various services/goods they use are based on the analysis of the survey data sets provided by the HIV/AIDS Alliance and extrapolated through weighted analysis to the universe presented in Table 64. HIV-positive general (non-risk group) population spending is estimated using the co-efficient (see below), derived based on comparison of per capita spending difference between HIV-positive and HIV-negative people (IDU and CSW), applied to per capita health spending in Ukraine (as estimated in general NHA) and also extrapolated to the universe of HIV-positive non-risk general population. Analysis samples

The IDU survey included 3542 IDU respondents. Among them 1901 reported that they were tested for HIV and out of those 1749 reported that they know the result of HIV test. Out of those who know the result of HIV test and agreed to report what their status is (1313), 283 people reported HIV-positive status, 1018 people â&#x20AC;&#x201C; HIV-negative status, and 12 people refused to answer. The CSW survey included 1413 CSW respondents. Among them 766 reported that they were tested for HIV and out of those 732 reported that they know the results of HIV test. Out of those who know the result of HIV test and agreed to report what their status is (534), 50 people reported HIV-positive status, 484 people â&#x20AC;&#x201C; HIV-negative status. As it was stated above, private spending for HIV/AIDS IP and OP services is estimated only for those that are HIV-positive. Representativeness of the analysis samples for age and sex distribution (identified HIVpositive CSW and IDU) was checked using available data (Table 65, Table 66) on general

Second generation HIV/AIDS surveillance survey, 2005, International HIV Alliance in Ukraine.

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123

population of HIV-positive IDU and CSW in Ukraine through â&#x20AC;&#x153;Goodness of Fitâ&#x20AC;? tests (based on chi-square test) in SAS. Where necessary, sampling weights were determined and used for a statistical adjustment for age and sex distribution imbalances in the samples for the analysis37. Sampling weights are needed to correct for deviations of the age and sex distributions in the sample from the known population distributions in the estimates. Such imbalance occurs because of the selection of units with unequal probabilities, non-coverage of the population, and non-response.38 It was shown that HIV-positive IDU sample needs adjustment for both age and sex, while sample of HIV-positive CSW showed no statistically significant difference in age distribution with compared available data on reference HIVpositive CSW population in Ukraine. In SAS, statement PROC MEANS with option WEIGHT was used for calculating weighted statistics. Goodness of fit tests were also performed for regional distribution, but no adjustment for this variable was done (even seeing that our samples regional distribution is not representative). The following considerations were taken into account. Prevalence of HIV does vary considerably across regions in Ukraine, where southern and eastern regions are most affected by HIV. However, the purpose of our analysis was for the NHA HIV subanalysis and not determination of HIV prevalence across regions. We need to look at the spending and health care services utilization patterns. It is difficult to argue that spending might be or will be different based on age and sex; therefore, it is important to adjust for these variables for sure. Economically there are no striking differences across regions (besides Kiev City, capital of Ukraine, and there were no respondents from Kiev City). While oblast city centers do better than smaller towns and rural areas, it becomes averaged out when the whole oblast is considered. Therefore, we believe that regional distribution of our samples may not affect NHA HIV subanalysis results. The following best available / most comprehensive data on reference population of HIVpositive IDU and CSW was used to check for the representatives of the samples for NHA analysis (Table 65, Table 66).

37 38

Advice on the methodology by K.P. Srinath, Senior statistician, Abt Associates, Inc. Ibrahim S. Yansaneh, Construction and use of sample weights, UN Secretariat Statistics Division, 2003.

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Ukraine National Health Accounts 2003-2004

Table 65 Distributions by sex and age among officially registered HIV-positive IDU (incidence)* 2003 2004 All Men Female All Men Female <= 19 99 40 62 41 139 103 20-24 635 269 632 299 904 931 25-29 1 098 370 1 202 365 1468 1567 30-39 1 338 424 1 822 496 1762 2318 40-49 399 85 627 115 484 742 >= 50 46 12 95 22 58 117 Total 4815 3615 1200 5778 4440 1338 *Source: National HIV Center data. Table 66 Results of sentinel surveillance among CSW in 2004: distribution by age for HIV-positive CSW* Age (years) HIV-positive CSW <= 19 6 20 - 24 26 25 - 29 26 30 - 34 11 >= 35 20 Total 89 *Source: National HIV Center data.

Estimating private spending for HIV-positive IDU and CSW

Analysis revealed that total private spending by HIV-positive IDU was 64,929,387 UAH (or 454 UAH per capita) and by HIV-positive CSW â&#x20AC;&#x201C; 17,089,824 UAH (or 354 UAH per capita) in 2004. It should be noted that this spending includes expenditures on syringes for IDU and condoms for CSW, which is not relevant for comparison with general non-risk population spending (without these expenditures it comes to per capita private spending of 398 UAH for IDU and 200 UAH for CSW). In order to come up with estimates of private spending in 2003, these amounts should be decreased in accordance with estimated number of HIVpositive people (Table 64) AND official SSC data on private households spending in 2003 and 2004 (total private household spending was 0.82 times lower in 2003 than in 200439). Therefore, estimated total private spending by HIV-positive IDU was 48,191,207 UAH and by HIV-positive CSW â&#x20AC;&#x201C; 12,684,230 UAH in 2003. Please note, that we estimate syringes, condoms and tests for the country-wide spending in the chapters that follow. Shown in this paragraph total private spending for HIV-positive CSW and IDU people is a reference point only for health policy purposes when only HIV-positive risk groups are concerned. Relevant for production of HIV NHA subanalysis tables is spending by HIV-positive IDU and CSW on IP, OP services and medicines other then syringes and condoms (HIV tests, syringes and condoms spending discussed in the following chapters). Due to the composition of questions in the questionnaires, drug costs are reported together under corresponding IP or OP category, while as it was shown in the general NHA, majority of drugs in Ukraine are purchased from private pharmacies, therefore, even if drugs are purchased physically in the hospitals, for example, for the purposed of NHA they should be reported under the separate pharmaceutical spending category in NHA. General NHA showed that spending for drugs accounts for about 82% of total out-of-pocket spending by private households. Therefore, we take 82% of spending for IP and OP services into drugs category for NHA purposes. It should

This adjustment should account for any relative changes in price indices and inflation in the country from 2003 to 2004.

Technical Notes

125

be noted that ARV drugs are purchased either by government or donors, therefore, the proportion of private expenditures on drugs that we are identifying above, does not include ARV drugs. Distribution of spending by HIV-positive IDU and CSW for IP and OP services, as well as medicines other than syringes and condoms mapped to NHA classification categories can be found in the following tables (Table 67, Table 68). Table 67 Spending only on IP and OP services by HIV-positive IDU and CSW 2004 2003 OP OP IP Services IP Services Services Services HP.3.1.1 Adults Policlinics / Взрослые 393 871 292 335 поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники (Reproductive health / Репродуктивное здоровье) HP.1.1.2.1 City general hospitals / Городские больницы общего профиля* HP.1.1.6 Maternity houses / Родильные дома HP.1.2.2 Substance abuse hospitals and dispensers / Наркологические больницы и диспансеры

294 115

218 295

115 483

1 252 414

85 713

929 554

152 915

634 934

113 495

471 254

1 692 065

1 148 898

1 255 867

852 723

HP.1.3.2 AIDS clinics and centers / 607 200 197 853 450 669 146 848 Клиники и центры ВИЧ/СПИД HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы 390 881 436 667 290 116 324 098 и диспансеры HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и 289 383 278 317 214 783 206 569 диспансеры HP.1.3.9 Other specialty hospitals / 339 840 234 592 252 232 174 116 Другие специализированные больницы HP.3.7 Private clinics / Частные 1 046 236 0 776 527 0 клиники HP.3.9.1 Ambulance services / Скорая 57 476 42 660 помощь HP.3.9.9 All other ambulatory health care services / Все прочие 197 610 146 668 амбулаторные медицинские услуги Total 5 577 075 4 183 675 4 139 358 3 105 163 *Note: HIV is mostly concentrated in urban areas, thus in absence of detailed data all general hospitals spending is attributed to city hospitals

Estimating spending on syringes by all IDU

Spending on syringes is estimated for all estimated number of IDU in the country. It is regarded as health-related spending regardless of HIV status of IDU person due to the fact that usage of new syringes for each injection is one of the primary means of HIV transmission prevention among IDU. Average annual per capita cost of purchasing syringes among all 3542 IDU respondents is 134 UAH (adjusting this amount by SSC health spending ratio for 2003 as described above it comes to 110 UAH in 2003). Extrapolating this amount

126

Ukraine National Health Accounts 2003-2004

to all estimated reference number of IDU in the country40 (number of IDU is considered to be constant over 2003-200541), it can be estimated that spending on syringes was 51,169,044 UAH in 2004 and 41,958,616 UAH in 2003. This spending can be found in the NHA HIV tables under function HC.5.1.3.9 Other medical nondurables. Estimating private spending on HIV tests in Ukraine

It is known that there could be user charges, either official (for emigrants, for example), or charitable donations, or unofficial (under-the-table payments to providers) for HIV tests. Results of sero-epidemiologic HIV monitoring by National HIV Center are grouped into categories of performed tests (i.e. for pregnant, donors, prisoners, IDU, anonymous testing, etc.). As it was already stated in the chapter on public spending for HIV tests, that neither pregnant, donors or prisoners would pay out-of-pocket. In order to estimate private spending for HIV tests (together official and unofficial spending) we will extrapolate average private spending per one HIV test among 1051 IDU who did the test in the last 12 months (including both who paid for the test and who did it for free), which comes to 4.50 UAH per test in 200442, or adjusted to 3.69 UAH in 2003, to the reported number of HIV tests, other than for pregnant women, blood donors and prisoners,43 to estimate country-wide private spending for HIV tests. Thus estimated private spending for HIV tests is 2,559,246 UAH in 2004 and 2,065,853 UAH in 2003. Estimating private spending by all adult population (15-49 years) on condoms as key means for HIV prevention

Unfortunately, no quantitative data exists on spending on condoms in Ukraine. Retail pharmaceutical data that is routinely captured by SSC statistics has a coding system where condoms do not have a separate code and become recorded in a higher category not allowing for their separation. Potentially export-import data may exist in Customs services in Ukraine that captures condoms as a category (almost all condoms in 2003 and 2004 were imported, no or almost no local production existed), however, project was not able to access it; neither existence nor absence of this data was confirmed. Donor agencies and NGO also do not have this information. Relevant studies conducted in Ukraine (1999 CDC Ukraine Reproductive Health Survey, 2005 POLICY project “Willingness and Ability to Pay for Contraception”) do not measure quantitative use of condoms. The only currently feasible option for estimating this important spending for HIV is to assess available data for condoms spending by IDU, assuming that their condoms spending patterns should not differ much from that found in general population who relies on condoms (see below). It is a questionable statement, but the best available. In addition, spending on condoms by CSW can be directly estimated from the available research data, and because they use condoms frequently we will estimate their spending

Analytical report on the research “Estimation of sizes of high risk groups for HIV infection in Ukraine”, 2005, International HIV Alliance in Ukraine. 41 Information obtained in a private interview with a national HIV expert. Expert opinion that there is no “epidemic” of injecting drug use in Ukraine, and some believe that total number of IDU may even have decreased over this period. 42 When out-of-pocket spending is concerned, average official charge for one test is 35 UAH and it covers supposedly not only the cost of the HIV kit but also labor, etc. This information is obtained in a private interview with a Head of a Regional HIV Center. The Head reported that average 35 UAH official charge per HIV test was checked by KRU (government audit agency) and found to be fair compensation to recover kit, labour and associated costs. Of course, these 35 UAH represent only official charge (when charged), and can not serve as a reference point for unofficial payments or charitable donations for HIV tests. 43 National HIV Center data on sero-epidemiologic monitoring.

Technical Notes

127

separately, adding to the general population spending. Average per capita spending by CSW on condoms was 221 UAH in 2004 and 181 UAH in 2003, thus total spending on condoms by CSW was 50,055,717 UAH in 2004 and 41,045,688 UAH in 2003. Analysis of the whole data set for IDU (3542 respondents) revealed that IDU per capita annual spending for condoms was 34 UAH in 2004. Adjusting for private health care household spending co-efficient in accordance to official SSC data it comes to 28 UAH per capita in 2003. Because there is only one condom needed per couple, we take number of women of reproductive age (15-49 years) who reported usage of condoms for contraceptive purposes in 2003 and 2004 in Ukraine44 to extrapolate these estimates country-wide (minus number of CSW in the country). It is very difficult to draw any line between condoms used purely for contraception and those used for HIV and STI prevention. In most cases, it is multipurpose. It was decided to apply all condoms to HIV when RH and HIV analysis boundaries were discussed. There are no other estimates on condom usage in Ukraine. Therefore, estimated annual spending by general population of Ukraine for condoms is 67,843,923 UAH in 200445 and 55,494,263 UAH in 2003. Total spending on condoms by general population and CSW together is estimated at 117,899,641 UAH in 2004 and 96,539,951 UAH in 2003. When better data becomes available, it will be possible to revise these estimates. It should be noted once again, that spending on condoms by CSW most likely is more or less precise (if total estimated number of CSW in the country is correct) due to available research data, while spending on condoms by general public is probably under-estimated. It is the first ever done attempt in Ukraine to estimate private spending on condoms in the country. Estimating private spending for general (non-risk group) population

Due to the need to derive spending comparison co-efficient between HIV-positive and HIVnegative people (for estimating spending in the general non-risk HIV-positive population), there was a need to define properly HIV-negative sample. It is known that due to high stigmatization in Ukraine under-reporting of HIV-positive status is possible. In order to obtain a purer sample of HIV-negative people for the purposes of the analysis, only those who did not report any HIV-related clinical symptoms as defined per WHO were included in the HIV-negative sample (800 people for IDU and 396 people for CSW). One additional consideration in this regard: even if we still have HIV-positive people in our defined samples of HIV-negative people due to their under-reporting of HIV-positive status, it is unlikely to affect our expenditure calculations. Since we take only those who have no clinical symptoms suggestive of HIV as defined by WHO, those HIV-positive should be in the beginning stages of HIV disease (1-2), therefore, their health care spending should not differ from patterns found in HIV-negative people (health services utilization should not differ). Analysis revealed that HIV-positive IDU spend 1.04 times more per capita than HIVnegative IDU, and HIV-positive CSW spend 1.22 times more per capita than HIV-negative CSW. It should be highlighted that these differences exclude spending on syringes for IDU and condoms for CSW as not relevant to general non-risk population. In order to come up

Research “Willingness and Ability to Pay for Contraception” by POLICY project showed that there are 17.6% of women of reproductive age 15-49 years (or 2,198,701 women in 2004 and 2,193,818 women in 2003) who use condoms as a method of contraception. In addition, they showed that median cost of a pack of three condoms was four UAH in 2004. 45 By the way, total estimated spending on condoms by all IDU in the country (extrapolated based on per capita spending data of 3542 IDU respondents) comes to 13,059,404 UAH in 2004. Under current approach, IDU are “part” of general population when condoms are concerned.

128

Ukraine National Health Accounts 2003-2004

with a single point estimate to apply it to the general non-risk reference population, these two coefficients were weighted using total estimated number of all CSW and IDU reference population. Therefore, HIV-positive people spend 1.11 times more per capita on average that HIV-negative. This low difference can be explained by the fact that the majority of HIVpositive people in Ukraine are still in the beginning stages (1-2) of HIV46 due to fast-growing epidemic, therefore, their spending health care patterns may not differ substantially from those found in HIV-negative population. Using general NHA per capita private spending, data on estimated universe of general nonrisk HIV-positive population (Table 64) and derived co-efficient, it can be estimated that private household spending by general non-risk HIV-positive population totaled 19,987,119 UAH in 2004 and 12,711,113 UAH in 2003. Proportional distribution for various services/goods of the total spending amount by HIV-positive general non-risk group population was used the same as found in HIV-positive IDU and CSW sample (excluding proportion on substance abuse hospitals spending as obviously not relevant) due to absence of primary data on spending patterns by HIV-positive non-risk population47. Interesting situation observed when condoms per capita spending is compared between HIVpositive and HIV-negative CSW. HIV-negative CSW spend 1.71 times more per capita on condoms than HIV-positive. Due to time limitations and absence of direct benefit to NHA estimations, this co-efficient was not adjusted by authors for potential confounders (such as number of commercial sexual contacts, and number of condoms received free from NGO services). However, if proven, this striking difference could mean that HIV-positive CSW (note: they did test and know the result of the test) engage in risky behaviors spreading HIV, while those who are HIV-negative (also did test and know the result) are trying to protect themselves. Distribution of spending by all HIV-positive people for IP and OP services, as well as medicines other than syringes and condoms mapped to NHA classification categories can be found in the following tables (Table 68 and Table 69). Table 68 Spending on medicines (other than syringes and condoms) by HIV-positive people 2004 2003 HIV-positive IDU 36 757 737 27 281 941 HIV-positive CSW 7 707 902 5 720 878 HIV-positive general non-risk population 16 389 438 10 423 113 Total 60 857 081 43 427 935

New official HIV reporting forms endorsed in 2005, allow estimating stages of officially registered HIVpositive people in Ukraine (National HIV Center data). It can be seen that there were 80.6% of HIV-positive people out of all registered (prevalence) in the first stage in 2005. Official statistics for 2003-2004 allows separating only prevalence of AIDS (stage 4) among all registered HIV-positive people as well: it was 4.76% in 2003 and 5.68% in 2004. At the same time, the world data shows that in countries with generalized longestablished epidemic AIDS prevalence reaches 11%, and only 12% are in the first stage. 47 Due to specifics of spending by HIV-positive people (i.e. spending within HIV/AIDS centers, not found in general NHA) it was decided not using proportional distribution found in general NHA private spending for this general non-risk HIV-positive population health spending.

Technical Notes

129

Table 69 Spending only on IP and OP services by all HIV-positive (IDU, CSW, general non-risk population) people 2004 2003 OP Services IP Services OP Services IP Services HP.3.1.1 Adults Policlinics / Взрослые 598 650 0 422 567 0 поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники (Reproductive health / Репродуктивное здоровье) HP.1.1.2.1 City general hospitals / Городские больницы общего профиля* HP.1.1.6 Maternity houses / Родильные дома HP.1.2.2 Substance abuse hospitals and dispensers / Наркологические больницы и диспансеры

447 029

315 543

175 524

1 903 560

123 897

1 343 659

232 417

965 044

164 055

681 193

1 692 065

1 148 898

1 255 867

852 723

HP.1.3.2 AIDS clinics and centers / 922 890 300 719 651 438 212 268 Клиники и центры ВИЧ/СПИД HP.1.3.3 Tuberculosis hospitals and 594 105 663 695 419 359 468 480 dispensers / Туберкулезные больницы и диспансеры HP.1.3.4 STI clinics and dispensers / 439 837 423 017 310 466 298 594 Кожно-венерологические клиники и диспансеры HP.1.3.9 Other specialty hospitals / Другие специализированные 516 527 356 559 364 599 251 683 больницы HP.3.7 Private clinics / Частные 1 590 187 0 1 122 461 0 клиники HP.3.9.1 Ambulance services / Скорая 87 359 0 61 664 0 помощь HP.3.9.9 All other ambulatory health 300 349 0 212 006 0 care services / Все прочие амбулаторные медицинские услуги Total 7 596 939 5 761 492 5 423 921 4 108 600 *Note: HIV is mostly concentrated in urban areas, thus in absence of detailed data all general hospitals spending is attributed to city hospitals

130

Ukraine National Health Accounts 2003-2004

Annex 9: Methodology of mapping NHA HIV/AIDS subanalysis classification to National AIDS Spending Assessments (NASA) classification 48 NASA – National AIDS Spending Assessments – is considered to be the initiative of the Joint United Nations Programme on HIV/AIDS (UNAIDS) aimed to build national and regional capacities for tracking financial flows and expenditures specially for HIV and AIDS49. The NASA framework clearly calls for the inclusion of activities happening in the education, social development, and welfare sectors, as well as for other activities which are clearly beyond any conceptualization of the health care services delivery system. NASA provides an example of “public health paradigm” in monitoring financial flows which influences a lot on the choice of the type of analysis and conclusions/recommendations, made at the end. Covering both health- and non-health-related issues, which are undeniably integrated into any health policy, NASA becomes an indispensable tool for policy-making process. As well as National Health Accounts (NHA), NASA attempts to be the first step towards achieving a harmonization of classifications across a series of policy instruments. It is hoped that a process of continued harmonization to link the exercises of resource tracking (i.e. recent past expenditures) with future resource needs and, potentially with at least some elements of the National Strategic Framework will help inform future developments in the responses to HIV. NASA methodology proposes the bottom-up and top-down estimation of the resource flows, by costing/pricing the services and goods delivered by the providers for each of the activities, or functions, and then reconstructing the financial transactions from the sources, through the financing agents, and describing the use of the resources by disaggregating the production function components and the beneficiaries of such influences. Describing the financial flows and reviewing each of the functions may facilitate achieving the comprehensiveness needed in the financial accounting of national responses to HIV/AIDS. The alignment was conducted in order to provide necessary information (as advised by the Global UNAIDS Resource Tracking Consortium) on the financial gap between resources available and resources needed. In addition to establishing a continuous information system of the financing of HIV/AIDS, NASA is a tool to facilitate a standardized method of reporting on the monitoring indicators to assess progress towards achieving the targets of the Declaration of Commitment adopted by the United Nations General Assembly Special Session on HIV/AIDS (UNGASS). The indicator on public expenditures on HIV/AIDS is expected to be reported annually.

This Annex was written by Anastasiya Nitsoy, consultant, ICF “International HIV/AIDS Alliance in Ukraine”, under the project supported by UNAIDS. 49 National AIDS Spending Assessment (NASA). A Notebook on the methods, definitions and procedures for resource tracking and measurement of the HIV and AIDS financing flows and expenditures. Joint United Nations Programme on HIV/AIDS (UNAIDS). UNISEF, WFP, UNDP, UNFPA, UNODS, ILO, UNESCO, WHO, World Bank, 2005.

Technical Notes

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NASA serves several purposes within different time-frames. In the short term NASA might be useful to provide information on the UNGASS indicator, as mentioned; in the long term, the full information provided by NASA may be used to monitor the implementation of the National Strategic Plan; monitor advances towards completion of internationally or nationally adopted goals such as universal access to treatment and care; provide evidences of compliance with the principle of additionally required by some international donors or agencies, and fulfil other information needs. In order to conduct international comparisons, in the reporting for any given calendar year, financial transactions are reconstructed and six dimensions of each transactions are recorded or estimated: • Financing sources; • Financing agents; • Functions (HIV/AIDS-related interventions and activities); • Providers; • Components or factors of the production functions (budgetary items/objects of expenditures); and, • Beneficiaries. Transactions should be comprehensively tracked to determine actual reach to beneficiary populations. NASAs comprise specific boundaries around the transactions related to HIV and AIDS, functions that include eight programmatic areas: 1. Prevention. 2. Treatment and care. 3. Orphans and vulnerable children. 4. Programme development. 5. Human resources. 6. Social mitigation. 7. Community development and enhanced environment. 8. HIV/AIDS-related research. This is one of the main points in which the SHA/NHA and NASA methodologies diverge. The basis for the construction of the NASA functions relies on the need for detailed information on the actual provision of services for HIV or AIDS. So far, the ICHA classification of functions does not provide the details required nor are them informative for AIDS managers in order to make policy decisions. Thus, the functions presented in the NASA country projects are focused on strategic programs, rather than the health production function inputs that may or may not be informative to AIDS decision makers. But as for ongoing activity that level of details can be provided for health expenditures both within the ICHA and NASA framework, as far as they contain all needed data for the further analysis. We show how that can be done in the annex to that document, here NASA categories are mapped to ICHA categories. Attention should be paid at some categories which have the similar name in both methodologies, but their definitions differ50. In an attempt to harmonize as much as possible the different dimensions of the resource tracking models, there was a purposeful exercise to use the general template of the Financing

Comments on the National AIDS Spending Assessments, PHRplus. January 2006. Prepared by: Tania Dmytraczenko, Maria Fernanda Merino, Catherine Chanfreau, Clara Burgert.

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Ukraine National Health Accounts 2003-2004

Sources, Financing Agents, Providers and Beneficiaries classifications used in health for all sector activities dealing with AIDS service delivery within the health system, as well as other relevant sectors. Thus these classifications are very similar and donâ&#x20AC;&#x2122;t have significant differences in NASA and SHA/NHA, but it seems more obvious to pay attention at Functions classification in both methodologies. A detailed comparison table across these methodological approaches is presented in the table below (Table 70). Main comments were made by PHRplus project, NHA and NASA national teams.

Technical Notes

133

Table 70 Mapping NASA to NHA HIV/AIDS subanalysis classification NASA Functions / Функции ОНРС

NHA HIV/AIDS subanalysis / Субанализ НСЗ по ВИЧ/СПИД

Comments / Комментарии

1. Prevention / Профилактика 1.1. Information for general awareness through mass media/Информация для кампаний по повышению уровня осведомлённости в СМИ

1.2. Community mobilization / Мобилизация сообществ

1.3. Voluntary counselling and testing / Добровольное консультирование и тестирование 1.4. Youth in school / Программы для молодёжи в школах 1.5. Youth out of school / Программы для молодёжи вне школ 1.6. Programs focused on sex workers and their clients / Программы для работников сексбизнеса и их клиентов 1.7. Programs focused on MSM / Программы для мужчин, имеющих секс с мужчинами

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HC.6.3.2 Information Education Communications (IEC) / Информация Обрзование Коммуникации

Mass media is only a component in SHA/NHA category, rest of the components refer mostly to other NASA`s categories / СМИ является одним компонентов в Суб-анализе по ВИЧ/СПИДу, другие компоненты относятся к разным категориям ОНРС

AD.3 Non-health IEC or HC.6 Prevention and public health services / AD.3 Информация Образование Коммуникации, не связанные со здравоохранением

FN 1.2. Community mobilization is a broad category, that includes activities form different categories within NASA classification. H.C.6.3.4. Information Education Communications is suitable here, but not to forget to exclude similar expenditures from the other codes / FN 1.2. Мобилизация населения - это широкая категория, которая включает в себя мероприятия из других категорий в рамках классификации ОНРС. H.C.6.3.4. Информационнопросветительская работа также относится сюда, но нужно не забыть исключить похожие расходы из других кодов

HC.1.3.3.5 VCT / Добровольное консультирование и тестирование HC.6.2 School health activities / HC.6.2 Мероприятия в школах AD.1.1 Social support services or subcategory of HC.6 Prevention and public health services - HC 6.6. Youth out-of-school / AD.1.1 Службы социальной поддержки или суб-категория HC.6 Профилактика и социальные службы - HC 6.6. Молодёжь вне школы HC.6 Prevention and public health services / HC.6 Профилактика и службы общественного здравоохранения HC.6 Prevention and public health services / HC.6 Профилактика и службы общественного здравоохранения

care must be taken to define the functions of this category so that it cannot be classified under any other category / Надо быть осторожным в определении функций этой категории с тем, чтобы это нельзя было классифицировать под любой другой категорией. Where a program offers distinct functions, it can be presented separately. Otherwise, the different functions can be classified in the corresponding category, with a subcategory code to identify the program with which it is associated. This allows adding up expenditure by program when needed, but also having the complete picture of expenditure per function. These functions can be subcategorised into more detailed codes, for example HC 6.i., HC 6.ii. etc. / Там где в

Ukraine National Health Accounts 2003-2004

NASA Functions / Функции ОНРС

NHA HIV/AIDS subanalysis / Субанализ НСЗ по ВИЧ/СПИД

Comments / Комментарии

1.8. Harm reduction programs for IDUs / Программы уменьшения вреда для потребителей инъекционных наркотиков

HC.6 Prevention and public health services + HC.1.3.3.9 Replacement therapy + HC.1.2. (day cases of curative care) in Substance abuse hospitals and dispensers + HC.5.1.3.9. Other medical nondurables (syringes for all IDU)/ HC.6 Профилактика и службы общественного здравоохранения + HC.1.3.3.9 Заместительная терапия + HC.1.2. Лечение в дневном стационаре для Наркологических больниц и диспансеров + HC.5.1.3.9. Прочие товары недлительного пользования (Расходы всех, ВИЧ+ и ВИЧ-, ПИН на шприцы)

программе предлагаются четкие функции, это можно представить отдельно. Или же, различные функции могут классифицироваться в соответсвующей категории, с кодом подкатегории для того, чтобы определить программу, с которой он связан. Это позволяет при необходимости подсчитывать расходы по программам, а также иметь полную картину расходов по функциям. Эти функции могут распределяться по подкатегориям за более детальными кодами, например HC 6.i., HC 6.ii. и т.п.

