You are using an outdated browser. For a faster, safer browsing experience, upgrade for free today.


4(41) 2014

Grechkovskaya N. V.


Shupyk National Medical Academy of Postgraduate Educational, Ukraine, Kiev

Full article (PDF), UKR

Introduction. The existing system of health care of workers at enterprises, where there are harmful and hazardous working conditions, is noneffective. Uncertainty of volumes and types of occupational care of workers with account of current require¬ments to reforming the healthcare system indicates its poor quality and nonefficiency.
The purpose of the study. Scientifically prove and develop an effective structural and functional model of occupational care of workers of large industrial centers in Ukraine in modern conditions, taking into account stages and volumes of health care to employees of selected categories by health care institutions (HCI), regardless types of ownership and subordination. Materials and methods. Sanitary and hygienic work conditions at enterprises of large industrial centers have been studied as well as work conditions associated with harmful and dangerous factors of the work environment. The historical analysis of different models of health care provision to workers in European Union and Ukraine has been made. A normative and legal base of organization and implementation of preventive medical examinations of workers, engaged in harmful and dangerous work conditions, has been analyzed, covering, also, modernization of the general health system at various levels.
Results. A structural-functional model of health care of workers at industrial enterprises has been developed, based on studying the material-technical base of HCI, their personnel provision, depending on different types of ownership and subordination, involved in providing occupational service for those, working in hazardous and dangerous conditions. The materials have been prepared for the normative-legal base of the Ministry of Health of Ukraine, for improving the occupational care of the working population. Conclusions. There is now such situation in Ukraine, when a sufficiently effective system of health care of workers in previous years, has been almost destroyed and a new one is not yet established. The number of medical and sanitary units, available at enterprises, being involved in providing medical care to employees, has been reduced and reorganized. The available models of health care of workers at industrial enterprises are rather different. The legal base, regulating the provision of occupa¬tional service to the working population in Ukraine, requires improvement and changing, with due account of socio-econom¬ic relations and requirements to reforms in the health system.

Key words: health care, occupational diseases, harmful and dangerous work conditions, preventive medical examinations


  1. Bogatyreva, R. V. 2011, Determinants of health and national safety. Kyiv:Avicenna, 446 p. (in Ukrainian).
  2. Grechkovskaya, N. V. 2013, «New organizational forms of occupational care of the working population». Modern medicine: Actual question», XXIV scientific conference, Novosibirsk, pp. 58-62 (in Russian).
  3. Gruzova, L. M., Lubyanova, I. P, Varyvonchyk, D. V., Sokolova, M. P. 2007, «Normative and legal provision of prophylaxis in occupational health». Collection of Abstracts of the «First All-Ukrainian Congress on Medical Law and Social Policy», Kyiv, pp. 42-43 (in Ukrainian).
  4. Karnaukh, M. G., Prokopchuk, O. L. 2004, Monitoring of the database on occupational health care of workers and enterprises in Kryvbass region. Guide for managers on occupational service, employers and other services, Ukr. NDI Industrial Medicine, Kryvyi Rig. 254 p. (in Ukrainian).
  5. Kundiyev, Y. I., Nahorna, A. M., Chernyuk, V. I. 2005, «The strategy on providing the safe work environment and preservation of workers' health in Ukraine for 2006-2010», Ukr J. Occup. Health, no. 3-4, pp. 4-10 (in Ukrainian).
  6. Lisohor, L. S. 2011, «Factors, influencing the quality of the working life in conditions of an economic crisis», Demography and social economy. Institute of Demography and Social Studies named after M. V. Ptu- kha, no. 1, pp. 79-85 (in Ukrainian).
  7. Mytnyk, Z. M., Slabkyi, G. O. 2010, Regional health systems in Ukraine: monograph in 2 parts, Kyiv, part 2, 392 p. (in Ukrainian).
  8. Morozov, A., Stepanenko A. 2000. «Current mechanisms of ensuring the quality of medical care», Medicines in Ukraine, no. 5, pp. 63-64 (in Ukrainian).
  9. Nahorna, A. M. 2006. Health: fundamental and applied aspects, «Nord-PRESS», 336 p. (in Ukrainian).
  10. Knyazevych, V. M, Lazoryshynets, V. V., Yakovenko, I. V. 2009, Health protection in Ukraine: state, problems and prospects., Ternopil State Medical University, Kyiv., 439 p. (in Ukrainian).
  11. Stepanenko, A., Tsimeyko, O.A., Kalyuzhna, A.V., Melnyk, Yu.V. 2000, «Selected aspects of management of the system of medical care quality at the modern stage», Visnyk sots. gigiyeny ta organ. okhorony zdorov'ya, no. 4, pp. 56-59 (in Ukrainian).
  12. Tkach, S. I., Lykyanenko, O. Y., Borovyk, I. G., Grygoryan, O. V. 2014, Normative and legal documents on organization of therapeutic and preventive care of workers, involved in hazardous and dangerous production conditions. Training manual for individual work of occupational pathologies and physicians of various specialties, conducting preventive medical examinations, Kharkiv, KhMAPE, 29 p. (in Ukrainian).