The aim: To evaluate the long-term dynamics of health losses caused by ambulatory care sensitive conditions (ACSCs) to justify the priorities of public policy regarding this group of diseases. Materials and methods: The data used were obtained from the Institute of Health Metrics and Evaluation, the European database “Health for All”, for 1990-2019. The study was conducted using bibliosemantic, historical and epidemiological study methods. Results: Disability-adjusted life years (DALYs) due to ACSC over 30 years in Ukraine averaged 5145.4 years per 100,000 population (95% CI 4731.1 -5559.7), which is approximately 14% of DALYs of all reasons without a clear trend of change - compound annual growth rate (CARG) of 0.14%. These five causes –angina pectoris, chronic obstructive pulmonary diseases (COPD), lower respiratory infections, diabetes, and tuberculosis – account for 90% of the disease burden associated with ACSCs. There was an increasing trend in DALYs (CARG varied for different ACSCs in the range of 0.59-1.88%), except for COPD, where the decrease in CARG reached -3.16%. Conclusions: This longitudinal study found a small trend toward increased DALYs due to ACSCs. State measures to influence modified risk factors to reduce the burden of losses from ACSCs proved to be ineffective. To significantly reduce DALYs, a more clear and more systematic healthcare policy regarding ACSCs is needed, which includes a set of primary prevention measures, and organizational and economic strengthening of the primary health care.

The aim: To assess the long-term dynamics of health spending in Ukraine from the standpoint of readiness to make progress in the universal health coverage (UHC) Materials and methods: Data from the Global Health Expenditure Database, European Health for All database, World Bank Open Data, collected during 2000-2019 were used. The research was conducted using bibliosemantic, historical methods and benchmarking. Results: All indicators of health spending in Ukraine showed some growth: total and government health spending of % Gross Domestic Product (GDP) by 34% (95% CI 13-55) and 28% (95% CI 8-48), total and government health spending per capita in US $ by 7.1 and 6.5 times and in Purchasing power parity (PPP) – by 4 and 3.8 times. Growth was interrupted during the global (2008) and national (2017-2019) financial crises. Out-of-pocket spending in Ukraine grew and amounted to 51.1% in 2019, which is by 2.1 times more than in the European region – 24.0% (15.5; 36.6). In 2019 Ukraine ranked among 10% of the countries with the worst combination of government health spending per share of GDP and share of OOPS in total health spending. Conclusions: The study found an unsustainable upward dynamic in health spending. In the last decade, there has been a clear trend towards an increase % OOPS in total health spending against low, aimed at reducing government health spending as % of GDP, which could negatively affect UHC.