Аннотация
The COVID-19 pandemic significantly disrupted inpatient healthcare systems worldwide, leading to rapid reorganization of hospital capacity, patient flows, and resource allocation. Urban healthcare systems were particularly affected due to high population density and increased demand for services.Objective: To assess changes in the performance of inpatient healthcare services in Almaty from 2017 to 2025, with a focus on differences between pre-pandemic, pandemic, and post-pandemic periods.Methods.A retrospective observational study was conducted using aggregated annual data from inpatient healthcare facilities in Almaty. Key indicators included hospitalizations, bed capacity, average length of stay (ALOS), in-hospital mortality, bed occupancy, workload indicators, patient routing, and quality measures. The study period was divided into three phases: pre-pandemic (2017–2019), pandemic (2020–2022), and post-pandemic (2023–2025). Descriptive statistics, one-way ANOVA, and linear regression analysis were applied to assess temporal trends and differences between periods.Results.Hospitalizations increased by approximately 33% from the pre-pandemic to post-pandemic period. Bed capacity expanded during the pandemic and remained elevated thereafter. ALOS decreased over time, indicating improved efficiency. In-hospital mortality increased during the pandemic and declined below pre-pandemic levels in the post-pandemic period. Bed occupancy showed a temporary decline followed by recovery. The pandemic led to a substantial redistribution of bed capacity, with a marked increase in infectious beds. Hospital workload increased significantly, while patient routing shifted toward outpatient referrals. Complication rates declined consistently, indicating improvements in quality of care.Conclusions.The COVID-19 pandemic acted as a catalyst for structural transformation of inpatient healthcare services in Almaty. The post-pandemic period was characterized by recovery, improved efficiency, and enhanced quality of care. These findings highlight the importance of strengthening health system resilience and optimizing resource allocation to sustain long-term improvements.Keywords:COVID-19, inpatient care, hospital performance, Kazakhstan.