1.9. Workplace Activities / Программы по месту работы

HC.6.5 Occupational health care or introduce HC 6.v. Workplace activities / HC.6.5 Гигиена труда или ввести HC 6.v. Мероприятия на рабочих местах

If HC.6.5 Occupational health care is not represented in SHA/NHA it can be classified as HC 6.iv. Workplace activities / Если HC.6.5 Гигиена труда не представлена в SHA/NHA ее можно классифицировать как HC 6.iv. Мероприятия на рабочем месте.

1.10. Prevention programmes for people living with HIV / Программы профилактики для людей, живущих с ВИЧ

HC.6 Prevention and public health services / HC.6. Профилактика и службы общественного здравоохранения

see FN 1.6, 1.7, 1.8 / См. FN 1.6, 1.7, 1.8

1.11. Special populations / Программы для специальных групп населения

HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп

Should be recorded in SHA/NHA as HC 6.iv. Prevention for specific accessable populations / Следует внести в SHA/NHA как HC 6.iv. Профилактика для специальных групп населения or HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп

1.12. Condom social marketing / Социальный маркетинг презервативов 1.13. Public and commercial sector condom provision / Распределение презервативов через государственный и частный сектор

HC.6.3.5 Condom distribution programs / HC.6.3.5 Программы распространения презервативов

Technical Notes

HC.5 Медицинские товары (HC 5.1.3.1. Condoms / Презервативы)

can be made a subcategory of HC.6.3.7 Condom distribution if it refers to condom distribution programs or of HC.5 Medical goods dispensed to outpatients if it refers to the commodity purchased directly from retail outlets. In case of FN 1.14. Female condom a new sub-category

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NASA Functions / Функции ОНРС

NHA HIV/AIDS subanalysis / Субанализ НСЗ по ВИЧ/СПИД

1.14. Female condom / Презервативы для женщин

Sub-category of HC 5.1. Pharmaceuticals and other medical nondurables / Суб-категория HC 5.1. Лекарства и товары недлительного пользования

1.15. Microbicides / Микробициды

Sub-category of HC 5.1. Pharmaceuticals and other medical nondurables / Суб-категория HC 5.1. Лекарства и товары недлительного пользования

1.16. Improving management of STIs / Лечение инфекций, передающихся половым путём 1.17. Prevention of mother-to-child transmission / Профилактика передачи ВИЧ от матери ребёнку 1.18. Blood safety / Безопасность крови 1.19. Post-exposure prophylaxis / Пост-контактная профилактика

1.20. Safe medical injections / Безопасная инъекционная медицинская практика

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Comments / Комментарии should be created in HC 5.1. Pharmaceuticals and other medical nondurables / Это можно сделать подкатегорией категории HC.6.3.7 Распределение презервативов, если это касается программ распределения презервативов или категории HC.5 Товары медицинского назначения которые даються амбулаторным больным, если это касается товаров, купленых прямо на розничных точках. В случае FN 1.14. Женские презервативы, следует создать подкатегорию в категории HC 5.1. Фармацевтические препараты и другие товары медицинского назначения недлительного пользования.

Microbicides are currently out of market / Микробицитов сейчас на рынке нет.

HC.1.3.3.2 STI Management / Менеджмент БППП + HC.6.3.3 STI Prevention Program / Программа профилактики БППП (IEC) HC.6.1.1. PMTCT / HC.6.1.1. Профилактика передачи ВИЧ от матери ребёнку HC.6.3.1 Blood Safety / HC.6.3.1 Безопасность крови HC.1.3.3.6 Post Exposure Prophylaxis (PEP) / Пост-контактная профилактика

H.C.6.3.2 Blood Safety + part of HC.R. 2. Education and training of health personnel + part of HC. 6 Needle exchange + part HC 1.1. In-patient curative care and HC 1.3. Out-patient curative care / H.C.6.3.2 Безопасность крови + часть HC.R. 2. Обучение и тренинг медицинского персонала + часть HC 1.1. Стационарная медицинская помощь и HC 1.3. Амбулаторная медицинская помощь

H.C.6.3.2 Blood Safety + part of HC.R. 2. Education and training of health personnel + part of HC. 6 Needle exchange (if it is correct to include squirt distributions as a part of harm reduction programs) + part HC 1.1. In-patient curative care and HC 1.3. Out-patient curative care (to include usage of squirts for in-patient and out-patient needs) / H.C.6.3.2 Безопасность крови + часть HC.R. 2. Образование и подготовка медработников +часть HC. 6 Обмен игл (если это правильно включать распределение шприцов в программы уменьшения вреда) + часть HC 1.1. Стационарная медицинская помощь и HC 1.3. Амбулаторная помощь (чтобы включить использование шприцов для нужд амбулаторных и стационарных больных).

Ukraine National Health Accounts 2003-2004

NASA Functions / Функции ОНРС

NHA HIV/AIDS subanalysis / Субанализ НСЗ по ВИЧ/СПИД

1.21. Universal precautions / Универсальные меры предосторожности

HC.6.3.2 Blood Safety? / HC.6.3.2 Безопасность крови?

1.22. Others Not Elsewhere Classified / Затраты, не определённые по типу

HC.6.9. All other miscellaneous public health services (FS+PS=Rest of the world)/ Все прочие различные услуги по охране здоровья (Источники финансирования + Провайдеры = Весь другой мир)

Comments / Комментарии

2. Care and Treatment / Лечение и уход 2.1. Provider initiated testing / Обязательное тестирование 2.2. Antiretroviral therapy / Антиретровирусная терапия 2.3. Nutritional support / Харчування

inside HC.1.3.1 Basic medical and diagnostic services / внутри категории HC.1.3.1 Основные медицинские и диагностические услуги HC.1.3.3.4 ARV Treatment / АРВ лечение, также, возможно, HC.5.1.1.1 ARV Drugs / Препараты АРВ HCR.4 Food, hygiene and drinking water control (including nutritional support) or HC.1.3.9 All other outpatient curative care / HCR.4 Питание, гигиена, контроль за качеством питьевой воды или HC.1.3.9 Другая амбулаторная помощь

2.4. OI Prophylaxis / Профилактика оппортунистических инфекций

HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом, probably HC.1.3.3.3 OI Treatment and monitoring / HC.1.3.3.3 Лечение и контроль оппортунистических заболеваний

2.5. OI Treatment / Лечение оппортунистических инфекций

HC.1.3.3.3 OI Treatment and monitoring / HC.1.3.3.3 Лечение и контроль оппортунистических заболеваний + HC.5.1.1.2 OI Drugs / Препараты ОИ (оппорт. инф.) + part of HC.1.2. (day cases of curative care) in TB hospitals and dispensers / + часть HC.1.2. (лечение в дневном стационаре) для ТБ больниц и диспансеров

2.6. Laboratory monitoring / Лабораторный мониторинг 2.7. Palliative care / Паллиативная помощь 2.8. Alternative/Informal Providers / Альтернативные поставщики / Нетрадиционная медицина

Technical Notes

here we shoul excluded (if they are counted under this code)in different categories cost of isoniazid to prevent TB for PLWHIV, cost of medication for kids under 18 month with HIV-risk \ из других категорий следует исключить (в пользу данной категории) затраты на изониазид для ТБ, а также лечение и профилактика ВИЧ у детей, младше 18 месяцев

HC.4.1 Clinical laboratory / HC.4.1 Клинические лаборатории sub-category for AD.1.1 Social support services / ввести подкатегорию для AD.1.1 Службы социальной поддержки HP.3.9.3 Alternative or traditional practitioners / HP.3.9.3 Альтернативные поставщики-нетрадиционная медицина

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NASA Functions / Функции ОНРС

NHA HIV/AIDS subanalysis / Субанализ НСЗ по ВИЧ/СПИД

2.9. Others Not Elsewhere Classified

HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология + HC.1.3.4. All other outpatient curative care (in adult policlinics and private clinics) / Все прочее амбулаторное лечение (взрослые поликлиники и частные клиники)

3. Orphans and Vulnerable children / Дети-сироты и уязвимые дети

AD.1.2 Non-health services to orphans and vulnerable children / AD.1.2 Услуги, не связанные с здравоохранением для детейсирот и уязвимых детей

3.1. Education / Образование

3.2. Skills training (out-of-school youth) / Тренинг умений (для детей вне школы) 3.3. Health-care support / Поддержка и уход 3.4. Family/home support / Поддержка в семье/на дому 3.5. Community support / Поддержка на уровне сообщества 3.6. Administrative costs / Административные расходы

138

outside of HIV/AIDS classifications / вне классификации субанализа outside of HIV/AIDS classifications / вне классификации субанализа AD.1.2.3 Grant to families taking care of orphans & vulnerable children / Выплаты семьям, которые заботяться о детяхсиротах и уязвимых детях AD 1.2.3.1. Community support / AD 1.2.3.1. Поддержка сообществ + HC.1.3.3.7. Psychosocial support (only public and private funds)/ HC.1.3.3.7.Психосоциальная поддержка (только государственные и приватные расходы) AD 1.2.3.2. Organization costs / AD 1.2.3.2. Административные расходы

Comments / Комментарии

FN 3. Orphans and vulnerable children refers to a beneficiary population, so it may be confusing to make it a functions classification. Some of the functions associated with it can be classified elsewhere, such as under the addendum functions. Further, ‘vulnerable children’ is not defined. This needs to be done because different agencies and initiatives use the term differently / FN 3. Сироты и уязвимые дети касается групп населения - -бенефициаров, поэтому тут может быть путаница в классификации функций. Некоторые из функций, связанные с этим, могут классифицироваться в других местах, например под функциями в приложении. Кроме того нет определения понятия ‘уязвимые дети ’. Это нужно сделать, поскольку разные организации и инициативы используют этот термин по-разному.

Care must be taken to avoid double-counting with FN 1.5. Youth outof-school (NASA) / Необходимо избегать дублировани подсчетов с категорией FN 1.5. Внешкольная молодежь (ОНРС) could add additional classification / Можна добавить дополнительную классификацию

AD 1.2.3. Grant to families taking care of orphans & vulnerable children includes items under AD 1.2.3.1. and AD 1.2.3.2. codes ans should be separated for NASA / AD 1.2.3. Гранты семьям, ухаживающим за сиротами и уязвимыми детьми, включает пункты под кодами AD 1.2.3.1. и AD 1.2.3.2. И их следует разделить для ОНРС

Ukraine National Health Accounts 2003-2004

NASA Functions / Функции ОНРС

NHA HIV/AIDS subanalysis / Субанализ НСЗ по ВИЧ/СПИД

4. Program Management costs / Расходы на разработку и внедрение программ

HC.7 Health administration and health insurance, HC.R. 3 Research and development in health / HC.7 Администрирование и страхование в здравоохранении, HC.R. 3 Исследования и развитие в здравоохранении

4.1. Programme Management / Программный менеджмент

HC 7.1.1.1. General government administration of health / HC 7.1.1.1. Расходы на государственное администрирование в здравоохранении

4.2. Advocacy and communications / Адвокация

AD.2 Policy Advocacy / AD.2. Адвокатирование политик

4.3. Monitoring and Evaluation / Мониторинг и оценка

HC 7.1.1.1. General government administration of health / HC 7.1.1.1. Расходы на государственное администрирование в здравоохранении

4.4. Operations Research / Операционные исследования 4.5. Surveillance (sero-sentinel, behaviour surveillance) / Эпиднадзор

In SHA/NHA classification Monitoring and Evaluation is mentioned in regarding to Government activity, when in NASA it includes also nongovernmental sector / В классификации SHA/NHA Мониторинг и оценка упомянуты в связи с деятельностью правительства, в NASA это также включает в себя негосударственный сектор.

HCR.3 Research and development in health / HC.R. 3 Исследования и развитие в здравоохранении HC.6.3.8 Disease surveillance / HC.6.3.8 Эпиднадзор + 2nd generation surveillance as a part of AD.5.1./ Епиднадзор второго поколения как часть AD.5.1.

4.6. Training / Тренинги

HCR.2 Education and training / HCR.2 Образование и тренинги

4.7. Logistic and supply, including transportation / Логистика и поставки, включая транспортировку

HC 7.1.1.1. General government administration of health / HC 7.1.1.1. Расходы на государственное администрирование в здравоохранении or HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях

Technical Notes

Comments / Комментарии FN 4 Program development/program support costs can be classified under HC.7 Health administration, HC.R. 3 Research and development in health and under corresponding subcategories for each type of function related to program development / FN 4 Расходы на разработку\поддержку программ могут классифицироваться под кодом HC.7 Управление медпомощью, HC.R. 3 Научноисследовательская деятельность в здравоохранении и под соответсвующими субкатегориями для каждого типу функции, которая относится к разработке программ. In SHA/NHA classification there is no a specific code for Programme Management in Non-governmental organizations, costs are spread through the number of categories. It is possible to add a sub-category under HC.7 Health administration and health insurance specifically to separate NGO and Governmental program management costs / В классификации SHA/NHA нет конкретного кода для программного управления и НГО, расходы распределены по ряду категорий. Можно добавить подкатегорию в HC.7 Управление здравоохранением и медицинское страхование с тем, чтобы разделить расходы на управление программ со стороны НГО и государственного сектора.

only Training part of HC.R. 2 Education and training / Только Подготовка часть HC.R. 2 Образование и подготовка Code for category general government administration of health is HC.7.1.1, having extra number means some lower category / Кодом для категории общее государственное управление здравоохранением является HC.7.1.1, а наличие дополнительных номеров означает более низкую категорию

139

NASA Functions / Функции ОНРС 4.8. Supervision of programmes and programme support for patient tracking / Супервизия программ и программная поддержка учёта пациентов 4.9. HIV drug resistance surveillance / Исследования резистентности к лекарственным средствам в области ВИЧ/СПИДа 4.10. Upgrading laboratory infrastructure / Оснащение лабораторий 4.11. Construction of new health centres / Создание новых лечебных учереждений 4.12. Non-govermental institutional capacity building / Развитие потенциала негосударственного сектора

NHA HIV/AIDS subanalysis / Субанализ НСЗ по ВИЧ/СПИД

Comments / Комментарии

HC 7.1.1.1. General government administration of health / HC 7.1.1.1. Расходы на государственное администрирование в здравоохранении HC 1.3.6. OI Treatment and Monitoring or HC.R. 3 Research and development in health / HC 1.3.6. Лечение и контроль оппортунистических инфекций или HC.R. 3 Исследования и развитие в здравоохранении HCR.1 Capital formation / HCR.1 Капитальные расходы HCR.1 Capital formation / HCR.1 Капитальные расходы AD.4 Empowerment and organization, HCR.2 Education and training / AD.4 Усиление и организация, HC.R. 2 Образование и тренинг для мед персонала

5. Human Resources Incentives / Стимулирование при найме и удержании кадров 5.1. Monetary incentive for doctor / Денежные стимулы для врачей 5.2. Monetary incentive for nurse / Денежные стимулы для среднего медперсонала 5.3. Monetary incentive for other staff / Денежные стимулы для остального персонала

this can be included into NHA tables under a sub-category HC.R. 1.i. / это можно включить в таблицы НСЗ в рамках подкатегории HC.R. 1.i. this can be included into NHA tables under a sub-category HC.R. 1.i.i. / это можно включить в таблицы НСЗ в рамках подкатегории HC.R. 1.i.i. content entirely depends on what will be excluded from other categories | сожержание полностью зависит от того, что будет исключено из других категорий

There is no specific line for Human Resources Incentives. To fulfil this category we should look at all the curative care functions in which the monetary incentives are included as payroll costs (60%) / Нет отдельной строки для Стимулирование людских ресурсов. Для выполнения этой категории следует рассмотреть все функции медицинской помощи, в которых денежные стимулы включены в расходы по зарплате (60%).

6. Social Mitigation / Смягчение социальных последствий 6.1. Human Rights / Права человека 6.2. Monetary Benefits / Денежные выплаты

140

AD.4 Empowerment and organization (Includes legal services) / Усиление и организация (Включает юридические услуги) Sub-category AD 1.1.4. Monetary benefits to PLWHA must be created / Должна быть создана подкатегория AD 1.1.4. Денежные выплаты ЛЖВС

Ukraine National Health Accounts 2003-2004

NASA Functions / Функции ОНРС 6.3. In kind benefits / Пособия в натуральной форме 6.4. Social services / Социальные услуги 7. Community development and enhanced environment / Развитие сообществ и улучшение среды для уменьшения уязвимости 7.1. Institutional Development / Институциональное развитие 7.2. Programs focused on Women / Программы, направленные на женщин 7.3. Income generation projects / Коммерческие проекты

NHA HIV/AIDS subanalysis / Субанализ НСЗ по ВИЧ/СПИД AD.1.1.2 In-kind benefits to PLWHA / AD.1.1.2 Помощь в натуральной форме ЛЖВС AD.1.1. Social Support Services / AD.1.1. Службы социальной поддержки

Comments / Комментарии Care must be taken in order not include FN 2.3. Nutirtional support / Не следует включать FN 2.3. Питание

AD 5. Community development and enhanced environment to reduce vulnerability / AD 5. Развитие сообществ и создание поддерживающей среды для уменьшения уязвимости AD.4 Empowerment and organization / AD.4 Усиление и организация AD 5.ii Programmes focused on women / AD 5.ii Программы, направленные на женщин AD.1.1 Social support services / AD.1.1 Службы социальной поддержки

8. HIV-related research / Исследования в области ВИЧ 8.1. Biomedical research / Биомедицинские исследования 8.2. Clinical research / Клинические исследования 8.3. Epidemiological research / Епидемиологические исследования 8.4. Social science research / Социальные исследования 8.5. Behavioural research / Поведенчиские исследования 8.6. Research capacity strengthening / Исследования по усилению возможностей 8.7. Vaccine-related research / Исследования вакцин FN 9. Functions, not specified by kind / Функции, не определённые по виду

Technical Notes

HC.n.s.k. HC Expenditures, not specified by kind / HC.n.s.k. HC Затраты. Не определённые по типу услуг

141

Detailed General NHA Tables

142

Ukraine National Health Accounts 2003-2004

Table 71 Ukraine general NHA 2003: Financial Sources by Financial Agents Financing sources / Источники финансирования (HF) FS.1 Public funds / Общественные

Financing agents / Финансирующие организации (FA)

HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство HF.1.1.1.1 Ministry of Health / Министерство здравоохранения HF.1.1.1.2 Ministry of Transport / Министерство транспорта HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел HF.1.1.1.4 Ministry of Defence / Министерство обороны HF.1.1.1.5 Ministry of Labor and Social Policy / Министерство труда и социальной политики HF.1.1.1.6 Academy of Medical Sciences / Академия Медицинских Наук HF.1.1.1.9 Other ministries / Другие министерства

FS.1.1.1 Central government revenue / Центральное правительство

HF.1.2.1 Social security fund for accidents at work and occupational diseases / Фонд социального страхования от несчастных случаев на производстве и профессиональных заболеваний

FS.2.3 Non-profit institutions serving FS.2.2 Household households / FS.2.1 Employer funds / funds / Ресурсы Неправительственные Работодатели домохозяйств организации, обслуживающие домохозяйства

Total / Итого

Total Rest of the World / Итого Весь остальной мир

Total / Итого

7 388 408 028

10 771 579 855

7 377 973 529

10 758 734 569 3 380 761 040

0 0

1 721 905 898

252 710 615

108 464 707

233 387 539

206 815 128

284 946 807

572 530 346

572 530 346 7 377 973 529

7 377 973 529

2 410 787

10 434 499

12 845 286

36 015 646

2 410 787

10 434 499

12 845 286

36 015 646

503 153 851

HF.2.2 Other private VOLUNTARY insurance / Другое частное ДОБРОВОЛЬНОЕ страхование HF.2.3 Private households' out-of pocket payment / Частные выплаты домохозяйствами HF.2.4 Non-profit Institutions serving households (other than social insurance) / Неправительственные организации, обслуживающие домохозяйства (другие, чем социальное страхование)

36 015 646

FS.3 Rest of

3 380 761 040 3 380 761 040

HF.2 Private Sector / Частный сектор

3 383 171 827

Ukraine National Health Accounts 2003-2004

7 388 408 028

1 721 905 898 252 710 615

0 0

108 464 707 233 387 539

206 815 128

0 0

284 946 807 572 530 346

7 377 973 529

36 015 646

48 860 932

36 015 646

7 219 854 172

5 591 693

16 639 900

7 174 537 772

5 591 693

503 153 851

16 639 900

7 174 537 772

5 591 693

503 153 851

28 676 500 0

539 169 497

48 860 932 0 0 7 728 599 716

7 728 599 716

16 639 900

10 771 579 855

0 0

Grand Total / Общий итог

0 10 807 595 501 0 10 758 734 569 0 3 380 761 040

36 015 646

HF.2.5 Private firms and corporations (other than health insurance, this includes all private/public factories that also have their health care provision facilities) / Частные фирмы и корпорации (другие, чем медицинское страхование, это включает все частные/общественные фабрики, которые имеют свои собственные медицинские учреждения) HF.2.6 Hospital kassa / Больничные кассы HF.3 Rest of the world / Весь другой мир HF.3.1 HIV/AIDS Alliance / Международный ВИЧ/СПИД Альянс в Украине HF.3.9 Other / Другое

Grand Total / Общий итог

FS.2 Private funds / Частные ресурсы

3 383 171 827

HF.1.1.2 Oblast/City/Local/Municipal governments (27) / Областные бюджеты/ Местное/муниципальное правительство (27) HF.1.2 Social security funds / Фонды социального страхования

FS.1.1.2 Regional and city government budget revenue, including rayon and local budgets revenue / Областные бюджеты, включая районные и местные бюджеты

7 219 854 172

5 591 693

7 764 615 362

503 153 851 0 0 28 676 500 85 432 171 85 432 171 8 532 320 76 899 851

85 432 171

8 532 320 76 899 851 18 621 627 388

143

Table 72 Ukraine general NHA 2003: Financial Agents by Providers Financing agents / Финан HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.1 Hospitals / Больницы HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 Oblast hospitals / Областные больницы HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.1.2 Children oblast general hospitals / Детские областные больницы общего профиля HP.1.1.2 City Hospitals / Городские больницы

HF.1.1.2 Oblast/City/Local/ HF.1.2 Social HF.1.1.1.5 Municipal HF.1.1.1.6 security funds / Ministry of Labor Academy of HF.1.1.1.9 Other governments (27) Фонды and Social Policy / Областные Medical Sciences ministries / социального / Министерство бюджеты/ / Академия Другие страхования труда и Медицинских министерства Местное/муници социальной пальное Наук политики правительство

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

318 464 871

235 697 475

100 675 509

3 148 954

222 357 122

158 220 811

5 657 585 994

23 190 040

235 697 475

100 675 509

117 993 665

4 527 148 334 492 071 259 320 656 225 171 415 034 1 895 241 785 1 679 069 561

HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.2.2 Children city general hospitals / Детские городские больницы общего профиля

216 172 224 1 577 527 917

HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы HP.1.1.4 Rayon Hospitals / Районные больницы HP.1.1.5 Dilnichni Hospitals / Участковые больницы HP.1.1.6 Maternity houses / Родильные дома HP.1.1.9 Other General hospitals / Другие Больницы общего профиля HP.1.2 Mental health and substance abuse hospitals / Психиатрические больницы для лечения алкогольной или наркотической зависимости HP.1.2.1 Mental health hospitals and dispensers / Психиатрические больницы и диспансеры HP.1.2.2 Substance abuse hospitals and dispensers / Наркологические больницы и диспансеры HP.1.3 Specialty (other than mental health and substance abuse) hospitals / Специализированные больницы(кроме психиатрических больниц для лечения алкогольной или наркотической зависимости) HP.1.3.1 Oncology hospitals and dispensers / Онкологические больницы и диспансеры HP.1.3.2 AIDS clinics and centers / Клиники и центры ВИЧ/СПИД HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы и диспансеры HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры HP.1.3.9 Other specialty hospitals / Другие специализированные больницы

Ukraine National Health Accounts 2003-2004

184 625 306 181 804 284 195 877 783 23 190 040

235 697 475

100 675 509

117 993 665 0

484 207 694

475 385 609 8 822 085

295 274 831

3 148 954

222 357 122

40 227 146

646 229 966

114 650 000

50 769 410

16 373 430

13 602 292

59 578 011

96 246 605

33 718 689 104 673 390

3 148 954

222 357 122

40 227 146

451 892 970

144

Table 72 Ukraine general NHA 2003: Financial Agents by Providers (cont.) Financing agents / Финан HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.2 Nursing and residential care facilities / Сестринские/врачебные учреждения длительного пребывания больных (по уходу) HP.2.1 Nursing care facilities / Учреждения сестринского ухода HP.2.3 Community care facilities for the elderly / Дома престарелых HP.2.4 Rehabilitation centers / Реабилитационные центры HP.2.9 All other residential care facilities / Все прочие учреждения по уходу HP.2.9.1 Hospice / Хоспис HP.2.9.9 Sanatoriums / Санатории HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.2 Children's Policlinics / Детские поликлиники HP.3.1.5 Village doctor posts / Сельские врачебные амбулатории HP.3.1.6 Feldsher-midwife posts / Фельдшерско-акушерские пункты HP.3.1.9 All other not described in the above groups / Все остальное не включенное в других категориях HP.3.2 Offices of dentists / Стоматологические кабинеты (отделения) HP.3.4 Outpatient care centres / Центры амбулаторного лечения HP.3.7 Private clinics / Частные клиники HP.3.9 Other providers of ambulatory health care / Прочие организации, предоставляющие амбулаторные медицинские услуги HP.3.9.1 Ambulance services / Скорая помощь HP.3.9.2 Blood and organ banks / Банки крови и органов HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции HP.4.2 Retail sale and other suppliers of optical glasses and other vision products / Розничная продажа и прочие поставщики очков и различной продукции для органов зрения HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

