Instituto de Estudios Políticos y Derecho Público "Dr. Humberto J. La Roche"
de la Facultad de Ciencias Jurídicas y Políticas de la Universidad del Zulia
Maracaibo, Venezuela
Publicación cientíca en formato digital
ISSN-Versión Impresa 0798-1406 / ISSN-Versión on line 2542-3185
Depósito legal pp 197402ZU34
ppi 201502ZU4645
Vol.40 N° 75
2022
Recibido el 11/08/22 Aceptado el 16/11/22
ISSN 0798-1406 ~ Depósito legal pp 198502ZU132
Cues tio nes Po lí ti cas
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de Es tu dios Po lí ti cos y De re cho Pú bli co “Dr. Hum ber to J. La Ro che” (IEPDP) de la Fa-
cul tad de Cien cias Ju rí di cas y Po lí ti cas de la Uni ver si dad del Zu lia.
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Vol. 40, Nº 75 (2022), 522-536
IEPDP-Facultad de Ciencias Jurídicas y Políticas - LUZ
Comparative Analysis of Public
Administration Models on the Example of
Healthcare Sector
DOI: https://doi.org/10.46398/cuestpol.4075.31
Nataliia Uvarova *
Oksana Adamchuk **
Yevheniia Zhukova ***
Iryna Nagorna ****
Maryna Nazarenko *****
Abstract
The goal of this article is to disclose the main models of public
administration in the example of healthcare sphere. The authors
used such general scientic and special methods: historical
and legal, comparative, relative and legal, system analysis and
formal logics. Revealed the link between the models of public
administration and the healthcare sphere. It was marked on the most
typical manifestations of administrative inuence inherent in particular
model in the sphere of healthcare. It was established that dierent models
of public administration function eectively in dierent states. However,
national healthcare systems predominantly use a combination of several
models by adding elements of other models to the dominant model. It was
concluded that the current models of public administration in the eld of
healthcare are characterized by: verticalization and centralization of power
responsibilities for OPM, implementation of market techniques in the
public sector for NPM and an emphasis on human rights and growth for GG.
Among modern paradigms of public administration, we have highlighted
the LG model, the essence of which lies in continuous implementation
* Doctor in Law, Associate Professor, Professor of the Department of Civil Law and process of
Dnipropetrovsk State University of Internal Aairs, Dnipro, Ukraine. ORCID ID: https://orcid.
org/0000-0001-5940-1878
** PhD in Law, Associate Professor, Department of Forensic Medicine and Law of National Pirigov
Memorial Medical University, Vinnytsia, Ukraine. ORCID ID: https://orcid.org/0000-0002-7869-
8942
*** PhD in Law, Doctoral Student of the Interregional Academy of Personnel Management, Kyiv, Ukraine.
ORCID ID: https://orcid.org/0000-0003-2471-5230
**** PhD in Public Administration, Associate Professor, Docent of the Department of Local
ment and Territorial Development, Educational and Scientific Institute of Public Service and
Management, National University “Odesa Polytechnic”, Odesa, Ukraine. ORCID ID: https://orcid.
org/0000-0002-3374-030X
***** PhD in Public Administration, Senior lecturer at the Department of Law and Public Administration,
Vinnytsia Mykhailo Kotsiubynskyi State Pedagogical University, Vinnytsia, Ukraine. ORCID ID:
https://orcid.org/0000-0003-2116-754X
Self-Govern-
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of innovations to improve eciency and prioritize the interests of the
consumer, which is the patient in the sphere of healthcare.
Keywords: public administration; health model; public interest; human
rights; comparative analysis.
Análisis comparativo de modelos de administración
pública sobre el ejemplo del sector salud
Resumen
El propósito del artículo es dar a conocer los principales modelos de
gestión pública sobre el ejemplo del sector salud. Los autores utilizaron
los siguientes métodos cientícos generales y especiales: histórico-legal,
comparativo, comparativo-legal, análisis de sistemas y lógica formal.
