You won't stay in the hospital anymore: 10 questions about the new hospitalization rules

It’s been two months since Ukraine’s healthcare system has been operating under new, fairly strict hospitalization criteria. The debates that raged around the reform after its publication have gradually subsided; nothing scandalous happened. Still, the system has so far been tested in a “warm bath”: during mild weather in August–September and in the absence of epidemics; time will tell what happens next. How hospitalization works under the new rules — in questions and answers. Briefly about.

1. What are the “new hospitalization criteria”?

This is a single medical standard approved by the Ministry of Health order No. 1044 dated 30 July 2026. It equally applies to both public and private medical facilities and consolidates and unifies existing clinical protocols. Previously, decisions about hospitalization could depend on the practices of a particular medical institution and be made based on diagnosis; now doctors are placed within strict limits where everything must be justified and reported. The main goal is to reduce the non-targeted use of so-called bed-spaces and, in effect, to save money.

“The new standard is not about restricting hospitalization or reducing medical care. If a person’s condition requires round-the-clock monitoring, complex treatment, or an intervention that cannot be safely performed on an outpatient basis, the patient must be hospitalized. At the same time, a hospital bed in itself is not treatment…” — the Ministry of Health press service quotes its head, Viktor Liashko.

2. Can a patient request hospitalization?

Yes, every person in Ukraine has the right to medical care, which includes inpatient treatment. However, the basis of “hospitalization at the patient's request” has never officially existed. A doctor is obliged to accept a person, listen to their complaints and wishes, conduct an initial examination, but the decision will be made not on the basis of the disease label but on the person’s current condition.

For example: a man with high blood pressure wants supportive therapy. As people say, to “get drips.” Under the old rules, a doctor could give a referral for hospitalization by writing “chronic hypertension.” Now such a diagnosis is not a reason for inpatient stay; a doctor may refuse to refer a patient if they do not see a direct threat of deterioration or life risks.

Main criteria for hospitalization:

the need for round-the-clock medical observation,

the necessity of continuous monitoring of vital functions (connection to bedside monitors for heart activity, respiration, blood pressure, etc.),

performance of invasive or high-risk procedures;

treatment that cannot be provided outside the clinic, or lack of an alternative,

critical indicators of breathing, circulation, consciousness, or laboratory test results.

This is a generalized list. Additional criteria are defined for cardiology, neurology, infectious diseases, surgery, gastroenterology, urology, obstetrics, pediatrics, and other conditions.

3. Does a doctor have the right not to follow the criteria?

No standard can account for the individual peculiarities of the human body. There is always a risk that a patient who appears sufficiently stable at the appointment may experience a sudden deterioration a few hours later or develop unexpected complications. The Ministry of Health order provides that clinical judgment and the doctor’s experience are priorities. That means a doctor has the right to depart from the criteria if there are grounds for concern.

The individual decision must be justified in the patient’s clinical record, and the doctor issues a referral to the hospital. But that is not hospitalization yet. It is a compromise between “no” and “yes” — diagnostic observation for 24 hours.

4. What happens during the 24 hours?

During the day in the hospital emergency department the patient receives initial care (for example, blood pressure stabilization) and undergoes rapid diagnostics — they have tests, an electrocardiogram, and, if needed, CT, ultrasound, and other procedures.

Based on the results of the 24-hour observation, the clinic physician now decides: to formalize full hospitalization or discharge the patient with recommendations for further treatment.

5. What is offered instead of hospitalization?

The reform aims to shift treatment from inpatient to outpatient care as much as possible. Two options are offered to patients in non-critical condition:

- Day hospital. A person comes to the facility in the morning, receives prescribed procedures — drips, injections, physiotherapy, rests, and returns home in the evening and night. Previously, such departments existed at outpatient clinics in villages and small towns, and this was convenient. Now day hospitals are funded by the National Health Service of Ukraine only in multiprofile hospitals, large district polyclinics, and diagnostic centers. For residents of urban-type settlements and villages, daily travel there and back is practically unrealistic.

- Supervision by the family doctor. This is routine administration of medications at home under the supervision of one’s primary care physician. The patient can visit them or use communication tools.

