Public policy instruments in the field of medical services for overcoming crisis demographic phenomena

Abstract

The essence of the demographic crisis is examined as a set of persistent negative changes in population reproduction manifested in declining birth rates, increasing mortality, intensified migration outflows, deformation of the age structure, and growing demographic pressure on the working-age population. It is highlighted that the aggravation of demographic problems is associated not only with the consequences of war, but also with harmful working conditions, road traffic injuries, the prevalence of behavioral risk factors, low living standards, poverty, as well as difficulties related to the accessibility and quality of medical care, especially in rural areas. The interrelation between demographic processes and the population’s need for medical services is substantiated, which is manifested in the influence of age structure, mortality, fertility, migration processes, and spatial distribution of the population on the volume, structure, and organization of medical care. It is determined that public policy instruments in the field of medical services should be considered as an interconnected system of legal, organizational, financial, informational, and human resource means through which the accessibility, quality, continuity, and effectiveness of medical care for the population are ensured. The content of regulatory and legal instruments that shape the framework of state guarantees, the powers of stakeholders, the rules for organizing care, and the legal grounds for exercising the right to medical care is disclosed. Organizational and managerial instruments related to planning the network of providers, forming patient pathways, contracting healthcare institutions, managing medical service packages, and monitoring compliance with service delivery requirements are characterized. The importance of financial and economic instruments, which determine the actual capacity of the medical services system, reduce barriers to access, and influence the timeliness of patients’ access, is established. The role of information and communication instruments related to healthcare digitalization, the functioning of the electronic healthcare system, e-prescriptions, referrals, and the analytical use of data is considered. The significance of human resource instruments covering training, distribution, retention, professional development, and qualification confirmation of medical personnel is shown. It is established that the highest effectiveness in overcoming crisis demographic phenomena is achieved through the combination of legal regulation, targeted financing, managerial coordination, and the targeted organization of services.