Se revela la conexión entre los modelos de administración pública y el
ámbito sanitario. Se hace hincapié en las manifestaciones más típicas de
inuencia administrativa inherentes a un determinado modelo en el campo
de la atención de la salud. Se ha establecido que diferentes modelos de
administración pública funcionan efectivamente en diferentes Estados.
Sin embargo, los sistemas nacionales de salud utilizan principalmente
una combinación de varios modelos al agregar elementos de otros
modelos al modelo dominante. Se concluyó que los modelos modernos
de administración pública en el campo de la salud se caracterizan por:
verticalización y centralización de poder para OPM, implementación de
métodos de mercado en el sector público para NPM, y énfasis en derechos
humanos y transparencia para GG. Entre los paradigmas modernos de la
administración pública destaca el modelo LG, cuya esencia es la constante
introducción de innovaciones para mejorar la eciencia y priorizar los
intereses del consumidor, que es el paciente en el ámbito de la salud.
Palabras clave: administración pública; modelo de salud; interés
público; derechos humanos; análisis comparativo.
Introduction
Each state aims to carry out eective implementation of national policy
by combining public administration with the system of administrative and
territorial organization of state and municipal authorities. This is most
important value during a special period (state of emergency, martial law)
or in relation to socially important spheres (healthcare, education), etc.
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Sector
In the most systematized form, the power-management inuence
can be represented through models of public administration as types of
organizational structures. At the same time, changes that accompany
the reform of this or that sphere often make it necessary to transform
the managerial model that functions in the state. Under such conditions
becomes actual research of models of public administration in relation to
certain components of social life.
In modern world one of the most important spheres for any state is
healthcare (Lohvynenko et al., 2019). This is explained by the fact that
healthcare issues is directly linked to the level of public health and average life
expectancy, economic stability, social policy, sanitary and epidemiological
well-being of the population and the sustainable development of the state as
a whole. In particular, it concerns resistance to the spread of the COVID-19
pandemic, which has become a kind of challenge of the national healthcare
systems for their eciency and eectiveness (Teremetskyi et al., 2021).
According to this, the study of modern models of public administration will
be carried out on the example of the healthcare sphere.
1. Methodology
Scientic and theoretical backgroundl of the presented research were
scientic works of scientists devoted to managerial, medical, social and
legal aspects of public administration in the sphere of healthcare. The
normative and informational basis of the study consists of international
and national legislation of individual states, which governs relations in the
sphere of healthcare, political and legal publicity, works on management
and administration, and materials from open Internet sources.
The choice of research methods is determined by the method, objectives
and the subject of the scientic article. The process of scientic search has
determined the use of general scientic and special methods of scientic
knowledge, which allowed to form a scientically grounded conclusions.
For example, the historical and legal method allowed us to consider
the formation of models of public administration. The comparative
method enabled us to compare the models of public administration of the
healthcare sphere in separate states. The comparative and legal method
assisted in reviewing international and national norms related to healthcare
management. The method of system analysis made it possible to identify the
advantages and disadvantages of each type of current public administration
model. The method of formal logics was used to identify advantages and
disadvantages of specic models and prospects for improvement of public
administration by the healthcare sphere.
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2. Results and Discussion
In general, the management model is understood as a theoretically
selected holistic set of ideas about how the management system looks like,
what its structure and functions are, how it interacts with dierent subjects,
how it adapts to changes. Such model includes the main principles of
management, strategic vision, goals and objectives, values, organizational
structure and the order of interaction of its elements (Kropyvnytskyi, 2018).
Throughout the history of its development, humanity has created and
implemented various models that reected the managerial connection
between the subject of power and the controlled object. By uniting, mixing,
and borrowing from each other certain elements, these models were
adapted by national administrations in each state. At the same time stable
forms of some of these models allowed us to consolidate the main types of
organization of public administration. Having their origins in the style of
state inuence on this or that sphere, modern types of models include a
broader number of subjects, becoming public, and replacing the traditional
management of the administrative process.