6. How does emergency care work?

In emergencies, hospitalization, as before, occurs around the clock and urgently. The decision is also made not by diagnosis but by current vital signs. If emergency medical teams bring a patient to the hospital who has not reached critical markers, the hospital cannot simply refuse hospitalization. The above-mentioned 24-hour diagnostic mode is activated.

Conditions that pose an unconditional indication for hospitalization and a direct threat to life include:

suspected acute myocardial infarction, stroke, transient ischemic attack (speech disturbance, numbness on one side of the body), critical drop or rise in blood pressure,

shock states — anaphylactic shock, septic, traumatic, or due to massive blood loss,

“acute abdomen,” symptoms of poisoning,

respiratory disorders, critical saturation,

obstetric and psychiatric crises,

severe injuries or polytrauma, massive hemorrhages.

7. How long does hospitalization last?

There are no specific terms, but there is a strict rule: hospitalization lasts as long as there are medical indications. Each day of stay in a bed-space must be justified in writing by the doctor in the patient’s medical record. “Stay with us a few more days so complications don’t happen, we’ll watch you” — you will no longer hear that in the hospital.

Discharge must be immediate as soon as the patient’s condition stabilizes to a level that allows a transition to outpatient treatment. Neither weekends, nor waiting for scheduled consultations or tests, nor lack of transport are reasons to keep a person in the hospital. For violation of these requirements, as well as for unjustified prolongation of hospitalization, hospitals may lose NSZU packages, effectively shifting patient care costs onto the institutions.

8. What is social hospitalization?

This is a new hospital operating mode as a temporary shelter for people whose condition does not meet hospitalization criteria but whose lives are threatened for other reasons.

Lack of safe home conditions for treatment — the patient’s dwelling has no electricity, water, heating, or communication due to shelling or other emergencies.

Inability to self-care — the person is alone, has no relatives or caregivers, cannot walk, prepare food, or reach the toilet independently.

Inability to take medications — the patient has cognitive impairments or physical weakness and cannot follow the doctor’s prescriptions.

Threat of domestic violence — a person is due to be discharged but faces physical or psychological aggression from household members at home.

In such cases the patient is hospitalized or additionally kept in the hospital for 48 hours with immediate notification of social services. They are to determine the next steps — provide a social worker for home care, locate relatives, or arrange placement in a geriatric center, hospice, or another residential facility.

The social factor is also taken into account when deciding on hospitalization of a child. The standard stipulates that a child may be admitted when there is no certainty that parents or other relatives will provide proper care, treatment, and will be able to recognize dangerous symptoms when complications begin.

9. Can a refusal of hospitalization or premature discharge be appealed?

There are several places to file complaints, but first you need to make sure the refusal is properly documented.

Written refusal. From the doctor you approached with health complaints or from the emergency medic, demand a written refusal of hospitalization stating the reasons, signed and with the medical facility’s address which the doctor represents.

Recording symptoms. Make sure all complaints about your health — duration of the disorder, pain, blood pressure, dizziness, etc. — are entered into your medical record.

The same should be done if you believe you are being discharged prematurely from the hospital.

The Ministry of Health recommends filing complaints to the management of the medical facility, the health department at the local authority, and to the government hotline 1545. To the National Health Service of Ukraine — by their email ( [email protected] ), attaching the doctor’s written refusal if you managed to obtain it.

Offended patients, like all citizens, have the right to go to court and even seek moral compensation. But you can win a case only if you can documentarily prove that the refusal of hospitalization caused additional harm to your health.

10. What are the criticisms of the new criteria?

Primarily that the strict standard is being implemented in a country where outpatient treatment is poorly developed, and the war further complicates the situation. Because of strict criteria many Ukrainians may simply be cut off from medical care. “I think about those people who don’t have the strength to stand with cardboard signs and go to demonstrations. About a patient with undefined chest pain who today may not meet hospitalization criteria. About an elderly person living alone in a village dozens of kilometers from a hospital. About a patient who today can still be helped on an outpatient basis, and tomorrow may end up in intensive care. The approved changes are being implemented in a system that is certainly not ready for them,” wrote Doctor of Medical Sciences Olha Bohomolets.

The situation is difficult for doctors, too, who are forced to justify patients’ stays in bed-spaces. Infectious disease specialist Olha Holubovska wrote back in the spring, when the draft Ministry of Health order was discussed in the medical community, that such a system—with strict requirements and inspections—could teach doctors to be afraid to hospitalize.