THE MARKET OF MEDICAL SERVICES FOR COMPULSORY MEDICAL INSURANCE: CURRENT STATE, OPPORTUNITIES AND RISKS OF MEDICAL ORGANIZATIONS
Relevance: The main issues of the medical services market in Kazakhstan are low government spending on health care, as a result, low tariffs for medical services, a lack of qualified personnel, which affects the nature of the redistribution of medical care between the public and private health sectors. Due to the implementation of compulsory social health insurance, the medical services market is undergoing structural changes, which requires an adequate assessment of the current state.
Objective: The aim of this project was to study the trends and issues in the field of healthcare in the context of compulsory health insurance to determine ways of regulation of a market balance and improve the quality of medical services.
Materials and methods: The object of the study was medical service providers – the private and public health sectors. The study is observational, cross-sectional, continuous for the study group at the stage of examining the indicators of private medical organizations providing compulsory social health insurance. Furthermore, the statistical indicators of the health care system for the period from 2015 to 2019, as well as official sources of legal and industry information were studied.
Results: Analysis of current spending on health care shows both an increase in public and spending by 2.8 and 4.1, respectively. For the period from 2015 to 2019, the use of private healthcare increased by an average of 23.6% and there has been a high rate of integration of the private sector into primary health care. This allows the private health sector to be considered a full-fledged participant in the medical services market in the Republic of Kazakhstan, which attracts private investment in the health care system.
Conclusion: Private healthcare has a high potential for further growth, provided that the policy of attracting it to the fulfillment of government orders and ensuring a barrier-free environment under compulsory social health insurance are maintained. The introduction of compulsory social health insurance and the provision of a unified approach to assessing the quality of services provided by all providers of medical services within the framework of the compulsory social health insurance ensures equal conditions for competition.
Askar R. Eskaliev 1,
Natal'ja E. Glushkova 2, https://orcid.org/0000-0003-1400-8436
Almagul' A. Kauysheva 2, https://orcid.org/0000-0002-5341-3189
Asel' A. Nauryzbaeva3,
Saltanat S. Kyrykbaeva4, https://orcid.org/0000-0001-6151-6025
1 RSE “Hospital of the Medical Center of the Office of the President of the Republic of Kazakhstan”,
Nur-Sultan c., Republic of Kazakhstan;
2 Kazakhstan Medical University "Higher School of Public Health", Almaty, Republic of Kazakhstan;
3 Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Republic of Kazakhstan;
4 NCJSC «Semey Medical University», Semey city, the Republic of Kazakhstan.
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Eskaliev A.R., Glushkova N.E., Kauysheva A.A., Nauryzbaeva A.A., Kyrykbaeva S.S. The market of medical services for compulsory medical insurance: current state, opportunities and risks of medical organizations // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 4, pp. 180-189. doi 10.34689/SH.2021.23.4.020Похожие публикации:
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