In the opinion of O.M. Okhotnikov and Y.O. Arbich, it is the transparency,
openness and stability in the activities of public authorities will contribute
to the eective maintenance and respect for human rights and freedoms,
as a result, eective public administration in the interests of the citizens
will increase the credibility and trust of the public in the functioning of
public authorities (Oкhotnikova and Arbych, 2020). It should be stressed
that this is what distinguishes the process of public administration from the
previously dominant public administration.
Models of public administration are not the same organizational and
social constructions that take place in the state, because the process of
administration precedes the formation of state policy in a certain sphere.
Thus, in the context of our research the models of social policy are of
interest. There are four such models:
1. scandinavian, which is characterized by wide participation in public
administration not only by the state, but also by trade unions.
Moreover, the main responsibility is held by the state, while public
administration is a suciently well-organized system, where power
actions are clearly coordinated and public responsibility is at a high
level;
2. the anglo-saxon model, which also provides for state responsibility,
but public administration is carried out only at the level of the state;
3. the continental model, under which public administration is carried
out through insurance organizations, while nancing of the social
sphere is carried out through insurance contributions;
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4. the southern European model, where public administration is
carried out through insurance organizations, and the family and the
church are included in the subjects of responsibility (Azarova, et al.,
2019).
The mentioned models dier in the subject composition and the scope of
managerial (administrative) inuence in the formation and implementation
of social policy, while the criterion for their typologization is the geography
of their spread across the countries.
Unlike social policy models, the main models of public administration
dier from each other in principles, subjects and methods of organization
and implementation of public administration, which is most clearly
manifested in relation to specic spheres of social life.
Besides this, it is worth mentioning the models of organization of health
care systems depending on the sources of funding, which are accepted to be
divided into market (provision of medical services through private funds),
state (budget nancing of healthcare spheres) and mixed (combination
of elements of the previous models, for example, the presence of a state
medical insurance fund and elements of state-guaranteed non-paid medical
services).
In lot of things those models have repeatedly been modied since the
time of their development and implementation, but in general, they have
retained their inherent features to the present. However, in healthcare
models, are considered and can be individualized some factors, that eect
on the transformation (state guarantees; mechanism for nancing the
healthcare, medical services and other).
Of course, national healthcare systems are inuenced by state policy in
the social sphere and are part of certain economic models of healthcare
nancing. At the same time, healthcare in one state or another is ensured
through the purposeful inuence of the subjects of power, which is a
reection of the model of public administration in the healthcare sphere.
In our conviction each of these models has its own specic manifestation in
the healthcare sphere.
Before outlining the main types of models of public administration,
we should take into account the opinion of G. Shaulsky about the fact that
the experience of foreign countries shows the absence of a specic model
successfully implemented in several countries. On the contrary, taking
as a basis the general principles, methods and outputs of the models
of public administration, taking into account national economic and
social peculiarities, each state adapts this model to its own realities and
requirements (Shaulska, 2018).
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Scientists distinguish three main types of models of public administration,
namely: Old Public Management (OPM), New Public Management (NPM),
Good Governance (GG). For example, V. I. Nikolaeva allocates the old
management model, which is characterized by bureaucracy, lack of initiative,
lack of eciency, and one-sidedness. Instead, she considers NPM to be a
new model and its more modern version - New Public Service (NPS). The
latter is a model of a new public service in which the people, the community
and the civil society as a whole are the key subjects, while the government’s
mission is to satisfy the public interest. Among the new models is also called
GG, which involves a signicant dialogue between private subjects and the
state, openness, transparency and broad involvement of the public in the
management process (Nykolaieva, 2019).
The importance of taking into account the level of public satisfaction with
the quality of services provided is an important part of public administration
in general and the sphere of healthcare in particular. It should be taken
into account that in the case when citizens are not involved in making
management decisions, they are less satised with the authorities. Then
the desire for a balanced connection between the people and the state will
encourage the population to support the state’s leading role in providing
public services instead of seeking alternative managerial methods (Cohen
et al., 2022).
The rst model, OPM, represents the traditional bureaucratic apparatus.