Ukraine National Health Accounts 2003-2004

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

95 168 832

101 405 524

272 220 133

229 503 505

18 656 700

3 924 214

7 481 900

17 644 536 3 616 525 95 168 832

95 168 832

101 405 524

57 184 709

101 405 524

57 184 709

272 220 133

204 318 230

11 174 800

272 220 133

204 318 230

11 174 800 0

15 792 156

17 013 140

7 789 198

3 711 032

99 453 065

1 140 871 825

14 826 318

7 789 198

99 453 065

646 278 101 249 438 209 150 804 830 123 566 723 122 468 339

14 826 318

7 789 198

99 453 065

7 810 665

170 740 362

7 981 491

3 711 032

2 186 822

57 405 307

266 448 055

202 442 749 2 186 822

31 352 138

64 005 306

142 077 600

12 999 999

6 810 600

3 410 900

6 600

27 800

145

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.4.4 Retail sale and other suppliers of medical appliances (other than optical glasses and hearing aids) / Розничная продажа и прочие поставщики медицинских приборов (кроме оптических очков и слуховых приборов) HP.4.9 All other miscellaneous sale and other suppliers of pharmaceuticals and medical goods / Продажа прочей продукции и прочие поставщики фармацевтических или медицинских товаров HP.5 Provision and administration of public health programmes / Обеспечение и управление программами общественного здоровья HP.6 General health administration and insurance / Общее управление здравоохранением и медицинское страхование HP.6.1 Government administration of health / Государственное управление здравоохранением HP.6.2 Social security funds / Фонды социального страхования HP.6.9 All other providers of health administration / Все прочие организации управления здравоохранением HP.7 All other industries (rest of the economy) / Все прочие сектора экономики HP.7.1 Establishments as providers of occupational health care services / Учреждения, предоставляющие услуги по охране здоровья на производстве HP.7.3 All other industries as secondary producers of health care / Все прочие отрасли промышленности как организации, предоставляющие вторичные медицинские услуги HP.8 Institutions providing health-related services / Учреждения, предоставляющие услуги, связанные со здравоохранением HP.8.1 Research institutions / Исследовательские институты HP 8.2 Education and training institutions / Учреждения образования и обучения

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

31 352 138

142 077 600

12 999 999

517 748 393 231 402 431

3 365 300

5 031 043

8 397 953

31 187 982

341 614 252

20 786 066

3 251 132

341 614 252 3 251 132

210 616 365 886 204

31 187 982 0

15 455 000

886 204

429 392 956

21 928 918

4 403 865

45 878 654

4 403 865

45 878 654

396 982 004

10 482 034

HP.nsk Provider not specified by kind / Провайдеры, не определенные по типу TOTAL

81 697 917

Ukraine National Health Accounts 2003-2004

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

1 721 905 898

17 312

131 982 015 252 710 615

108 464 707

233 387 539

6 400 000 206 815 128

284 946 807

572 530 346

4 687 500 7 377 973 529

48 860 932

146

Table 72 Ukraine general NHA 2003: Financial Agents by Providers (cont.) сирующие организации (FA)

Providers / Поставщики (провайдеры) медицинских услуг (HP)

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

6 696 150 736

HF.2.4 Non-profit HF.2.5 Private HF.2.3 Private Institutions firms and HF.2.2 Other households' outserving corporations private of pocket households (other than health HF.2.6 Hospital VOLUNTARY kassa / payment / (other than social insurance, this insurance / Частные Больничные insurance) / includes all Другое частное выплаты кассы Неправительств private/public ДОБРОВОЛЬНО домохозяйствам енные factories that also Е страхование и организации, have their health обслуживающие care provision 0

522 904 111

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

522 904 111

Grand Total / Общий итог

7 219 054 847

5 004 705 023

505 566 130

5 510 271 153

492 071 259

77 630 726

569 701 985

320 656 225

51 044 322

371 700 546

171 415 034

26 586 404

198 001 439

1 895 241 785

178 379 694

2 073 621 480

1 679 069 561

154 581 566

1 833 651 127

216 172 224

23 798 129

239 970 353

1 577 527 917

138 434 594

1 715 962 511

184 625 306

15 526 808

200 152 114

181 804 284

65 087 864

246 892 148

195 877 783

20 733 945

216 611 728

477 556 689

9 772 498

487 329 187

484 207 694

2 851 229

487 058 923

475 385 609

2 851 229

11 673 314

14 486 752

1 221 724 771

475 385 609 2 851 229

8 822 085

1 207 238 019

14 486 752

165 419 410

29 975 722

2 929 559

32 905 281

155 824 616

1 547 842

157 372 459

33 718 689

1 271 560

34 990 249

822 299 582

8 737 791

831 037 373

147

Table 72 Ukraine general NHA 2003: Financial Agents by Providers (cont.) сирующие организации (FA)

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.2 Nursing and residential care facilities / Сестринские/врачебные учреждения длительного пребывания больных (по уходу) HP.2.1 Nursing care facilities / Учреждения сестринского ухода HP.2.3 Community care facilities for the elderly / Дома престарелых HP.2.4 Rehabilitation centers / Реабилитационные центры HP.2.9 All other residential care facilities / Все прочие учреждения по уходу HP.2.9.1 Hospice / Хоспис HP.2.9.9 Sanatoriums / Санатории HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.2 Children's Policlinics / Детские поликлиники HP.3.1.5 Village doctor posts / Сельские врачебные амбулатории HP.3.1.6 Feldsher-midwife posts / Фельдшерско-акушерские пункты HP.3.1.9 All other not described in the above groups / Все остальное не включенное в других категориях HP.3.2 Offices of dentists / Стоматологические кабинеты (отделения) HP.3.4 Outpatient care centres / Центры амбулаторного лечения HP.3.7 Private clinics / Частные клиники HP.3.9 Other providers of ambulatory health care / Прочие организации, предоставляющие амбулаторные медицинские услуги HP.3.9.1 Ambulance services / Скорая помощь HP.3.9.2 Blood and organ banks / Банки крови и органов HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции HP.4.2 Retail sale and other suppliers of optical glasses and other vision products / Розничная продажа и прочие поставщики очков и различной продукции для органов зрения HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

774 139 403

254 930 674

374 325 826

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

Grand Total / Общий итог

629 256 500

1 403 395 903

11 406 114

17 644 536

3 616 525

374 325 826

629 256 500

1 370 728 728

374 325 826

629 256 500

1 370 728 728

741 472 228

254 930 674

0 254 930 674

741 472 228 1 284 630 416

515 530 382

768 346 682

308 887 092

249 438 209 150 804 830

128 828 026

644 358 408

1 928 988 824

308 887 092

1 077 233 774

219 506 493

468 944 701

89 380 599

240 185 429

123 566 723

122 468 339

122 068 581

178 551 027

89 870 929

268 421 956

69 097 830

9 884 387

78 982 217

87 736 974

216 565 000

268 634 877

19 151 000

128 828 026 0

19 151 000

287 785 877

202 442 749

66 192 128

19 151 000

193 240 337

28 676 500

5 905 211 755

28 676 500

5 905 211 755

5 908 622 655

6 600

27 800

3 410 900

5 876 535 255

6 098 452 092

148

Table 72 Ukraine general NHA 2003: Financial Agents by Providers (cont.) сирующие организации (FA)

Providers / Поставщики (провайдеры) медицинских услуг (HP)

Total HF1. General Government

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

Grand Total / Общий итог

189 795 037

5 591 693

536 769 082

531 177 389 607 455 797

5 591 693 0

607 455 797

362 400 318

3 251 132

241 804 347

HP.7 All other industries (rest of the economy) / Все прочие сектора экономики

16 341 204

15 455 000

886 204

479 692 787

362 400 318

16 341 204

479 692 787

72 211 437

396 999 316

10 482 034

HP.nsk Provider not specified by kind / Провайдеры, не определенные по типу TOTAL

224 767 432

16 639 900

4 637 349

10 807 595 501

16 639 900

7 174 537 772

HP 8.2 Education and training institutions / Учреждения образования и обучения

Ukraine National Health Accounts 2003-2004

85 432 171

21 277 249 5 591 693

503 153 851

28 676 500

7 728 599 716

85 432 171 246 044 681

85 432 171

18 621 627 388

149

Table 73 Ukraine general NHA 2003: Financial Agents by Functions Financing agents / Финан HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.1.2 Gynecology / Гинекология HC 1.1.1.2.1 Abortion / Аборты HC 1.1.1.2.9 Other Gynecology / Другая Гинекология HC 1.1.2 Oncology / Онкология HC 1.1.2.1 Gynecology Oncology / Гинекологическая онкология HC 1.1.2.2 Other Oncology / Другая онкология HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.1 Basic medical and diagnostic services / Основные медицинские и диагностические услуги HC.1.3.2 Outpatient dental care / Амбулаторное стоматологическое лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение HC.1.4 Services of curative home care / Услуги лечения на дому HC.2 Services of rehabilitative care / Услуги реабилитационного лечения HC.2.1 Sanatorium services / Санаторные услуги

Ukraine National Health Accounts 2003-2004

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

298 204 971

237 997 603

103 041 472

2 802 569

201 126 436

242 376 553

6 097 773 224

206 370 541

176 773 106

75 506 632

2 133 668

150 664 739

115 752 358

4 171 903 418 560 715 028 252 574 084 308 140 944 5 607 150 302 533 793

77 684 547

34 400 337

3 806 543

1 685 617

73 878 004

32 714 720 2 364 265 720

3 463 955 88 370 474

61 224 497

27 534 840

39 110

2 761 675

499 621

58 990 438

629 791

47 700 022

126 124 574

1 866 879 368

7 420 132

162 203 344

76 312 334

629 791

47 700 022

8 045 429

11 915 602

278 568 447 19 249 321 6 743 738 9 625 507

6 432 823 6 364 702

2 402 271

790 632 57 845 390 377 413 321 95 168 832

101 405 524

57 184 709

272 220 133

207 934 755

11 174 800

95 168 832

101 405 524

57 184 709

272 220 133

204 318 230

11 174 800

150

Table 73 Ukraine general NHA 2003: Financial Agents by Functions (cont.) Financing agents / Финан HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Functions / Функции (HC)

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

31 352 138

142 077 600

12 999 999

6 810 600

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.1.9 Other maternal and child health; family planning and counselling / Другие услуги здоровья матери и ребенка; планирование семьи и семейные консультации HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.3.9 Other prevention of communicable diseases / Другие услуги по профилактике инфекционных болезней

Ukraine National Health Accounts 2003-2004

7 481 900

3 410 900

31 352 138 517 748 393

142 077 600 2 186 822

12 999 999

3 399 700 5 031 043

110 304 505

15 455 000

995 987

995 987 2 186 822

64 005 306

2 186 822

64 005 306

151

Functions / Функции (HC)

HC.6.4 Prevention of noncommunicable diseases / Профилактика неинфекционных заболеваний HC.6.5 Occupational health care / Охрана здоровья на производстве HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением HC.7.1.1 General government administration of health (except social security) / Общее государственное управление здравоохранением (за исключением социального обеспечения) HC.7.1.2 Administration, operation and support of social security funds / Управление, проведение и поддержка фондов социального обеспечения HC.n.s.k HC expenditure not specified by kind / Расходы здравоохранения, не определенные по типу услуг HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.2 Education and training of health personnel / Образование и обучение медицинского персонала HC.R.3 Research and development in health / Исследования и разработки в здравоохранении HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

Ukraine National Health Accounts 2003-2004

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

15 455 000

231 402 431

31 187 982

341 614 252

3 251 132

231 402 431

31 187 982

341 614 252

3 251 132

231 402 431

31 187 982

341 614 252

3 251 132 886 204

131 982 015

4 687 500

547 142 929

12 526 190

5 423 235

4 750 250

70 820 372

21 714 635

396 335 294

117 749 973

12 526 190

5 423 235

346 385

24 941 718

21 697 323

396 335 294

396 982 004

17 312

21 928 918

4 403 865

45 878 654

206 815 128

284 946 807

10 482 034 1 721 905 898

252 710 615

108 464 707

233 387 539

572 530 346

7 377 973 529

48 860 932

152

Functions / Функции (HC)

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки AD.2.1 Policy advocacy (Includes support to national strategic plan for HIV/AIDS (lobbying)) / Политическая адвокация (Включает поддержку национальному стратегическому плану по ВИЧ/СПИД (лоббирование)) AD.2.2 Policy advocacy for RH / Политическая адвокация для РЗ AD.4.1 Empowerment and organization in HIV / Усиление и организация по ВИЧ AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) AD.5.2 RH specific surveillance activities / деятельность по эпиднадзору, специфическая для РЗ Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

1 721 905 898

252 710 615

108 464 707

233 387 539

206 815 128

284 946 807

572 530 346

7 377 973 529

48 860 932

153

Table 73 Ukraine general NHA 2003: Financial Agents by Functions (cont.) сирующие организации (FA)

Functions / Функции (HC)

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

HF.2.4 Non-profit HF.2.5 Private HF.2.3 Private Institutions firms and HF.2.2 Other households' outserving corporations private of pocket households (other than health HF.2.6 Hospital VOLUNTARY kassa / payment / (other than social insurance, this insurance / Больничные Частные insurance) / includes all Другое частное выплаты кассы Неправительств private/public ДОБРОВОЛЬНО домохозяйствам енные factories that also Е страхование и организации, have their health обслуживающие care provision 109 565 658

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

528 567 667

24 515 474

Grand Total / Общий итог

7 183 322 829

419 002 008

4 899 104 463

94 391 039

4 993 495 501

560 715 028

6 963 642

567 678 670

252 574 084

6 963 642

259 537 726

308 140 944

7 736 405 969

308 140 944

5 607 150

302 533 793

112 084 884

5 492 159

106 592 724

2 364 265 720

64 621 705

2 428 887 425

65 754 800 2 218 463 566

65 754 800 324 610 970

109 565 658

434 176 628

24 515 474

2 677 155 668

56 373 095

56 373 095 287 611 888

169 623 476

89 870 929

28 117 483

117 988 413

411 256 023

23 254 295

54 431

23 308 726

24 515 474

459 080 223

31 164 923

419 359

9 125 530

40 709 812

6 743 738

532 972

9 625 507

651 438

6 432 823 8 766 973

7 276 709 10 276 944 4 639 449

2 065 853

790 632

11 072 272 10 832 826

4 919 864

5 710 496

5 830 632

79 549 680

57 845 390

15 819 228

54 431

15 873 658

377 413 321

119 552 167

25 020 649

144 572 817

521 986 138

745 088 753

254 930 674

374 325 826

629 256 500

1 374 345 253

741 472 228

254 930 674

374 325 826

629 256 500

1 370 728 728

154

Table 73 Ukraine general NHA 2003: Financial Agents by Functions (cont.) сирующие организации (FA)

Functions / Функции (HC)

HC.2.9 All other services of rehabilitative care / Все другие услуги реабилитационного лечения HC.3 Services of long-term nursing care / Услуги долгосрочного медсестринского ухода HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.4.9 All other miscellaneous ancillary services / Все прочие виды дополнительных услуг для медицинского лечения HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.1.9 Other maternal and child health; family planning and counselling / Другие услуги здоровья матери и ребенка; планирование семьи и семейные консультации HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.3.9 Other prevention of communicable diseases / Другие услуги по профилактике инфекционных болезней

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

Grand Total / Общий итог

3 616 525

29 050 650

202 442 749

619 432 485

202 442 749

19 262 367

638 694 852

841 137 601

10 124 152

212 566 901

9 138 215

193 240 337

5 876 535 255

28 676 500

5 905 211 755

6 098 452 092

3 410 900

5 876 535 255

28 676 500

5 905 211 755

5 908 622 655

189 829 437 650 725 763

189 829 437 25 777 628

682 095 084

8 306 134

9 302 121

2 039 580

995 987

6 266 554

7 262 541

66 192 128

14 984 142

81 176 270

995 987

5 591 693

66 192 128

66 192 128 7 239 112

7 239 112

853 232

4 758 718

2 133 080

155

Table 73 Ukraine general NHA 2003: Financial Agents by Functions (cont.) сирующие организации (FA)

Functions / Функции (HC)

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

1 262 709 15 455 000

Grand Total / Общий итог

1 262 709 15 455 000

1 224 643

607 455 797

14 535 298

621 991 095

607 455 797

14 535 298

621 991 095

604 204 665

14 535 298

618 739 963

3 251 132 137 555 719

3 251 132 16 639 900

4 637 349

21 277 249

12 585 172

171 418 140

1 058 712 905

8 018 599

1 066 731 504

579 020 118

2 766 896

581 787 014

396 999 316

323 771

397 323 087

72 211 437

10 482 034 10 807 595 501

16 639 900

7 174 537 772

5 591 693

503 153 851

28 676 500

7 728 599 716

4 927 932

15 409 966

85 432 171

18 621 627 388

156

Table 73 Ukraine general NHA 2003: Financial Agents by Functions (cont.) сирующие организации (FA)

Functions / Функции (HC)

Total HF1. General Government

Total HF.2 Private Sector

Ukraine National Health Accounts 2003-2004

10 807 595 501

16 639 900

7 174 537 772

5 591 693

503 153 851

28 676 500

7 728 599 716

HF.3 Rest of the world / Весь другой мир

Grand Total / Общий итог

2 099 861

1 701 291

2 133 080

3 797 493

902 229

3 133 277

13 767 231

99 199 402

18 635 394 620

157

Table 74 Ukraine general NHA 2003: Providers by Functions

HP.1.1 General hospitals / Больницы общего профиля

Functions / Функции (HC)

HP.1.1.1 Oblast hospitals / Областные HP.1.1.2 City Hospitals / Городские больницы HP.1.1.2.2 HP.1.1.2.1 City HP.1.1.1.2 HP.1.1.1.1 Children city general Oblast general Children oblast general hospitals / general hospitals / hospitals / Городские hospitals / Областные Детские больницы Детские больницы Total / Итого Total / Итого городские общего областные общего больницы профиля больницы профиля общего общего профиля профиля

HP.1.1.4 Rayon HP.1.1.3 Hospitals / Central Rayon Районные Hospitals / больницы Центральные районные больницы

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

320 067 573

170 829 738

490 897 311

1 637 784 976

211 628 675

1 849 413 650

1 537 057 912

179 775 283

187 966 257

249 139 390

132 509 401

381 648 791

1 265 741 626

162 321 307

1 428 062 932

1 188 611 722

139 201 379

137 085 530

35 272 185

184 697 652

173 528 071

20 308 784

35 272 185 15 888 356

15 888 356

83 197 057

78 165 720

9 148 092

19 383 829

101 500 594

95 362 351

11 160 692

352 722

1 846 977

1 735 281

203 088

19 031 107

99 653 618

93 627 071

10 957 604

118 892 595

HC 1.1.2.1 Gynecology Oncology / Гинекологическая онкология HC 1.1.2.2 Other Oncology / Другая онкология HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.1 Basic medical and diagnostic services / Основные медицинские и диагностические услуги HC.1.3.2 Outpatient dental care / Амбулаторное стоматологическое лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ)

213 867 205

1 081 043 974

1 015 083 651

3 693 960

2 314 103

6 008 063

19 342 881

2 918 325

22 261 206

18 173 122

2 126 884

2 454 358

67 234 223

36 006 234

103 240 457

352 700 469

46 389 043

399 089 512

330 273 069

38 447 021

48 426 369

HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение

Ukraine National Health Accounts 2003-2004

158

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.1.1 General hospitals / Больницы общего профиля

Functions / Функции (HC)

HC.1.4 Services of curative home care / Услуги лечения на дому HC.2 Services of rehabilitative care / Услуги реабилитационного лечения HC.2.1 Sanatorium services / Санаторные услуги HC.2.9 All other services of rehabilitative care / Все другие услуги реабилитационного лечения HC.3 Services of long-term nursing care / Услуги долгосрочного медсестринского ухода HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.4.9 All other miscellaneous ancillary services / Все прочие виды дополнительных услуг для медицинского лечения HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам

35 600 163

18 600 949

54 201 112

111 912 673

17 533 067

129 445 740

HP.1.1.4 Rayon HP.1.1.3 Hospitals / Central Rayon Районные Hospitals / больницы Центральные районные больницы

100 028 204

11 145 566

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

49 835 677

Ukraine National Health Accounts 2003-2004

159

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.1.1 General hospitals / Больницы общего профиля

Functions / Функции (HC)

HP.1.1.4 Rayon HP.1.1.3 Hospitals / Central Rayon Районные Hospitals / больницы Центральные районные больницы

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.3.9 Other prevention of communicable diseases / Другие услуги по профилактике инфекционных болезней HC.6.4 Prevention of noncommunicable diseases / Профилактика неинфекционных заболеваний HC.6.5 Occupational health care / Охрана здоровья на производстве HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением HC.7.1.1 General government administration of health (except social security) / Общее государственное управление здравоохранением (за исключением социального обеспечения) HC.7.1.2 Administration, operation and support of social security funds / Управление, проведение и поддержка фондов социального обеспечения HC.n.s.k HC expenditure not specified by kind / Расходы здравоохранения, не определенные по типу услуг HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.2 Education and training of health personnel / Образование и обучение медицинского персонала HC.R.3 Research and development in health / Исследования и разработки в здравоохранении

Ukraine National Health Accounts 2003-2004

16 032 811

8 570 752

24 603 563

83 953 478

10 808 611

94 762 089

78 876 396

9 231 265

9 090 214

16 032 811

8 570 752

24 603 563

83 953 478

10 808 611

94 762 089

78 876 396

9 231 265

9 090 214

160

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.1.1 General hospitals / Больницы общего профиля

Functions / Функции (HC)

HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

HP.1.1.4 Rayon HP.1.1.3 Hospitals / Central Rayon Районные Hospitals / больницы Центральные районные больницы

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

371 700 546

198 001 439

569 701 985

1 833 651 127

239 970 353

2 073 621 480

1 715 962 511

200 152 114

246 892 148

371 700 546

198 001 439

569 701 985

1 833 651 127

239 970 353

2 073 621 480

1 715 962 511

200 152 114

246 892 148

Ukraine National Health Accounts 2003-2004

161

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1.6 Maternity houses / Родильные дома

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

HP.1.2 Mental health and substance abuse HP.1.3 Specialty (other than mental h hospitals / Психиатрические больницы для Специализированные больницы(кроме HP.1.3.3 HP.1.3.2 AIDS HP.1.3.1 HP.1.2.2 HP.1.2.1 Total /Итого Total /Итого Tuberculosis clinics and Oncology Substance Mental health hospitals and centers / hospitals and hospitals and abuse hospitals dispensers / Клиники и dispensers / dispensers / and dispensers Туберкулезные центры Онкологически / Психиатричес больницы и ВИЧ/СПИД е больницы и кие больницы Наркологическ диспансеры диспансеры и диспансеры ие больницы и диспансеры

193 211 591

456 961 017

4 895 283 021

423 093 192

10 209 666

433 302 858

147 223 275

28 847 283

139 623 122

153 871 979

361 449 679

3 789 932 011

392 630 482

7 079 812

399 710 294

112 084 884

514 058

106 103 497

153 871 979

567 678 670

73 138 502

259 537 726

80 733 477

308 140 944

1 469 083

5 607 150

79 264 393

302 533 793 112 084 884

Ukraine National Health Accounts 2003-2004

5 492 159 106 592 724 2 428 887 425 51 023 632 39 339 612

95 511 338

1 054 327 377

109 570

2 054 509

30 462 710

3 020 284

33 482 993

33 083 882

28 333 226

31 584 282

1 935 342

30 462 710

3 020 284

33 482 993

33 083 882

28 333 226

31 584 282 31 584 282

10 276 944 6 432 823 10 832 826 790 632

162

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1.6 Maternity houses / Родильные дома

13 606 248

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

6 490 336

364 752 881

493 219

608 629

Ukraine National Health Accounts 2003-2004

163

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1.6 Maternity houses / Родильные дома

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

Ukraine National Health Accounts 2003-2004

9 793 889

23 877 834

250 235 251

52 292 417

970 429

53 262 846

18 196 135

4 057 998

17 140 708

9 793 889

23 877 834

250 235 251

52 292 417

970 429

53 262 846

18 196 135

4 057 998

17 140 708

164

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

HP.1.1.6 Maternity houses / Родильные дома

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

216 611 728

487 329 187

5 510 271 153

475 385 609

11 673 314

487 058 923

165 419 410

32 905 281

157 372 459

216 611 728

487 329 187

5 510 271 153

475 385 609

11 673 314

487 058 923

165 419 410

32 905 281

157 372 459

Ukraine National Health Accounts 2003-2004

165

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.2 Nursing and residential care facilities / Сестринские/вра

Functions / Функции (HC)

health and substance abuse) hospitals / психиатрических больниц для лечения HP.1.3.4 STI HP.1.3.9 Other Total /Итого specialty clinics and hospitals / dispensers / Другие КожноTotal /Итого венерологичес специализиров анные кие клиники и больницы диспансеры

30 841 198

737 042 530

1 083 577 408

6 412 163 287

23 145 703

562 005 054

803 853 196

4 993 495 501

Ukraine National Health Accounts 2003-2004

HP.2.9 All other residential care facilities / Все прочие HP.2.9.9 Total /Итого Sanatoriums / Санатории

567 678 670 259 537 726 308 140 944 5 607 150 302 533 793 112 084 884

HP.2.4 HP.2.1 Nursing HP.2.3 care facilities / Community Rehabilitation centers / Учреждения care facilities сестринского for the elderly / Реабилитаци онные ухода Дома центры престарелых

112 084 884

5 492 159

106 592 724

106 592 724 2 428 887 425

418 786

10 212 961

14 621 598

65 754 800

7 276 709

164 824 515

265 102 615

1 352 912 985

7 276 709

164 824 515

265 102 615

298 585 608

31 584 282

7 276 709

10 276 944

6 432 823

10 832 826

790 632

7 276 709

166

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.2 Nursing and residential care facilities / Сестринские/вра

Functions / Функции (HC)

3 616 525

HP.2.9 All other residential care facilities / Все прочие HP.2.9.9 Total /Итого Sanatoriums / Санатории

1 370 728 728

3 616 525 11 406 114 439 995

3 541 889

4 590 513

17 644 536

369 836 613

Ukraine National Health Accounts 2003-2004

167

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.2 Nursing and residential care facilities / Сестринские/вра

Functions / Функции (HC)

HP.2.9 All other residential care facilities / Все прочие HP.2.9.9 Total /Итого Sanatoriums / Санатории

Ukraine National Health Accounts 2003-2004

3 709 056

90 452 954

133 556 851

437 054 948

3 709 056

90 452 954

133 556 851

437 054 948

168

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

HP.2 Nursing and residential care facilities / Сестринские/вра

Functions / Функции (HC)

HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

HP.2.9 All other residential care facilities / Все прочие HP.2.9.9 Total /Итого Sanatoriums / Санатории

34 990 249

831 037 373

1 221 724 771

7 219 054 848

11 406 114

17 644 536

3 616 525

1 370 728 728

34 990 249

831 037 373

1 221 724 771

7 219 054 848

11 406 114

17 644 536

3 616 525

1 370 728 728

Ukraine National Health Accounts 2003-2004

169

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

чебные

Providers / Поставщики (провайдеры) медицинских услуг (HP) HP.3 Providers of ambulatory health care / Организации, предоставля HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники

Functions / Функции (HC) Total /Итого

HP.3.1.1 Adults Policlinics / Взрослые поликлиники

HP.3.1.2 Children's Policlinics / Детские поликлиники

HP.3.2 Offices HP.3.4 of dentists / Outpatient HP.3.1.9 All HP.3.1.6 HP.3.1.5 Total /Итого Стоматологич Total /Итого еские other not FeldsherVillage doctor кабинеты midwife posts / described in the posts / (отделения) Фельдшерско- above groups / Сельские акушерские Все остальное врачебные не включенное пункты амбулатории в других категориях

