Evaluation of economic efficiency and organization of medical aid to rural population in Kazakhstan

AK Ozhikenova, KK Kurakbayev, К.А. Ожикенов

2016

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DOI 10.1093/eurpub/ckw174.013
Data confidence 70 medium
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Abstract

Background One of the effective ways for resource conservation, improvement of the quality and availability of medical care in rural areas should be a change in funding mechanism for rural health organizations. Methods Cross-sectional and full study was carried out in 14 RoK rural areas. Object of the study-medical organizations, statistical data for 2013-15. Inclusion criteria-rural residents who were provided specialized medical care (SMC), exclusion criteria-non-rural residents. Results In 2015 517 860 rural residents (2013-546608) were treated in RoK, including 413025 (2013-391567) on hospital-replacing technologies (HRT). The number of ambulance calls-2897001 (2013-2914908). 41,0% patients were directed to day and night care hospitals from PHC, 40,9%-from diagnostic centers, 14,2%-by ambulance, 21,7% on their own accord, 0,8% other types of assignment. Hospitalization types: emergency-72%(2013-74,9%), planned 27%(2013-25%). The growth rate of average cost of 1 case in 2015 in PHC-0,8(2013-0,6), emergency aid-1,1(2013-1,0), HRT-0,8(2013-0,6). Patients treated on HRT in day care unites of polyclinics-55,4%, in hospitals-36%, at home - 8,6%. Correlation analysis was used to measure between the number of ambulance calls in rural population and volume of ambulance financing (P < 0.97), between the number of diagnosis services and volume of financing these services (P < 0.9), between the number of patients treated on HRT and HRT financing volume (P < 0.9). Average absolute increase of workers a year in rural areas: in PHC-34 doctors, 682 nurses; in ambulance 23 doctors, 84 nurses; on HRT-9 doctors, 11 nurses. Conclusions After implementing UNHS in RoK availability and quality of medical care in rural areas are gradually increasing. Correlation analysis showed that the quality of medical care in rural areas is closely connected with financing volume. Structure of financing rural health care: 51,3%-PMC, 16,6% clinical and diagnostic services, 6,4 %-ambulance, 25,7%-«SMC+HRT». Key messages: In most Kazakhstan regions there are outstanding issues of financing medical care and pharmaceutical provision in day hospitals and home care The problem of rural health is the shortage of doctors and nurses. In RoK regions the average absolute growth of the number of doctors a year on SMC-1683 doctors (the growth rate 1,94), 7079 nurses