As M. Syomich notes, the OPM model has the longest history of application,
which allowed it to form an eective combination of managerial methods
and techniques. The essence of this model lies in the functional approach
to division of labour, clear subordination, rules that enshrine the rights and
duties of the ocials, the system of standardization of processes, promotion
and career, the unication of oce management (Syomych, 2019).
This is most clearly represented by healthcare in authoritarian states,
where severe centralization of power is combined with bureaucratization
of any organizational procedures, and the population’s access to quality
medical services is nervous and uncomfortable. For example, in the sphere
of healthcare in North Korea, researchers emphasize the great dierencies
in the state of public health and real access to medical care, which is mostly
due to political and economic inequality. The possibilities for eliminating
such inequality are severely limited, while informing international
organizations about the existence of such problems gives hope that they
will be solved (Lee et al., 2020).
The second classical model of the NPM is based on the theory of public
choice, in which the performance of public ocials is subject to public
control to prevent ineective activities and corruption. A new perspective
of public service that is embodied in the democratic theory of social system
development, predetermines the accountability of public ocials and civil
servants to the citizens.
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This model assumes that public ocials will serve public interests and
meet the expectations of the citizens with the proper public service, and
the state together with the local self-government will take care of public
benets and become more sensitive to the needs of society. In the opinion
of Y. I. Lyakh namely Great Britain became the founder of this model,
which during the last decade of the XX century spread to the United States,
Australia, Ireland, the countries of the Asia Pacic region (Liakh, 2019).
S.O. Levchenko notes that the NPM model concerns not only the
implementation of modern rational management methods, but also
suggests a new pricing paradigm, genesis of which is similar to business
management methods. The main postulate of NPM is the management of
the state according to market approaches and implementation of market
approaches in the public sector.
First of all, it concerns the various practices successfully implemented
in the private sector. Thus, the state becomes a participant in the market
process, using methods of business management in the activities of public
institutions and sharing business values. Managed approach has gradually
made NPM one of the most popular models of public administration, which
is successfully used today (Levchenko, 2017).
As N.S. Latipova notes correctly, NPM is a model of public administration,
which is used for modernization of the state sector. The corresponding
model is based on the approach where the person (citizen) is a client who
has a variety of alternatives to choose from, while the market approaches
are used in management. This can be expressed in three words: economy,
eciency and eectiveness (Latipova, 2020).
Gudbjörg Erlingsdottir and Cecilia Lindholm pay attention to the fact
that NPM as a model of public administration is no longer new and, perhaps,
it is time to remove the component of newness from this abreviation. On
the other hand, the emphasis on novelty of public management allows to
separate this model from the old, so-called OPM. What concerns the sphere
of healthcare, innovations in medicine, particularly eHealth, have emerged,
in the opinion of the authors, due to the introduction of the NPM model in
the public sector (Erlingsdottir and Lindholm, 2013).
The NPM model manifests itself mainly in those states where healthcare
nancing is carried out at the expense of the combination of state programs
and the developed private sector. For example, in the United States, private
health insurance funds cover most of the healthcare needs of the population.
Currently, a public guarantee of realization of the right to health protection
for socially unprotected groups of the population or for all citizens at the
basic level (package of guaranteed medical services) is ensured at the
expense of state and municipal programs, for example, «Medicaid».
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The shortcomings of the managerial approach to public management,
implemented in the NPM model, provoked the emergence of a new
management model – «Good Governance» (proper management), which
has been expanded in Japan, Indonesia, New Zealand, Germany and Brazil.
The new model was mainly aimed at overcoming such shortcomings of the
NPM as secondary importance in solving social problems and increasing
social inequality and poverty. This is especially relevant in developing
states, where there is an erosion of the exclusive role of the state (public
ocials) in social relations. Instead, the emphasis is shifting toward the
universality of management methods instead of seeking components
inherent to a particular state.
In general, the concept of “Good Governance” rst appeared on the
agenda of the World Bank’s Annual Conference in the eld of economic
development in 1992 (Bolotina and Nikitenko, 2017). According to the
recommendations “What is Good Governance?” developed by the United
Nations Economic and Social Commission for Asia and the Pacic, GG has
a number of basic characteristics.
