Economic determinants in healthcare quality optimization inUkrainian metropolises

Conclusions: An analysis was conducted of morbidity trends in the Dnipro metropolis during 2010, 2013-2014, and 2018-2020 with respect to socially significant diseases - hypertension, myocardial infarction, stroke, HIV/AIDS, as well as AIDS-related mortality, all of which pose risks of premature death (18 years and older). Consideration was also given to the human resources available in primary health care and prevailing demographic trends. A comparative analysis of the effectiveness of health care systems in the metropolises of Dnipro and Kharkiv was undertaken by assessing the number of emergency medical service calls per 100,000 average annual population. The study proposes approaches to assessing the influence of metropolitan health care infrastructure on medical institutions within the metropolitan region and substantiates the prospects for establishing a unified metropolitan health care system. In the context of the ongoing war in Ukraine, there is an urgent need to create a competitive health care environment in metropolitan areas, prioritizing economic determinants of quality optimization. This will require the joint efforts of government, business, academia, and the media in developing modern competitivestrategies for metropolitan development, supported by the adoption and implementation of legislation on the status and functions of metropolises. Such measures are expected to reduce irrational and unjustified financial expenditures in the health care sector.