Ahead of the Curve

2015 is the final year for the Salamatty Kazakhstan program. What are the key features?

First of all, I would like to underline that the main goals of the Program to improve the healthcare system have been reached. The measures we have taken have helped us to stabilize the situation in healthcare, decrease the level of illness and death rates, and improve main demographic indicators. The average life expectancy has gone over the 70-year milestone, and in the past five years birth rates in the country have improved significantly; 338,180 newborns within the first 10 months of 2014 compared with 305,357 in the same period of 2009. As a result of this program, the average life expectancy for many Kazakhstani people increased to 70, and we managed to decrease mortality rates among newborns and mothers. It all became possible because of the new model of managing and financing the department. If before the financing strictly depended on the number of hospital beds and medical staff, now it is based on payments per patient. The same rates for medical services are established throughout the entire country, and financing is attached to patients with particular diseases, and is directly proportional to the gravity and complexity of the illness. We have implemented the national screening program, which allows us to reveal 11 illnesses that influence mortality at the early stages, and also broadened the accessibility of professional medical care at in-patient facilities regardless of their physical address in the country. New medical technologies are being developed, and last year we held over 60,000 cardiac surgeries, over 500 surgeries for organ and tissue transplants, and implemented new technologies to operate on the human brain. The healthcare infrastructure is developing, and over 3,300 outpatient facilities are now fully providing the population with medical care. Mobility in the medical sector is developing faster, enabling us to provide medical care even in the most remote parts of the country. We have done a lot, and we are not stopping here. Please elaborate on the key elements that can characterize your strategy of development of the healthcare sector in Kazakhstan. At the moment we are assessing the results of the current Salamatty Kazakhstan program. This assessment was carried out by leading experts from the WHO and the World Bank. It is necessary to underline that despite our continuous success in the reduction of mortality and disease rates, life expectancy rates in Kazakhstan are still much lower than in other OECD countries. The effectiveness of early detection and treatment of illnesses remains quite low, among all age groups. In addition, we are experiencing problems with staffing in the medical sector. In these circumstances the strategic goal for Kazakhstan—to be included in the 30 most-developed countries in the world and advance government policy for social protection, including the rights for healthcare and proportional amount of free medical assistance—requires further advancements in the healthcare system. When we talk about perspectives in the healthcare sector, we need to remember the constant scientific and technical progress in medical studies and the global trend of the ageing population. According to UN data, the amount of people aged 60 and above will double by 2050 and will comprise 22% of total world population. With the increase in life expectancy, chronic non-infectious diseases will lead to a steady increase in medicinal consumption in the future, and financial pressure on the medical sector. This is a global trend that we can feel in our country as well.

The government is intending to provide easier access to medical care. How does the e-Healthcare system help to achieve this goal?

Access to information about medical services among citizens, as well as an increase in accessibility to medical services, are some of the main priorities of the new national healthcare system, or e-Healthcare. At the moment, 14 web applications are implemented all around the country, in the form of web portals. Such portals as the electronic hospitalization bureau and the register of assigned population allow anyone even today to choose their preferred medical facility for medical check-up and treatment. It is necessary to underline that patients’ access to medical facilities, be it regional clinics or national medical centers, is provided as part of free medical care. In the future, we are planning to broaden our use of information technologies in medical care. The central link of the electronic healthcare system will be the electronic health record (EHR). The EHR will contain key medical information on each patient, collected from various medical resources and information systems. It will be accessible for the patient and medical doctors providing the service. EHR will allow medical workers to monitor patient health and consider all previous medical history to make decisions. On the other hand, the patient will be able to receive notifications on upcoming medical check-ups, procedures, and doctor’s appointments. We are expecting that EHR implementation will allow us to provide continuity in medical care because of the collaboration of medical workers who work for different organizations but attend to the same patient. At the same time, this will reduce the duplications and unreasonable prescription of medical services provided at early stages by different medical establishments, and will also help to optimize patients for medical care.

How important is the human factor for the Ministry when it comes to the planning of quality medical services?

The human factor is incredibly important in our field of work, because patient health and life depends on our staff’s professionalism and dedication. In 2013, a group from the ministry analyzed establishments’ need in qualified staff, and it showed that in primary healthcare facilities, such as clinics, female wards, and ER, there is shortage of around 2,700 specialists. In order to overcome the deficit in human resources, we are taking measures for the professional development of our specialists in order to broaden their competencies through qualification improvements in niche specialisms. I would like to share some figures to illustrate it: by the end of the current year, over 5,000 specialists from all regions will have gone through education and training in the most frequent ambulatory clinical diseases. At the same time we are increasing the role of nursing services by delegating some doctor responsibilities to nurses. When it comes to the preparation of new qualified professionals, there are measures being taken to improve professional education at the undergraduate level. Last year, the passing score to enter medical universities was increased to 65. It is worth noting that, for the moment, six medical universities around the country already have functional clinical educational centers, equipped with modern technology, including simulation equipment for practice, training facilities, and more. The international practice of human resource management calls for the planning and preparation of your acting personnel. This means a thorough analysis of current and future market requirements with consideration of local demographics, epidemiological indicators, and demand for medical assistance. The social status and prestige of the medical profession are also taken into consideration, and are often determined by the salary rates and social benefits. For this purpose, the government of Kazakhstan is improving the legal base, developing professional standards, and renewing the nomenclature and professional demands for its medical workers. We anticipate all these measures will improve and strengthen human resources in the medical sector.

© The Business Year – January 2015