Myocardial infarction is the most common heart disease. More specifically, it is the severe stage of coronary heart disease, during which damage and necrosis of certain areas of the heart occur due to insufficient blood supply. Most importantly, it is an acute condition requiring urgent medical attention, as a heart attack causes irreversible changes in the heart muscle and can lead to cardiac arrest.
VoxCheck, with the support of the USAID Health Reform Support Project, continues to explain to patients how the state Medical Guarantees Program works and what free medical services it provides. “Medical assistance for acute myocardial infarction” is one of the packages in the Medical Guarantees Program. We will explain which services are included in this package, where to get the necessary help, and what patients should do if their rights are violated.
How to recognize a heart attack: main symptoms
If a heart attack lasts more than 15-20 minutes, it can develop into a myocardial infarction. Part of the heart muscle that stops receiving blood begins to die within 20-40 minutes, so it’s essential to call an ambulance immediately in the event of a heart attack.
Symptoms of myocardial infarction include:
- Persistent chest pain that intensifies;
- Recurring pain waves at rest;
- Pain spreading to the left shoulder, left arm, or lower jaw;
- Sudden weakness and a sense of fear;
- Increased heart rate;
- Sudden fluctuations in blood pressure.
If you experience at least one of these symptoms, seek medical help. Before the ambulance arrives, if cardiac arrest occurs, an external heart massage should be performed. If the person is conscious, it is recommended to:
- Sit or lie down with the upper body elevated;
- Take an aspirin and nitroglycerin tablet if blood pressure is high and there are no contraindications;
- Free the chest from anything that may be compressing it or obstructing breathing;
- Open windows for ventilation.
How to get free help because of heart attack: patient’s route
Under the Medical Guarantees Program, help because of myocardial infarction can be obtained free of charge at 77 medical institutions contracted with the National Health Service of Ukraine (NHSU). These facilities are equipped with everything necessary to provide quality and timely treatment, including specialized doctors and equipment.
Since myocardial infarction is an acute condition, a referral from a doctor is not required to receive help under the Medical Guarantees Program for free. In this case, you should call an ambulance: emergency medical teams are trained to handle such urgent cases and will transport the patient as quickly as possible to a facility with an NHSU contract. Assistance will also be free for the patient in cases of self-referral to a hospital or transfer from another medical facility.
When calling 103, it is important to describe the patient’s condition as accurately as possible, indicating the exact time of the onset of chest pain and its duration. This will help establish a preliminary diagnosis, confirming or excluding a myocardial infarction.
Free medical services for myocardial infarction
Within the “Medical Assistance for Acute Myocardial Infarction” package, patients should receive all necessary diagnostic examinations and therapy for free, continuous monitoring of their condition, as well as medication and meals.
Key services for myocardial infarction include:
- Diagnostics (CT, MRI, angiography, ECG, echocardiography, X-ray, laboratory tests);
- Treatment of acute myocardial infarction, including coronary artery catheterization with blood flow restoration;
- Stenting (if needed);
- 24/7 patient monitoring in intensive care;
- Pain relief at all stages of diagnosis and treatment;
- Provision of blood components and drugs;
- Medical rehabilitation during the acute period;
- Medicines from the National List of Essential Medicines and consumables;
- Nutrition in inpatient conditions.
A complete list of medical services can be found on the NHSU website. The address and contacts of the nearest medical institutions with a corresponding NHSU contract can be obtained from the contact center operator at 16-77 or via the “Concluded contracts for medical services for the population under the Medical Guarantees Program” dashboard. It is worth noting that stents are not covered by the Medical Guarantees Program: medical institutions receive them through centralized purchases by the Ministry of Health.
What to do if your rights are violated while receiving medical care
If a patient is denied medical care provided by the Medical Guarantees Program, receives it incompletely, or is charged for it, they should file a complaint with the chief physician. If the issue cannot be resolved this way, they should contact the local health department. If that does not help, a complaint should be filed with the NHSU.
Since the beginning of 2023, the NHSU has received 21 complaints about medical institutions providing care for myocardial infarction treatment, with the most in Dnipropetrovsk, Kyiv, and Lviv regions (three in each). For instance, in December 2023, a man with a massive heart attack was taken to the Dnipropetrovsk Regional Center for Diagnosis and Treatment. From the first day of his stay, the patient’s wife bought medications and everything needed for his care. She later sent a complaint to the NHSU, including all the lists of purchased medicines and receipts. After reviewing the complaint, the medical institution refunded all the money spent on drugs and consumables.
“Treatment of acute myocardial infarction is one of the priority services in the Medical Guarantees Program, and for good reason. The cost of mistakes in providing medical care in this case is very high because the speed and quality of care determine the patient’s life. Therefore, the NHSU pays special attention to medical institutions with a contract for the ‘Medical Assistance for Acute Myocardial Infarction’ package and to complaints from patients about them. The NHSU’s requirements for contracted hospitals are clearly defined so that patients can receive the full range of necessary assistance for free — from examination to rehabilitation during the acute phase. For providing care, medical institutions will be paid by the NHSU: UAH 25,000 without stenting and almost UAH 44,000 with stenting,” says NHSU Head Natalia Husak.
How to file a complaint to the NHSU
You can file a complaint with the NHSU in several ways:
- Submit a complaint via the online form on the NHSU website in the “For Citizens” section: https://cutt.ly/hewPO7gU.
- By calling the free hotline at 16-77. The hotline operator will record the complaint and help prepare the submission.
- Send an official letter to the email: [email protected].
- Send a letter to the NHSU postal address: 19 Stepan Bandera Avenue, Kyiv, 04073.
- Submit a request in person during a citizen’s reception.
What to include in the complaint:
- Full name, and date of birth of the patient.
- Date of the event that caused the complaint.
- Name of the hospital.
- Position, full name of the person who demanded payment for medical services, medications, or other materials, refused to provide a service, or otherwise violated the patient’s rights.
- Detailed description of the incident.
- The amount spent or demanded. If available, copies of receipts for medicines or medical services.
- Contact details: mobile or landline phone number, email address, postal address.
To ensure a positive outcome, it is important to provide as many facts and evidence of the demand for payment (receipts, photos or videos, names of medical staff who demanded payment). This will help establish the facts of the demand and return the money to the patient.
Complaints not only defend your own rights but also those of other patients and contribute to increased transparency in the healthcare system as a whole. Corruption in healthcare causes inequality in service delivery and reduces the effectiveness of medical care. In the context of acute conditions such as myocardial infarction or stroke, timely and qualified medical care is crucial for preserving not only health but also the life of the patient. Therefore, it is particularly important that funds from the NHSU go to those medical institutions capable of providing such assistance.
This information piece was produced with the assistance of the United States Agency for International Development (USAID), provided on behalf of the people of the United States of America. This article’s content, which does not necessarily reflect the views of USAID, the United States Government, is the sole responsibility of Deloitte Consulting under contract #72012118C00001.
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The authors do not work for, consult to, own shares in or receive funding from any company or organization that would benefit from this article, and have no relevant affiliations
