BackgroundWe examined the human toll and subsequent humanitarian crisis resulting from the Russian invasion of Ukraine, which began on 24 February 2022.MethodWe 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.ResultsAs 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).ConclusionsThe 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.

Aim. The research aims at improving the quality of rendering medical care in the urology departments of health care facilities by conducting the clinical audit with advanced study of causes of dissatisfaction of patients with the medical service provided. Material and Methods. Sociological research included the questioning of 405 patients who were treated in the urology departments of the municipal nonprofit enterprise of the Lviv Regional Council "Clinical Emergency Hospital". The respondents estimated the quality of providing health care in the sphere of medical service, informational content, financing, the quality of diagnosis and treatment. Methods of structural-logical analysis, systemic approach and analysis, calculation of mean and relative values, calculation of satisfaction index with services provided are used in this work. Results and Discussion. The determination of the level of respondents' satisfaction with inpatient treatment showed that, in total, that the number of dissatisfied among the interviewed were 7.16±1.28 % persons. The focus-group of such persons was singled out: patients of active working age, financially - able, mainly with higher education, most often with diagnosis of urolithiasis, who suffered from pain syndrome, with late appealing for medical care (more than 24 hours), they were operated on and waited for the quick results of treatment, even despite the positive final result of treatment. These patients demanded more attention of a doctor, were dissatisfied with the work of paramedical personnel, conflicted with ward neighbors, had claims to availability and quality of medical equipment, sanitary state of premises of the department. Conclusions. The results of the clinical audit targeting the satisfaction of patients with medical services provided as one of the forms of receiving the patient feedback concerning the quality of medical aid, point out, on one hand, the appropriate level of availability of services, interpersonal attitudes, infrastructure, execution of technical demands as to quality and standard compliance by the staff of department. While, on the other hand, the audit results indicate the presence of dissatisfied with some certain services in the department. The focus-groups of dissatisfied make it possible to take into account the personal approaches in rendering medical aid to such categories of population, that in total will improve and increase the quality of providing medical services. Basing on the results of clinical audit, the recommendations as to the perfection of medical care management in the urology departments of health care facilities.

Aim. The medical care quality remains one of the most pressing issues of the health care system, especially at the stage of reforming of the medical sector. Medical-statistical information comprising reporting forms is the basis for analyzing the status of medical care quality and incorporating management decisions to improve it. Material and Methods. The study was performed by the means of analysis of the annual reports of the Urology Department of Municipal Non-profit Enterprise "Lviv Clinical Emergency Hospital" over a ten-year period: from 2010 to 2019. Statistical analysis included the analysis of average and relative values, as well as the calculation of indicators of the dynamic range: growth rate and absolute increase. Results and Discussion. Analysis of the use of bed stock of the Urology Department of MNELCEH during 2010-2019 showed that the average quantity of inpatient days is 251.12-340.18 days per year. Inpatient turnover was in the range of 30.28-36.55 patients per year. The indicator of surgical activity increased by 5.4 percentage points (from 33.0% in 2010 to 38.4% in 2019). There was also a positive tendency of decrease of the duration of post-surgery stay of patients at the inpatient department of the Urology Department (from 9.25 in 2010 to 8.55 in 2019). During the study period of 2010-2019, the ratio of post-surgical complications remained relatively stable and did not exceed 5.1% (the indicator is in the range of 4.38% -5.09%). The analysis of the total mortality among all treated patients was in the range of 0.06%-0.65%. Conclusion. The indicators analyzed in the annual reports make it possible to identify the main problematic issues in the work of the department. In order to provide professional specialized care, quality and rational use of property and human resources, algorithms should be developed to increase treatment of patients with malignant tumors and urolithiasis at the department, as in recent years we could observe an outflow of patients with these diagnoses to other healthcare establishments. There is a need for individual analysis of the causes of post-surgical complications and mortality. These issues can be resolved by introducing clinical audit into the work of the department

Aim - the search, analysis and systematization of historical facts concerning the formation and evo-lution of the world medical standartization; severance of its certain long-standing models for the optimization of settling and introduction of the existing, and future analogs, particularly, in the clinical audit format. Material and Methods. In order to study the medical standard as a historical component the fol-lowing methods were used: bibliographic, historical, analytical and methods of systematization and comparison. Results and Discussion. As a result of the conducted research the main historical events in the world development of the medical standartization starting from 1500 up till nowadays were col-lected. In order to study the evolution of the medical standartization, the analysis of the normative documents that have regulated the process of standartization, especially the Doctor's statute(s) in Russia, Minimal standard of the medical equipment and works of the American college of surgeons, was carried out. The scientific works that initiated the introduction of the clinical audit in the Health Care system in Ukraine, Turkey, the USA and Great Britain were throroughly analyzed. Conclusions. The improvement of quality as to rendering the medical aid is a job priority in the health care systems in many countries. For that reason, the search for its optimization was and is still retrieved for many centuries. The territorial formation of medical standartization is associated with England, Russia and the USA, but the occurrence of clinical audit is connected with Ukraine, Turkey, the USA and Great Britain. The foundations of the medical standardization was lauched in 1500 year, while the clinical audit - in 1854 year. The medical standartization is a reflection of the history of development of the organization of health care system, that's why the expertness (knowl-edge) of historical stages concerning the setting and the introduction of medical standartization may give a new impulse in its improvement and development under present-day conditions of reforma-tion in the medical sphere in Ukraine. The earlier beginning of implementation of the medical stan-dartization in the health care system in different countries makes it possible to actualize its introduc-tion into the clinical audit format, that, in its turn, allows to improve the quality of rendering the medical aid. Key words: medical standartization, clinical audit, quality of medical aid

An anonymous questionnaire survey among healthcare professionals in Ukraine (n = 10737) showed contradictions in the attitude to the peculiarities of clinical pharmacy compared to a general pharmacy, the relation to the specialists who provide clinical pharmacy services, and the healthcare settings for them. The respondents considered the activity of clinical pharmacist necessary in 74.2%. The community pharmacies were identified as prior professional settings for clinical pharmacists in 55.3%; hospitals – 47.7%, hospital pharmacies – 45.0%. Among the directions of the clinical pharmacist’s activity at the hospital, monitoring of drug safety and efficacy was stated by 69.9%, provision of the pharmaceutical care – 50.5%, evaluation of pharmacotherapy – 42.1%, processing of the local drug formulary – 26.8%. The respondents saw prospects for the development of clinical pharmacy in Ukraine in 54.2%. Therefore, there were differences in views on the key issues of clinical pharmacy throughout Ukraine and the insufficient support for its prospects.