"Introduction of innovative technologies of medical rehabilitation of patients with diseases of the musculoskeletal system, central and peripheral nervous systems in a multidisciplinary health care institution"
The purpose of the project:
Meeting demand
Key spending unit
State administration of affairs
Functional classification of expenditures and budget crediting
0763 - Інші заклади та заходи у сфері охорони здоров'я
Target priority of the government
030200 - Розвиток спроможної мережі медзакладів в секторі "охорона здоров’я", підсектору "медична допомога" (забезпечення надання екстреної медичної допомоги, забезпечення надання первинної медичної допомоги, забе...
Score
3.9775
Basic data
Problems
Current status, description of problems and needs for their solution
Preserving the health of the nation is a key task of our state. The difficult socio-economic situation associated with military operations on the territory of our country and insufficient financing of the health care system have led to the deterioration of the health indicators of the population.
Low resource provision, in particular the low share of health care costs relative to Ukraine's gross domestic product, has fluctuated within 3.5% over the past five years, which is lower than the world average health care costs.
Today, the health care system of Ukraine has a situation where the availability of medical rehabilitation for patients with diseases of the musculoskeletal system, central and peripheral nervous systems does not fully meet the needs of patients. The essence of the problem lies in limited access to modern medical technologies that meet world standards. This is related to the insufficient level of qualification of specialists due to the lack of skills in working with high-tech equipment and, accordingly, the lack of motivation to acquire knowledge that involves the use of modern equipment in the process of their implementation. That is why in most medical institutions there is no possibility to provide high-tech assistance in medical rehabilitation according to modern world standards.
Also problematic is the issue of the conditions for providing medical rehabilitation with the use of high-tech equipment in cases where the staffing of specialists of various specialties is necessary, especially if it concerns central and peripheral nervous system infections, such as multidisciplinary health care institutions where specialists of various profiles cooperate as of today are single.
The medical and social aspect of the problem to be solved consists in:
1) for patients with injuries and diseases of the musculoskeletal system, central and peripheral nervous systems (including after a stroke, with cerebral and spinal injuries, peripheral neuropathies and plexopathies, vertebrogenic syndrome, and others), the main goal of rehabilitation is to achieve full recovery of impaired functions, or optimal realization of the physical, mental, and social potential of the disabled, their integration into society, prevention of complications, relapse of the disease;
2) for patients with progressive degenerative and hereditary diseases (multiple sclerosis, Huntington's disease, Parkinson's disease, motor neuron diseases and others), the goal of rehabilitation is to reduce the main symptoms, prevent and treat complications, correct functional disorders, adapt to the existing defect, improve the quality of life , slowing down the progression of the disease.
The implementation of the project will make it possible to increase the overall scope of medical rehabilitation services in the conditions of a multidisciplinary health care facility, expand the range of medical services, significantly affect the quality of life and professional fitness of adult patients of various age groups, including the active age group of 20-60 years , with diseases of the musculoskeletal system, central and peripheral nervous systems, for the rehabilitation of which the investment project is directed.
The project provides for the organization and provision of high-tech medical rehabilitation assistance according to modern world standards for patients with diseases of the musculoskeletal system, central and peripheral nervous systems, which will allow not only to return the patient to an independent lifestyle, but also to improve the patient's quality of life.
In order to provide a full range of medical rehabilitation services, the use of innovative technologies in neuromyographic diagnostics and neurorehabilitation, ergotherapy, kinesiotherapy, vibrotherapy and other methods of physical rehabilitation with feedback is necessary within the framework of DNU "CYTOZ" DUS.
In the event that the specified project is not implemented, patients are forced to wait for medical rehabilitation for a long time due to the low availability of this type of medical care, which is due to the insufficient number of state institutions and the high cost of medical rehabilitation services in private institutions, and, as a result, lose physical, psychological, social adaptation with subsequent loss of professional suitability and registration of disability.
A detailed description of the project goal and the way to achieve it
The market analysis establishes an urgent need to expand the possibilities of providing high-quality medical rehabilitation services to the adult population in the conditions of a multidisciplinary institution (one institution) - this fully realizes the need for timely comprehensive assistance, will provide comfort and service for patients, will allow to increase the efficiency of medical assistance to patients with chronic diseases - locomotor apparatus, central and peripheral nervous systems and will minimize the risk of disability.
Every year, about 200,000 patients need high-quality medical rehabilitation assistance, so Ukraine will develop a rehabilitation system based on medical facilities. When analyzing the scope of providing rehabilitation services, it was established that the demand for such services in the next 10 years will be stably high and maintain a clear trend of growth, which in turn will allow effective use of available material, technical and personnel resources.
According to the results of the demographic analysis, it was established that more than 360,000 internally displaced persons have been registered in the capital since 2014, of which about 207,000 after the start of the full-scale invasion, who are provided with rehabilitation assistance at the DNU "CYTOZ" DUS.
Among internally displaced persons, more than 60% are persons of working age (20-60 years).
According to the World Health Organization (WHO), diseases of the musculoskeletal system are the 4th leading cause of disability and mortality in the world. In Ukraine, chronic diseases of the musculoskeletal system are also one of the most frequent problems, and about 3.5 million people have problems with the musculoskeletal system and its various complications, which require continuous long-term therapy and rehabilitation.
