Анализ текущей ситуации после внедрения системы обязательного социального медицинского страхования Республики Казахстан

Abstract

The aim of the study: To assess the current state, the balance of functions and development trends of Social Health Insurance Fund NJSC. Methods. In order to study the level of awareness of the population about the implementation of the compulsory social health insurance system (CSHI), a mass survey was conducted twice during 2019 (in May and September) with a total sample of 2,150 respondents, including all regions of Kazakhstan. Also, within the framework of the study, such indicators of the activity of the Social Health Insurance Fund as the availability of funding for 2019-2020, the amount of funding by service providers, and coverage of the population were analyzed. Results. There is a positive trend in the compulsory health insurance system: awareness of the population is growing; the population positively assesses the changes in the provision of health services; there is a twofold increase in PHC visits; the share of private spending on health is twice the ceiling recommended by WHO; the level of coverage of the population with the compulsory health insurance system is quite high - 84%. However, about 3 million of the country's citizens remain uncovered. Conclusions. It is necessary to create a system for monitoring the effectiveness of the implementation of compulsory health insurance on the basis of information systems with the further adoption of managerial decisions both at the regional level and at the republican level. The introduction of mechanisms for proactive monitoring of the quality of medical care will protect the rights of patients, as well as improve feedback with them. Key words: Compulsory social health insurance, Medical services, Health care financing, Kazakhstan