COMPARATIVE ANALYSIS OF THE ACTIVITIES OF HEALTHCARE INSTITUTIONS PROVIDING PERINATAL CARE DEPENDING ON THE NUMBER OF DELIVERIES PER YEAR

Introduction. In the context of a constant decline in the birth rate in Ukraine, the issue of organizing accessible and high-quality perinatal care for mothers and newborns is acute. Since 2020, the National Health Service of Ukraine, the central executive body, the activities of which are directed and coordinated by the Cabinet of Ministers of Ukraine, has concluded contracts with medical service providers for a group of priority services, which include assistance during childbirth. Thus, perinatal care services have been identified as priority medical services for the state. Aim. The purpose of the study was to compare the data of the main performance indicators of health care facilities in Ivano-Frankivsk, Zhytomyr, and Chernihiv regions that provided perinatal care in 2023, depending on the number of births per year. Materials and methods. A comparison of performance indicators (indicators characterizing the provision of perinatal care, indicators of bed capacity utilization, indicators of physician workload, indicators of personnel potential of health care providers) for three groups of health care providers depending on the number of births per year, namely: up to 300 births (group 1, n=22), 300-1500 births (group 2, n=23), more than 1500 births (group 3, n=10). Data from the reporting forms No. 21, No. 20 of the Center for Public Health of the Ministry of Health of Ukraine, as well as questionnaires on personnel support (age structure of medical workers, number of obstetrician-gynecologists who personally provide medical care in delivery) were used. The study was conducted in health centers that provided perinatal care during childbirth in Ivano-Frankivsk, Zhytomyr, and Chernihiv regions. Results. It was determined that the 3rd group had the lowest average share of normal births, the largest share of multiple deliveries, the largest share of premature births among all newborns, the largest share of newborns with a body weight of up to 1000 g, the largest number of respiratory system disorders occurring in the perinatal period, and the number of preeclampsia, eclampsia per 1000 births. In all three groups of HCPs, the proportion of cesarean sections from the total number of births differed significantly (p=0.002). The largest share of caesarean sections was found in the 3rd group (28.96% [26.77–40.16]). The significantly lowest value of the occupancy rate of beds for pregnant women was determined in the 1st group (22.88% (18.19-38.85), only 83.5 days a year the bed was occupied. In the HSP of the 2nd group, the bed was occupied per year 124.9 days, and in the 3rd group of hospitals – 192.43 days, respectively. It was determined that during the year, obstetrician-gynecologists are on standby at the workplace, taking 1 birth, mostly physiological, for 9 days. The 2nd and 3rd group of health care providers — 1 birth in 4 days. Conclusions. Improving the quality and availability of perinatal care in the network of the hospital district requires the transformation of the organization of the provision of this care on the basis of effective management of personnel, financial, material and technical resources and the creation of rational scientifically based clinical routes in accordance with medical indications.