It is participatory, consensus-oriented, accountable, transparent,
responsive, eective and ecient, equitable and inclusive, and adheres to
the rule of law. The GG model requires minimizing corruption and taking
into account the views that the positions of the most diverse members of
society are taken into account in decision-making process. This model of
public administration is also respectful of the current and future needs of
society (Yap Kioe Sheng, 2016).
O.A. Morgunov emphasizes the popularity of the GG model in the
modern European community. In his research he pays attention to the
fact that despite the widespread nature of the relevant model, it is not
characterized by the typical principles, tasks and goal.
This peculiarity is explained by the fact that the GG model is a unique
template, according to which each state that chooses this paradigm makes
changes and additions to it, forms its own priorities in the implementation
of public administration. At the same time, despite the disagreements in the
determination of priorities, the choice of forms and methods of managerial
inuence, the GG model is based on adherence to the key principles -
democracy and the rule of law (Morgunov, 2018).
In June 2006, the Ministers of Health of the European Union member
states agreed that healthcare must be based on certain values and principles,
which they considered: universality, accessibility of high quality medical
care, fairness and solidarity.
Moreover, the corresponding statement of the Council of the European
Union stipulates that universality means ensuring accessibility of medical
care for everyone.
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Fairness means equal access to medical care according to need,
regardless of ethnicity, status, age, social status or ability to pay.
In its turn, solidarity is closely linked to the nancing of healthcare
systems, according to which everyone contributes to the medical fund
according to its capabilities. This requires that the member states have
open access to the necessary medical services through a fair distribution
of healthcare costs and medical services to the entire population. This can
be achieved through the institution of social medical insurance, based
on solidarity. In this case, the more wealthy subsidize the poor and the
healthier subsidize the sick.
Access to high quality medical care requires states to ensure the provision
of the most feasible such care, which must be patient-oriented and meet the
individual needs of the patient (Kickbusch and Gleicher, 2012).
In the sphere of healthcare GG model is associated, rst of all, with
a focus on people’s needs, on the patient’s guidance from the moment
of his application for medical care to the completion of the treatment
(rehabilitation) process, on the openness and accessibility of the national
healthcare system. Mentioned model is the most appropriate for democratic
and developing countries. Primarily, it concerns the member-states of the
European Union and some other countries of the world, which are guided
by European democratic principles and values.
Referring to the works of R.B. Denhardt devoted to the New Public Service
(NPS), researchers consider this model to be a distinctive development of
GG. It should be noted that this model was formed in response to the need
to reform the institution of public service from a bureaucratic system in the
direction of the service concept, according to which the activity of public
servants is focused on satisfying the needs of citizens and helping to provide
them with public services.
The supporters of this model believe that the basis for large-scale social
and economic changes in society is improvement of working conditions.
Moreover, the signicant importance is attached to the behavior of the
individual, but also for all the components that inuence interrelations
between people, an open dialogue between all parties, including between
citizens and public servants (Gordon et al., 2018).
In the aspect of healthcare it is about the dialogue between patients
and the state. The latter formulates, for example, a list of pharmaceutical
products, the cost of which requires partial or full reimbursement of
expenses for acquisition by citizens, based on the identication of the needs
of the population in the provision of appropriate medicines.
Considering other modern models of public administration, Y.O.
Arkhipova points to Networked Government (NG), a model of merged
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administration that denes the overall goal of modern public administration
as the development of a democratic state using eective new management
methods and technologies to provide the population with simple and
high-quality public services (Arkhipova, 2015). For instance, making an
appointment with a doctor on a certain date via an electronic line greatly
simplies the patient’s life and unloads the healthcare facility and the
medical sta themselves from an excessive number of people, which
becomes especially important in the period of spread of infectious diseases,
pandemic threats, etc.