283 604 732

162 660 795

100 089 046

99 199 355

115 965 152

761 519 079

259 494 405

62 260 092

283 604 732

162 660 795

100 089 046

99 199 355

115 965 152

761 519 079

259 494 405

62 260 092

Ukraine National Health Accounts 2003-2004

259 494 405 47 239 882

13 271 353

13 153 384

73 664 618

47 239 882

13 271 353

13 153 384

73 664 618

236 364 850

86 817 693

86 045 971

409 228 514

62 260 092

170

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

чебные

Functions / Функции (HC) Total /Итого

HP.3.1.1 Adults Policlinics / Взрослые поликлиники

HP.3.1.2 Children's Policlinics / Детские поликлиники

1 374 345 253 1 370 728 728 3 616 525 29 050 650 171 872 072

69 984 393

241 856 465

7 739 407

Ukraine National Health Accounts 2003-2004

995 987

18 535 008

18 370 251

37 901 246

995 987

171

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

чебные

Functions / Функции (HC) Total /Итого

HP.3.1.1 Adults Policlinics / Взрослые поликлиники

HP.3.1.2 Children's Policlinics / Детские поликлиники

Ukraine National Health Accounts 2003-2004

12 471 910

7 540 242

4 942 669

4 898 734

6 103 429

35 956 983

8 927 551

8 982 718

12 471 910

7 540 242

4 942 669

4 898 734

6 103 429

35 956 983

8 927 551

8 982 718

172

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

чебные

Functions / Функции (HC) Total /Итого

HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

HP.3.1.1 Adults Policlinics / Взрослые поликлиники

HP.3.1.2 Children's Policlinics / Детские поликлиники

1 403 395 903

468 944 701

240 185 429

123 566 723

122 468 339

122 068 581

1 077 233 774

268 421 956

78 982 217

1 403 395 903

468 944 701

240 185 429

123 566 723

122 468 339

122 068 581

1 077 233 774

268 421 956

78 982 217

Ukraine National Health Accounts 2003-2004

173

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

ющие амбулаторные медицинские услуги HP.3.7 Private clinics / Частные клиники

Functions / Функции (HC)

HP.4 Retail sale and other providers of m

HP.4.1 HP.4.2 Retail HP.3.9 Other providers of ambulatory health care / Прочие Dispensing sale and other организации, предоставляющие амбулаторные chemists / suppliers of HP.3.9.2 Blood HP.3.9.9 All HP.3.9.1 Total /Итого Розничная optical glasses other Ambulance and organ banks продажа and other ambulatory / Банки крови services / фармацевтиче vision products health care и органов Скорая Total /Итого ской / Розничная services / Все помощь продукции продажа и прочие прочие амбулаторные поставщики медицинские очков и услуги различной

197 302 633

19 151 000

1 299 727 209

197 302 633

19 151 000

1 299 727 209

HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

Ukraine National Health Accounts 2003-2004

56 373 095

28 117 483

287 611 888

54 431

135 979 141

54 431

73 719 049

112 757 624

521 986 138

174

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

ющие амбулаторные медицинские услуги HP.3.7 Private clinics / Частные клиники

Functions / Функции (HC)

HP.4 Retail sale and other providers of m

19 262 367

202 442 749

471 300 988

10 124 152

202 442 749

212 566 901

9 138 215

9 138 215 5 908 622 655

Ukraine National Health Accounts 2003-2004

HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

6 600

27 800

6 600

27 800

5 908 622 655

66 192 128

104 093 374 995 987

995 987 66 192 128

66 192 128

175

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

ющие амбулаторные медицинские услуги HP.3.7 Private clinics / Частные клиники

Functions / Функции (HC)

HP.4 Retail sale and other providers of m

HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

Ukraine National Health Accounts 2003-2004

53 867 253 53 867 253

176

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

ющие амбулаторные медицинские услуги HP.3.7 Private clinics / Частные клиники

Functions / Функции (HC)

HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

HP.4 Retail sale and other providers of m

HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

216 565 000

202 442 749

66 192 128

19 151 000

287 785 877

1 928 988 824

5 908 622 655

6 600

27 800

216 565 000

202 442 749

66 192 128

19 151 000

287 785 877

1 928 988 824

5 908 622 655

6 600

27 800

Ukraine National Health Accounts 2003-2004

177

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

medical goods / Розничная

Functions / Функции (HC)

HP.5 Provision

HP.4.4 Retail and administration sale and other of public health suppliers of programmes / medical Обеспечение и appliances управление (other than программами optical glasses Total /Итого and hearing общественного aids) / здоровья Розничная продажа и прочие

HP.6 General health administration and insurance / HP.6.1 Government administration of health / Государствен ное управление здравоохране нием

HP.6.2 Social HP.6.9 All security funds / other Фонды providers of социального health страхования administration / Все прочие организации Total /Итого управления здравоохране нием

HP.7 All other industries HP.7.1 Establishments as providers of occupational health care services / Учреждения, предоставляю щие услуги по охране здоровья на производстве

HP.7.3 All other industries as secondary producers of health care / Все прочие отрасли промышленнос ти как организации, предоставляю щие вторичные

Ukraine National Health Accounts 2003-2004

178

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

medical goods / Розничная

Functions / Функции (HC)

189 795 037

Ukraine National Health Accounts 2003-2004

HP.5 Provision

HP.6 General health administration and insurance / HP.6.1 Government administration of health / Государствен ное управление здравоохране нием

6 098 452 092

5 908 622 655

189 795 037

189 829 437 536 769 082

15 455 000

179

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

medical goods / Розничная

Functions / Функции (HC)

HP.5 Provision

HP.6 General health administration and insurance / HP.6.1 Government administration of health / Государствен ное управление здравоохране нием

15 455 000

362 400 318

3 251 132

241 804 347

607 455 797

362 400 318

3 251 132

241 804 347

607 455 797

241 804 347

604 204 665

362 400 318

3 251 132

3 251 132 886 204

HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.2 Education and training of health personnel / Образование и обучение медицинского персонала HC.R.3 Research and development in health / Исследования и разработки в здравоохранении

Ukraine National Health Accounts 2003-2004

180

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

medical goods / Розничная

Functions / Функции (HC)

HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

HP.5 Provision

HP.6 General health administration and insurance / HP.6.1 Government administration of health / Государствен ное управление здравоохране нием

189 795 037

6 098 452 092

536 769 082

362 400 318

3 251 132

241 804 347

607 455 797

15 455 000

886 204

189 795 037

6 098 452 092

536 769 082

362 400 318

3 251 132

241 804 347

607 455 797

15 455 000

886 204

Ukraine National Health Accounts 2003-2004

181

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

(rest of the

Functions / Функции (HC)

HP.8 Institutions providing health-related services /

HP.9 Rest of

24 515 474

Ukraine National Health Accounts 2003-2004

GRAND TOTAL / ОБЩИЙ ИТОГ

7 736 405 969 4 993 495 501 567 678 670 259 537 726 308 140 944 5 607 150 302 533 793 112 084 884

HP.nsk

HP.8.1 HP 8.2 HP.8.3 Other the world / Provider not Research Education and institutions Остальной specified by institutions / training providing мир kind / Исследовател institutions / health-related Провайдеры, ьские Учреждения services / не институты образования и Прочие Total /Итого определенные обучения учреждения, Total /Итого предоставляю по типу щие услуги, связанные со здравоохране нием

5 492 159 106 592 724 2 428 887 425 65 754 800 24 515 474

2 677 155 668 56 373 095 287 611 888

24 515 474

459 080 223

9 125 530

40 709 812 7 276 709 10 276 944

4 639 449

11 072 272 10 832 826

4 919 864

5 710 496

5 830 632

79 549 680 521 986 138

182

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

(rest of the

Functions / Функции (HC)

HP.8 Institutions providing health-related services /

HP.9 Rest of

Ukraine National Health Accounts 2003-2004

GRAND TOTAL / ОБЩИЙ ИТОГ

1 374 345 253 1 370 728 728 3 616 525 29 050 650 841 137 601 212 566 901 9 138 215 6 098 452 092

HP.nsk

5 908 622 655

189 829 437 15 455 000

25 777 628

682 095 084

8 306 134

9 302 121

2 039 580

6 266 554

7 262 541

14 984 142

81 176 270 66 192 128

183

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

(rest of the

Functions / Функции (HC)

Ukraine National Health Accounts 2003-2004

HP.8 Institutions providing health-related services /

HP.9 Rest of

HP.nsk

GRAND TOTAL / ОБЩИЙ ИТОГ

7 239 112

853 232

4 758 718

2 133 080

1 262 709

15 455 000

15 455 000 1 224 643

1 224 643

14 535 298

621 991 095

14 535 298

621 991 095

14 535 298

618 739 963

3 251 132 886 204 72 211 437

396 999 316

396 999 316 72 211 437

10 482 034

479 692 787

396 999 316 72 211 437

12 585 172

157 946 764

171 418 140

8 018 599

88 097 917

1 066 731 504

2 766 896

88 097 917

581 787 014

323 771

397 323 087 72 211 437

184

Table 74 Ukraine general NHA 2003: Providers by Functions (cont.)

(rest of the

Functions / Функции (HC)

HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

HP.8 Institutions providing health-related services /

16 341 204

72 211 437

396 999 316

10 482 034

4 927 932

10 482 034

479 692 787

85 432 171

Ukraine National Health Accounts 2003-2004

HP.9 Rest of

HP.nsk

16 341 204

72 211 437

396 999 316

10 482 034

479 692 787

GRAND TOTAL / ОБЩИЙ ИТОГ

15 409 966 246 044 681

18 621 627 388

2 099 861

1 701 291

2 133 080

3 797 493

902 229

3 133 277

13 767 231

99 199 402

246 044 681

18 635 394 620

185

Table 75 Ukraine general NHA 2004: Financial Sources by Financial Agents Financing sources / Источники финансирования (HF) FS.1 Public funds / Общественные

Financing agents / Финансирующие организации (FA)

FS.1.1.2 Regional and city government budget revenue, FS.1.1.1 Central including rayon government and local revenue / budgets revenue Центральное / Областные правительство бюджеты, включая районные и местные бюджеты

FS.2 Private funds / Частные ресурсы

FS.2.3 Non-profit institutions serving FS.2.2 households / FS.2.1 Employer funds / Household funds Неправительственные Работодатели / Ресурсы организации, домохозяйств обслуживающие домохозяйства

Total / Итого

4 631 269 158

8 684 859 140

13 316 128 298

4 628 636 821 4 628 636 821 2 524 003 367 269 427 392

8 673 465 716 0

13 302 102 537 4 628 636 821 2 524 003 367 269 427 392

39 325 465

FS.3 Rest of

Total Rest of the World / Итого Весь остальной мир

Total / Итого

39 325 465

0 0 0 0

Grand Total / Общий итог

13 355 453 763 13 302 102 537 4 628 636 821 2 524 003 367 269 427 392

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

130 148 752

HF.1.1.1.4 Ministry of Defence / Министерство обороны HF.1.1.1.5 Ministry of Labor and Social Policy / Министерство труда и социальной политики

266 296 497

240 884 567

HF.1.1.1.6 Academy of Medical Sciences / Академия Медицинских Наук

481 426 527

716 449 719

0 0

8 673 465 716

2 632 337

11 393 424

14 025 761

39 325 465

53 351 226

2 632 337

11 393 424

14 025 761

39 325 465

HF.1.1.1.9 Other ministries / Другие министерства HF.1.1.2 Oblast/City/Local/Municipal governments (27) / Областные бюджеты/ Местное/муниципальное правительство (27) HF.1.2 Social security funds / Фонды социального страхования HF.1.2.1 Social security fund for accidents at work and occupational diseases / Фонд социального страхования от несчастных случаев на производстве и профессиональных заболеваний

HF.2 Private Sector / Частный сектор

481 426 527 716 449 719

572 644 326

8 851 262 506

29 651 487

20 866 250

8 797 272 566

8 797 272 566 29 651 487

9 453 558 318

0 0

9 453 558 318 20 866 250 8 797 272 566 29 651 487

29 651 487 0

HF.3.1 HIV/AIDS Alliance / Международный ВИЧ/СПИД Альянс в Украине HF.3.9 Other / Другое

Ukraine National Health Accounts 2003-2004

240 884 567

53 351 226

39 325 465

Grand Total / Общий итог

130 148 752 266 296 497

HF.2.2 Other private VOLUNTARY insurance / Другое частное ДОБРОВОЛЬНОЕ страхование HF.2.3 Private households' out-of pocket payment / Частные выплаты домохозяйствами HF.2.4 Non-profit Institutions serving households (other than social insurance) / Неправительственные организации, обслуживающие домохозяйства (другие, чем социальное страхование)

HF.2.6 Hospital kassa / Больничные кассы HF.3 Rest of the world / Весь другой мир

0 0

4 631 269 158

8 684 859 140

572 644 326

0 0

33 123 690 0

13 316 128 298

611 969 791

572 644 326

8 851 262 506

29 651 487

9 492 883 784

0 0 156 923 324 64 446 688 92 476 636

156 923 324

33 123 690 156 923 324 64 446 688 92 476 636 22 965 935 406

186

Table 76 Ukraine general NHA 2004: Financial Agents by Providers Financing agents / Финан HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.1 Hospitals / Больницы HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 Oblast hospitals / Областные больницы HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.1.2 Children oblast general hospitals / Детские областные больницы общего профиля HP.1.1.2 City Hospitals / Городские больницы

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

429 158 076

251 152 354

10 043 898

3 330 987

317 423 996

246 758 309

6 602 496 934

26 421 348

251 152 354

10 043 898

185 354 934

5 269 522 924 578 696 788 375 729 090 202 967 698 2 195 524 325 1 939 560 903

255 963 422 1 845 314 355

Ukraine National Health Accounts 2003-2004

218 447 981 198 388 264 233 151 211 26 421 348

251 152 354

10 043 898

185 354 934 0

574 828 830

564 355 662 10 473 168

402 736 728

3 330 987

317 423 996

61 403 375

758 145 180

161 957 804

60 998 559

21 055 442

13 907 536

58 758 160

112 658 447

40 029 257 160 965 322

3 330 987

317 423 996

61 403 375

530 551 380

187

Table 76 Ukraine general NHA 2004: Financial Agents by Providers (cont.) Financing agents / Финан HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

114 583 284

107 615 191

38 249 100

289 873 693

38 249 100 114 583 284

HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары

33 235 929

Ukraine National Health Accounts 2003-2004

57 045 246

276 264 415

22 019 300

4 571 826

8 845 800

21 249 357

HP.2.9 All other residential care facilities / Все прочие учреждения по уходу HP.2.9.9 Sanatoriums / Санатории HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.2 Children's Policlinics / Детские поликлиники HP.3.1.5 Village doctor posts / Сельские врачебные амбулатории HP.3.1.6 Feldsher-midwife posts / Фельдшерско-акушерские пункты HP.3.1.9 All other not described in the above groups / Все остальное не включенное в других категориях HP.3.2 Offices of dentists / Стоматологические кабинеты (отделения) HP.3.4 Outpatient care centres / Центры амбулаторного лечения HP.3.7 Private clinics / Частные клиники HP.3.9 Other providers of ambulatory health care / Прочие организации, предоставляющие амбулаторные медицинские услуги HP.3.9.1 Ambulance services / Скорая помощь HP.3.9.2 Blood and organ banks / Банки крови и органов HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги

HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции HP.4.2 Retail sale and other suppliers of optical glasses and other vision products / Розничная продажа и прочие поставщики очков и различной продукции для органов зрения HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

114 583 284

107 615 191

57 045 246

107 615 191

57 045 246

2 730 108 289 873 693

247 713 124

13 173 500

289 873 693

247 713 124

13 173 500 0

43 275 385

18 275 038

120 104 854

3 860 080

82 758 651

1 425 275 387

15 776 047

120 104 854

82 758 651

825 630 960 314 925 606 192 022 865 168 712 559 149 969 930

15 776 047

120 104 854

82 758 651

8 967 301

195 161 596

34 308 084

3 860 080

2 498 991

75 857 476

328 625 355

257 641 545 2 498 991

70 983 810

176 081 900

59 843 800

9 547 400

5 221 500

26 000 000

9 600

50 800

188

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.4.4 Retail sale and other suppliers of medical appliances (other than optical glasses and hearing aids) / Розничная продажа и прочие поставщики медицинских приборов (кроме оптических очков и слуховых приборов) HP.5 Provision and administration of public health programmes / Обеспечение и управление программами общественного здоровья HP.6 General health administration and insurance / Общее управление здравоохранением и медицинское страхование HP.6.1 Government administration of health / Государственное управление здравоохранением HP.6.2 Social security funds / Фонды социального страхования HP.6.9 All other providers of health administration / Все прочие организации управления здравоохранением HP.7 All other industries (rest of the economy) / Все прочие сектора экономики HP.7.1 Establishments as providers of occupational health care services / Учреждения, предоставляющие услуги по охране здоровья на производстве HP.7.3 All other industries as secondary producers of health care / Все прочие отрасли промышленности как организации, предоставляющие вторичные медицинские услуги HP.8 Institutions providing health-related services / Учреждения, предоставляющие услуги, связанные со здравоохранением HP.8.1 Research institutions / Исследовательские институты HP 8.2 Education and training institutions / Учреждения образования и обучения

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

33 235 929

150 081 900

59 843 800

612 004 711 322 376 540

4 265 500

8 035 891

8 961 029

30 000 751

360 467 951

25 065 126

3 377 926

360 467 951 3 377 926

297 311 414 889 876

30 000 751 0

10 016 500

889 876

503 586 306

18 878 316

4 426 434

62 049 551

4 426 434

62 049 551

471 619 128

13 088 862

HP.nsk Provider not specified by kind / Провайдеры, не определенные по типу TOTAL

464 893 260

Ukraine National Health Accounts 2003-2004

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

2 524 003 367

23 320

158 681 306 269 427 392

130 148 752

266 296 497

58 999 104 240 884 567

481 426 527

716 449 719

8 390 100 8 673 465 716

53 351 226

189

Table 76 Ukraine general NHA 2004: Financial Agents by Providers (cont.) сирующие организации (FA)

Providers / Поставщики (провайдеры) медицинских услуг (HP)

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

7 860 364 554

640 893 817

26 676

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

Grand Total / Общий итог

640 920 493

8 501 285 047

5 742 495 458

619 643 640

6 362 139 098

578 696 788

95 147 564

673 844 352

375 729 090

62 562 121

438 291 211

202 967 698

32 585 443

235 553 141

2 195 524 325

218 629 842

2 414 154 167

1 939 560 903

189 461 830

2 129 022 732

255 963 422

29 168 012

285 131 434

1 845 314 355

169 671 405

2 014 985 760

218 447 981

19 030 325

237 478 306

198 388 264

79 774 492

278 162 756

233 151 211

25 412 417

258 563 628

472 972 534

11 977 595

484 950 129

574 828 830

3 751 174

578 580 004

564 355 662

3 751 174

14 224 342

17 525 679

1 560 565 945

564 355 662 3 751 174

10 473 168

17 499 003

26 676

34 962 978

3 782 855

26 676

171 416 607

1 543 040 266

222 956 363

3 809 531

38 772 509

1 897 102

173 313 710

40 029 257

1 674 842

41 704 100

1 073 675 060

10 144 203

1 083 819 263

190

Table 76 Ukraine general NHA 2004: Financial Agents by Providers (cont.) сирующие организации (FA)

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.2 Nursing and residential care facilities / Сестринские/врачебные учреждения длительного пребывания больных (по уходу) HP.2.1 Nursing care facilities / Учреждения сестринского ухода HP.2.3 Community care facilities for the elderly / Дома престарелых HP.2.4 Rehabilitation centers / Реабилитационные центры HP.2.9 All other residential care facilities / Все прочие учреждения по уходу HP.2.9.9 Sanatoriums / Санатории HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.2 Children's Policlinics / Детские поликлиники HP.3.1.5 Village doctor posts / Сельские врачебные амбулатории HP.3.1.6 Feldsher-midwife posts / Фельдшерско-акушерские пункты HP.3.1.9 All other not described in the above groups / Все остальное не включенное в других категориях HP.3.2 Offices of dentists / Стоматологические кабинеты (отделения) HP.3.4 Outpatient care centres / Центры амбулаторного лечения HP.3.7 Private clinics / Частные клиники HP.3.9 Other providers of ambulatory health care / Прочие организации, предоставляющие амбулаторные медицинские услуги HP.3.9.1 Ambulance services / Скорая помощь HP.3.9.2 Blood and organ banks / Банки крови и органов HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции HP.4.2 Retail sale and other suppliers of optical glasses and other vision products / Розничная продажа и прочие поставщики очков и различной продукции для органов зрения HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

905 650 229

307 197 477

415 052 123

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

Grand Total / Общий итог

722 249 600

1 627 899 829

13 417 626

21 249 357

40 979 208

415 052 123

722 249 600

1 552 253 638

415 052 123

722 249 600

1 552 253 638

830 004 038

307 197 477

830 004 038

307 197 477

1 693 549 395

640 962 636

1 044 270 512

378 585 333

314 925 606 192 022 865

157 592 203

798 554 839

2 492 104 234

378 585 333

1 422 855 845

269 036 619

583 962 225

109 548 714

301 571 579

168 712 559

149 969 930

218 639 552

204 128 897

110 149 685

314 278 582

114 025 640

12 114 731

126 140 371

116 640 597

274 232 800

331 124 346

23 472 291

157 592 203 0

23 472 291

354 596 637

257 641 545

73 482 801

23 472 291

278 709 029

33 123 690

7 235 658 591

33 123 690

7 235 658 591

7 240 880 091

26 009 600

50 800

5 221 500

7 202 534 901

7 514 367 620

191

Table 76 Ukraine general NHA 2004: Financial Agents by Providers (cont.) сирующие организации (FA)

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.4.4 Retail sale and other suppliers of medical appliances (other than optical glasses and hearing aids) / Розничная продажа и прочие поставщики медицинских приборов (кроме оптических очков и слуховых приборов) HP.5 Provision and administration of public health programmes / Обеспечение и управление программами общественного здоровья HP.6 General health administration and insurance / Общее управление здравоохранением и медицинское страхование HP.6.1 Government administration of health / Государственное управление здравоохранением HP.6.2 Social security funds / Фонды социального страхования HP.6.9 All other providers of health administration / Все прочие организации управления здравоохранением

Total HF1. General Government

247 427 129

629 001 631 716 223 168

28 367 304 0

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

Grand Total / Общий итог

247 427 129

28 367 304

657 368 935

716 223 168

385 533 077

3 377 926

327 312 165

HP.7 All other industries (rest of the economy) / Все прочие сектора экономики

10 906 376

10 016 500

889 876

HP 8.2 Education and training institutions / Учреждения образования и обучения HP.8.3 Other institutions providing health-related services / Прочие учреждения, предоставляющие услуги, связанные со здравоохранением HP.9 Rest of the world / Остальной мир HP.nsk Provider not specified by kind / Провайдеры, не определенные по типу TOTAL

Ukraine National Health Accounts 2003-2004

570 085 611

10 906 376

570 085 611

85 354 301

471 642 448

13 088 862

690 963 770

20 866 250

5 683 734

1 257 507

13 355 453 763

20 866 250

8 797 272 566

29 651 487

156 923 324

22 965 935 406

27 807 491 572 644 326

33 123 690

9 453 558 318

718 771 261

192

Table 77 Ukraine general NHA 2004: Financial Agents by Functions Financing agents / Финанс HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.1.2 Gynecology / Гинекология HC 1.1.1.2.1 Abortion / Аборты HC 1.1.1.2.9 Other Gynecology / Другая Гинекология HC 1.1.2 Oncology / Онкология HC 1.1.2.1 Gynecology Oncology / Гинекологическая онкология HC 1.1.2.2 Other Oncology / Другая онкология HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.1 Basic medical and diagnostic services / Основные медицинские и диагностические услуги HC.1.3.2 Outpatient dental care / Амбулаторное стоматологическое лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.6 Post Exposure Prophylaxis (PEP) / Пост-контактная профилактика HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.3.9 Replacement therapy / Заместительная терапия HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение

Ukraine National Health Accounts 2003-2004

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

420 637 309

253 581 981

123 641 314

2 964 578

285 865 626

309 356 910

7 182 496 300

278 435 617

188 364 266

7 532 924

2 257 010

215 080 151

180 621 899

4 870 620 268 656 559 164 295 747 076 360 812 089 6 565 592 354 246 497

109 739 369

41 331 404

5 377 229

2 025 239

104 362 140

39 306 165 2 752 146 807

4 740 482 137 461 211

65 217 715

116 108 391

41 371

3 942 406

762 630

68 694 003

666 197

66 843 069

127 972 380

2 243 182 030

8 518 936 123 658 005 11 751 632

185 403 516 666 197

66 843 069

12 280 675

339 294 595 22 531 689 8 005 851 9 855 131

8 272 300 8 184 700

2 440 329

1 016 715 73 897 057

482 157 612

193

Table 77 Ukraine general NHA 2004: Financial Agents by Functions (cont.) Financing agents / Финанс HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Functions / Функции (HC)

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

114 583 284

107 615 191

57 045 246

114 583 284

107 615 191

57 045 246

38 249 100

289 873 693

250 443 232

13 173 500

289 873 693

247 713 124

13 173 500

38 249 100

2 730 108 25 821 183 257 641 545 257 641 545

33 235 929

176 081 900

59 843 800

9 547 400

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.1.9 Other maternal and child health; family planning and counselling / Другие услуги здоровья матери и ребенка; планирование семьи и семейные консультации HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.3 STI Prevention Program / Программа профилактики БППП (IEC) HC.6.3.5 Condom distribution programs / Программа распространения презервативов

Ukraine National Health Accounts 2003-2004

8 845 800

5 221 500

33 235 929 612 004 711

176 081 900 2 498 991

59 843 800

4 325 900 8 035 891

129 004 685

10 016 500

1 257 473

1 257 473 2 498 991

70 983 810

2 498 991

70 983 810

194

Functions / Функции (HC)

HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.3.9 Other prevention of communicable diseases / Другие услуги по профилактике инфекционных болезней HC.6.4 Prevention of noncommunicable diseases / Профилактика неинфекционных заболеваний HC.6.5 Occupational health care / Охрана здоровья на производстве HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением HC.7.1.1 General government administration of health (except social security) / Общее государственное управление здравоохранением (за исключением социального обеспечения) HC.7.1.2 Administration, operation and support of social security funds / Управление, проведение и поддержка фондов социального обеспечения HC.n.s.k HC expenditure not specified by kind / Расходы здравоохранения, не определенные по типу услуг HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.2 Education and training of health personnel / Образование и обучение медицинского персонала HC.R.3 Research and development in health / Исследования и разработки в здравоохранении HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

