Transformation of Government Functions in Healthcare in the Context of Digitalization

Анотація

The article provides a comprehensive theoretical and methodological justification and develops the conceptual foundations for the transformation of state functions in the healthcare sector of Ukraine amidst global challenges and the total digitalization of public governance. The relevance of the topic is driven by the need to overcome the institutional inertia of the post-Soviet «state-provider» model, which, due to the critical concentration of functions as owner, payer, and service provider, proved incapable of ensuring the quality and accessibility of medical care under resource constraints. It is substantiated that the current stage of societal development requires a transition to a state service model, where healthcare is viewed not merely as a costly social function but as a fundamental component of national security. Through a critical analysis of existing scientific approaches, a significant methodological gap has been identified: the absence of a holistic functional-relational model that combines institutional changes with the technological potential of the electronic health system (e-Health). It is demonstrated that most existing studies are fragmentary, describing only individual stages of reform without revealing the logic behind the change in the essential characteristics of state activity. The central scientific result of the study is the developed and verified functional-relational model of the «State as a Strategic Purchaser». The model is based on the separation of power and economic mandates by splitting the traditional monopoly function of the state into three autonomous vectors: evidence-based political planning (MoH), economic financial guarantee through strategic purchasing of services (NHSU), and regulatory oversight of clinical results. It is argued that such a distribution eliminates deep-seated conflicts of interest and creates conditions for equitable competition between the state, municipal, and private sectors. Special attention is paid to digital transformation as a driving force for improving service quality. The author's definition of «digital transformation of state regulation in healthcare» is formulated and justified as a process of transitioning from subjective administrative supervision to objective algorithmic monitoring of provider performance indicators based on Big Data. It is proven that digital transparency is a fundamental anti-corruption mechanism, as it prevents budget manipulation through the automatic verification of every medical episode. The scientific novelty of the result lies in substantiating the role of the state as a «digital regulator» that shapes the market through intellectual ordering of treatment outcomes rather than the maintenance of a hospital bed network. The practical significance of the article lies in the development of applied tools for optimizing hospital networks and attracting investment through public-private partnership mechanisms. In summary, the implementation of the proposed model allows for the transformation of the healthcare system into a flexible, transparent, and human-centric governance structure.

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