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Home    Pilot regions and pilot work    Zhytomyr

Zhytomyr

General information
Demographics
The health care network

General information

The population of the Zhytomyr region is currently 1,317,912. The region is made up of 54 urban settlements and 1624 rural ones. Population density is 45 persons per sq. kilometer (79 persons per sq. km. across Ukraine). 753,000 persons are town-dwellers, making up for 56,6% of the region’s total population (67,4% across Ukraine).

The region includes four districts whose population is less than 30 thousand people. 365,642 of the region’s inhabitants have suffered from the Chornobyl nuclear catastrophe.

Demographics

Birth rate, per 1000 persons

  • the population in total – 10.26
  • urban population – 10.54
  • rural population – 9.90

Mortality rate, per 1000

  • the population in total – 18.18
  • urban population – 14.20
  • rural population – 23.28

Natality rate, per 1000

  • the population in total – -7.92
  • urban population – -3.66
  • rural population – -13.48

Infant mortality, per 1000 live births

  • the population in total – 11.25
  • urban population – 8.69
  • rural population – 13.99

Maternal mortality, per 100,000 live births
Mortality according to various causes (per 100,000)

Causes of death

Index

All causes, including:
contagious and parasitic diseases:
Diseases of the circulatory system,
Including coronary heart disease
Hypertension
Acute myocardical infarction
Stroke
Tumors,
Including malignant newgrowth
Accidents, poisonings and injuries, including:
Respiratory diseases
Diseases of the digestive system

1818,4
21,2
1256,1
1291,0
0,4
12,7
53,1
176,1
169,6
147,7
58,9
61,1

Mortality among the employable population, major causes (per 100,000 persons aged accordingly)

Causes of death

Index

All causes
Accidents, injuries and poisonings
Circulatory system diseases
Newgrowth
Respiratory system diseases
Digestive system diseases
Urinogenital system diseases

732,2
181,5
229,1
90,9
30,4
68,5
5,0

Disease incidence:

  • total, per 100,000 persons: 62270.8
  • among children, per 1000 of junior population: 1369.1
  • among teenagers, per 10,000 of teenage population: 10252.0
  • among the employable population, per 100,000 persons aged accordingly: 50543.7
  • senior citizens, per 100,000 persons aged accordingly: 31961.5

Incidence of certain somatic diseases (per 100,000 persons):

  • Respiratory system diseases 25867.8
  • Circulatory system diseases 2753.1
  • Digestive system diseases 2674.1
  • Malignant tumors 295.5
  • Endocrynic system diseases 1113.4
  • Skeleton and muscle system diseases 1986.9
  • Urinogenital system diseases 6294.3

Specific indices

Total disease rate – 43234.6 per 100,000 ( + 1%) ; children’s disease rate (0-17 years of age) – 8725.1 per 10,000 of junior population; cf. 8500.0 in 2006 with a  2.6% growth. The growth of infectious diseases incidence has been marked at 5.2%, mostly due to the spread of respiratory infections.

Incidence of separate diasases:

  • circulatory system diseases – 1850.0 per 100,000 persons;
  • acute myocarditic infarction – 54.0 per 100,000 persons (51.7 in the first 9 months of 2007), mortality caused by acute myocarditic infarction 8.7 and 7.8 rspectively;
  • malignant tumors – 178.8 (182,7 in the first 9 months of 2007);
  • active tuberculosis – 58.3 per 100,000 persons versus 64.1 in 2006 (59,5 in the first 9 months of 2007 across Ukraine).