Ukraine National Health Accounts 2003-2004

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

10 016 500

322 376 540

30 000 751

360 467 951

3 377 926

322 376 540

30 000 751

360 467 951

3 377 926

322 376 540

30 000 751

360 467 951

3 377 926 889 876

158 681 306

55 939 704

8 390 100

1 020 275 718

13 346 420

6 507 438

4 792 843

97 468 001

23 242 771

467 590 820

516 689 412

13 346 420

6 507 438

366 409

35 418 450

23 219 451

467 590 820

471 619 128

23 320

18 878 316

4 426 434

62 049 551

240 884 567

481 426 527

13 088 862 2 524 003 367

269 427 392

130 148 752

266 296 497

716 449 719

8 673 465 716

53 351 226

195

Functions / Функции (HC)

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

Ukraine National Health Accounts 2003-2004

2 524 003 367

269 427 392

130 148 752

266 296 497

240 884 567

481 426 527

716 449 719

8 673 465 716

53 351 226

196

Table 77 Ukraine general NHA 2004: Financial Agents by Functions (cont.) сирующие организации (FA)

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.1.2 Gynecology / Гинекология HC 1.1.1.2.1 Abortion / Аборты HC 1.1.1.2.9 Other Gynecology / Другая Гинекология HC 1.1.2 Oncology / Онкология HC 1.1.2.1 Gynecology Oncology / Гинекологическая онкология HC 1.1.2.2 Other Oncology / Другая онкология HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.1 Basic medical and diagnostic services / Основные медицинские и диагностические услуги HC.1.3.2 Outpatient dental care / Амбулаторное стоматологическое лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.6 Post Exposure Prophylaxis (PEP) / Пост-контактная профилактика HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.3.9 Replacement therapy / Заместительная терапия HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

131 276 361

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

654 702 670

64 211 576

Grand Total / Общий итог

8 578 544 019

523 399 633

5 742 912 135

115 891 092

5 858 803 226

656 559 164

8 534 939

665 094 104

295 747 076

8 534 939

304 282 015

360 812 089

9 297 458 265

360 812 089

6 565 592

354 246 497

151 070 773

7 402 468

143 668 305

2 752 146 807

79 203 147

2 831 349 955

78 180 891 2 757 450 993

78 180 891 407 508 541

26 676

131 276 361

538 811 578

64 211 576

3 360 474 147

67 523 515

31 237 107

141 386 792

335 309 244

47 640

193 922 452

110 149 685

542 742 541

29 015 089

29 089 405

64 211 576

636 043 522

34 283 321

594 105

11 229 576

46 107 003

8 005 851

712 549

9 855 131

922 890

26 676

8 272 300 10 625 029

2 559 246

1 016 715 73 897 057

482 157 612

155 634 669

2 363 809

13 141 831

24 339 653

32 611 953

2 559 246

26 676 19 388 727

8 718 400

47 640

32 468 099

13 184 275 52 341

52 341

26 676

17 348 338

18 391 729

19 436 367

7 976 318

101 309 742

901 541

188 102 767

670 260 380

197

Table 77 Ukraine general NHA 2004: Financial Agents by Functions (cont.) сирующие организации (FA)

Functions / Функции (HC)

HC.2 Services of rehabilitative care / Услуги реабилитационного лечения HC.2.1 Sanatorium services / Санаторные услуги HC.2.9 All other services of rehabilitative care / Все другие услуги реабилитационного лечения HC.3 Services of long-term nursing care / Услуги долгосрочного медсестринского ухода HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.4.9 All other miscellaneous ancillary services / Все прочие виды дополнительных услуг для медицинского лечения HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.1.9 Other maternal and child health; family planning and counselling / Другие услуги здоровья матери и ребенка; планирование семьи и семейные консультации HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.3 STI Prevention Program / Программа профилактики БППП (IEC) HC.6.3.5 Condom distribution programs / Программа распространения презервативов

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

Grand Total / Общий итог

870 983 246

307 197 477

415 052 123

722 249 600

1 593 232 846

830 004 038

307 197 477

415 052 123

722 249 600

1 552 253 638

40 979 208

34 666 983

257 641 545

758 456 820

257 641 545

26 315 842

784 772 662

1 042 414 207

12 918 659

270 560 204

13 397 183

278 709 029

7 202 534 901

33 123 690

7 235 658 591

7 514 367 620

5 221 500

7 202 534 901

33 123 690

7 235 658 591

7 240 880 091

273 487 529 761 560 778

273 487 529 49 973 120

839 901 202

9 379 880

10 637 352

5 681 263

1 257 473

3 698 617

4 956 090

73 482 801

28 229 365

101 712 166

1 257 473

28 367 304

73 482 801

73 482 801 15 445 086

15 445 086

1 519 771

198

Table 77 Ukraine general NHA 2004: Financial Agents by Functions (cont.) сирующие организации (FA)

Functions / Функции (HC)

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

Total HF.2 Private Sector

HF.3 Rest of the world / Весь другой мир

9 744 736

3 698 617 10 016 500

Grand Total / Общий итог

9 744 736

3 698 617 10 016 500

8 665 258

716 223 168

21 442 963

737 666 131

716 223 168

21 442 963

737 666 131

712 845 242

21 442 963

734 288 205

3 377 926 223 900 986

3 377 926 20 866 250

5 683 734

26 549 984

5 281 966

255 732 936

1 633 224 009

1 257 507

16 013 700

1 650 495 217

1 063 138 398

1 257 507

12 905 797

1 077 301 702

322 951

471 965 399

471 642 448 85 354 301

85 354 301

13 088 862 13 355 453 764

20 866 250

8 797 272 566

29 651 487

572 644 326

33 123 690

9 453 558 318

2 784 952

15 873 814

156 923 324

22 965 935 406

199

Table 77 Ukraine general NHA 2004: Financial Agents by Functions (cont.) сирующие организации (FA)

Functions / Функции (HC)

Total HF1. General Government

AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки

Total HF.2 Private Sector

25 564

Ukraine National Health Accounts 2003-2004

13 355 453 764

20 866 250

8 797 272 566

Grand Total / Общий итог

2 376 463

2 716 591

1 063 840

1 704 172

72 463

3 823 859

2 154 276

98 028

13 839 201

170 762 525

22 979 774 607

AD.2.1 Policy advocacy (Includes support to national strategic plan for HIV/AIDS (lobbying)) / Политическая адвокация (Включает поддержку национальному стратегическому плану по ВИЧ/СПИД (лоббирование)) AD.2.2 Policy advocacy for RH / Политическая адвокация для РЗ AD.4.1 Empowerment and organization in HIV / Усиление и организация по ВИЧ AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) AD.5.2 RH specific surveillance activities / деятельность по эпиднадзору, специфическая для РЗ Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

HF.3 Rest of the world / Весь другой мир

29 749 514

572 644 326

33 123 690

9 453 558 318

200

Table 78 Ukraine general NHA 2004: Providers by Functions

Functions / Функции (HC)

HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 Oblast hospitals / Областные HP.1.1.4 Rayon HP.1.1.2 City Hospitals / Городские больницы HP.1.1.3 Hospitals / Central Rayon HP.1.1.2.2 HP.1.1.2.1 City HP.1.1.1.2 HP.1.1.1.1 Районные Hospitals / Children city general Oblast general Children oblast больницы Центральные general hospitals / general hospitals / районные hospitals / Городские hospitals / Областные больницы Детские больницы Детские больницы Total / Итого Total / Итого городские общего областные общего больницы профиля больницы профиля общего общего профиля профиля

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

375 871 663

202 606 632

578 478 295

1 894 879 692

250 843 981

2 145 723 672

1 800 121 164

212 895 421

207 162 589

292 594 302

157 160 966

449 755 269

1 463 926 878

192 329 379

1 656 256 257

1 391 700 606

164 823 925

150 018 682

41 330 200

213 351 699

202 984 579

24 029 278

41 330 200 18 617 189

18 617 189

96 104 273

91 434 404

10 823 988

22 713 011

117 247 426

111 550 175

13 205 290

413 302

2 133 517

2 029 846

240 293

22 299 709

115 113 909

109 520 330

12 964 997

140 794 647

251 264 103

1 250 575 179

1 188 716 027

4 328 399

2 740 064

7 068 463

22 343 742

3 455 506

25 799 248

21 258 021

2 516 521

2 678 242

78 948 961

42 705 601

121 654 563

408 609 072

55 059 096

463 668 168

387 162 537

45 554 976

54 465 665

HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги

Ukraine National Health Accounts 2003-2004

201

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

Functions / Функции (HC)

HC.1.3.3.9 Replacement therapy / Заместительная терапия HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение HC.1.4 Services of curative home care / Услуги лечения на дому HC.2 Services of rehabilitative care / Услуги реабилитационного лечения HC.2.1 Sanatorium services / Санаторные услуги HC.2.9 All other services of rehabilitative care / Все другие услуги реабилитационного лечения HC.3 Services of long-term nursing care / Услуги долгосрочного медсестринского ухода HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.4.9 All other miscellaneous ancillary services / Все прочие виды дополнительных услуг для медицинского лечения HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам

43 633 094

22 798 125

66 431 218

137 164 996

21 489 283

158 654 278

122 598 878

13 660 486

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

61 080 754

Ukraine National Health Accounts 2003-2004

202

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

Functions / Функции (HC)

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.3 STI Prevention Program / Программа профилактики БППП (IEC) HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.4 Prevention of noncommunicable diseases / Профилактика неинфекционных заболеваний HC.6.5 Occupational health care / Охрана здоровья на производстве HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением HC.7.1.1 General government administration of health (except social security) / Общее государственное управление здравоохранением (за исключением социального обеспечения) HC.7.1.2 Administration, operation and support of social security funds / Управление, проведение и поддержка фондов социального обеспечения HC.n.s.k HC expenditure not specified by kind / Расходы здравоохранения, не определенные по типу услуг HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.2 Education and training of health personnel / Образование и обучение медицинского персонала

Ukraine National Health Accounts 2003-2004

18 786 455

10 148 385

28 934 839

96 978 045

12 798 171

109 776 216

92 265 718

10 922 399

9 919 413

18 786 455

10 148 385

28 934 839

96 978 045

12 798 171

109 776 216

92 265 718

10 922 399

9 919 413

203

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

Functions / Функции (HC)

HC.R.3 Research and development in health / Исследования и разработки в здравоохранении HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

HP.1.1.5 Dilnichni Hospitals / Участковые больницы

438 291 211

235 553 141

673 844 352

2 129 022 732

285 131 434

2 414 154 167

2 014 985 760

237 478 306

278 162 756

438 291 211

235 553 141

673 844 352

2 129 022 732

285 131 434

2 414 154 167

2 014 985 760

237 478 306

278 162 756

Ukraine National Health Accounts 2003-2004

204

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1.6 Maternity houses / Родильные дома

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

Total /Итого

HP.1.2 Mental health and substance abuse HP.1.3 Specialty (other than mental h HP.1.2.2 HP.1.2.1 HP.1.3.3 HP.1.3.2 AIDS HP.1.3.1 Total /Итого Substance Mental health Tuberculosis clinics and Oncology hospitals and abuse hospitals hospitals and centers / hospitals and dispensers / and dispensers dispensers / Клиники и dispensers / / Психиатричес Туберкулезные центры Онкологически кие больницы Наркологическ больницы и ВИЧ/СПИД е больницы и и диспансеры ие больницы и диспансеры диспансеры диспансеры

230 261 007

453 346 667

5 627 988 816

502 276 539

12 467 784

514 744 323

198 431 163

33 887 696

153 792 041

183 398 348

358 752 160

4 354 705 247

466 112 628

8 551 009

474 663 637

151 070 773

609 708

116 785 620

183 398 348

665 094 104

87 302 162

304 282 015

96 096 186

360 812 089

1 748 634

6 565 592

94 347 552

354 246 497 151 070 773

Ukraine National Health Accounts 2003-2004

7 402 468 143 668 305 2 831 349 955 59 320 495 46 862 659

94 594 507

1 213 963 074

130 077

2 769 118

36 163 911

3 786 699

39 950 609

44 591 273

33 277 987

34 877 427

2 128 994

36 163 911

3 786 699

39 950 609

44 591 273

33 277 987

34 877 427 34 877 427

10 778 022 8 272 300 13 184 275

1 043 391

205

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1.6 Maternity houses / Родильные дома

16 645 061

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

7 954 835

Total /Итого

447 025 510

604 510

665 842

Ukraine National Health Accounts 2003-2004

206

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1.6 Maternity houses / Родильные дома

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

Total /Итого

Ukraine National Health Accounts 2003-2004

11 657 561

23 648 627

287 124 773

62 079 123

1 152 049

63 231 171

24 525 200

4 884 814

18 855 827

11 657 561

23 648 627

287 124 773

62 079 123

1 152 049

63 231 171

24 525 200

4 884 814

18 855 827

207

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1.6 Maternity houses / Родильные дома

258 563 628

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

484 950 129

Total /Итого

6 362 139 098

564 355 662

14 224 342

578 580 004

222 956 363

AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки

38 772 509

173 313 710

25 564

Ukraine National Health Accounts 2003-2004

72 463

98 028 258 563 628

484 950 129

6 362 139 098

564 355 662

14 224 342

578 580 004

222 956 363

38 870 537

173 313 710

208

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

HP.2 Nursing and residential care facilities / Сестринские/вра

Functions / Функции (HC)

health and substance abuse) hospitals / HP.1.3.4 STI HP.1.3.9 Other Total /Итого clinics and specialty dispensers / hospitals / КожноДругие венерологичес специализиров Total /Итого кие клиники и анные диспансеры больницы

36 761 605

962 008 784

1 384 881 289

7 527 614 427

27 546 041

733 422 201

1 029 434 343

5 858 803 226

Ukraine National Health Accounts 2003-2004

HP.2.9 All other residential HP.2.9.9 Total /Итого Sanatoriums / Санатории

665 094 104 304 282 015 360 812 089 6 565 592 354 246 497 151 070 773

151 070 773

7 402 468

143 668 305

143 668 305 2 831 349 955

497 163

13 335 044

18 730 320

78 180 891

8 718 400

215 251 539

336 716 626

1 590 630 309

8 718 400

215 251 539

336 716 626

376 667 235

34 877 427

8 718 400

10 778 022

8 272 300

13 184 275

1 043 391

8 718 400

209

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

HP.2 Nursing and residential care facilities / Сестринские/вра

Functions / Функции (HC)

40 979 208

HP.2.9 All other residential HP.2.9.9 Total /Итого Sanatoriums / Санатории

1 552 253 638

40 979 208 13 417 626 539 277

3 706 223

4 911 341

21 249 357

452 541 361

Ukraine National Health Accounts 2003-2004

210

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

HP.2 Nursing and residential care facilities / Сестринские/вра

Functions / Функции (HC)

HP.2.9 All other residential HP.2.9.9 Total /Итого Sanatoriums / Санатории

Ukraine National Health Accounts 2003-2004

4 403 218

118 104 257

170 773 315

521 129 260

4 403 218

118 104 257

170 773 315

521 129 260

211

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

HP.2 Nursing and residential care facilities / Сестринские/вра

Functions / Функции (HC)

HP.2.9 All other residential HP.2.9.9 Total /Итого Sanatoriums / Санатории

41 704 100

1 083 819 263

1 560 565 945

8 501 285 047

13 417 626

21 249 357

40 979 208

1 552 253 638

41 704 100

1 083 819 263

1 560 565 945

8 501 285 047

13 417 626

21 249 357

40 979 208

1 552 253 638

Ukraine National Health Accounts 2003-2004

212

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

чебные

Functions / Функции (HC)

Providers / Поставщики (провайдеры) медицинских услуг (HP) HP.3 Providers of ambulatory health care / Организации, предоставля

HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.2 Offices HP.3.4 of dentists / HP.3.1.9 All HP.3.1.6 HP.3.1.5 HP.3.1.2 HP.3.1.1 Adults Total /Итого Total /Итого Стоматологич other not FeldsherVillage doctor Children's Policlinics / еские midwife posts / described in the posts / Policlinics / Взрослые кабинеты Фельдшерско- above groups / Сельские Детские поликлиники (отделения) акушерские Все остальное врачебные поликлиники Total /Итого не включенное пункты амбулатории в других категориях

356 304 652

206 194 547

136 657 173

121 475 643

207 707 574

1 028 339 590

304 072 137

101 831 287

356 304 652

206 194 547

136 657 173

121 475 643

207 707 574

1 028 339 590

304 072 137

101 831 287

Ukraine National Health Accounts 2003-2004

304 072 137 59 058 546

18 120 120

16 107 118

93 285 785

59 058 546

18 120 120

16 107 118

93 285 785

101 831 287

213

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

чебные

Functions / Функции (HC)

Providers / Поставщики (провайдеры) медицинских услуг (HP) HP.3 Providers of ambulatory health care / Организации, предоставля

297 246 106

118 537 053

105 368 525

521 151 684

1 593 232 846 1 552 253 638 40 979 208 34 666 983 210 653 820

85 775 889

296 429 708

9 485 751

Ukraine National Health Accounts 2003-2004

1 257 473

25 306 884

22 495 490

49 059 846

1 257 473

214

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

чебные

Functions / Функции (HC)

Providers / Поставщики (провайдеры) медицинских услуг (HP) HP.3 Providers of ambulatory health care / Организации, предоставля

Ukraine National Health Accounts 2003-2004

15 746 280

9 601 143

6 748 502

5 998 797

10 931 978

49 026 701

10 206 445

14 823 333

15 746 280

9 601 143

6 748 502

5 998 797

10 931 978

49 026 701

10 206 445

14 823 333

215

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

чебные

Functions / Функции (HC)

Providers / Поставщики (провайдеры) медицинских услуг (HP) HP.3 Providers of ambulatory health care / Организации, предоставля

1 627 899 829

583 962 225

301 571 579

168 712 559

149 969 930

218 639 552

1 422 855 845

314 278 582

126 140 371

1 627 899 829

583 962 225

301 571 579

168 712 559

149 969 930

218 639 552

1 422 855 845

314 278 582

126 140 371

Ukraine National Health Accounts 2003-2004

216

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

ющие амбулаторные медицинские услуги

Functions / Функции (HC)

HP.3.7 Private clinics / Частные клиники

247 916 958

HP.4 Retail sale and other providers of m

HP.3.9 Other providers of ambulatory health care / Прочие HP.4.1 HP.4.2 Retail Dispensing sale and other HP.3.9.2 Blood HP.3.9.9 All HP.3.9.1 Total /Итого chemists / suppliers of other Ambulance and organ banks Розничная optical glasses ambulatory / Банки крови services / продажа and other health care и органов Скорая services / Все помощь Total /Итого фармацевтиче vision products ской / Розничная прочие продукции продажа и амбулаторные прочие медицинские поставщики услуги очков и й 23 472 291 23 472 291 1 705 632 262

HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

Ukraine National Health Accounts 2003-2004

247 916 958

23 472 291

1 705 632 262

67 523 515

31 237 107

335 309 244

47 640

195 164 711

47 640

93 333 424

217

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

ющие амбулаторные медицинские услуги

Functions / Функции (HC)

HP.3.7 Private clinics / Частные клиники

HP.4 Retail sale and other providers of m

149 108 696

670 260 380

26 315 842

257 641 545

589 872 846

12 918 659

257 641 545

270 560 204

13 397 183

13 397 183 7 240 880 091

Ukraine National Health Accounts 2003-2004

HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

26 009 600

50 800

26 009 600

50 800

7 240 880 091

73 482 801

122 542 647 1 257 473

1 257 473

218

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

ющие амбулаторные медицинские услуги

Functions / Функции (HC)

Ukraine National Health Accounts 2003-2004

HP.3.7 Private clinics / Частные клиники

HP.4 Retail sale and other providers of m

73 482 801

HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

74 056 479 74 056 479

219

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

ющие амбулаторные медицинские услуги

Functions / Функции (HC)

HP.3.7 Private clinics / Частные клиники

HP.4 Retail sale and other providers of m

HP.4.3 Retail sale and other suppliers of hearing aids / Розничная продажа и прочие поставщики слуховых средств

274 232 800

257 641 545

73 482 801

23 472 291

354 596 637

2 492 104 234

7 240 880 091

26 009 600

50 800

274 232 800

257 641 545

73 482 801

23 472 291

354 596 637

2 492 104 234

7 240 880 091

26 009 600

50 800

Ukraine National Health Accounts 2003-2004

220

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

medical goods / Розничная

Functions / Функции (HC)

HP.5 Provision

HP.4.4 Retail and administration sale and other of public health suppliers of programmes / medical Обеспечение и appliances управление (other than Total /Итого программами optical glasses and hearing общественного aids) / здоровья Розничная продажа и

HP.6 General health administration and insurance / HP.6.1 Government administration of health / Государствен ное управление здравоохране нием

HP.6.9 All HP.6.2 Social other security funds / providers of Фонды health социального страхования administration / Все прочие Total /Итого организации управления здравоохране нием

HP.7 All other industries HP.7.1 Establishments as providers of occupational health care services / Учреждения, предоставляю щие услуги по охране здоровья на

HP.7.3 All other industries as secondary producers of health care / Все прочие отрасли промышленнос ти как организации, предоставляю

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.1.2 Gynecology / Гинекология HC 1.1.1.2.1 Abortion / Аборты HC 1.1.1.2.9 Other Gynecology / Другая Гинекология HC 1.1.2 Oncology / Онкология HC 1.1.2.1 Gynecology Oncology / Гинекологическая онкология HC 1.1.2.2 Other Oncology / Другая онкология HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.1 Basic medical and diagnostic services / Основные медицинские и диагностические услуги HC.1.3.2 Outpatient dental care / Амбулаторное стоматологическое лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.6 Post Exposure Prophylaxis (PEP) / Пост-контактная профилактика HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги

Ukraine National Health Accounts 2003-2004

221

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

medical goods / Розничная

Functions / Функции (HC)

247 427 129

Ukraine National Health Accounts 2003-2004

HP.5 Provision

HP.6 General health administration and insurance / HP.6.1 Government administration of health / Государствен ное управление здравоохране нием

HP.7.3 All other industries as secondary producers of health care / Все прочие отрасли промышленнос ти как организации, предоставляю

7 514 367 620

7 240 880 091

247 427 129

273 487 529 657 368 935

10 016 500

222

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

medical goods / Розничная

Functions / Функции (HC)

HP.5 Provision

HP.6 General health administration and insurance / HP.6.1 Government administration of health / Государствен ное управление здравоохране нием

HP.7.3 All other industries as secondary producers of health care / Все прочие отрасли промышленнос ти как организации, предоставляю

10 016 500

385 533 077

3 377 926

327 312 165

716 223 168

385 533 077

3 377 926

327 312 165

716 223 168

327 312 165

712 845 242

385 533 077

3 377 926

3 377 926 889 876

Ukraine National Health Accounts 2003-2004

223

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

medical goods / Розничная

Functions / Функции (HC)

HP.5 Provision

HP.6 General health administration and insurance / HP.6.1 Government administration of health / Государствен ное управление здравоохране нием

HP.7.3 All other industries as secondary producers of health care / Все прочие отрасли промышленнос ти как организации, предоставляю

247 427 129

7 514 367 620

657 368 935

385 533 077

3 377 926

327 312 165

716 223 168

10 016 500

889 876

247 427 129

7 514 367 620

657 368 935

385 533 077

3 377 926

327 312 165

716 223 168

10 016 500

889 876

Ukraine National Health Accounts 2003-2004

224

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

(rest of the

Functions / Функции (HC)

HP.8 Institutions providing health-related services /

HP.9 Rest of

64 211 576

Ukraine National Health Accounts 2003-2004

GRAND TOTAL / ОБЩИЙ ИТОГ

9 297 458 265 5 858 803 226 665 094 104 304 282 015 360 812 089 6 565 592 354 246 497 151 070 773

HP.nsk

HP.8.1 HP 8.2 HP.8.3 Other the world / Provider not Research Education and institutions Остальной specified by institutions / training providing мир kind / Исследовател institutions / health-related Провайдеры, ьские Учреждения services / не Прочие Total /Итого институты образования и Total /Итого определенные обучения учреждения, предоставляю по типу щие услуги, связанные со здравоохране

7 402 468 143 668 305 2 831 349 955 78 180 891 64 211 576

3 360 474 147 67 523 515 335 309 244

64 211 576

636 043 522

11 229 576

46 107 003 8 718 400

2 363 809

13 141 831

24 339 653

32 611 953 13 184 275

52 341

17 348 338

18 391 729

7 976 318

101 309 742

225

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

(rest of the

Functions / Функции (HC)

HP.8 Institutions providing health-related services /

HP.9 Rest of

901 541

Ukraine National Health Accounts 2003-2004

GRAND TOTAL / ОБЩИЙ ИТОГ

901 541 670 260 380 1 593 232 846 1 552 253 638 40 979 208 34 666 983 1 042 414 207 270 560 204 13 397 183 7 514 367 620

HP.nsk

HP.8.1 HP 8.2 HP.8.3 Other the world / Provider not Research Education and institutions Остальной specified by institutions / training providing мир kind / Исследовател institutions / health-related Провайдеры, ьские Учреждения services / не Прочие Total /Итого институты образования и Total /Итого определенные обучения учреждения, предоставляю по типу щие услуги, связанные со здравоохране

7 240 880 091

273 487 529 10 016 500

49 973 120

839 901 202

9 379 880

10 637 352

5 681 263

3 698 617

4 956 090

226

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

(rest of the

Functions / Функции (HC)

Ukraine National Health Accounts 2003-2004

HP.8 Institutions providing health-related services /

HP.9 Rest of

HP.nsk

HP.8.1 HP 8.2 HP.8.3 Other the world / Provider not Research Education and institutions Остальной specified by institutions / training providing мир kind / Исследовател institutions / health-related Провайдеры, ьские Учреждения services / не Прочие Total /Итого институты образования и Total /Итого определенные обучения учреждения, предоставляю по типу щие услуги, связанные со здравоохране 28 229 365

GRAND TOTAL / ОБЩИЙ ИТОГ

101 712 166 73 482 801

15 445 086

1 519 771

9 744 736

3 698 617

10 016 500

10 016 500 8 665 258

8 665 258

21 442 963

737 666 131

21 442 963

737 666 131

21 442 963

734 288 205

3 377 926 889 876 85 354 301

471 642 448

13 088 862

570 085 611

471 642 448

5 281 966

249 561 094

255 732 936

16 013 700

469 210 167

1 650 495 217

12 905 797

469 210 167

1 077 301 702

322 951

471 965 399

227

Table 78 Ukraine general NHA 2004: Providers by Functions (cont.)

