Аннотация
Considering the international experience, the ratio of primary health care and hospital care that plays a key role in rational use of resource-saving technologies is reviewed and gradually brought into line with the real needs. Methods of investigation Cross-sectional, full study was carried out in 76 outpatient organizations of Almaty. The object of investigation - day hospitals, statistical data for 2010–14. Inclusion criterion was medical organizations providing hospital-replacing care, exclusion criterion - organizations not providing hospital-replacing care. Results In Almaty in 2014 312 965 patients were treated, in hospital-224647(72%), in day hospital-88318(28%), (2010-68755(24%). Total amount invoiced for day hospitals increased 4,9 times (2011-1,7 times). Average cost growth rate of 1 case in day hospital increased 3,8 times (in 2011–1,7 times), in hospitals it increased 2,6 times (2011-1,8 times). On forms of hospital-replacing care in day patient facilities at clinic 51342(58%) patients were treated, in hospitals - 21278 (24,1%), home care - 15968 (17,8%). Average cost of 1 case in day patient facilities at the clinic increased 4,2 times, (2011-1,77), in hospitals - 2,8 times (2011-1,74). In day hospitals the number of beds - 1404 (734 in 2010), availability of hospital-replacing technologies for population in 2010–5,5 for 10000 population; 2013–7,9, 2014–9,1. Annual average absolute increase is 159 beds, increase of the number of beds at an average in 5 years - 16%. Average annual growth rate of financial expenditure to hospital-replacing care in RoK is 35%, in Almaty-49%. Discussion There is a reduction of financial expenditures for inpatient care from 93% to 87%, and increase of the relative share of financial expenditure to hospital-replacing care is from 7% to 13%. Also there is a slowdown of growth rate of the treated in hospitals to (−34% in 2014), (−35% in 2013г.), increase in the growth rate of the treated to 28% in day hospitals of Almaty Key messages The trend of the growth of the number of beds in day hospital reflects the demand of hospital-replacing forms of medical care which directly indicates the active development of day hospitals in RoK Integrated assessment of health care quality and availability in primary health care conditions