One has to agree that the factors that hinder the formation of electronic
governance include: the low level of interest of the population in the
electronic form of interaction with the institutions of public authority; lack
of awareness of digital technologies; low indicators of electronic interaction
between authorities and citizens; lack of awareness and interest of the
population in using the possibilities of digital technologies for interaction
with state institutions, etc.
For example, in Ukraine the elements of this model are manifested
in some aspects of the healthcare sphere. Thus, at the strategic level the
necessity of forming a unied medical space as a system of interaction
between healthcare bodies and institutions at all organizational levels is
determined. For its part, the development and implementation of eHealth
allows for simplication of document management and access to medical
services. Let us emphasize that the Ukrainian electronic healthcare system
is a two-component system where the user is connected to the central data
base through the electronic medical information system.
The eHealth system consists of two components:
1. The central data base is an information and telecommunication
system, which contains the statutory registers, software modules,
the information system of the National Health Service of Ukraine,
to the extent necessary for the implementation of state nancial
guarantees and others. (provides the possibility to create, review,
exchange the information and documents between registries, state
electronic information resources, electronic medical information
systems).
2. The electronic medical information system is an information and
telecommunication system that enables to automate the work
of public entities in the sphere of healthcare, to create, view and
exchange information in electronic form, in particular, including the
central data base (in case of connection) (The Ministry of Healthcare
of Ukraine, 2022).
Another new model to consider is Lean Government (LG), i.e.,
economical management. The essence of this model is that the subjects of
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authorities act «economically,» reducing the budgetary cost of their own
maintenance, simplifying for and improving administrative services, and
minimizing costs and barriers upon applying of citizens. In the long term,
this will improve the quality of services provided to the population, save
budget expenditures and minimize bureaucratic obstacles.
It should be noted that the methods of free administration are used
for a wide range of public services and administrative procedures, from
the development of rules to the execution of grants and contracts. That is
why a lot of state institutions today take part in programs of economical
transformation, achieving signicant results due to a signicant
improvement in the quality, transparency and speed of relevant processes.
Using the LG model helps government institutions to change their
methods of work, creating new capabilities and competencies, as well as
improving organizational capabilities for better service to the population.
For example, taking the LG model as the basis for the management of a
specic healthcare facility, we can talk about these innovations: all rooms
are created as single rooms; standard rooms are projected so that they can
be easily adapted to provide more specialized care than usual; individual
rooms are created to a «bariatric» standard, which allows for comfortable
housing of tall or overweight patients; rooms are not designed for specic
medical services and can easily be recongured to meet the needs of dierent
patients to avoid an imbalance in beds; the department is allowed to admit
more patients to its areas by expanding the appropriate neighboring units if
necessary; the facilities take into account epidemic standards and infection
control; minimizing waiting areas; in the emergency department, patients
are taken directly to the room, rather than being transported after sorting
to the waiting area, before being placed in the room (Florizone, 2015).
Of course, it should be noted that the implementation of LG model in
the sphere of healthcare in general, despite its signicant cost at the stage of
implementation, can signicantly improve the indicators of economics and
eciency in the near future.
The importance and relevance of this model of public administration
is also evidenced by the fact that healthcare providers around the world
are still facing enormous challenges, because the aging of the population
and unhealthy lifestyles are increasing the cost of healthcare faster than the
income and tax revenues of the middle class are growing. At the same time
the quality of medical care has not improved as much as public services
in other spheres, so more and more medical organizations are turning
to the implementation of the lean management in their activities (Lean
Healthcare, 2021).
Continuous implementation of quality changes in activities together
with a change of orientation to meet the needs of the customer and the
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formation of an economical worldview of the subjects of power are the key
foundations of this model of public administration.
Conclusion
The authors of the article analyzed the main modern models of public
administration on the application of the sphere of healthcare. It was
established that the traditional models are Old public management, New
public management and Good governance. And each of mentioned models
can be fully eective in a particular state. At the same time, it is also
impossible to talk about the appropriateness of any state borrowing and
implementing a particular model of public administration in its pure form.