(rest of the

Functions / Функции (HC)

HP.8 Institutions providing health-related services /

85 354 301

10 906 376

85 354 301

471 642 448

10 906 376

85 354 301

471 642 448

13 088 862

2 784 952

570 085 611

156 923 324

13 088 862

570 085 611

GRAND TOTAL / ОБЩИЙ ИТОГ

85 354 301

13 088 862

Ukraine National Health Accounts 2003-2004

HP.nsk

85 354 301

AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки

AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) AD.5.2 RH specific surveillance activities / деятельность по эпиднадзору, специфическая для РЗ Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

HP.9 Rest of

HP.8.1 HP 8.2 HP.8.3 Other the world / Provider not Research Education and institutions Остальной specified by institutions / training providing мир kind / Исследовател institutions / health-related Провайдеры, ьские Учреждения services / не Прочие Total /Итого институты образования и Total /Итого определенные обучения учреждения, предоставляю по типу щие услуги, связанные со здравоохране

15 873 814 718 771 261

22 965 935 406

2 376 463

2 716 591

1 063 840

1 704 172

3 823 859

2 154 276

13 839 201

170 762 525

718 771 261

22 979 774 607

228

Detailed NHA RH Subanalysis Tables

Technical Notes

231

Table 79 Ukraine NHA RH Subanalysis 2003: Financial Sources by Financial Agents Financing sources / Источники финансирования (HF) FS.1 Public funds / Общественные

Financing agents / Финансирующие организации (FA)

HF.1 General government / Правительство

FS.1.1.2 Regional and city government budget revenue, FS.1.1.1 Central including rayon government and local budgets revenue / revenue / Центральное Областные правительство бюджеты, включая районные и местные бюджеты

FS.2 Private funds / Частные ресурсы FS.2.3 Non-profit institutions serving FS.2.2 households / FS.2.1 Employer funds / Household funds Неправительств Работодатели / Ресурсы енные домохозяйств организации, обслуживающие домохозяйства

Total / Итого

Total Rest of the World / Итого Весь остальной мир

Total / Итого

146 174 253

876 714 730

1 022 888 982

HF.1.1 Territorial government / Территориальное правительство

146 108 089

876 428 358

1 022 536 447

HF.1.1.1 Central government / Центральное правительство HF.1.1.1.1 Ministry of Health / Министерство здравоохранения

146 108 089

42 598 176

26 877 226

11 480 303

12 168 663

6 862 165

46 121 556

46 121 556 876 428 358

876 428 358

HF.1.1.1.2 Ministry of Transport / Министерство транспорта HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел HF.1.1.1.4 Ministry of Defence / Министерство обороны HF.1.1.1.5 Ministry of Labor and Social Policy / Министерство труда и социальной политики HF.1.1.1.6 Academy of Medical Sciences / Академия Медицинских Наук HF.1.1.1.9 Other ministries / Другие министерства HF.1.1.2 Oblast/City/Local/Municipal governments (27) / Областные бюджеты/ Местное/муниципальное правительство (27)

988 440

FS.3 Rest of

HF.1.2 Social security funds / Фонды социального страхования

66 163

286 372

352 536

988 440

66 163

286 372

352 536

988 440

44 973 530

HF.2 Private Sector / Частный сектор HF.2.2 Other private VOLUNTARY insurance / Другое частное ДОБРОВОЛЬНОЕ страхование HF.2.3 Private households' out-of pocket payment / Частные выплаты домохозяйствами HF.2.4 Non-profit Institutions serving households (other than social insurance) / Неправительственные организации, обслуживающие домохозяйства (другие, чем социальное страхование) HF.2.5 Private firms and corporations (other than health insurance, this includes all private/public factories that also have their health care provision facilities) / Частные фирмы и корпорации (другие, чем медицинское страхование, это включает все частные/общественные фабрики, которые имеют свои собственные медицинские учреждения) HF.3 Rest of the world / Весь другой мир

Grand Total / Общий итог

146 174 253

Ukraine National Health Accounts 2003-2004

876 714 730

1 022 888 982

26 877 226

6 862 165

0 0

0 46 121 556

876 428 358

1 340 976

988 440

857 173 767

0 857 173 767

45 961 970

0 1 340 976 0 902 147 296

902 147 296

42 598 176

11 480 303 12 168 663

857 173 767

988 440

1 022 536 447 146 108 089

44 973 530

0 0

0 1 023 877 423

988 440

Grand Total / Общий итог

857 173 767

44 973 530

857 173 767

903 135 737

0 44 973 530 18 552 200 18 552 200

18 552 200

1 944 576 919

232

Table 80 Ukraine NHA RH Subanalysis 2003: Financial Agents by Providers Financing agents / Финансирующие о HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.1 Hospitals / Больницы HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 Oblast hospitals / Областные больницы HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.2 City Hospitals / Городские больницы HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы HP.1.1.4 Rayon Hospitals / Районные больницы HP.1.1.5 Dilnichni Hospitals / Участковые больницы HP.1.1.6 Maternity houses / Родильные дома HP.1.1.9 Other General hospitals / Другие Больницы общего профиля HP.1.3 Specialty (other than mental health and substance abuse) hospitals / Специализированные больницы(кроме психиатрических больниц для лечения алкогольной или наркотической зависимости) HP.1.3.1 Oncology hospitals and dispensers / Онкологические больницы и диспансеры HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры HP.2 Nursing and residential care facilities / Сестринские/врачебные учреждения длительного пребывания больных (по уходу) HP.2.9 All other residential care facilities / Все прочие учреждения по уходу HP.2.9.9 Sanatoriums / Санатории HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.5 Village doctor posts / Сельские врачебные амбулатории HP.3.1.6 Feldsher-midwife posts / Фельдшерско-акушерские пункты HP.3.7 Private clinics / Частные клиники HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции HP.4.4 Retail sale and other suppliers of medical appliances (other than optical glasses and hearing aids) / Розничная продажа и прочие поставщики медицинских приборов (кроме оптических очков и слуховых приборов) HP.9 Rest of the world / Остальной мир TOTAL

Ukraine National Health Accounts 2003-2004

HF.1.1.1.4 Ministry of Defence / Министерство обороны

HF.1.1.2 Oblast/City/Local/ HF.1.2 Social Municipal HF.1.1.1.5 governments (27) security funds / Ministry of Labor HF.1.1.1.9 Other Фонды / Областные and Social Policy ministries / социального бюджеты/ / Министерство Другие Местное/муници страхования труда и министерства пальное социальной правительство политики (27)

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

8 262 274

26 877 226

11 480 303

13 455 140

790 011 869

2 644 424

26 877 226

11 480 303

13 455 140

753 805 480 45 789 686 45 789 686 239 771 015 239 771 015 225 270 876 26 364 481 20 731 639 195 877 783

2 644 424

26 877 226

11 480 303

13 455 140

5 617 850

36 206 390

5 617 850

2 487 701 33 718 689

11 420 260

12 168 663

6 862 165

32 666 416

24 518 188

1 340 976

11 420 260

12 168 663

6 862 165

32 666 416

24 518 188

1 340 976

11 420 260

12 168 663

6 862 165

32 666 416

24 518 188

1 340 976

61 898 301 61 898 301 34 125 293 13 948 498 13 824 510

22 915 643 13 629 243 9 286 400

42 598 176

26 877 226

11 480 303

12 168 663

6 862 165

46 121 556

876 428 358

1 340 976

233

Table 80 Ukraine NHA RH Subanalysis 2003: Financial Agents by Providers (cont.) организации (FA) HF.2.5 Private firms and corporations HF.2.3 Private (other than health households' outinsurance, this HF.3 Rest of the of pocket Total HF.2 includes all world / Весь payment / private/public Private Sector другой мир Частные factories that also выплаты have their health домохозяйствам care provision и facilities) / Частные фирмы и корпорации

Providers / Поставщики (провайдеры) медицинских услуг (HP)

Total HF1. General Government

HP.1 Hospitals / Больницы HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 Oblast hospitals / Областные больницы HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.2 City Hospitals / Городские больницы HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы HP.1.1.4 Rayon Hospitals / Районные больницы HP.1.1.5 Dilnichni Hospitals / Участковые больницы HP.1.1.6 Maternity houses / Родильные дома HP.1.1.9 Other General hospitals / Другие Больницы общего профиля HP.1.3 Specialty (other than mental health and substance abuse) hospitals / Специализированные больницы(кроме психиатрических больниц для лечения алкогольной или наркотической зависимости) HP.1.3.1 Oncology hospitals and dispensers / Онкологические больницы и диспансеры HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры HP.2 Nursing and residential care facilities / Сестринские/врачебные учреждения длительного пребывания больных (по уходу) HP.2.9 All other residential care facilities / Все прочие учреждения по уходу HP.2.9.9 Sanatoriums / Санатории HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.5 Village doctor posts / Сельские врачебные амбулатории HP.3.1.6 Feldsher-midwife posts / Фельдшерско-акушерские пункты HP.3.7 Private clinics / Частные клиники HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции HP.4.4 Retail sale and other suppliers of medical appliances (other than optical glasses and hearing aids) / Розничная продажа и прочие поставщики медицинских приборов (кроме оптических очков и слуховых приборов) HP.9 Rest of the world / Остальной мир TOTAL

850 086 812

70 012 188

920 099 000

808 262 572

69 349 688

877 612 260

45 789 686

5 417 991

51 207 677

45 789 686

5 417 991

51 207 677

239 771 015

17 262 119

257 033 134

Ukraine National Health Accounts 2003-2004

Grand Total / Общий итог

239 771 015

17 262 119

257 033 134

225 270 876

15 418 470

240 689 346

26 364 481

1 714 006

28 078 487

20 731 639

7 833 644

28 565 283

195 877 783

20 733 945

216 611 728

54 457 093

969 511

55 426 604

41 824 240

662 500

42 486 740

33 718 689

662 500

34 381 189

88 976 667

30 591 681

44 919 099

75 510 780

164 487 447

88 976 667

30 591 681

44 919 099

75 510 780

164 487 447

88 976 667

30 591 681

44 919 099

75 510 780

164 487 447

61 898 301

51 385 667

54 431

51 440 098

113 338 399

61 898 301

39 365 702

101 264 003

34 125 293

39 365 702

73 490 994

8 105 551

13 948 498

13 824 510

13 824 510 12 019 966

54 431

12 074 396

22 915 643

705 184 231

728 099 873

13 629 243

695 897 831

709 527 073

9 286 400

18 572 800

1 023 877 423

857 173 767

44 973 530

902 147 296

18 552 200

1 944 576 919

234

Table 81 Ukraine NHA RH Subanalysis 2003: Financial Agents by Functions Financing agents / Финансирующие организации (F HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Functions / Функции (HC)

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

HF.1.1.2 Oblast/City/Local/ HF.1.2 Social HF.1.1.1.5 Municipal security funds / Ministry of Labor HF.1.1.1.9 Other governments (27) Фонды and Social Policy / Областные ministries / социального / Министерство бюджеты/ Другие страхования труда и министерства Местное/муници социальной пальное политики правительство

Total HF1. General Government

7 488 009

25 288 625

10 801 750

12 659 862

807 500 242

863 738 489

5 719 721

19 445 042

8 305 729

9 734 477

599 976 628

643 181 597

560 715 028

HC 1.1.2.1 Gynecology Oncology / Гинекологическая онкология HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.2 Services of rehabilitative care / Услуги реабилитационного лечения HC.2.1 Sanatorium services / Санаторные услуги HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.3 Oral contraceptives / Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации

Ukraine National Health Accounts 2003-2004

252 574 084

308 140 944

5 607 150

302 533 793

3 806 543

1 685 617

5 492 159

3 806 543

1 685 617

5 492 159

69 774

5 486 716

5 556 489

202 036 899

215 000 402

65 086 668

66 210 238

6 743 738

1 698 514

5 843 584

2 496 021

2 925 385

1 123 570

57 845 390

11 420 260

12 168 663

6 862 165

32 666 416

24 518 188

1 340 976

88 976 667

11 420 260

12 168 663

6 862 165

32 666 416

24 518 188

1 340 976

88 976 667

22 915 643

13 629 243

9 286 400

9 286 400 995 987

995 987

235

Table 81 Ukraine NHA RH Subanalysis 2003: Financial Agents by Functions (cont.) Financing agents / Финансирующие организации (F HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Functions / Функции (HC)

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

Total HF1. General Government

995 987

774 264

1 588 601

678 553

795 277

43 413 941

47 250 637

795 277

43 413 941

47 250 637

HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

774 264

1 588 601

678 553

42 598 176

26 877 226

11 480 303

12 168 663

6 862 165

46 121 556

876 428 358

1 340 976

1 023 877 423

AD. Addendum Items / Дополнительные статьи AD.2.2 Policy advocacy for RH / Политическая адвокация для РЗ AD.5.2 RH specific surveillance activities / деятельность по эпиднадзору, специфическая для РЗ Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

42 598 176

26 877 226

11 480 303

12 168 663

6 862 165

46 121 556

876 428 358

1 340 976

1 023 877 423

Ukraine National Health Accounts 2003-2004

236

Table 81 Ukraine NHA RH Subanalysis 2003: Financial Agents by Functions (cont.) FA)

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.1.2 Gynecology / Гинекология HC 1.1.1.2.1 Abortion / Аборты HC 1.1.1.2.9 Other Gynecology / Другая Гинекология HC 1.1.2 Oncology / Онкология HC 1.1.2.1 Gynecology Oncology / Гинекологическая онкология HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.2 Services of rehabilitative care / Услуги реабилитационного лечения HC.2.1 Sanatorium services / Санаторные услуги HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.3 Oral contraceptives / Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации

Ukraine National Health Accounts 2003-2004

HF.2.5 Private HF.2.3 Private firms and households' outcorporations HF.3 Rest of the of pocket (other than health Total HF.2 world / Весь payment / insurance, this Private Sector другой мир Частные includes all выплаты private/public домохозяйствам factories that also и have their health care provision 48 071 061

54 431

48 125 492

5 830 632

Grand Total / Общий итог

917 694 613

14 016 403

657 198 000

13 374 641

574 089 670

9 847 075

262 421 159

3 527 567

311 668 510

80 198

5 687 348

3 447 369

305 981 162 5 492 159 5 492 159 5 556 489

34 054 658

54 431

34 109 089

5 830 632

254 940 123

28 061 699

54 431

28 116 129

5 830 632

100 156 999

222 505

6 966 243

27 839 193

54 431

27 893 624

30 591 681

44 919 099

75 510 780

5 830 632

164 487 447

91 569 646

30 591 681

44 919 099

75 510 780

164 487 447

73 326 794

705 184 231

728 099 873

695 897 831

709 527 073

695 897 831

709 527 073

189 792 287

203 421 530

506 105 543

9 286 400

18 572 800 7 937 477

8 933 464

6 266 554

7 262 541

237

Table 81 Ukraine NHA RH Subanalysis 2003: Financial Agents by Functions (cont.) FA)

Functions / Функции (HC)

HC.6.1.9 Other maternal and child health; family planning and counselling / Другие услуги здоровья матери и ребенка; планирование семьи и семейные консультации HC.6.4 Prevention of noncommunicable diseases / Профилактика неинфекционных заболеваний HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением HC.7.1.1 General government administration of health (except social security) / Общее государственное управление здравоохранением (за исключением социального обеспечения) HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ AD. Addendum Items / Дополнительные статьи AD.2.2 Policy advocacy for RH / Политическая адвокация для РЗ AD.5.2 RH specific surveillance activities / деятельность по эпиднадзору, специфическая для РЗ Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

857 173 767

44 973 530

902 147 296

Grand Total / Общий итог

6 266 554

7 262 541

1 262 709

408 214

950 415

3 833 676

51 084 313

105 602

47 356 239

3 728 075

18 552 200

1 944 576 919

2 133 080

3 133 277

5 266 357

23 818 558

1 949 843 277

238

Table 82 Ukraine NHA RH Subanalysis 2003: Providers by Functions

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 HP.1.1.5 HP.1.1.4 Rayon HP.1.1.2 City HP.1.1.3 HP.1.1.6 Dilnichni Hospitals / Maternity HP.1.1.2.1 City Central Rayon HP.1.1.1.1 Hospitals / Районные Hospitals / houses / general Oblast general Участковые больницы Центральные Родильные hospitals / hospitals / районные дома больницы Городские Областные больницы больницы больницы общего общего профиля профиля

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

Total /Итого

HP.1.3 Specialt HP.1.3.1 Oncology hospitals and dispensers / Онкологически е больницы и диспансеры

45 237 466

233 105 223

218 814 141

25 592 438

21 318 107

193 047 536

51 563 978

788 678 888

7 213 940

36 496 530

187 255 469

175 873 243

20 592 448

15 045 018

153 871 979

39 724 044

628 858 732

5 492 159

36 496 530

187 255 469

175 873 243

20 592 448

153 871 979

16 439 021

84 347 470

79 220 492

9 275 673

73 138 502

262 421 159

20 057 509

102 907 999

96 652 751

11 316 774

80 733 477

311 668 510

574 089 670

368 038

1 878 973

1 764 617

206 636

1 469 083

5 687 348

19 689 471

101 029 026

94 888 133

11 110 138

79 264 393

305 981 162 5 492 159 5 492 159

406 336

2 127 717

1 999 043

233 957

269 979

8 334 600

43 722 037

40 941 854

4 766 033

6 003 109

39 175 557

11 839 934

5 037 032

100 671

154 783 124

1 621 110 1 621 110

3 808 989

12 610 982

11 242 667

1 241 675

6 021 815

13 770 303

643 894

49 340 325

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.3 Oral contraceptives / Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья

Ukraine National Health Accounts 2003-2004

239

Table 82 Ukraine NHA RH Subanalysis 2003: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 HP.1.1.6 HP.1.1.5 HP.1.1.4 Rayon HP.1.1.2 City HP.1.1.3 Maternity Dilnichni Hospitals / HP.1.1.2.1 City Central Rayon HP.1.1.1.1 houses / Hospitals / Районные Hospitals / general Oblast general Родильные Участковые больницы Центральные hospitals / hospitals / дома больницы районные Городские Областные больницы больницы больницы общего общего профиля профиля

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

Total /Итого

HP.1.3 Specialt HP.1.3.1 Oncology hospitals and dispensers / Онкологически е больницы и диспансеры

2 161 223

11 316 929

10 632 538

1 244 375

1 225 361

9 793 889

3 218 732

39 593 047

891 611

2 161 223

11 316 929

10 632 538

1 244 375

1 225 361

9 793 889

3 218 732

39 593 047

891 611

51 207 677

257 033 134

240 689 346

28 078 487

28 565 283

216 611 728

55 426 604

877 612 260

8 105 551

51 207 677

257 033 134

240 689 346

28 078 487

28 565 283

216 611 728

55 426 604

877 612 260

8 105 551

Ukraine National Health Accounts 2003-2004

240

Table 82 Ukraine NHA RH Subanalysis 2003: Providers by Functions (cont.) Providers / Поставщики (провайдеры) медицинских услуг (HP) HP.2 Nursing and HP.3 Providers of ambulatory health care / Организа

Functions / Функции (HC)

HP.2.9 All y (other than mental health and HP.3.1 Offices of physicians and policlinics / Врачебные HP.3.1.6 HP.1.3.4 STI HP.3.1.5 HP.2.9.9 HP.3.1.1 Adults Total /Итого Total /Итого Feldsherclinics and Village doctor Sanatoriums / Policlinics / midwife posts / dispensers / posts / Санатории Взрослые ФельдшерскоКожноСельские поликлиники акушерские венерологичес врачебные Total /Итого Total /Итого пункты кие клиники и амбулатории диспансеры

30 232 138

37 446 079

826 124 967

22 847 109

28 339 268

657 198 000

47 239 882

13 271 353

13 153 384

73 664 618

574 089 670 262 421 159 311 668 510 5 687 348 305 981 162 5 492 159

5 492 159

418 786

519 457

5 556 489

6 966 243

8 587 353

163 370 477

47 239 882

13 271 353

13 153 384

73 664 618

6 966 243

8 587 353

47 239 882

13 271 353

13 153 384

73 664 618

6 966 243

6 966 243 47 239 882

13 271 353

13 153 384

73 664 618

439 995

49 780 320

164 487 447

164 487 447 23 546 474

23 546 474

995 987

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.3 Oral contraceptives / Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья

Ukraine National Health Accounts 2003-2004

241

Functions / Функции (HC)

995 987

3 709 056

4 600 666

44 193 713

1 708 652

677 146

671 126

3 056 924

1 708 652

677 146

671 126

3 056 924

3 709 056

4 600 666

44 193 713

34 381 189

42 486 740

920 099 000

164 487 447

73 490 994

13 948 498

13 824 510

101 264 003

34 381 189

42 486 740

920 099 000

164 487 447

73 490 994

13 948 498

13 824 510

101 264 003

Ukraine National Health Accounts 2003-2004

242

Table 82 Ukraine NHA RH Subanalysis 2003: Providers by Functions (cont.)

ации, предоставляющие

Functions / Функции (HC)

HP.3.7 Private clinics / Частные клиники

12 074 396

Розничная medical продажа appliances Total /Итого фармацевтиче (other than Total /Итого ской optical glasses продукции and hearing aids) / Розничная продажа и 85 739 014

Ukraine National Health Accounts 2003-2004

5 830 632

GRAND TOTAL / ОБЩИЙ ИТОГ

917 694 613 657 198 000 574 089 670 262 421 159 311 668 510 5 687 348 305 981 162 5 492 159 5 492 159 5 556 489

12 074 396

85 739 014

5 830 632

254 940 123

12 074 396

85 739 014

5 830 632

100 156 999 6 966 243

12 074 396

85 739 014

5 830 632

91 569 646 164 487 447 164 487 447

23 546 474

73 326 794 709 527 073

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.3 Oral contraceptives / Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья

HP.4 Retail sale and other providers of HP.9 Rest of HP.4.1 HP.4.4 Retail the world / Dispensing sale and other Остальной chemists / suppliers of мир

18 572 800

728 099 873

709 527 073

203 421 530

506 105 543

18 572 800

18 572 800 995 987

7 937 477

8 933 464

243

Table 82 Ukraine NHA RH Subanalysis 2003: Providers by Functions (cont.)

ации, предоставляющие

Functions / Функции (HC)

HP.3.7 Private clinics / Частные клиники

HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.9 Other maternal and child health; family planning and counselling / Другие услуги здоровья матери и ребенка; планирование семьи и семейные консультации HC.6.4 Prevention of noncommunicable diseases / Профилактика неинфекционных заболеваний HC.6.5 Occupational health care / Охрана здоровья на производстве HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением HC.7.1.1 General government administration of health (except social security) / Общее государственное управление здравоохранением (за исключением социального обеспечения) HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ AD. Addendum Items / Дополнительные статьи AD.2.2 Policy advocacy for RH / Политическая адвокация для РЗ AD.5.2 RH specific surveillance activities / деятельность по эпиднадзору, специфическая для РЗ Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

12 074 396

HP.4 Retail sale and other providers of HP.9 Rest of HP.4.1 HP.4.4 Retail the world / Dispensing sale and other Остальной chemists / suppliers of мир

Розничная medical продажа appliances Total /Итого фармацевтиче (other than Total /Итого ской optical glasses продукции and hearing aids) / Розничная продажа и

GRAND TOTAL / ОБЩИЙ ИТОГ

995 987

6 266 554

7 262 541

995 987

6 266 554

7 262 541

1 262 709

408 214

950 415

3 056 924

3 833 676

51 084 313

3 056 924

105 602

47 356 239

113 338 399

709 527 073

18 572 800

728 099 873

3 728 075

18 552 200

1 944 576 919

2 133 080

3 133 277

5 266 357

23 818 558

1 949 843 277

244

Table 83 Ukraine NHA RH Subanalysis 2004: Financial Sources by Financial Agents Financing sources / Источники финансирования (HF) FS.1 Public funds / Общественные

Financing agents / Финансирующие организации (FA)

HF.1 General government / Правительство

FS.2 Private funds / Частные ресурсы

FS.2.3 Non-profit institutions serving FS.2.2 households / FS.2.1 Employer Household funds Неправительстве funds / / Ресурсы нные Работодатели домохозяйств организации, обслуживающие домохозяйства

Total / Итого

Total Rest of the World / Итого Весь остальной мир

Total / Итого

144 514 272

1 033 241 835

1 177 756 107

HF.1.1 Territorial government / Территориальное правительство

144 436 275

1 032 904 243

1 177 340 518

HF.1.1.1 Central government / Центральное правительство HF.1.1.1.1 Ministry of Health / Министерство здравоохранения

144 436 275

38 970 729

28 639 588

1 165 231

FS.3 Rest of

0 0 0 0

1 178 921 338 1 177 340 518 144 436 275 38 970 729 28 639 588

1 145 333

12 913 823

6 845 430

55 921 372

0 0

55 921 372

1 032 904 243

HF.1.2 Social security funds / Фонды социального страхования

77 997

337 592

415 589

1 165 231

77 997

337 592

415 589

1 165 231

0 0 0

1 165 231

1 145 333 12 913 823 6 845 430 0

1 580 820 1 580 820

1 165 231 0

HF.2 Private Sector / Частный сектор

HF.2.2 Other private VOLUNTARY insurance / Другое частное ДОБРОВОЛЬНОЕ страхование HF.2.3 Private households' out-of pocket payment / Частные выплаты домохозяйствами HF.2.5 Private firms and corporations (other than health insurance, this includes all private/public factories that also have their health care provision facilities) / Частные фирмы и корпорации (другие, чем медицинское страхование, это включает все частные/общественные фабрики, которые имеют свои собственные медицинские учреждения) HF.3 Rest of the world / Весь другой мир

Grand Total / Общий итог

1 165 231

Grand Total / Общий итог

144 514 272

Ukraine National Health Accounts 2003-2004

1 033 241 835

1 177 756 107

49 853 895

1 051 205 903

49 853 895

51 019 125

1 101 059 797

0 0

1 051 205 903

1 102 225 028

0 1 051 205 903

49 853 895

1 101 059 797

0 20 847 023

20 847 023

20 847 023 2 300 828 157

245

Table 84 Ukraine NHA RH Subanalysis 2004: Financial Agents by Providers Financing agents / Финансирующие о HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.1 Hospitals / Больницы HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 Oblast hospitals / Областные больницы HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.2 City Hospitals / Городские больницы HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы HP.1.1.4 Rayon Hospitals / Районные больницы HP.1.1.5 Dilnichni Hospitals / Участковые больницы HP.1.1.6 Maternity houses / Родильные дома HP.1.1.9 Other General hospitals / Другие Больницы общего профиля HP.1.3 Specialty (other than mental health and substance abuse) hospitals / Специализированные больницы(кроме психиатрических больниц для лечения алкогольной или наркотической зависимости) HP.1.3.1 Oncology hospitals and dispensers / Онкологические больницы и диспансеры HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры HP.2 Nursing and residential care facilities / Сестринские/врачебные учреждения длительного пребывания больных (по уходу) HP.2.9 All other residential care facilities / Все прочие учреждения по уходу HP.2.9.9 Sanatoriums / Санатории HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.5 Village doctor posts / Сельские врачебные амбулатории HP.3.1.6 Feldsher-midwife posts / Фельдшерско-акушерские пункты HP.3.7 Private clinics / Частные клиники HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции HP.4.4 Retail sale and other suppliers of medical appliances (other than optical glasses and hearing aids) / Розничная продажа и прочие поставщики медицинских приборов (кроме оптических очков и слуховых приборов) HP.9 Rest of the world / Остальной мир TOTAL

Ukraine National Health Accounts 2003-2004

HF.1.1.1.4 Ministry of Defence / Министерство обороны

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

10 948 831

28 639 588

1 145 333

21 136 529

924 120 517

3 012 898

28 639 588

1 145 333

21 136 529

881 102 331 53 654 088 53 654 088 276 969 160 276 969 160 263 510 760 31 194 356 22 622 755 233 151 211

3 012 898

28 639 588

1 145 333

21 136 529

7 935 932

43 018 187

7 935 932

2 988 929 40 029 257

13 749 994

12 913 823

6 845 430

34 784 843

29 725 575

1 580 820

13 749 994

12 913 823

6 845 430

34 784 843

29 725 575

1 580 820

13 749 994

12 913 823

6 845 430

34 784 843

29 725 575

1 580 820

79 058 150 79 058 150 43 084 532 19 044 665 16 928 953

14 271 904 13 659 581 612 323

38 970 729

28 639 588

1 145 333

12 913 823

6 845 430

55 921 372

1 032 904 243

1 580 820

246

Table 84 Ukraine NHA RH Subanalysis 2004: Financial Agents by Providers (cont.) организации (FA) HF.2.5 Private HF.2.3 Private firms and households' outcorporations HF.3 Rest of the of pocket (other than health Total HF.2 world / Весь payment / insurance, this Private Sector другой мир Частные includes all выплаты private/public домохозяйствам factories that also и have their health care provision

