The vast majority of respondents are women (89.1%), mostly aged 40–65 and living in urban areas. These are predominantly people with moderate or vulnerable financial situations, for whom the cost of treatment is critical — it is through this experience that they evaluate the healthcare system.

The healthcare system itself does not appear to be failing, but it does not inspire unconditional trust either. Most patients rate its performance as satisfactory (54.5%), while the share of negative ratings (21.8%) is nearly equal to that of positive ones. In other words, this is not a matter of outright rejection, but rather a restrained, cautious assessment: the system works, but not well enough to inspire a genuine sense of confidence.

Patients are far more critical of the healthcare reform. A total of 44.0% of respondents are dissatisfied with its results, while the proportion of those who are satisfied is lower — 38.9%. This is a very telling figure: the reform has been in the public eye for a long time, yet for a significant portion of the population, it remains either unconvincing or insufficiently understood. This is confirmed by another finding: 37.7% of respondents explicitly state that they need further explanation of how the reform works. In other words, the system may be changing institutionally, but without sufficient communication, it does not become clearer to patients.

At the same time, the situation regarding everyday access to care appears relatively stable: most patients do not encounter serious barriers. However, when difficulties arise, they tend to be systemic in nature. Most often, these involve financial factors — 50.0% cite the cost of services or medications as the key problem, and nearly the same proportion (48.8%) report long wait times or a lack of appointment availability.

A separate paradox of the study concerns patients’ rights. Almost everyone is aware of the Affordable Medicines Program: 36.2% have used it, and another 57.5% are aware of it but have not used it. Similarly, 64.4% consider themselves knowledgeable about free medical services guaranteed by the state. However, this confidence in their knowledge translates poorly into practice: 40.7% have never checked which services are supposed to be free and which are paid.

In terms of digitalization, the picture is much more optimistic. Digital services — prescriptions, referrals, and doctors’ appointments — have already become standard practice for most patients. At the same time, 70.6% of users rate them as convenient, which is one of the strongest positive signals in the study.

However, there is a “but” here as well. Even with high awareness, patients rarely use available channels to protect their rights. Although 64.7% are aware of the National Health Service of Ukraine (NHSU) hotline, only 9.1% have actually used it. This means that people are aware of the existence of this channel for protecting their rights, but it has not become a habitual course of action for them. This closely mirrors behavior in cases of improper billing: awareness of the mechanisms exists, but the habit of using them does not.

As for actual experiences at healthcare facilities, the results here are also mixed. Over the course of the year, 96.0% of respondents sought care at healthcare facilities, most often at primary care clinics (39.2%). Overall, the quality of services is rated positively, but inpatient facilities consistently receive the lowest ratings.

At the same time, there is a positive trend. Half of the respondents say that the quality of services has not changed over the past year, less than a third see an improvement, and only 7.7% report a decline. Compared to the previous wave, this indicates a decrease in the proportion of those reporting deterioration and an increase in the proportion of those seeing progress.

The theme of human contact stands out particularly strongly in the study. Patients highly rate the professionalism of medical staff: 65.4% describe it as high or very high. Even more striking is the level of trust in doctors — 91.3% fully or partially trust the doctors at the facilities they visited. Almost the same proportion, 91.4%, say that doctors clearly explained their condition, diagnosis, and treatment plan. In terms of clinical communication, this is a very strong signal: despite systemic problems, personal contact with a doctor remains one of the main pillars of support for patients.

However, this trust does not negate traumatic experiences. A total of 37.8% of respondents have, to some extent, encountered humiliation, disrespect, or inappropriate treatment in healthcare facilities. Among respondents with disabilities, 18.6% reported negative attitudes from medical staff, particularly related to their disability. In other words, high overall trust in doctors coexists with a tangible experience of disrespect. This is one of the most striking contradictions in the entire study: professionalism is recognized, but service culture and the quality of interaction remain problematic.

A similar duality exists regarding inclusivity. In general assessments, healthcare facilities are more often described as accessible to people with disabilities and other mobility-impaired groups. However, when patients are asked about specific barriers, a different picture emerges: they mention difficulties with elevators or lifts, challenges in reaching the building, problems accessing the facility via ramps, stairs, or doors, and a lack of accessible restrooms. Thus, while accessibility may be formally assessed as present, the patient’s actual route within the facility is still fraught with obstacles.

A particularly sensitive area concerns mental health. Respondents’ self-assessment of their mental state averages about 4.2 points on a scale from 0 to 10, which the authors interpret as indicating a moderate level of problems. However, only 17.5% of respondents received professional psychological help in 2025. This suggests that the actual need for support and the practice of seeking help still do not align.

At the same time, the logic of trust here is very revealing. When it comes to mental health, respondents place the greatest trust in specialized professionals — psychotherapists and psychologists; however, the level of trust in psychiatrists and family doctors is significantly lower. This is an important signal for the system: people seek specialized care and do not fully view primary care as a comprehensive entry point to mental health services.

Another alarming finding: 24.6% of respondents in 2025 were taking antidepressants or other medications to support their mental health, and 37.8% of those taking them did so without a doctor’s prescription. This is one of the most significant findings of the study, as it transcends the “seek help/do not seek help” dichotomy and highlights the widespread practice of self-medication in an area where professional support is crucial.

Although nearly all patients have a family doctor (97.6%), psychological support at the primary care level has not yet become standard practice; 69.5% report that they were not offered it. In other words, the integration of mental health into primary care remains, for now, more of an idea than a widespread practice that patients actually experience.

The situation with children is somewhat different: in 2025, only 11.8% of respondents with children under 18 sought help from a child psychologist or psychotherapist. This is not a large proportion, but at the same time, parents’ general attitude toward such assistance is more open than resistant.

The survey results on disease prevention reveal another important trait of the modern patient: they tend to know what needs to be done rather than consistently doing it. Over 70% know which preventive screenings are recommended for their age group, meaning basic awareness is quite high. However, despite this high level of awareness, preventive practices — including vaccination — remain limited.

This is most evident in the case of vaccination. In 2025, fewer than one-third of respondents were vaccinated, while 66.5% were not, even though they had been vaccinated previously. The main reason for refusal is not so much a lack of access as a lack of perceived need. Among those who did get vaccinated, flu shots, as well as tetanus and diphtheria vaccines, were the most common. In other words, for most people, adult vaccination has not yet become a regular part of healthcare but remains an occasional or situational practice.

At the same time, the situation is significantly better when it comes to childhood vaccinations: 85.8% of respondents reported that they give their children all recommended or additional vaccines. This creates a noticeable gap between attitudes toward one’s own health and that of children. Yet even in childhood vaccination, a risk zone persists — the main reasons for refusal include distrust of vaccines, fear of side effects, and skepticism toward pharmaceutical companies.

When all the data is brought together, the main conclusion of the study is this: patients do not perceive the Ukrainian healthcare system as broken, but it also does not appear sufficiently transparent, understandable, or responsive. Patients trust their doctors, but they do not always trust the system. They use digital services but do not utilize mechanisms to protect their rights. They are aware of free guarantees but still pay. They recognize the need for mental health support but often do not seek it — or self-medicate. They view accessibility positively but still encounter barriers at doors, in elevators, and in restrooms.

This is precisely why the study captures not only attitudes toward healthcare, but also the state of the relationship between the individual and the system. And this relationship in 2026 can be described as follows: the patient has already adapted to the new healthcare system, but has not yet felt that it has fully adapted to them.

The project is implemented with the support of the Askold and Dir Fund as a part of the Strong Civil Society of Ukraine – a Driver Towards Reforms and Democracy Project, implemented by ISAR Ednannia and funded by Norway and Sweden.