INSTITUTIONAL-REGULATORY ASYMMETRY OF PUBLIC-PRIVATE PARTNERSHIP IN THE HEALTHCARE SECTOR OF UKRAINE

Abstract

The article substantiates the author’s concept of “institutional and regulatory asymmetry”
as an analytical framework for diagnosing the gaps between the formal normative legal basis and the real
institutional capacity to implement public-private partnership (hereinafter – PPP) in the healthcare sector
of Ukraine. A heuristic model of “critical deficits” is proposed – a set of concentrated points of regulatory
system failure, the identification of which allows the formation of targeted interventions instead of general
reform rhetoric. The relevance of the study is conditioned by the paradox of the Ukrainian case: despite
the existence of a full-fledged legal framework for PPP since 2010 (Law of Ukraine No. 2404-VI, from
October 31, 2025 – Law No. 4510-IX), the actual implementation of partnership projects in the healthcare
sector remains fragmentary and disproportionate to the volume of need for investment, which according
to the updated assessment of the World Bank (RDNA4, February 25, 2025) amounts to 524 billion U.S.
dollars. The aim of the article is to conceptualise institutional and regulatory asymmetry, to build an
operationalised model of critical deficits and to verify it on the materials of public management of PPP in
the healthcare sector of Ukraine for 2020-2025. The methodology combines systemic and structural
analysis, content analysis of normative legal acts and analytical reports, comparative institutional
analysis, case analysis, and methods of multi-criteria diagnostics. As a result of the study: (1) the concept
of institutional and regulatory asymmetry is formulated as a three-level phenomenon (formal-normative,
executive-institutional, praxeological levels); (2) seven classes of critical deficits are distinguished –
normative-operational, coordinative-institutional, personnel-competence, financial-instrumental,
informational-digital, risk-management, legitimacy-communicative; (3) a matrix of diagnostics of critical
deficits with 21 indicators in four qualifying gradations is developed; (4) verification of the model is carried
out on the Ukrainian case of 2020-2025 with the identification of dominant types of deficits. The scientific
novelty consists in the formation of a holistic analytical framework that replaces the descriptivecataloguing approach with concentrated diagnostics. The practical significance of the article is manifested
in the possibility of applying the model for the adoption of regulatory decisions, expertise of PPP projects
and preparation of scientific research.