ORGANIZATION AND QUALITY OF MEDICAL AND REHABILITATION CARE FOR ACUTE MYOCARDIAL INFARCTION IN THE CONTEXT OF PUBLIC HEALTH

Abstract

Introduction. Acute myocardial infarction (AMI) remains one of the leading causes of mortality in Ukraine, despite healthcare reforms and the development of reperfusion care. High hospital mortality and limited rehabilitation coverage highlight the need for a systemic revision of treatment and recovery approaches.

Aim. To analyze the organizational aspects and quality of medical and rehabilitation care for AMI patients in Ukraine in the context of public health and to compare the findings with international practice.

Materials and methods. The study used content analysis of legal and clinical guidelines, statistical analysis of data from the Ministry of Health and Public Health Center of Ukraine, and scientific publications from 2019–2024. A comparative assessment of core indicators was conducted using data from the EU and USA.

Results. Hospital mortality after AMI in Ukraine is 2–3 times higher than in EU countries. Only 40% of patients undergo full cardiac rehabilitation, compared to 70–80% in Germany and the USA. Key barriers include limited access to percutaneous coronary intervention (PCI) in rural areas, staff shortages, outdated infrastructure, and low patient awareness. According to current clinical medicine perspectives, following acute myocardial infarction (AMI), the primary objectives extend beyond stabilization of the patient's condition to include the prevention of recurrent cardiovascular complications, preservation of functional capacity, and improvement of quality of life. Achieving these outcomes largely depends on the proper organization of cardiac rehabilitation, which, according to the European Society of Cardiology, is an essential component of comprehensive AMI management.

At the same time, rehabilitation strategies vary significantly across countries: Ukraine is characterized by a fragmented approach with limited patient coverage, whereas the European Union and the United States implement structured, personalized programs that consider sex, social, and individual factors. Effective post-AMI recovery requires the integration of multidisciplinary approaches, advanced digital technologies, and gender-sensitive rehabilitation strategies.

Conclusions. Effective AMI care in Ukraine requires strengthening human resources, expanding rehabilitation infrastructure, implementing telemedicine, and integrating a multidisciplinary, evidence-based approach in line with European standards.