Providers / Поставщики (провайдеры) медицинских услуг (HP)

Total HF1. General Government

HP.1 Hospitals / Больницы HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 Oblast hospitals / Областные больницы HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.2 City Hospitals / Городские больницы HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы HP.1.1.4 Rayon Hospitals / Районные больницы HP.1.1.5 Dilnichni Hospitals / Участковые больницы HP.1.1.6 Maternity houses / Родильные дома HP.1.1.9 Other General hospitals / Другие Больницы общего профиля HP.1.3 Specialty (other than mental health and substance abuse) hospitals / Специализированные больницы(кроме психиатрических больниц для лечения алкогольной или наркотической зависимости) HP.1.3.1 Oncology hospitals and dispensers / Онкологические больницы и диспансеры HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры HP.2 Nursing and residential care facilities / Сестринские/врачебные учреждения длительного пребывания больных (по уходу) HP.2.9 All other residential care facilities / Все прочие учреждения по уходу HP.2.9.9 Sanatoriums / Санатории HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.1.5 Village doctor posts / Сельские врачебные амбулатории HP.3.1.6 Feldsher-midwife posts / Фельдшерско-акушерские пункты HP.3.7 Private clinics / Частные клиники HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции HP.4.4 Retail sale and other suppliers of medical appliances (other than optical glasses and hearing aids) / Розничная продажа и прочие поставщики медицинских приборов (кроме оптических очков и слуховых приборов) HP.9 Rest of the world / Остальной мир TOTAL

985 990 799

85 809 955

1 071 800 754

935 036 680

84 997 966

1 020 034 646

53 654 088

6 640 523

60 294 611

53 654 088

6 640 523

60 294 611

276 969 160

21 157 197

298 126 357

Ukraine National Health Accounts 2003-2004

Grand Total / Общий итог

276 969 160

21 157 197

298 126 357

263 510 760

18 897 542

282 408 302

31 194 356

2 100 760

33 295 117

22 622 755

9 601 252

32 224 007

233 151 211

25 412 417

258 563 628

53 934 349

1 188 275

55 122 624

50 954 119

811 989

51 766 108

40 029 257

811 989

40 841 246

99 600 485

36 863 697

49 806 255

86 669 952

186 270 437

99 600 485

36 863 697

49 806 255

86 669 952

186 270 437

99 600 485

36 863 697

49 806 255

86 669 952

186 270 437

79 058 150

64 228 062

47 640

64 275 702

143 333 853

79 058 150

48 248 301

127 306 451

43 084 532

48 248 301

91 332 833

10 924 862

19 044 665

16 928 953

16 928 953 15 979 762

47 640

16 027 402

14 271 904

864 304 188

878 576 092

13 659 581

855 777 361

869 436 942

612 323

8 526 827

9 139 150

1 178 921 338

1 051 205 903

49 853 895

1 101 059 797

20 847 023

2 300 828 157

247

Table 85 Ukraine NHA RH Subanalysis 2004: Financial Agents by Functions Financing agents / Финансирующие организации (F HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Functions / Функции (HC)

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

Total HF1. General Government

9 897 798

26 946 822

1 077 637

19 887 237

950 776 064

1 008 585 558

7 556 990

20 720 069

828 622

15 291 782

701 779 853

746 177 316

656 559 164

HC 1.1.2.1 Gynecology Oncology / Гинекологическая онкология HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.2 Services of rehabilitative care / Услуги реабилитационного лечения HC.2.1 Sanatorium services / Санаторные услуги HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.3 Oral contraceptives / Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации

Ukraine National Health Accounts 2003-2004

295 747 076

360 812 089

6 565 592

354 246 497

5 377 229

2 025 239

7 402 468

5 377 229

2 025 239

7 402 468

98 564

6 378 028

6 476 592

242 618 184

255 931 651

82 500 695

84 087 881

8 005 851

2 242 244

6 226 752

249 016

4 595 455

1 587 186

73 897 057

13 749 994

12 913 823

6 845 430

34 784 843

29 725 575

1 580 820

99 600 485

13 749 994

12 913 823

6 845 430

34 784 843

29 725 575

1 580 820

99 600 485

14 271 904

13 659 581

612 323

612 323 1 257 473

1 257 473

248

Table 85 Ukraine NHA RH Subanalysis 2004: Financial Agents by Functions (cont.) Financing agents / Финансирующие организации (F HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство HF.1.1.1 Central government / Центральное правительство

Functions / Функции (HC)

HF.1.1.1.1 Ministry of Health / Министерство здравоохранени я

HF.1.1.1.2 Ministry of Transport / Министерство транспорта

HF.1.1.1.3 Ministry of Internal Affairs / Министерство внутренних дел

HF.1.1.1.4 Ministry of Defence / Министерство обороны

Total HF1. General Government

1 257 473

1 051 032

1 692 767

67 696

1 249 292

51 145 131

55 205 919

1 249 292

51 145 131

55 205 919

1 051 032

1 692 767

67 696

38 970 729

28 639 588

1 145 333

12 913 823

6 845 430

55 921 372

1 032 904 243

1 580 820

1 178 921 338

38 970 729

28 639 588

1 145 333

12 913 823

6 845 430

55 921 372

1 032 904 243

1 580 820

1 178 921 338

Ukraine National Health Accounts 2003-2004

249

Table 85 Ukraine NHA RH Subanalysis 2004: Financial Agents by Functions (cont.) FA)

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.1.2 Gynecology / Гинекология HC 1.1.1.2.1 Abortion / Аборты HC 1.1.1.2.9 Other Gynecology / Другая Гинекология HC 1.1.2 Oncology / Онкология HC 1.1.2.1 Gynecology Oncology / Гинекологическая онкология HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.2 Services of rehabilitative care / Услуги реабилитационного лечения HC.2.1 Sanatorium services / Санаторные услуги HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.3 Oral contraceptives / Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации

Ukraine National Health Accounts 2003-2004

47 640

60 213 178

7 976 318

Grand Total / Общий итог

1 076 775 054

17 179 107

763 356 423

16 392 537

672 951 701

12 068 999

307 816 075

4 323 538

365 135 627

98 294

6 663 886

4 225 244

358 471 741 7 402 468 7 402 468 6 476 592

42 986 431

47 640

43 034 071

7 976 318

306 942 039

35 641 201

47 640

35 688 841

7 976 318

127 753 040

272 712

8 278 564

35 368 489

47 640

35 416 129

36 863 697

49 806 255

86 669 952

7 976 318

186 270 437

117 289 504

36 863 697

49 806 255

86 669 952

186 270 437

89 872 479

864 304 188

878 576 092

855 777 361

869 436 942

855 777 361

869 436 942

190 214 759

203 874 340

665 562 602

8 526 827

9 139 150 7 804 415

9 061 888

3 698 617

4 956 090

250

Table 85 Ukraine NHA RH Subanalysis 2004: Financial Agents by Functions (cont.) FA)

Functions / Функции (HC)

HC.6.1.9 Other maternal and child health; family planning and counselling / Другие услуги здоровья матери и ребенка; планирование семьи и семейные консультации HC.6.4 Prevention of noncommunicable diseases / Профилактика неинфекционных заболеваний HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением HC.7.1.1 General government administration of health (except social security) / Общее государственное управление здравоохранением (за исключением социального обеспечения) HC.n.s.k HC expenditure not specified by kind / Расходы здравоохранения, не определенные по типу услуг HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ AD. Addendum Items / Дополнительные статьи AD.2.2 Policy advocacy for RH / Политическая адвокация для РЗ AD.5.2 RH specific surveillance activities / деятельность по эпиднадзору, специфическая для РЗ Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

1 051 205 903

49 853 895

1 101 059 797

Grand Total / Общий итог

3 698 617

4 956 090

3 698 617

407 181

1 026 648

3 191 520

848 122

56 054 040

114 072

55 319 991

734 050

20 847 023

2 300 828 157

1 063 840

2 154 276

3 218 116

24 065 139

2 304 046 273

251

Table 86 Ukraine NHA RH Subanalysis 2004: Providers by Functions

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

Total /Итого

HP.1.3 Specialt HP.1.3.1 Oncology hospitals and dispensers / Онкологически е больницы и диспансеры

53 093 736

269 597 154

256 191 386

30 300 927

23 506 274

230 028 590

51 145 605

913 863 672

9 723 127

42 830 811

216 486 671

205 858 923

24 376 949

16 459 905

183 398 348

39 419 325

728 830 931

7 402 468

42 830 811

216 486 671

205 858 923

24 376 949

183 398 348

672 951 701

19 292 108

97 514 268

92 727 178

10 980 358

87 302 162

307 816 075

23 538 702

118 972 403

113 131 745

13 396 591

96 096 186

365 135 627

432 074

2 172 734

2 065 802

244 642

1 748 634

6 663 886

23 106 629

116 799 669

111 065 942

13 151 949

94 347 552

358 471 741 7 402 468 7 402 468

476 124

2 457 812

2 338 382

276 817

294 607

9 786 801

50 652 671

47 994 081

5 647 161

6 751 763

46 630 242

11 726 280

5 843 742

135 687

179 188 999

2 184 972 2 184 972

4 668 461

15 456 563

13 779 497

1 521 850

7 380 596

16 877 477

789 184

60 473 629

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.3 Oral contraceptives / Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья

Ukraine National Health Accounts 2003-2004

252

Table 86 Ukraine NHA RH Subanalysis 2004: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HP.1.1.9 Other General hospitals / Другие Больницы общего профиля

Total /Итого

HP.1.3 Specialt HP.1.3.1 Oncology hospitals and dispensers / Онкологически е больницы и диспансеры

2 532 414

13 072 640

12 437 419

1 472 339

1 337 137

11 657 561

3 187 835

45 697 345

1 201 735

2 532 414

13 072 640

12 437 419

1 472 339

1 337 137

11 657 561

3 187 835

45 697 345

1 201 735

60 294 611

298 126 357

282 408 302

33 295 117

32 224 007

258 563 628

55 122 624

1 020 034 646

10 924 862

60 294 611

298 126 357

282 408 302

33 295 117

32 224 007

258 563 628

55 122 624

1 020 034 646

10 924 862

Ukraine National Health Accounts 2003-2004

253

Table 86 Ukraine NHA RH Subanalysis 2004: Providers by Functions (cont.) Providers / Поставщики (провайдеры) медицинских услуг (HP) HP.2 Nursing and HP.3 Providers of ambulatory health care / Организа

Functions / Функции (HC)

35 898 751

45 621 878

959 485 550

27 123 024

34 525 492

763 356 423

59 058 546

18 120 120

16 107 118

93 285 785

672 951 701 307 816 075 365 135 627 6 663 886 358 471 741 7 402 468

7 402 468

497 163

632 850

6 476 592

8 278 564

10 463 536

189 652 535

59 058 546

18 120 120

16 107 118

93 285 785

8 278 564

10 463 536

59 058 546

18 120 120

16 107 118

93 285 785

8 278 564

8 278 564 59 058 546

18 120 120

16 107 118

93 285 785

539 277

61 012 906

186 270 437

186 270 437 28 859 573

28 859 573

1 257 473

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.3 Oral contraceptives / Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья

Ukraine National Health Accounts 2003-2004

254

Functions / Функции (HC)

1 257 473

4 403 218

5 604 953

51 302 298

2 157 240

924 545

821 835

3 903 620

2 157 240

924 545

821 835

3 903 620

4 403 218

5 604 953

51 302 298

40 841 246

51 766 108

1 071 800 754

186 270 437

91 332 833

19 044 665

16 928 953

127 306 451

40 841 246

51 766 108

1 071 800 754

186 270 437

91 332 833

19 044 665

16 928 953

127 306 451

Ukraine National Health Accounts 2003-2004

255

Table 86 Ukraine NHA RH Subanalysis 2004: Providers by Functions (cont.)

ации, предоставляющие

Functions / Функции (HC)

HP.3.7 Private clinics / Частные клиники

16 027 402

Розничная medical продажа appliances Total /Итого фармацевтиче (other than Total /Итого ской optical glasses продукции and hearing aids) / Розничная продажа и 109 313 186

Ukraine National Health Accounts 2003-2004

7 976 318

GRAND TOTAL / ОБЩИЙ ИТОГ

1 076 775 054 763 356 423 672 951 701 307 816 075 365 135 627 6 663 886 358 471 741 7 402 468 7 402 468 6 476 592

16 027 402

109 313 186

7 976 318

306 942 039

16 027 402

109 313 186

7 976 318

127 753 040 8 278 564

16 027 402

109 313 186

7 976 318

117 289 504 186 270 437 186 270 437

28 859 573

89 872 479 869 436 942

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.3 Oral contraceptives / Оральные контрацептивы HC.5.1.1.9 Other prescribed medicines / Другие рецептурные медикаменты HC.5.2 Therapeutic appliances and other medical durables / Терапевтические приборы и прочие медицинские товары длительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья

HP.4 Retail sale and other providers of HP.9 Rest of HP.4.1 HP.4.4 Retail the world / Dispensing sale and other Остальной chemists / suppliers of мир

9 139 150

878 576 092

869 436 942

203 874 340

665 562 602

9 139 150

9 139 150 1 257 473

7 804 415

9 061 888

256

Table 86 Ukraine NHA RH Subanalysis 2004: Providers by Functions (cont.)

ации, предоставляющие

Functions / Функции (HC)

HP.3.7 Private clinics / Частные клиники

HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.9 Other maternal and child health; family planning and counselling / Другие услуги здоровья матери и ребенка; планирование семьи и семейные консультации HC.6.4 Prevention of noncommunicable diseases / Профилактика неинфекционных заболеваний HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением HC.7.1.1 General government administration of health (except social security) / Общее государственное управление здравоохранением (за исключением социального обеспечения) HC.n.s.k HC expenditure not specified by kind / Расходы здравоохранения, не определенные по типу услуг HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ AD. Addendum Items / Дополнительные статьи AD.2.2 Policy advocacy for RH / Политическая адвокация для РЗ AD.5.2 RH specific surveillance activities / деятельность по эпиднадзору, специфическая для РЗ Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

16 027 402

HP.4 Retail sale and other providers of HP.9 Rest of HP.4.1 HP.4.4 Retail the world / Dispensing sale and other Остальной chemists / suppliers of мир

GRAND TOTAL / ОБЩИЙ ИТОГ

1 257 473

3 698 617

4 956 090

1 257 473

3 698 617

4 956 090

3 698 617

407 181

1 026 648

3 191 520

3 903 620

848 122

56 054 040

3 903 620

114 072

55 319 991

143 333 853

869 436 942

9 139 150

878 576 092

734 050

20 847 023

2 300 828 157

1 063 840

2 154 276

3 218 116

24 065 139

2 304 046 273

257

Detailed NHA HIV/AIDS Subanalysis Tables

258

Ukraine National Health Accounts 2003-2004

Table 87 Ukraine NHA HIV/AIDS Subanalysis 2003: Financial Sources by Financial Agents Financing sources / Источники финансирования (HF) FS.1 Public funds / Общественные

Financing agents / Финансирующие организации (FA)

FS.2.3 Non-profit institutions serving FS.2.2 households / Household funds Неправительственные / Ресурсы организации, домохозяйств обслуживающие домохозяйства

Total / Итого

FS.3 Rest of the world / Весь

FS.3.1 GFATM / Total Rest of the Grand Total / Общий Глобальный FS.3.9 Other Rest of World / Итого итог фонд по the world / другие Весь остальной СПИД, Весь остальной мир мир туберкулезу и малярии

Total / Итого

19 600 916

31 313 632

50 914 547

19 600 916

31 313 632

50 914 547

19 600 916

0 31 313 632

31 313 632

193 524 877

HF.1.1.1.4 Ministry of Defence / Министерство обороны HF.1.1.1.5 Ministry of Labor and Social Policy / Министерство труда и социальной политики HF.1.1.1.6 Academy of Medical Sciences / Академия Медицинских Наук HF.1.1.1.9 Other ministries / Другие министерства HF.1.1.2 Oblast/City/Local/Municipal governments (27) / Областные бюджеты/ Местное/муниципальное правительство (27) HF.1.2 Social security funds / Фонды социального страхования HF.1.2.1 Social security fund for accidents at work and occupational diseases / Фонд социального страхования от несчастных случаев на производстве и профессиональных заболеваний

Grand Total / Общий итог

FS.2 Private funds / Частные ресурсы

19 600 916

Ukraine National Health Accounts 2003-2004

31 313 632

50 914 547

50 914 547 19 600 916

0 0

19 600 916

0 0

31 313 632

0 0

0 50 914 547

5 591 693

193 524 877

5 591 693

0 0 0 199 116 570

199 116 570

8 532 320

193 524 877

33 349 022

0 5 591 693 41 881 342 41 881 342

33 349 022

8 532 320 33 349 022

8 532 320

33 349 022

41 881 342

8 532 320 33 349 022 291 912 459

259

Table 88 Ukraine NHA HIV/AIDS Subanalysis 2003: Financial Agents by Providers Financing agents / Финансирующие организации (FA) HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HF.1.1.1 Central HF.1.1.2 government / HF.1.2 Social Центральное Oblast/City/Local/ security funds / Municipal правительство Фонды governments (27) социального / Областные страхования бюджеты/ HF.1.1.1.1 Местное/муници Ministry of Health пальное / Министерство правительство здравоохранения (27)

19 600 916

HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы HP.1.1.4 Rayon Hospitals / Районные больницы HP.1.1.5 Dilnichni Hospitals / Участковые больницы HP.1.1.6 Maternity houses / Родильные дома HP.1.2 Mental health and substance abuse hospitals / Психиатрические больницы для лечения алкогольной или наркотической зависимости HP.1.2.2 Substance abuse hospitals and dispensers / Наркологические больницы и диспансеры HP.1.3 Specialty (other than mental health and substance abuse) hospitals / Специализированные больницы(кроме психиатрических больниц для лечения алкогольной или наркотической зависимости) HP.1.3.2 AIDS clinics and centers / Клиники и центры ВИЧ/СПИД HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы и диспансеры HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры HP.1.3.9 Other specialty hospitals / Другие специализированные больницы HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники

Ukraine National Health Accounts 2003-2004

Total HF1. General Government

HF.2.4 Non-profit Institutions serving HF.2.3 Private households households' out- (other than social HF.3 Rest of the of pocket insurance) / Total HF.2 world / Весь payment / Неправительств Private Sector другой мир Частные енные выплаты организации, домохозяйствам обслуживающие и домохозяйства (другие, чем социальное страхование)

Grand Total / Общий итог

30 673 579

50 274 494

9 464 134

59 738 628

707 207

2 312 804

3 020 011

44 487

232 952

1 467 556

1 700 508

232 952

1 467 556

1 700 508

218 864

25 615

185 290

845 248

1 030 538

2 288 574

2 108 590

4 397 164

2 288 574

2 108 590

4 397 164

19 600 916

27 677 797

47 278 712

5 042 740

52 321 452

16 373 430

13 602 292

29 975 722

2 929 559

32 905 281

3 227 486

5 213 912

8 441 398

887 839

9 329 237

609 060

8 861 592

616 282

9 477 874

640 053

2 134 241

2 774 294

738 110

260

Table 88 Ukraine NHA HIV/AIDS Subanalysis 2003: Financial Agents by Providers (cont.) Financing agents / Финансирующие организации (FA) HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.3.7 Private clinics / Частные клиники HP.3.9 Other providers of ambulatory health care / Прочие организации, предоставляющие амбулаторные медицинские услуги HP.3.9.1 Ambulance services / Скорая помощь HP.3.9.2 Blood and organ banks / Банки крови и органов HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги

640 053

Total HF1. General Government

640 053

Grand Total / Общий итог

1 122 461

273 670

913 723

61 664

640 053

640 053 212 006

212 006

HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары

181 926 502

HP.4.1 Dispensing chemists / Розничная продажа фармацевтической продукции HP.5 Provision and administration of public health programmes / Обеспечение и управление программами общественного здоровья HP.9 Rest of the world / Остальной мир TOTAL

181 926 502

5 591 693

199 116 570

Ukraine National Health Accounts 2003-2004

19 600 916

31 313 632

50 914 547

193 524 877

41 881 342

291 912 459

261

Table 89 Ukraine NHA HIV/AIDS Subanalysis 2003: Financial Agents by Functions Financing agents / Финансирующие организации (FA) HF.1 General government / Правительство

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.2 OI Drugs / Препараты ОИ (оппорт. инф.)

Ukraine National Health Accounts 2003-2004

HF.1.1.1 Central government / Центральное правительство

HF.1.1.2 Oblast/City/Local/ Municipal governments (27) / Областные бюджеты/ HF.1.1.1.1 Ministry Местное/муници of Health / пальное Министерство правительство здравоохранения (27)

Total HF1. General Government

HF.2.4 Non-profit Institutions serving HF.2.3 Private households (other than households' outHF.3 Rest of the social insurance) / Total HF.2 of pocket world / Весь Неправительственные Private Sector payment / другой мир организации, Частные обслуживающие выплаты домохозяйства домохозяйствам (другие, чем и социальное страхование)

16 460 619

27 600 805

44 061 424

11 536 711

2 186 880

12 096 970

14 283 849

4 108 600

18 392 450

707 207

681 193

1 388 400

707 207

681 193

1 388 400

1 343 659

40 085

203 242

243 327

14 233 654

15 300 594

29 534 248

7 428 111

14 431 929

51 394 287

14 233 654

15 300 594

29 534 248

5 383 125

14 431 929

49 349 301

645 497

1 042 782

1 688 280

419 359

912 553

3 020 192

310 466

651 438

9 625 507 6 432 823 6 364 702 790 632

9 625 507

8 766 973

70 030 064

243 327

6 432 823 2 402 271

14 431 929

Grand Total / Общий итог

310 466 10 276 944 4 639 449

2 065 853

790 632

11 072 272 10 832 826

4 919 864

5 710 496

3 960 063

4 275 606

315 543

1 545 028

61 664

181 926 502

43 427 935

262

Table 89 Ukraine NHA HIV/AIDS Subanalysis 2003: Financial Agents by Functions (cont.) Financing agents / Финансирующие организации (FA) HF.1 General government / Правительство

Functions / Функции (HC)

HF.1.1.1 Central government / Центральное правительство

HC 5.1.3 Other medical nondurables / Прочие медицинские товары недлительного пользования HC.5.1.3.1 Condoms / Презервативы HC.5.1.3.9 Other medical nondurables / Другие прочие медицинские товары недлительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.3.9 Other prevention of communicable diseases / Другие услуги по профилактике инфекционных болезней HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.n.s.k HC expenditure not specified by kind / Расходы здравоохранения, не определенные по типу услуг HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

Ukraine National Health Accounts 2003-2004

640 053

Total HF1. General Government

138 498 567

96 539 951

41 958 616

640 053

Grand Total / Общий итог

5 591 693

17 431 936

23 663 683

2 039 580

14 984 142

15 624 195 640 053

7 239 112

853 232

4 758 718

2 133 080

408 214

8 852 282

3 140 297

3 072 773

6 213 070

1 165 195

7 378 265

3 140 297

3 072 773

6 213 070

765 242

6 978 312

19 600 916

31 313 632

50 914 547

193 524 877

5 591 693

199 116 570

399 953

41 881 342

291 912 459

263

Functions / Функции (HC)

HF.1.1.1 Central government / Центральное правительство

Total HF1. General Government

Grand Total / Общий итог

AD.1.1 Social support services / Социальные услуги поддержки

2 099 861

1 701 291

3 797 493

AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

19 600 916

31 313 632

50 914 547

193 524 877

5 591 693

199 116 570

902 229

8 500 874

50 382 216

300 413 333

264

Table 90 Ukraine NHA HIV/AIDS Subanalysis 2003: Providers by Functions

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам

HP.1.1 General hospitals / Больницы общего профиля HP.1.1.6 HP.1.1.4 Rayon HP.1.1.3 HP.1.1.2.1 City HP.1.1.1.1 Maternity Hospitals / Central Rayon general Oblast general houses / Районные Hospitals / hospitals / hospitals / Родильные больницы Центральные Городские Областные дома районные больницы больницы больницы общего общего профиля профиля

Total /Итого

HP.1.2 Mental HP.1.3 Specialty (other than m HP.1.3.2 AIDS HP.1.2.2 HP.1.3.3 clinics and Substance Tuberculosis centers / abuse hospitals hospitals and Клиники и and dispensers dispensers / центры / Туберкулезные Наркологическ ВИЧ/СПИД больницы и ие больницы и диспансеры диспансеры

44 487

1 700 508

218 864

25 615

1 030 538

3 020 011

4 145 421

28 847 283

8 400 684

44 487

1 576 611

218 864

25 615

866 482

2 732 060

2 403 416

514 058

6 188 203

44 487

232 952

218 864

25 615

866 482

1 388 400

44 487

232 952

218 864

25 615

866 482

1 388 400

1 713 581

28 333 226

2 107 639

1 713 581

28 333 226

2 107 639

1 343 659

1 343 659 28 424

123 897

164 055

287 952

104 842

2 107 639

10 276 944 6 432 823 10 832 826 790 632

Ukraine National Health Accounts 2003-2004

265

Table 90 Ukraine NHA HIV/AIDS Subanalysis 2003: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

Total /Итого

HP.1.2 Mental HP.1.3 Specialty (other than m HP.1.2.2 HP.1.3.3 HP.1.3.2 AIDS Substance Tuberculosis clinics and abuse hospitals hospitals and centers / and dispensers dispensers / Клиники и / Туберкулезные центры Наркологическ ВИЧ/СПИД больницы и ие больницы и диспансеры диспансеры

HC.5.1.3.1 Condoms / Презервативы HC.5.1.3.9 Other medical nondurables / Другие прочие медицинские товары недлительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.3.9 Other prevention of communicable diseases / Другие услуги по профилактике инфекционных болезней HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.n.s.k HC expenditure not specified by kind / Расходы здравоохранения, не определенные по типу услуг HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

Ukraine National Health Accounts 2003-2004

44 487

1 700 508

218 864

25 615

1 030 538

3 020 011

251 743

4 057 998

928 554

251 743

4 057 998

928 554

4 397 164

32 905 281

9 329 237

266

Table 90 Ukraine NHA HIV/AIDS Subanalysis 2003: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

Total /Итого

AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки AD.2.1 Policy advocacy (Includes support to national strategic plan for HIV/AIDS (lobbying)) / Политическая адвокация (Включает поддержку национальному стратегическому плану по ВИЧ/СПИД (лоббирование)) AD.4.1 Empowerment and organization in HIV / Усиление и организация по ВИЧ AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

44 487

1 700 508

218 864

25 615

1 030 538

3 020 011

4 397 164

32 905 281

9 329 237

267

Table 90 Ukraine NHA HIV/AIDS Subanalysis 2003: Providers by Functions (cont.) Providers / Поставщики (провайдеры) медицинских услуг (HP) HP.3 Providers of ambulatory health care / Организации, предоста

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам

HP.3.1 Offices HP.3.7 Private mental health and substance abuse) hospitals / clinics / HP.3.1.1 Adults HP.1.3.4 STI HP.1.3.9 Other Total /Итого Частные Policlinics / clinics and specialty клиники Взрослые dispensers / hospitals / поликлиники КожноДругие Total /Итого венерологичес специализиров кие клиники и анные диспансеры больницы

609 060

8 503 099

46 360 126

53 525 558

298 594

6 256 121

13 256 974

18 392 450

HP.3.9 Other providers of ambulatory health HP.3.9.2 Blood HP.3.9.9 All HP.3.9.1 other Ambulance and organ banks ambulatory / Банки крови services / health care и органов Скорая services / Все помощь прочие амбулаторные медицинские услуги

738 110

1 122 461

212 006

1 122 461

212 006

1 388 400 1 388 400 1 343 659 110 061

214 903

243 327

310 466

2 136 917

32 888 248

34 889 781

738 110

310 466

2 136 917

32 888 248

34 601 829

315 543

2 107 639

310 466

10 276 944

6 432 823

10 832 826

790 632

310 466

315 543 422 567

1 122 461 61 664 61 664

Ukraine National Health Accounts 2003-2004

268

Functions / Функции (HC)

640 053

640 053 640 053

HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

Ukraine National Health Accounts 2003-2004

609 060

974 775

5 961 327

6 213 070

974 775

5 961 327

6 213 070

9 477 874

52 321 452

59 738 628

738 110

1 122 461

61 664

640 053

212 006

269

Functions / Функции (HC)

AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки AD.2.1 Policy advocacy (Includes support to national strategic plan for HIV/AIDS (lobbying)) / Политическая адвокация (Включает поддержку национальному стратегическому плану по ВИЧ/СПИД (лоббирование)) AD.4.1 Empowerment and organization in HIV / Усиление и организация по ВИЧ AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

609 060

9 477 874

52 321 452

59 738 628

738 110

1 122 461

61 664

640 053

212 006

270

Table 90 Ukraine NHA HIV/AIDS Subanalysis 2003: Providers by Functions (cont.)