Most often, national healthcare systems use models of public
administration, where the dominant model is supplemented by elements
of other models. It is also possible to talk about the transformation of
the corresponding models of public administration, caused by changes in
approaches to the formation and implementation of public policy in the
sphere of healthcare.
However, it is impossible to claim the existence of only three models:
OPM, NPM and GG, because the rapid development of technology,
combined with external factors, necessitates the testing of new universal
paradigms to achieve a balance between the private needs of the individual
and the public interest of the state. Such modern models change the view
of traditional notions of public administration, making important not only
the vectors of managerial inuence, but also the methods and ways of its
implementation.
The analysis of national normative legal acts and international soft law
allows us to determine the peculiarities of each of the main models of public
administration in the sphere of healthcare. These are the verticalization and
centralization of power for the OPM, the introduction of market techniques
in the public sector for the NPM, and the emphasis on human rights and
transparency for the GG.
Among modern paradigms of public administration, we consider
the LG model to be the most promising, the essence of which lies in the
constant introduction of innovations to improve eciency and the priority
of consumer interests, which in the sphere of healthcare is the patient. In
addition, lean methods not only simplify the services received by the patient,
but also involve the constant transformation of public administration
in order to nd the most eective combination of forms and methods of
management.
534
Nataliia Uvarova, Oksana Adamchuk, Yevheniia Zhukova, Iryna Nagorna y Maryna
Nazarenko Comparative Analysis of Public Administration Models on the Example of Healthcare
Sector
The sphere of healthcare in any state is extremely important, and this is
common to all countries of the world. At the same time, national healthcare
systems dier greatly from one another in terms of economic capabilities,
level of public health, sanitary and epidemiological state and other
indicators. In its turn, a better understanding of management processes
should help to form a sustainable link between public health policy and
public administration in order to take into account everyone’s needs and
satisfy the public interest.
Bibliographic References
ARKHIPOVA, Evgenia. Network governance as a model of public administration.
Materials of the VIII International science and practice conference:
“Modern problems of management: the dialectic of centralization
and decentralization” (Kyiv, December 10, 2015). Convenors: A.A.
Melnychenko, I.V. Village. NVP «Interservice» LLC, 2015. pp. 87-88.
Kyiv, Ukraine.
AZAROVA, Angelika; TKACHUK, Lyudmila; NIKIFOROVA, Liliia. 2019.
Public management and administration: study guide. VNTU. Vinnytsia,
Ukraine.
BOLOTINA, Yevgenia; NIKITENKO, Anatolii. 2017. “The modern western
concepts of management and models in public administration” In:
Economic Herald of the Donbas. Vol. 47, No. 1, pp. 96-100.
COHEN, Nissim; MIZRAHI, Shlomo; VIGODA-GADOT, Eran. 2022.
“Alternative provision of public health care: the role of citizens’ satisfaction
with public services and the social responsibility of government” In:
Health Economics, Policy and Law. Cambridge University Press. Vol. 17,
No. 2, pp. 121-140.
ELECTRONIC HEALTHCARE SYSTEM IN UKRAINE. 2022. Digital
transformation of the healthcare system. Available online. In: https://
ehealth.gov.ua/. Consultation date: 20/07/2022.
ERLINGSDOTTIR, Gudbjörg; LINDHOLM, Cecilia. 2013. “Because we can –
eHealth encounters New Public Management in Swedish Healthcare”.
In: B. Czarniawska (ed.). Nordiska Företagsekonomiska Föreningens
(NFF) konferens 2013, Reykjavík, pp. 1-13, Nordisk Företagsekonomisk
Förenings (NFF) konferens, 2013. Reykjavík, Iceland.
FLORIZONE, Dan. 2015. “Implementing lean management principles across
government”. Planet Lean. Available online. In: https://planet-lean.
com/saskatchewan-lean-government/. Consultation date: 19/07/2022.
535
CUESTIONES POLÍTICAS
Vol. 40 Nº 75 (2022): 522-536
GORDON, Marina; OLENTSEVYCH, Nataliya; KOLISNYK, Inna. 2018.
