THE IMPACT OF DESTABILIZING SYSTEMIC RISKS (COVID AND WAR) ON THE RESILIENCE OF THE HEALTHCARE SYSTEM
Abstract
This article investigates the impact of destabilizing systemic risks, specifically the COVID-19 pandemic and the full-scale war in Ukraine, on the resilience of the healthcare system. The aim of this study is to analyze how multidimensional shocks transform the functioning of the healthcare sector, deepen inequalities in access to medical services, and create long-term structural deformations. The relevance stems from the urgent need to understand and mitigate the cumulative effects of these large-scale crises on critical public services. The methodology involves a comprehensive analysis of the system's capacity to adapt, sustain critical functions, and ensure continuity of medical care under conditions of resource constraints and rapidly changing population needs. The study focuses on evaluating the system's ability to maintain operations and equitable access despite severe external pressure. The results reveal key vulnerabilities exposed by the systemic crises. The cumulative effect of COVID-19 not only caused short-term disruptions but also laid the foundation for long-term consequences within the system, which were significantly exacerbated by the start of the full-scale war. This dual impact has led to a reduction in the institutional capacity of the healthcare system. The findings underscore that these crises have created complex, lasting challenges far beyond immediate emergency response. An acute social problem in Ukraine remains the inability of Ukrainian households to pay for medical services, even despite the declared state guarantee of free medicine. According to research, the share of out-of-pocket expenses for healthcare in Ukraine is the highest in Europe. and during the pandemic and war, these expenses increased several times, reaching almost half of the total current healthcare expenses. This leads to the spread of catastrophic medical expenses, which is especially noticeable for low-income households and pensioners. The practical value of the article lies in highlighting the necessity of developing integrated strategies for strengthening systemic resilience. These strategies must account for the specifics of complex crises and focus on enhancing adaptability, recoverability, and ensuring equitable access to medical services in the future.
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