Today, the most common diseases in Ukraine include neurological diseases, the prevalence of which has almost doubled over the past 10 years. Such a tendency to increase is noted in other countries of the world, so diseases of the nervous system are a heavy burden on society. Thus, almost 35% of all health care funds of European countries are spent on patients with diseases of the central and peripheral nervous systems. In the structure of neurological pathology, the most relevant and socially significant are vascular diseases of the brain, demyelinating lesions of the nervous system (in particular, multiple sclerosis), diseases of the peripheral nervous system, consequences of craniocerebral injuries, and others.
If the project is implemented, the share of penetration into the relevant market of medical rehabilitation services of DNU "CYTOZ" DUS may be about 5%.
Pricing is carried out in accordance with the methodology for calculating the cost of providing paid medical services for patients approved by the State Administration of Affairs; the geographical boundaries of the market are not limited to the city of Kyiv and the territory of Ukraine, medical assistance can be provided to patients from other regions; the number of consumers of such services increases annually.
When conducting an analysis of competition in the market of rehabilitation medical services, we took into account health care institutions of Ukraine of various forms of ownership - state, communal and private.
The cost of providing services for neuromyographic diagnostics in private institutions ranges from UAH 1,200 to UAH 2,700, and the cost of medical rehabilitation services of the corresponding level in private institutions is UAH 500 to UAH 1,690, which does not allow to ensure the availability of medical rehabilitation for broad sections of the able-bodied population, in particular domestic displaced persons and military personnel.
The implementation of this project will provide a unique opportunity to provide patients with the requested services in full and of high quality, in accordance with treatment standards. If the project is implemented, it is planned to increase services by 1.5 times. The projected number of medical services in 2027 is 161,765 services, the actual number of medical services in 2023 is 107,215 services.
Such a number of medical services will fully satisfy the demand of patients with diseases of the musculoskeletal system, central and peripheral nervous systems, not only attached to the DNU "CYTOZ" DUS for medical care, but also other categories of the population - military personnel and temporarily displaced persons.
Coordination of the project with strategic documents
National Strategy for Regional Development of Ukraine
The state regional development strategy for 2021-2027 was adopted on August 13, 2024. The strategic goal is "Formation of a united state in social, humanitarian, economic, climatic, ecological, security and spatial dimensions." Operational goal 2. Meeting the population's need for high-quality administrative and public services. Tasks in the field of "Medical services". 36. Ensuring the functioning of a capable public health system in regions and territorial communities. 37. Creation of conditions for the prevention of infectious and non-infectious diseases, provision of immunization of the population in accordance with the calendar of preventive vaccinations in territorial communities. 40. Organization of a capable network of cluster and supra-cluster health care institutions, including the creation of rehabilitation departments. Operational objective 3. Social protection of war veterans and their families, internally displaced persons and other vulnerable population groups. Tasks in the direction "Integration of internally displaced persons". 5. Development in cooperation with international organizations and state authorities of foreign countries of measures for the return of Ukrainian citizens from abroad, as well as their rapid integration into the educational, medical, social space, regional and local labor markets. The project meets the main goals and tasks that ensure the achievement of the strategic goals of regional development.
Sphere development strategiesThe project corresponds to the directions of the state's development. The main provisions of the Law of Ukraine "On the Public Health System" dated September 6, 2022 No. 2573-IX, the Decree of the President of Ukraine "On the Goals of Sustainable Development of Ukraine for the Period Until 2030" dated September 30, 2019 No. 722/ 2019. The available strategic documents determine the ways to achieve the Global Goals adopted by the United Nations in 2015, which complement each other: actions in one area also affect the results in others, so development should have balanced social, economic and environmental components by 2030 (Goal 3 "Ensuring a healthy way of life and promoting well-being for all at any age" is defined as ensuring universal coverage of health care services, including protection from financial risks, access to quality health care services). And in order to implement the Plan for the Prevention and Control of Non-Communicable Diseases in the European Region, defined by WHO for 2016-2025, the National Action Plan for Non-Communicable Diseases to Achieve the Global Goals of Sustainable Development, which was approved by the Order of the Cabinet of Ministers of Ukraine dated 07/26/2018 No. 530 -p. The project complies with the main provisions of the Resolution of the Cabinet of Ministers of Ukraine dated November 3, 2021 No. 1268 "Issues of the organization of rehabilitation in the field of health care" (as amended from March 30, 2023).
Involved organizations
Organization
STATE ORGANIZATION (INSTITUTION, INSTITUTION) State Scientific Institution "Center for Innovative Healthcare Technologies" of the State Administration of Affairs
Roles
- Project author
- A balance holder
- An executor
- An initiator
- Beneficiary
Demand for the service and its dynamics
Category
Year
Rating
Measure
Annual demand for services/infrastructure
2023
200000
units
Project indicators
Indicator
Base value
Target value
Number of people to use the service
107215
161765
Risk assessment
Risk
Category
Degree
Probability
Strategy
Exchange rate fluctuations
Financial risk
Considerable
Medium
Acceptance
the implementation of the project does not have a negative impact on the environment
Ecological risk
Considerable
Low
Avoidance
Project plan
Assessment
Implementation
Preparation
Technical design
Feasibility study
Financing
Budgeting
Appraisal
729 days
275 days
89 days
74 days
74 days
60 days
31 days
29 days
