MODELLING STAKEHOLDER INTERACTION IN THE IMPLEMENTATION OF A REGIONAL REHABILITATION PROGRAMME BASED ON SECURITY-ORIENTED MANAGEMENT

Abstract

The article substantiates the relevance of implementing security-oriented management in municipal healthcare enterprises under the conditions of the full-scale war, institutional changes, and the transformation of approaches to hospital operations. It is emphasized that healthcare institutions’ acquisition of the status of municipal enterprises and the right to provide paid services increases the need to strengthen their financial autonomy, improve management processes, and take security challenges into account. The purpose of the study is to model the interaction of different stakeholder groups in the implementation of joint healthcare projects. Seven alternatives for implementing a regional rehabilitation programme for the population of Khmelnytskyi Region involving Khmelnytskyi City Hospital, Khmelnytskyi National University, and a private clinic are considered: separate implementation by each entity, bilateral cooperation, and the joint participation of all three institutions. To assess the feasibility and benefits of the alternatives, a questionnaire covering 41 combinations of damage states was developed. The expert evaluation involved 30 specialists representing the city hospital, the university, and the private clinic. Based on the obtained assessments, a decision matrix was constructed, while the acceptability of discrepancies among expert responses was verified using the k-means method. According to the maximin, Bayes–Laplace, Savage, Hodges–Lehmann, and product criteria, the most appropriate option was found to be the implementation of the programme with the joint participation of all three entities. It is substantiated that the participation of the municipal medical institution and the state educational institution should be equal, whereas the share of the private medical sector should be 26.5% higher. Balancing funding sources and distributing the workload in the proportion of 1:1:1.265 was identified as optimal for the socio-economic security of Khmelnytskyi Region. It is noted that the implementation of the programme will contribute to strengthening the economic security of hospitals, ensuring the efficient allocation of resources, creating jobs, generating additional revenues, and reducing the risks of inefficient management of earmarked funds.