COST ACCOUNTING AND PRICING OF PAID MEDICAL SERVICES: UKRAINIAN AND INTERNATIONAL EXPERIENCE

The reform of modern healthcare, aimed at increasing the efficiency of healthcare entities, has affected not only the organizational and legal forms of management but also numerous other aspects, including cost accounting and pricing. As a central element of managerial influence, costs serve not only as the basis for pricing paid medical services but also as a crucial factor in ensuring financial transparency and the rational use of resources. However, the existing methodology for cost accounting and pricing in municipal nonprofit enterprises – healthcare institutions (MNEs) – has certain shortcomings and requires appropriate adaptation to the new financing conditions. The aim of the article is to conduct a critical analysis of the existing methods of cost accounting and medical service pricing applied in MNEs, as well as to develop and substantiate recommendations for their improvement, taking into account national specifics and best international practices. The study's methodological framework includes a critical analysis of various authors' along with an assessment and generalization of the existing needs and opportunities for further development and improvement perspectives on cost accounting and pricing in healthcare institutions. The schematic illustration and generalization method were applied to identify the specific features of cost accounting and pricing in MNEs. Additionally, analysis, observation, synthesis, and formalization were used to explore the existing practices of base rate calculation in developed countries. The study identified the challenges faced by healthcare institutions in Ukraine when calculating the cost of services. The specifics and principles of regulatory frameworks governing cost accounting and pricing in municipal non-profit healthcare institutions were examined, revealing the combined application of regulations for the public sector and business. The regulatory aspects of medical service tariff setting were reviewed, emphasizing the need for clear identification of responsibility in tariff approval. The primary pricing methodologies used in developed countries were critically analyzed, and the institutional entities authorized to develop and publish pricing methodologies and other instructional materials were identified. The study substantiated promising research directions to facilitate the selection of the most suitable pricing method for implementation in Ukrainian healthcare practice.