The role of the entrepreneurial approach in the development of medical services within the healthcare services market

The purpose of this study was to examine the impact of the entrepreneurial approach on the development of efficient and competitive medical services in the context of market transformations. The methodology was based on an analytical and theoretical approach, which included an analysis of the dynamics of state and local budgets, healthcare guarantee programmes, international financial assistance, and a review of practical case studies of selected healthcare institutions. The main findings indicated that in 2023, state expenditure on healthcare amounted to UAH 207 billion, increased to UAH 238.7 billion in 2024, but declined to UAH 217 billion in 2025. In turn, funding for the healthcare guarantee programme rose from UAH 142.7 billion in 2023 to UAH 175.5 billion in 2025. Local budgets provided UAH 441.9 billion in 2023, with projected growth of 15% by 2025. Despite this, around 46% of healthcare expenses were covered directly by patients, and the average payment for an outpatient visit in 2024 reached UAH 600. Voluntary health insurance generated UAH 1.5 billion in premiums in the first quarter of 2024, with a pay-out ratio of 56.8%, reflecting the growing role of the private sector. International support also played an important role: between 2023 and 2025, Ukraine received over USD 1.2 billion in grants, including the Transforming Health Systems for Resilience and Improved Efficiency project with a budget of USD 454 million. This funding facilitated the modernisation of hospitals, procurement of medical equipment, and development of telemedicine, which was projected to cover 80% of healthcare facilities by 2025. The study analysed the operations of several medical centres, including the National Specialised Children’s Hospital “Ohmatdyt”, the Municipal Non-Profit Enterprise “Uman Central City Hospital”, and the Medical Centre “AILAZ”. The practical value of this study lies in the possibility of using its findings to develop strategies aimed at improving the financial sustainability and competitiveness of healthcare institutions through the implementation of entrepreneurial approaches, digital innovations, and diversification of funding sources