авляющие амбулаторные HP.4 Retail care / Прочие Total /Итого

Functions / Функции (HC)

HP.5 Provision

HP.9 Rest of

HP.4.1 and administration the world / Dispensing of public health Остальной chemists / programmes / мир Розничная Обеспечение и продажа Total /Итого фармацевтиче управление программами ской продукции общественного

GRAND TOTAL / ОБЩИЙ ИТОГ

здоровья HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.2 OI Drugs / Препараты ОИ (оппорт. инф.) HC 5.1.3 Other medical nondurables / Прочие медицинские товары недлительного пользования

Ukraine National Health Accounts 2003-2004

212 006

2 072 577

14 431 929

70 030 064 18 392 450 1 388 400 1 388 400 1 343 659 243 327

212 006

2 072 577

14 431 929

51 394 287

315 543

14 431 929

49 349 301

912 553

3 020 192 310 466 10 276 944

4 639 449

11 072 272 10 832 826

315 543

4 919 864

5 710 496

3 960 063

4 275 606

1 545 028

61 664

61 664 181 926 502

181 926 502

43 427 935

138 498 567

271

Table 90 Ukraine NHA HIV/AIDS Subanalysis 2003: Providers by Functions (cont.)

авляющие амбулаторные HP.4 Retail care / Прочие Total /Итого

Functions / Функции (HC)

HP.5 Provision

HP.9 Rest of

GRAND TOTAL / ОБЩИЙ ИТОГ

здоровья HC.5.1.3.1 Condoms / Презервативы HC.5.1.3.9 Other medical nondurables / Другие прочие медицинские товары недлительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.3.9 Other prevention of communicable diseases / Другие услуги по профилактике инфекционных болезней HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.n.s.k HC expenditure not specified by kind / Расходы здравоохранения, не определенные по типу услуг

640 053

96 539 951

41 958 616

640 053

5 591 693

Ukraine National Health Accounts 2003-2004

913 723

2 774 294

23 663 683

2 039 580

14 984 142

15 624 195 640 053

HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

17 431 936

181 926 502

5 591 693

7 239 112

853 232

4 758 718

2 133 080

408 214

8 852 282

1 165 195

7 378 265

765 242

6 978 312

399 953

41 881 342

291 912 459

272

Table 90 Ukraine NHA HIV/AIDS Subanalysis 2003: Providers by Functions (cont.)

авляющие амбулаторные HP.4 Retail care / Прочие Total /Итого

Functions / Функции (HC)

HP.5 Provision

HP.9 Rest of

GRAND TOTAL / ОБЩИЙ ИТОГ

здоровья AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки AD.2.1 Policy advocacy (Includes support to national strategic plan for HIV/AIDS (lobbying)) / Политическая адвокация (Включает поддержку национальному стратегическому плану по ВИЧ/СПИД (лоббирование)) AD.4.1 Empowerment and organization in HIV / Усиление и организация по ВИЧ AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

913 723

2 774 294

181 926 502

5 591 693

2 099 861

1 701 291

3 797 493

902 229

8 500 874

50 382 216

300 413 333

273

Table 91 Ukraine NHA HIV/AIDS Subanalysis 2004: Financial Sources by Financial Agents Financing sources / Источники финансирования (HF) FS.1 Public funds / Общественные

Financing agents / Финансирующие организации (FA)

Total / Итого

FS.3 Rest of the world / Весь

FS.3.1 GFATM / FS.3.9 Other Rest Total Rest of the Глобальный of the world / World / Итого фонд по другие Весь Весь остальной СПИД, остальной мир мир туберкулезу и малярии

Total / Итого

24 238 514

34 679 167

58 917 681

24 238 514

34 679 167

58 917 681

24 238 514

34 679 167

245 843 442

24 238 514

Ukraine National Health Accounts 2003-2004

34 679 167

58 917 681

29 651 487

0 0 0 0 0 0 0 0 0 0

0 0

275 494 929

Grand Total / Общий итог

58 917 681 58 917 681 24 238 514 24 238 514 0 0 0 0 0 0

34 679 167 0 275 494 929 0 245 843 442

29 651 487

275 494 929

245 843 442

29 651 487

HF.3 Rest of the world / Весь другой мир HF.3.1 HIV/AIDS Alliance / Международный ВИЧ/СПИД Альянс в Украине HF.3.9 Other / Другое

Grand Total / Общий итог

FS.2 Private funds / Частные ресурсы

64 446 688

36 015 356

0 100 462 044

36 015 356

64 446 688 36 015 356

64 446 688

36 015 356

100 462 044

100 462 044 64 446 688 36 015 356 434 874 654

274

Table 92 Ukraine NHA HIV/AIDS Subanalysis 2004: Financial Agents by Providers Financing agents / Финансирующие организации (FA) HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.1 Hospitals / Больницы HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 Oblast hospitals / Областные больницы HP.1.1.1.1 Oblast general hospitals / Областные больницы общего профиля HP.1.1.2 City Hospitals / Городские больницы HP.1.1.2.1 City general hospitals / Городские больницы общего профиля HP.1.1.3 Central Rayon Hospitals / Центральные районные больницы HP.1.1.4 Rayon Hospitals / Районные больницы HP.1.1.6 Maternity houses / Родильные дома HP.1.2 Mental health and substance abuse hospitals / Психиатрические больницы для лечения алкогольной или наркотической зависимости HP.1.2.2 Substance abuse hospitals and dispensers / Наркологические больницы и диспансеры HP.1.3 Specialty (other than mental health and substance abuse) hospitals / Специализированные больницы(кроме психиатрических больниц для лечения алкогольной или наркотической зависимости) HP.1.3.2 AIDS clinics and centers / Клиники и центры ВИЧ/СПИД HP.1.3.3 Tuberculosis hospitals and dispensers / Туберкулезные больницы и диспансеры HP.1.3.4 STI clinics and dispensers / Кожно-венерологические клиники и диспансеры HP.1.3.9 Other specialty hospitals / Другие специализированные больницы HP.3 Providers of ambulatory health care / Организации, предоставляющие амбулаторные медицинские услуги HP.3.1 Offices of physicians and policlinics / Врачебные кабинеты и поликлиники HP.3.1.1 Adults Policlinics / Взрослые поликлиники HP.3.7 Private clinics / Частные клиники

Ukraine National Health Accounts 2003-2004

HF.1.1.1 Central government / HF.1.1.2 Центральное правительство Oblast/City/Local/ Municipal governments (27) / Областные HF.1.1.1.1 бюджеты/ Ministry of Health Местное/муници / Министерство пальное здравоохранени правительство я (27)

24 238 514

Total HF1. General Government

HF.2.4 Non-profit Institutions serving households HF.2.3 Private households' out- (other than social HF.3 Rest of the Total HF.2 insurance) / of pocket world / Весь Неправительств Private Sector payment / другой мир енные Частные организации, выплаты домохозяйствам обслуживающие домохозяйства и (другие, чем социальное страхование)

26 676

Grand Total / Общий итог

33 969 329

58 207 843

12 894 102

1 005 540

3 276 545

12 920 778

71 128 621

3 276 545

63 298

4 282 085 63 298

63 298

326 755

2 079 083

2 405 838

326 755

2 079 083

2 405 838

310 877

36 802

267 809

1 197 461

1 465 270

2 716 889

2 840 963

5 557 852

2 716 889

2 840 963

5 557 852

24 238 514

30 246 900

54 485 414

6 776 595

26 676

6 803 270

61 288 685

21 055 442

13 907 536

34 962 978

3 782 855

26 676

3 809 531

38 772 509

3 183 072

6 102 982

9 286 054

1 257 800

10 543 854

862 854

310 877 36 802

10 236 382

873 086

11 109 468

709 838

3 023 575

3 733 413

1 045 679

1 590 187

275

Table 92 Ukraine NHA HIV/AIDS Subanalysis 2004: Financial Agents by Providers (cont.) Financing agents / Финансирующие организации (FA) HF.1 General government / Правительство HF.1.1 Territorial government / Территориальное правительство

Providers / Поставщики (провайдеры) медицинских услуг (HP)

HP.3.9 Other providers of ambulatory health care / Прочие организации, предоставляющие амбулаторные медицинские услуги HP.3.9.1 Ambulance services / Скорая помощь HP.3.9.2 Blood and organ banks / Банки крови и органов HP.3.9.9 All other ambulatory health care services / Все прочие амбулаторные медицинские услуги

709 838

Total HF1. General Government

709 838

HF.2.4 Non-profit Institutions serving HF.2.3 Private households households' out- (other than social HF.3 Rest of the Total HF.2 of pocket insurance) / world / Весь payment / Неправительств Private Sector другой мир Частные енные выплаты организации, домохозяйствам обслуживающие и домохозяйства (другие, чем социальное страхование)

387 708

87 359

Grand Total / Общий итог

1 097 546 87 359

709 838

709 838 300 349

300 349

HP.4 Retail sale and other providers of medical goods / Розничная продажа и прочие организации, предоставляющие медицинские товары

229 925 765

28 367 304

1 257 507

29 651 487

275 494 929

HP.nsk Provider not specified by kind / Провайдеры, не определенные по типу TOTAL

Ukraine National Health Accounts 2003-2004

100 462 044

24 238 514

34 679 167

58 917 681

245 843 442

100 462 044 1 257 507

100 462 044

434 874 654

276

Table 93 Ukraine NHA HIV/AIDS Subanalysis 2004: Financial Agents by Functions Financing agents / Финансирующие организации (FA) HF.1 General government / Правительство

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.6 Post Exposure Prophylaxis (PEP) / Пост-контактная профилактика HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.3.9 Replacement therapy / Заместительная терапия HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам

Ukraine National Health Accounts 2003-2004

HF.1.1.1 Central government / Центральное правительство

HF.1.1.2 Oblast/City/Local/ Municipal governments (27) / Областные бюджеты/ HF.1.1.1.1 Ministry Местное/муници of Health / пальное Министерство здравоохранения правительство (27)

Total HF1. General Government

HF.2.4 Non-profit HF.2.3 Private Institutions serving households' out- households (other than HF.3 Rest of the Total HF.2 of pocket social insurance) / world / Весь payment / Неправительственные Private Sector другой мир Частные организации, выплаты обслуживающие домохозяйствам домохозяйства (другие, и чем социальное страхование)

20 306 649

30 570 054

50 876 704

15 830 318

2 156 786

14 226 665

16 383 451

5 761 492

22 144 943

1 005 540

965 044

1 970 584

1 005 540

965 044

1 970 584

1 903 560

39 534

236 679

276 212

18 110 329

16 106 711

34 217 040

10 068 826

26 676

10 095 502

46 128 640

90 441 181

18 110 329

16 106 711

34 217 040

7 171 699

26 676

7 198 374

46 128 640

87 544 054

636 614

1 220 596

1 857 211

594 105

1 122 958

3 574 274

439 837

922 890

9 855 131 8 272 300 8 184 700

1 016 715

9 855 131

26 676

15 856 994

10 625 029

112 862 337

276 212

8 272 300 2 440 329

46 128 640

Grand Total / Общий итог

2 559 246

1 016 715

2 363 809

13 141 831

24 339 653

32 611 953

2 559 246

26 676 447 029

439 837

26 676

13 184 275 52 341

52 341

17 348 338

18 391 729

447 029

447 029 901 541

901 541

2 188 837

87 359

229 925 765

277

Table 93 Ukraine NHA HIV/AIDS Subanalysis 2004: Financial Agents by Functions (cont.) Financing agents / Финансирующие организации (FA) HF.1 General government / Правительство

Functions / Функции (HC)

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.2 OI Drugs / Препараты ОИ (оппорт. инф.) HC 5.1.3 Other medical nondurables / Прочие медицинские товары недлительного пользования HC.5.1.3.1 Condoms / Презервативы HC.5.1.3.9 Other medical nondurables / Другие прочие медицинские товары недлительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.3 STI Prevention Program / Программа профилактики БППП (IEC) HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением

Ukraine National Health Accounts 2003-2004

HF.1.1.1 Central government / Центральное правительство

709 838

Total HF1. General Government

709 838

Grand Total / Общий итог

229 925 765

60 857 081

169 068 684

117 899 641

51 169 044

28 367 304

41 761 524

70 838 666

5 681 263

28 229 365

28 939 203 709 838

15 445 086

1 519 771

9 744 736

7 850 896

40 853

278

Functions / Функции (HC)

HF.1.1.1 Central government / Центральное правительство

Total HF1. General Government

HC.7.1.1 General government administration of health (except social security) / Общее государственное управление здравоохранением (за исключением социального обеспечения) HC.n.s.k HC expenditure not specified by kind / Расходы здравоохранения, не определенные по типу услуг HC.R.1–5 Health-related functions / Деятельность, связанная со здравоохранением HC.R.1 Capital formation for health care provider institutions / Привлечение капитала для учреждений, предоставляющих медицинские услуги HC.R.nsk HC.R expenditure not specified by kind / Расходы HC.R, не определенные по типу Total NHA / Итого НСЗ

40 853

2 090 446

3 399 274

7 331 139

1 257 507

10 440 582

19 029 228

3 931 865

3 399 274

7 331 139

1 257 507

9 485 434

18 074 080

955 147

24 238 514

34 679 167

58 917 681

29 651 487

275 494 929

100 462 044

434 874 654

3 397 894

78 357 756

2 376 463

2 402 027

2 716 591

1 704 172

245 843 442

25 564

Ukraine National Health Accounts 2003-2004

40 853

3 931 865

AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки

AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Grand Total / Общий итог

24 238 514

34 679 167

58 917 681

245 843 442

72 463

3 823 859

3 896 323

98 028

10 621 085

10 719 112

29 749 514

275 592 956

111 083 128

445 593 766

279

Table 94 Ukraine NHA HIV/AIDS Subanalysis 2004: Providers by Functions

HP.1 Hospitals / Больницы

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.6 Post Exposure Prophylaxis (PEP) / Пост-контактная профилактика HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги

HP.1.1 General hospitals / Больницы общего профиля HP.1.1.1 HP.1.1.6 HP.1.1.4 Rayon HP.1.1.2 City HP.1.1.3 Maternity Hospitals / HP.1.1.2.1 City Central Rayon HP.1.1.1.1 houses / Районные Hospitals / general Oblast general Родильные больницы Центральные hospitals / hospitals / дома районные Городские Областные больницы больницы больницы общего общего профиля профиля

Total /Итого

HP.1.2 Mental HP.1.3 Specialty (other than m HP.1.3.3 HP.1.3.2 AIDS HP.1.2.2 Tuberculosis clinics and Substance hospitals and centers / abuse hospitals dispensers / Клиники и and dispensers Туберкулезные центры / больницы и Наркологическ ВИЧ/СПИД диспансеры ие больницы и диспансеры

63 298

2 405 838

310 877

36 802

1 465 270

4 282 085

5 258 994

33 887 696

9 522 388

63 298

2 230 314

310 877

36 802

1 232 853

3 874 144

2 989 808

609 708

6 955 739

63 298

326 755

310 877

36 802

1 232 853

1 970 584

63 298

326 755

310 877

36 802

1 232 853

1 970 584

2 235 443

33 277 987

2 451 316

2 235 443

33 277 987

2 451 316

1 903 560

1 903 560 33 744

175 524

232 417

407 941

115 333

2 451 316

10 778 022 8 272 300 13 184 275

1 043 391

HC.1.3.3.9 Replacement therapy / Заместительная терапия HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам

Ukraine National Health Accounts 2003-2004

280

Table 94 Ukraine NHA HIV/AIDS Subanalysis 2004: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

Total /Итого

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.2 OI Drugs / Препараты ОИ (оппорт. инф.) HC 5.1.3 Other medical nondurables / Прочие медицинские товары недлительного пользования HC.5.1.3.1 Condoms / Презервативы HC.5.1.3.9 Other medical nondurables / Другие прочие медицинские товары недлительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.3 STI Prevention Program / Программа профилактики БППП (IEC) HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением

Ukraine National Health Accounts 2003-2004

281

Table 94 Ukraine NHA HIV/AIDS Subanalysis 2004: Providers by Functions (cont.)

HP.1 Hospitals / Больницы

Functions / Функции (HC)

Total /Итого

63 298

2 405 838

310 877

36 802

1 465 270

4 282 085

298 858

4 884 814

1 021 466

298 858

4 884 814

1 021 466

5 557 852

38 772 509

10 543 854

AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки

25 564

AD.2.1 Policy advocacy (Includes support to national strategic plan for HIV/AIDS (lobbying)) / Политическая адвокация (Включает поддержку национальному стратегическому плану по ВИЧ/СПИД (лоббирование)) AD.4.1 Empowerment and organization in HIV / Усиление и организация по ВИЧ AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

72 463 98 028 63 298

2 405 838

310 877

36 802

1 465 270

4 282 085

5 557 852

38 870 537

10 543 854

282

Table 94 Ukraine NHA HIV/AIDS Subanalysis 2004: Providers by Functions (cont.) Providers / Поставщики (провайдеры) медицинских услуг (HP) HP.3 Providers of ambulatory health care / Организации, предоста

Functions / Функции (HC)

HC.1 Services of curative care / Услуги лечения HC.1.1 Inpatient curative care / Стационарное лечение HC 1.1.1 Obstetrics & Gynecology/ Акушерство и гинекология HC 1.1.1.1 Obstetrics / Акушерство HC 1.1.9 Other Inpatient curative care / Другое стационарное лечение HC.1.2 Day cases of curative care / Лечение в дневном стационаре HC.1.3 Outpatient curative care / Амбулаторное лечение HC.1.3.3 All other specialized medical services / Все прочие специализированные медицинские услуги HC.1.3.3.1 TB Services / Услуги, связанные с туберкулезом HC.1.3.3.2 STI Management / Менеджмент БППП HC.1.3.3.3 OI Treatment and Monitoring / Лечение и мониторинг оппортунистических инфекций HC.1.3.3.4 ARV Treatment / АРВ лечение HC.1.3.3.5 Voluntary Counseling & Testing (VCT) / Добровольное консультирование и тестирование (ДКТ) HC.1.3.3.6 Post Exposure Prophylaxis (PEP) / Пост-контактная профилактика HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.3.9 Replacement therapy / Заместительная терапия HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам

Ukraine National Health Accounts 2003-2004

mental health and substance abuse) hospitals / HP.3.1 Offices HP.3.7 Private clinics / HP.1.3.4 STI HP.1.3.9 Other Total /Итого HP.3.1.1 Adults Частные specialty clinics and Policlinics / клиники hospitals / dispensers / Взрослые Другие Кожнополиклиники венерологичес специализиров Total /Итого анные кие клиники и больницы диспансеры

862 854

9 983 466

54 256 403

63 797 482

423 017

7 292 527

15 280 991

22 144 943

1 045 679

1 590 187

300 349

1 590 187

300 349

1 970 584 1 970 584 1 903 560 127 136

242 469

276 212

439 837

2 563 803

38 732 943

41 376 326

1 045 679

439 837

2 563 803

38 732 943

40 968 386

447 029

2 451 316

439 837

10 778 022

8 272 300

13 184 275

1 043 391

439 837

447 029

598 650

1 590 187 87 359 87 359

283

Functions / Функции (HC)

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.2 OI Drugs / Препараты ОИ (оппорт. инф.) HC 5.1.3 Other medical nondurables / Прочие медицинские товары недлительного пользования HC.5.1.3.1 Condoms / Презервативы HC.5.1.3.9 Other medical nondurables / Другие прочие медицинские товары недлительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.3 STI Prevention Program / Программа профилактики БППП (IEC) HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением

Ukraine National Health Accounts 2003-2004

709 838

709 838 709 838

284

Functions / Функции (HC)

1 126 002

7 032 282

7 331 139

1 126 002

7 032 282

7 331 139

862 854

11 109 468

61 288 685

71 128 621

1 045 679

1 590 187

87 359

709 838

300 349

862 854

11 109 468

61 288 685

71 128 621

1 045 679

1 590 187

87 359

709 838

300 349

AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки AD.2.1 Policy advocacy (Includes support to national strategic plan for HIV/AIDS (lobbying)) / Политическая адвокация (Включает поддержку национальному стратегическому плану по ВИЧ/СПИД (лоббирование)) AD.4.1 Empowerment and organization in HIV / Усиление и организация по ВИЧ AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

Ukraine National Health Accounts 2003-2004

285

Table 94 Ukraine NHA HIV/AIDS Subanalysis 2004: Providers by Functions (cont.)

авляющие амбулаторные HP.4 Retail care / Прочие Total /Итого

Functions / Функции (HC)

HP.5 Provision

HP.9 Rest of

HP.nsk

HP.4.1 and administration the world / Provider not Dispensing of public health Остальной specified by chemists / programmes / мир kind / Розничная Обеспечение и Провайдеры, продажа управление не Total /Итого фармацевтиче программами определенные ской продукции общественного по типу

GRAND TOTAL / ОБЩИЙ ИТОГ

300 349

Ukraine National Health Accounts 2003-2004

46 128 640

112 862 337 22 144 943 1 970 584 1 970 584 1 903 560 276 212

300 349

2 936 216

46 128 640

90 441 181

447 029

46 128 640

87 544 054

1 122 958

3 574 274 439 837

2 363 809

13 141 831

24 339 653

32 611 953 13 184 275

HC.1.3.3.7 Psychosocial support / Психосоциальная поддержка HC.1.3.3.8 OB & Gyn OP care / Амбулаторные акушерскогинекологические услуги HC.1.3.3.9 Replacement therapy / Заместительная терапия HC.1.3.4 All other outpatient curative care / Все прочее амбулаторное лечение HC.4 Ancillary services to medical care / Вспомогательные услуги для медицинского лечения HC.4.3 Patient transport and emergency rescue / Транспортировка пациентов и спасение жизни в чрезвычайных ситуациях HC.5 Medical goods dispensed to outpatients / Предоставление медицинских товаров амбулаторным пациентам

2 936 216

52 341

17 348 338

18 391 729

447 029

447 029 901 541

901 541

2 188 837

87 359

87 359 229 925 765

229 925 765

286

Table 94 Ukraine NHA HIV/AIDS Subanalysis 2004: Providers by Functions (cont.)

авляющие амбулаторные HP.4 Retail care / Прочие Total /Итого

Functions / Функции (HC)

HP.5 Provision

HP.9 Rest of

HP.nsk

GRAND TOTAL / ОБЩИЙ ИТОГ

здоровья

HC.5.1 Pharmaceuticals and other medical nondurables / Фармацевтические и прочие медицинские товары недлительного пользования HC.5.1.1 Prescribed medicines / Рецептурные медикаменты HC.5.1.1.2 OI Drugs / Препараты ОИ (оппорт. инф.) HC 5.1.3 Other medical nondurables / Прочие медицинские товары недлительного пользования HC.5.1.3.1 Condoms / Презервативы HC.5.1.3.9 Other medical nondurables / Другие прочие медицинские товары недлительного пользования HC.6 Prevention and public health services / Профилактические услуги и услуги по охране здоровья HC.6.1 Maternal and child health; family planning and counselling / Здоровье матери и ребенка; планирование семьи и семейные консультации HC.6.1.1 PMTCT / Профилактика вертикальной трансмиссии от матери к ребенку HC.6.3 Prevention of communicable diseases / Профилактика инфекционных заболеваний HC.6.3.1 Blood Safety / Безопасность крови HC.6.3.2 Info. Educ. Communic. Prog. (IEC) / Информационнообразоват. кампании HC.6.3.3 STI Prevention Program / Программа профилактики БППП (IEC) HC.6.3.5 Condom distribution programs / Программа распространения презервативов HC.6.3.6 Prevention programs for specific groups / Программы по профилактике для специфических групп HC.6.9 All other miscellaneous public health services / Все прочие различные услуги по охране здоровья HC.7 Health administration and health insurance / Управление здравоохранением и медицинское страхование HC.7.1 General government administration of health / Общее государственное управление здравоохранением

Ukraine National Health Accounts 2003-2004

709 838

229 925 765

60 857 081

169 068 684

117 899 641

51 169 044

51 169 044 28 367 304

41 761 524

70 838 666

5 681 263

28 229 365

28 939 203 709 838

15 445 086

1 519 771

9 744 736

7 850 896

40 853

287

Table 94 Ukraine NHA HIV/AIDS Subanalysis 2004: Providers by Functions (cont.)

авляющие амбулаторные HP.4 Retail care / Прочие Total /Итого

Functions / Функции (HC)

HP.5 Provision

HP.9 Rest of

HP.nsk

GRAND TOTAL / ОБЩИЙ ИТОГ

здоровья

3 733 413

229 925 765

28 367 304

Ukraine National Health Accounts 2003-2004

40 853

2 090 446

10 440 582

1 257 507

19 029 228

9 485 434

1 257 507

18 074 080

1 257 507

434 874 654

955 147 1 097 546

AD. Addendum Items / Дополнительные статьи AD.1.1 Social support services / Социальные услуги поддержки

AD.5.1 HIV specific surveillance activities (including second generation surveillance activities) / деятельность по эпиднадзору, специфическая для ВИЧ (включая деятельность по эпиднадзору второго поколения) Total Addendum / Итого Доп. Статьи Total NHA and Addendum / Итого НСЗ и Доп. Статьи

40 853

1 097 546

3 733 413

229 925 765

28 367 304

100 462 044

955 147

2 376 463

2 716 591

1 704 172

3 823 859

10 621 085

111 083 128

1 257 507

445 495 738

288

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