Policy Briefing Series

  • 03.01.2008

    How you pay is what you get! Reforming hospital reimbursement in Ukraine


    Hospitals are the main component of Ukraine's health system and should be at the centre of health reform. Payment systems - the methods used to pay hospitals - occupy a central position in the supply side of the health sector. The comparison of structural indicators with the EU shows that patients in Ukraine are more often admitted to hospital where they stay longer and in more crowded hospitals but receive less treatment.

    Payment reform in Ukraine will improve the allocation of scarce resources. Ukraine should follow the recent reimbursement reforms in OECD and European countries. In a first reform step the present line item budgets should by substituted with global budgets. Next, the reimbursement of acute care and long term care should be separated. Long term care should be compensated with hospital days. The reform would be completed by introduction of diagnosis related groups (DRG) as the main reimbursement mechanism for acute care hospitals.


    1. Introduction: hospitals and payment systems
    2. Current system of health care provision and reimbursement in Ukraine
    3. Options for reforming hospital reimbursement
    4. Hospital reimbursement reforms in Europe
    5. Policy recommendation for Ukraine
    6. Appendix
    Authors:  , Handrich Lars
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