REHABILITATION SERVICES AS AN ECONOMIC CATEGORY AND THEIR PLACE IN THE STRUCTURE OF THE SERVICE SECTOR

Abstract

The article substantiates rehabilitation services as a distinct economic category and defines their place within the structure of the service sector. It shows that a rehabilitation service is an economic good of a dual nature (both a process and an outcome), produced through co-production involving the patient and bearing positive externalities that turn it into a merit good systematically underproduced by the market. Rehabilitation, medical and social services are differentiated by their purpose, expected outcome and the method of assessing utility, which allows the author to propose the concept of the 'triad of restorative services' providing a common analytical language for economists, clinicians and managers. A comparison of the KVED, ISIC, CPC and GATS classifications reveals the structural fragmentation of rehabilitation between health care and social protection, providing grounds for its positioning as a cross-sectoral service for human capital development that institutionally integrates the medical, social and labour dimensions. The article analyses the structure of the rehabilitation services market, identifies market failures and the dominant role of the state as a monopsonistic purchaser that replaces the absent market price signal through a differentiated tariff. Evidence of the economic effectiveness of rehabilitation is summarised and the methodological limitations of economic evaluations are identified, including the delayed nature of outcomes, the multidimensionality of effects and the predominance of indirect benefits. Particular attention is paid to the Ukrainian context: the sharp rise in demand caused by the war, the dynamics of budgetary financing of rehabilitation within the Programme of Medical Guarantees and the prospects of adaptation to EU and WHO standards within post-war recovery. It is concluded that rehabilitation should be perceived as an investment in human capital rather than as an expenditure.