A Comparison of Ukrainian Hospital Services and Functions Before and During the Russia-Ukraine War.

Importance: Since the full-scale Russian invasion, hospitals in Ukraine have been compelled to close or operate at reduced capacity due to inadequate supplies, damage, or destruction caused by war. Objective: To analyze hospital services in Ukraine during the period before and after the Russian invasion. Design, Setting, and Participants: Of the 450 hospitals currently functioning in Ukraine, a cross-sectional survey was carried out with the participation of 74 hospitals from 12 oblasts. Hospital administrators responded to an online survey with questions on the use of hospital services. Data were abstracted from hospital databases for the prewar period (before February 23, 2022) and during the war (February 23, 2022, to May 30, 2023). Main Outcomes and Measures: Hospital services (including emergency services, preventive services, screenings, laboratory tests, obstetrics, telehealth, pharmacy, and rehabilitation services) were compared during the prewar and war periods. Results: Of 450 Ukrainian hospitals in operation, 74 hospitals (16.0%) across 12 oblasts provided data for the current analyses. During the war, daily emergency admissions increased to 2830, compared with 2773 before the war. At the same time, hospitals reported reduced laboratory testing (72 [97%] vs 63 [85%]), tobacco education (52 [70%] vs 36 [49%]), cancer screening (49 [66%] vs 37 [50%]), gynecological services (43 [58%] vs 32 [43%]), rehabilitation services (37 [50%] vs 27 [36%]), pharmacy services (36 [49%] vs 27 [36%]), and telehealth programs (33 [45%] vs 21 [28%]). Hospitals reported additional difficulties during the war, including disruptions in the supply chain for essential equipment and pharmaceuticals, shortages of laboratory test kits, delays in the delivery of crucial medications, and problems around appropriate medication storage due to power outages. Conclusions and Relevance: The ongoing war has inflicted profound devastation on Ukraine's hospitals. The findings of this cross-sectional survey offer valuable insights into the formidable challenges that hospitals confront in war-affected regions and underscore the pressing necessity for bolstering support to sustain and enhance hospital services during wartime.

The human toll and humanitarian crisis of the Russia-Ukraine war: the first 162 days.

BACKGROUND: We examined the human toll and subsequent humanitarian crisis resulting from the Russian invasion of Ukraine, which began on 24 February 2022. METHOD: We extracted and analysed data resulting from Russian military attacks on Ukrainians between 24 February and 4 August 2022. The data tracked direct deaths and injuries, damage to healthcare infrastructure and the impact on health, the destruction of residences, infrastructure, communication systems, and utility services - all of which disrupted the lives of Ukrainians. RESULTS: As of 4 August 2022, 5552 civilians were killed outright and 8513 injured in Ukraine as a result of Russian attacks. Local officials estimate as many as 24 328 people were also killed in mass atrocities, with Mariupol being the largest (n=22 000) such example. Aside from wide swaths of homes, schools, roads, and bridges destroyed, hospitals and health facilities from 21 cities across Ukraine came under attack. The disruption to water, gas, electricity, and internet services also extended to affect supplies of medications and other supplies owing to destroyed facilities or production that ceased due to the war. The data also show that Ukraine saw an increase in cases of HIV/AIDS, tuberculosis, and Coronavirus (COVID-19). CONCLUSIONS: The 2022 Russia-Ukraine War not only resulted in deaths and injuries but also impacted the lives and safety of Ukrainians through destruction of healthcare facilities and disrupted delivery of healthcare and supplies. The war is an ongoing humanitarian crisis given the continuing destruction of infrastructure and services that directly impact the well-being of human lives. The devastation, trauma and human cost of war will impact generations of Ukrainians to come.

Public health and social supervision issues within public administration of ukrainian territories in the late 8th- early 9th centuries.

OBJECTIVE: Introduction: The public health system modernization history is based upon the progress in state country administration and administration of healthcare within the sectorwide approach. The WHO European Bureau pays much attention to the National Health Service systems development while implementing their basic policies. The Ukrainian state health service management was founded basing on the regulatory field of the Russian Empire, using the European healthcare promotion experience. Aim: of the article is the analysis of the regulatory field of police and amenity authorities of the Russian Empire and Ukraine within the medical and social service in the 18th-19th centuries. PATIENTS AND METHODS: Materials and methods: The structure of the article corresponds to the problem city and chronology principles, using the following methods and techniques of scientific learning: the systemic, historic, regulatory comparative, logical and structural-functional analysis of the studied medical-legal phenomena. The study sources are the scientific publications, collections of laws and executive orders of the Russian Empire and Ukraine in the 18th-19th centuries. RESULTS: Review: As a result of the performed work it can be determined were the main directions of the police competence in late 18th- early 19th centuries. CONCLUSION: Conclusion: Preserving health, treatment of the ill and injured, management of medical and social service of those in need, holding various preventive activities and supporting safe environment and regulating the safety of food were the main directions of the police competence in late 18th- early 19th centuries.

