The report explores healthcare productivity in Kazakhstan using national health accounts data, with comparisons to OECD countries. Productivity in healthcare is assessed through multiple indicators at systemic, sub-sectoral, and disease-based levels. Key productivity measures include healthcare expenditures, mortality rates, service delivery efficiency, and resource utilization.
The study by Omirbayeva B.S. analyzes healthcare productivity in Kazakhstan using national health accounts data, comparing key performance indicators with those of OECD countries. The analysis spans from 2016 to 2021 and examines systemic, sub-sectoral, and disease-based productivity levels. It provides critical insights into expenditures, mortality rates, service delivery, and resource utilization.
Healthcare expenditures have almost doubled during the study period. Public healthcare spending grew faster than private out-of-pocket costs, improving financial protection. By 2021, out-of-pocket payments accounted for 25% of total healthcare expenditures, down from 36% in 2016. However, this remains higher than the OECD average of around 18%. Investments have increased in ambulatory and preventive services, but hospital services still consume a substantial portion of healthcare funding. Resource allocation inefficiencies persist, particularly in rural and remote regions.
Mortality rates are a significant concern. Infant mortality averaged 8.09 per 1,000 live births between 2016 and 2021, more than double the OECD average of 4 per 1,000. Maternal mortality surged to 44.7 per 100,000 live births in 2021, up from 12.7 in 2016, driven largely by the COVID-19 pandemic. Over half of maternal deaths were linked to COVID-19 and related complications. These high mortality rates indicate the need for better access to prenatal, postnatal, and emergency maternal care.
Ambulatory care services have seen growth, with per capita spending reaching 54,385 tenge in 2021. Expanded access has led to greater utilization of outpatient services, but preventive care, including early detection and disease screening, remains underdeveloped. This lack of preventive services contributes to higher rates of hospital admissions for preventable conditions, particularly in rural areas.
Hospital services display both strengths and inefficiencies. Kazakhstan has 6.8 hospital beds per 1,000 people, compared to the OECD average of 4.4. However, longer hospital stays (8.9 days versus the OECD’s 7.6 days) suggest inefficiencies in care and discharge planning. Resource management challenges intensified during the COVID-19 pandemic, with hospitals facing increased demand and financial pressure due to bed expansion. Hospital spending also rose significantly, but post-operative complications and mortality worsened during the pandemic.
Disease-based indicators reveal weak early detection for conditions such as cancer. The proportion of cancer diagnoses made at late stages has increased, particularly for breast, cervical, and lung cancers. This highlights the need for improved screening and diagnostic services to catch diseases earlier and reduce mortality rates.
The COVID-19 pandemic exposed critical weaknesses in Kazakhstan’s healthcare infrastructure. Routine services were disrupted, and hospitals struggled to manage the surge in severe cases, particularly among high-risk groups like pregnant women. This led to increased mortality and worsened health outcomes across the system.
Based on the findings, the report offers several recommendations to enhance productivity and efficiency in the healthcare system:
- Strengthen Preventive and Primary Care:
Increase investments in early detection and screening programs to reduce preventable hospital admissions. - Improve Maternal and Infant Health Services:
Expand access to high-quality prenatal and postnatal care, particularly in underserved areas, to lower mortality rates. - Optimize Hospital Resources:
Implement strategies to shorten hospital stays, improve discharge planning, and better allocate resources based on regional demand. - Enhance Financial Protection:
Continue efforts to reduce out-of-pocket costs by expanding insurance coverage and providing targeted subsidies for vulnerable populations. - Strengthen Emergency Response Systems:
Build resilience in emergency care infrastructure to better handle future crises.
These reforms are essential for improving healthcare productivity and ensuring equitable access to high-quality care in Kazakhstan.