Incidence of tuberculosis among children remains frozen at a rate of 6.0 versus 5.9, 7.3 per 100,000 of junior population across Ukraine in the first 9 months of 2007). There has been a decline in the incidence of tuberculosis among teenagers: the rate has plummeted to 6.9 per 100,000 teenagers from 22.2 in 2006 (22,5 in the first 9 months of 2007 across Ukraine) . The incidence rate of tuberculosis has dropped by 9% in the first 9 months of 2007 (by 5,3% across Ukraine). Tuberculosis mortality rate in the first 9 months of 2007 is 15.8 per 100,000 persons versus 15.9 in 2006 (21.9 and 22.2 respectively across Ukraine),the spread of the HIV is 14.2 per 100,000 persons (13.2 in 2006), AIDS has receded slightly from 4.1 to 3.8 respectively.

The rate of primary disability among the region’s employable population amounted to 48.0, against 49.1 per 100,000 persons (- 2.3%), children’s disability has increased by 1.7% from 17.5 to 17.8 in 2007.

Financing

The first three quarters of 2007 saw the health care industry receive UAH 343224.4 thousand (67% of the total expenditures), equivalent to UAH 260.58 per capita, which is an almost 20% increase since last year (UAH 206.27). The influx of additional costs is accounted for by the pay rise for medical personnel and the towering energy bills. The expenditure structure has remained the same.

The amount of extra-budgetary costs involved is UAH 35449.8 thousand (UAH 26.91 per capita), comparable to UAH 25.41 in the first 9 months of 2006. The Hospital fund, among other sources, has yielded UAH 11353.7 (UAH 8.62 per citizen).

The ‘Zhytomyr regional hospital fund’ charity now has 194,553 members, totaling in 14.87% of the region’s populace. In the first 9 months of 2007, 185,084 hospital cases were treated with financial support from the Fund amounting up to UAH 10,774 thousand. With the inflow of public investment into the region’s healthcare sector, the community now is in the position to control the utilization of the costs. 887 orphaned children remain in the care of the Fund.

The region’s network of healthcare institutions comprises 1150 units, of which 1037 are situated in rural areas. Primary medical assistance is delivered in 1121 institutions, including 21 local hospitals, 13 village hospitals, 2 emergency units, 190 outpatient units, 838 feldsher-midwife and feldsher stations, 14 aid posts, 14 dentist polyclinics and departments (general therapy, pediatrics, family doctors). The network also incorporates 22 central district hospitals, 1 central district polyclinic, 1 district hospital and 5 central city hospitals. Specialized medical assistance is delivered by central district and city hospitals (28 in total); highly specific medical issues are dealt with in 25 establishments which also host 30 specialized centers. The overall number of stationary hospital beds is 9800, which makes the bed population ratio in the region 74.4 per 10,000 persons (87.56 across Ukraine). The average duration of hospital stay is 11.1 days (13.3 across Ukraine). In 2007, 211,000 patients have received treatment via the regional healthcare network, showing a 9,000 cases increase compared with 2006.

At the time being, the region’s outpatient polyclinic institutions have received an additional 2,786 stationary hospital beds (+56 beds this year); the bed population ratio here is 21.14 per 10,000 persons as opposed to 20.7 in 2006. 715 day stationary beds have been installed in feldsher-midwife stations. 106,000 patients have received medical care in day stationary departments in the course of 2007’s first 9 months, thus the index is 806.7 per 10,000 persons versus 745.1 in 2006. Outpatient polyclinic institutions have performed more than 73,000 surgeries (556.7 per 10,000 persons versus 530.1 for the same period last year).

With assistance from the EU Project ‘Support to the medical standards development in Ukraine”, the elaboration of standards for 15 nosologies has now been completed and contributes to better medical quality and efficiency as well as the creation of a unified clinical recommendations methodology and elaboration of evidential healthcare-based medical standards in the Zhytomyr region. UAH 538,000 worth of equipment has been received and is now in use.

Finally, a memorandum on cooperation with the EU Project ‘Support to the Secondary Healthcare Reform in Ukraine’ ( Europe Aid / 123236 / C / SER / UA ) has been signed.