Medical evaluation of efficiency of optimized models for early detection and primary prevention of cardiovascular diseases.

INTRODUCTION: Nowadays cardiovascular disease occupies a leading place in the structure of the prevalence, incidence, disability causes and mortality of the adult population in Ukraine and in the whole world. The prevalence of hypertension in the adult population ranges from 25 - 40%, coronary heart disease is almost 20% of people aged 50-59 years while 24.3% of them have a form of silent coronary artery disease. The feasibility of study is justified by the need to perform health institutions Law of Ukraine dated 07.07.2011 year №3611-VI ≪On Amendments to the Basic Laws of Ukraine on health care on improvement of care" and MoH of Ukraine from 24.07.2013 № 621/60 "On the system of cardiac care in health facilities of Ukraine" therefore extremely important is to develop an optimized model of early detection and primary prevention of cardiovascular diseases at primary level of health care. The aim of the research is to develop methods and evaluation models optimized for early detection and primary prevention of cardiovascular diseases at a general practitioner of family medicine. MATERIAL AND METHODS: The methodical apparatus is of complex of medical and social research methods that meet the requirements of public health: bibliosemantyc, systematic approach and analysis, statistical, expert evaluations. To determine the effectiveness of medical evaluation was conducted in its 33 clinics of general practice in Poltava region, including 7 urban and 26 rural. In expert opinion is taken 825 patients, of which 175 urban and 650 in rural areas. The results of the study found that 193 patients (23.4%) achieved target blood pressure through the implementation of the recommendations concerning the optimization behavior towards of risk factors, lifestyle.

Risk factors for development of hypertension in poltava region.

INTRODUCTION: Given the very dangerous situation in relation to cardiovascular morbidity, purpose of the study was to identify the main risk factors of hypertension among the population of Poltava region, to determine their role in the formation of this pathology. AIM: study the factors for development of hypertension in Poltava region Material and methods: The study was conducted by anonymous questionnaires of adults of Poltava region (1285 individuals in 2 groups: 563 individuals with hypertension, 722 people - healthy). The data, obtained in the study, were processed using special software - IBM SPSS Statistic Version 22.0. By logistic regression were identified risk factors that significantly affect the development of hypertension. RESULTS: According to the study identified major, statistically significant risk factors of hypertension among the population of Poltava region. Proved reliable impact these risk factors: age (over 40 years) - OR - 7.9, CI - 6,132-10,176, (p<0,001), gender (male) - OR - 1.899, CI - 1,512-2,386, (p<0,001), BMI (obesity) - OR - 3.9632, CI - 2,881-4,580, (p<0,001), smoking - OR - 1.918, CI - 1,263-2,913, (p=0,002), consumption of dairy products (occasionally) - OR - 1,553, CI - 1,215-1,985, (p<0,001), consumption of pork (often) - OR - 1,805, CI - 1,422-2,290, (p<0,001), consumption of beef (occasionally) - OR - 1,547, CI - 1,229-1,949, (p=0,006), consumption of smoked meat (often) - OR - 1,341, CI - 1,070-1,678, (p=0,006), consumption of sweets (often) - OR - 1,510, CI - 1,210-1,884, (p<0,001), night sleep (restless) - OR - 1,762, CI - 1,279-2,426, (p<0,001), duration of sleep (less than 6 hours) OR - 1,648, CI - 1,126-2,411, (p=0,01), physical activity (low) - OR - 2,734, CI - 2,102-3,555, (p<0,001), nature of the rest (passive) - OR - 2,476, CI - 1,970-3,112, (p<0,001), feeling stress (always) - OR - 1,537, CI - 1,227-1,926, (p<0,001), relations at home (tense) - OR - 3,072, CI - 1,517-6,221, (p=0,001), CVD in the family - OR - 1,397, CI - 1,110-1,758, (p=0,004), discomfort in the heart aria - OR - 3,090, CI - 2,453-3,893, (p<0,001), self-treatment - OR - 1.942, CI - 1,553-2,428, (p<0,001). CONCLUSIONS: The study found regional differences in risk factors of hypertension among the population of Poltava region, emphasized the need to increase attention of health professionals of primary care for problems of cardiovascular disease, make a point of the need to intensify primary prevention, modernization of behavior on health among population, promotion of the principles of a healthy lifestyle.