“Models of Public Administration: Comparative Analysis and Proposals
for Ukraine” Nº3, pp. 1-6. Available online. In: http://www.dy.nayka.
com.ua/pdf/3_2018/43.pdf. Consultation date: 21/07/2022.
KICKBUSCH, Ilona; GLEICHER, David. (2012). Governance for health in the
21st century. World Health Organization. Regional Oce for Europe.
Available online. In: https://apps.who.int/iris/handle/10665/326429.
Consultation date: 18/07/2022.
KROPYVNYTSKYI, Roman. 2018. “Models and features of state management
of scientic activity of scientic institutions” In: Investment: Practice and
Experience. No. 12, pp. 136-140.
LATIPOVA, Natalia. Peculiarities of modern models in public administration.
Scientic Collection “InterConf”, (36): with the Proceedings of the 7th
International Scientic and Practical Conference “Challenges in Science
of Nowadays”. EnDeavours Publisher, 2020. Washington, USA.
LEAN HEALTHCARE. 2021. Planet Lean. Available online. In: https://planet-
lean.com/focus/lean-healthcare/. Consultation date: 21/07/2022.
LEE, Hayoung; ROBINSON, Courtland; KIM Jaeshin; McKee, Martin; CHA,
Jiho. 2020. “Health and healthcare in North Korea: a retrospective study
among defectors” In: Conict and Health. Vol. 14, No. 41, pp. 1-8.
LEVCHENKO, Serhii. 2017. “Evolution of Scientic Concepts of Public
Administration in the 20th Century” In: State Formation. No. 2. pp. 1-15.
LIAKH, Yuri. 2019. “Establishment of adaptation of progressive western
concepts of public administration in Ukraine” In: State and regions.
Series: Public Management and Administration. Vol. 65, No. 1, pp. 70-75.
LOHVYNENKO, Borys; MYRONIUK, Roman; SVITLYCHNYY, Olexandr;
PROKOPENKO, Aleksey; KALENICHENKO, Lidija. 2019. “The way the
health care system in Ukraine looks like: international practices within
national realities” In: Wiadomosci lekarskie. Vol. 72, No. 4, pp. 685-691.
MORGUNOV, Oleksandr. 2018. “Changing the principles of public
administration of physical culture and sports in Ukraine in the context of
deepening European integration” In: Subcarpathian Law Herald. Vol. 3,
No. 2 (23), pp. 20-24.
NYKOLAIEVA, Valentyna. 2019. “Modern Models of Public Administration
in EU Countries: Implementation Experience” In: University Scientic
Notes. Vol. 18, No. 4 (72), pp. 38-47.
536
Nataliia Uvarova, Oksana Adamchuk, Yevheniia Zhukova, Iryna Nagorna y Maryna
Nazarenko Comparative Analysis of Public Administration Models on the Example of Healthcare
Sector
OКHOTNIKOVA, Olena; ARBYCH, Yaroslava. 2020. “Public administration as
a guarantee of human rights and freedoms in Ukraine” In: Law Review
of Kyiv University of Law. Vol. 7, No. 4, pp. 174-177.
SHAULSKA, Galina. 2018. “Modern Оccidental management models” In: The
Scientic Papers of the Legislation Institute of the Verkhovna Rada of
Ukraine. No 3. pp. 111-116.
SYOMYCH, Mykola. 2019. “Features of modern models of public administration”
In: Public Administartion Aspects. Vol. 7, No. 7(4), pp. 44-52.
TEREMETSKYI, Vladyslav; DULIBA, Yevheniia; DIDKIVSKA, Galyna. 2021.
“Responsibility for ensuring the world biosafety: rethinking in the
context of the COVID-19 pandemic” In: Journal of Clinical Immunology.
Vol. 1, No. 4, pp. 1-7.
YAP KIOE SHENG. 2016. What is good governance. United Nations. Economic
and Social Commission for Asia and the Pacic. Available online. In:
https://www.unescap.org/sites/default/files/good-governance.pdf.
Consultation date: 18/07/2022
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Esta revista fue editada en formato digital y publicada
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