The Challenges:

  • construction of the cancer center building
  • equipping the blood transfusion center with modern facilities
  • elaboration and adoption of the Regional blood transfusion service framework for the years 2008-2012
  • renovating the imaging equipment and acquiring an angiograph
  • raising the costs for emergency healthcare delivery, with special care given to rural areas

The health care network

The total number of healthcare establishments: 75
Including:

  • regional hospitals – 1
  • regional children’s hospitals – 1
  • city hospitals (in cities) – 4
  • city hospitals in townships – 13
  • children’s city  hospitals – 1
  • hospital for WW II veterans – 1
  • specialized hospitals – 2
  • CDHs – 22
  • District (numbered) hospitals – 70
  • Local hospitals - 355
  • Regional mother and child health centers – 135
  • Mental hospitals – 980
  • Dispensaries – 930

Bed population ratio (hospital beds of various kinds), per 10,000 persons – 74.0.
Hospitalization level per 100 persons – 20.7
Healthcare institutions delivering outpatient care:

  • polyclinics incorporated into healthcare establishments – 70
  • independent polyclinics – 2
  • outpatient institutions – 189
    • including 175 village o.i.
  • diagnostic centers – 2
  • AIDS prevention and treatment center - 1
  • dispensary – 1
  • dentistry polyclinics – 5
  • feldsher and feldsher-midwife stations – 842
  • first aid stations – 2
  • emergency departments – 24
  • first aid posts – 6
  • feldsher first aid posts

Day stationary facilities:

    • 255 in total
    • A total of 2729 beds
    • Number of patients treated – 139313

Home-based stationary treatment facilities

    • 238 in total
    • Number of patients treated – 74387

Indices of treatment and prevention activities:
Outpatient polyclinic institutions:
Persons per one doctor (except for dentists) – 471.8
Number of visits per person (total) – 10.4
Number of outpatient surgeries – 103202
Number of surgeries per 10,000 persons – 775.5
Number of patients operated upon – 102,669
Including 11,429 children
Emergency services
Number of calls – 457,916
Number of persons served on an emergency basis – 433,018
Timely delivery of emergency services (within 15 minutes) – 88.46%
Stationary facilities
Patients admitted – 276,000
Average duration of hospital stay (days) – 11.2
According to type of hospital:

  • regional hospital – 10.6
  • children’s regional hospital 10.0
  • city hospital  (in cities) 9.1
  • city hospital (in townships) 10.3
  • children’s city hospital 9.2
  • CDH 9.3
  • local hospital 11.2

Hospital mortality as percentage of total patient number 0.8
Including infant mortality of 0.85
Total number of intrusive surgeries on a stationary basis 62,471
Including surgeries performed on children 8,634
Number of surgeries per 10,000 persons – 469.4
Post-surgical lethality as percentage of the number of operated patients – 0.58
Number of emergency surgeries 5,430
Including surgeries performed on children – 1002
Post-surgical lethality after the performance of emergency interventions – 1.3%

Major nosological forms

 

Intestinal obstruction

Acute appendicitis

Acute gastric and dodecadactylon ulcer

Intestinal bleeding

Strangulated hernia

Acute holecistitis

Acute pancreatitis

Extrauterine pregnancy

Internal injury of the chest, abdominal cavity and pelvis

Post-surgical lethality, %

3,6

-

3,05

11,29

3,0

1,2

10,81

-

6,13

Post-surgical lethality with hospitalization taking place more than 24 hours after first symptoms

5,0

-

19,23

22,58

5,56

1,28

11,11

-

4,23

The Zhytomyr region hospital fund

      • members – 197,948
      • costs raised, UAH thousand: 10,224,5
      • expenditures on treatment of one fund member, UAH 85.86
        • on a stationary basis - 127.3
        • on an outpatient basis – 23.8
        • in day stationary institutions – 60.54
        • in home-based stationary conditions – 39.42


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This project is funded by European Union This project is implemented by Consortium EPOS Health Consultants with ECORYS and NICO
     

The views in this publication do not necessarily reflect the views of the European Commission.