Kazakhstan Medical University "Higher School of Public Health", Almaty, Kazakhstan.
Almaty Branch of the Non-Profit Joint Stock "Social Health Insurance Fund", Almaty, Kazakhstan.
Front Public Health. 2024 Oct 15;12:1418367. doi: 10.3389/fpubh.2024.1418367. eCollection 2024.
Between 2020 and 2022, there was a rise in employment and entrepreneurial activity, despite some unemployment growth. In the Compulsory Social Health Insurance (CSHI), insured individuals, especially privileged and wage workers, increased. However, certain contributors, like those exempt from contributions and single social taxpayers, decreased, possibly due to legislative changes or the economic climate. The study aimed to evaluate the effectiveness and accessibility of medical services within the frameworks of Compulsory Social Health Insurance and the state Guaranteed volume of free medical care based on data regarding waiting times and the volume of services provided.
This retrospective study analyzed data from 2020 to 2022 on patients receiving care under Kazakhstan's Mandatory Social Medical Insurance System (MSMIS) and Guaranteed Volume of Free Medical Care. Data included insurance status, labor market indicators, and medical service procurement. Descriptive statistics were calculated, and -tests, with -values indicating statistical significance ( < 0.05).
It has been identified that overall, the execution of the plan for all types of medical care in Kazakhstan, including Almaty, reaches 100.0%, indicating sufficient financial support for the healthcare system. Rehabilitation centers and COVID-19 testing services stand out with shorter waiting times, whereas comprehensive diagnostic and advisory services require significantly longer waiting periods. The Guaranteed Volume of Free Medical Care typically offers a greater number of services with shorter waiting times compared to MSMIS, except for specialized medical care services in diagnosing new formations, where the Guaranteed Volume of Free Medical Care also has shorter waiting times but provides a greater number of services.
The study has allowed us to identify differences in the availability and volume of medical services provided between Compulsory Social Health Insurance and the state Guaranteed volume of free medical care.
2020 年至 2022 年期间，尽管失业率有所上升，但就业和创业活动有所增加。在强制性社会健康保险（CSHI）中，参保人数，尤其是特权和工资劳动者增加了。然而，某些缴费人，如免缴费人和单一社会纳税人，却减少了，这可能是由于立法变化或经济环境的影响。本研究旨在评估强制性社会健康保险和国家免费医疗保障计划框架内的医疗服务的有效性和可及性，基于关于等待时间和服务提供量的数据。
这是一项回顾性研究，分析了 2020 年至 2022 年哈萨克斯坦强制性社会医疗保险系统（MSMIS）和国家免费医疗保障计划框架内接受治疗的患者的数据。数据包括保险状况、劳动力市场指标和医疗服务采购。计算了描述性统计数据，并进行了 t 检验，以检验值表示统计学意义（ < 0.05）。
总体而言，哈萨克斯坦包括阿拉木图在内的所有类型医疗保健计划的执行率达到 100.0%，表明医疗体系有足够的财政支持。康复中心和 COVID-19 检测服务的等待时间较短，而综合诊断和咨询服务的等待时间则显著延长。与 MSMIS 相比，国家免费医疗保障计划通常提供更多服务且等待时间更短，但在诊断新形成的专科医疗服务方面，国家免费医疗保障计划的等待时间也较短，但提供的服务更多。
本研究能够识别出强制性社会健康保险和国家免费医疗保障计划在提供医疗服务的可用性和数量方面的差异。
