Abstract

The aim of this study was to assess the feasibility of the national electronic primary health care (PHC) database in Kyrgyzstan in producing information on the disease burden of the patient population and on the processes and quality of care of noncommunicable diseases (NCDs) in PHC. Strengthening of the PHC is essential for low- and middle-income countries (LMICs) to tackle the increasing burden of NCDs. Capacity building and quality improvement require timely data on processes and quality of care. A data extraction was carried out covering four PHC clinics in Bishkek in 2019 to pilot the use of the national data for quality assessment purposes. The data included patient-level information on all appointments in the clinics during the year 2018 and consisted of data of altogether 48564 patients. Evaluation indicators of the WHO Package of Essential NCD Interventions framework were used to assess the process and outcome indicators of patients with hypertension or diabetes. The extracted data enabled the identification of different patient populations and analyses of various process and outcome indicators. The legibility of data was good and the structured database enabled easy data extraction and variable formation on patient level. As an example of process and outcome indicators of those with hypertension, the blood pressure was measured at least on two occasions of 90% of women and 89% of men, and blood pressure control was achieved among 61% of women and 53% of men with hypertension. This study showed that a rather basic system gathering nationally patient-level data to an electronic database can serve as an excellent information source for national authorities. Investments should be made to develop electronic health records and national databases also in LMICs.

Highlights

  • Health service systems in developing countries are struggling with the weakest and the lowest resourced health systems with underdeveloped primary health care (PHC), while at the same time having the highest burden of noncommunicable diseases (NCDs) within the WHO European Region (Jakab et al, 2018)

  • Aim: The aim of this study was to assess the feasibility of the national electronic primary health care (PHC) database in Kyrgyzstan in producing information on the disease burden of the patient population and on the processes and quality of care of noncommunicable diseases (NCDs) in PHC

  • The information in the database of the eHealth Center enabled the identification of different patient populations and analyses of various process and outcome indicators on management of NCDs

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Summary

Introduction

Health service systems in developing countries are struggling with the weakest and the lowest resourced health systems with underdeveloped primary health care (PHC), while at the same time having the highest burden of noncommunicable diseases (NCDs) within the WHO European Region (Jakab et al, 2018). In Kyrgyzstan, a lower-middle income, former-SovietUnion country in central Asia, NCDs are the leading cause of mortality and cardiovascular diseases (CVDs) alone cause around half of all deaths (WHO Regional Office for Europe, 2017). Almost 4% of Kyrgyzstan’s gross domestic product is lost due to NCDs. Life expectancy of men is only 67 years of age (women 75 years of age) having major influence on workforce (WHO Regional Office for Europe, 2017). Significant improvements in PHC are needed to meet the universal health coverage, one of the principal goals among the Sustainable Development Goals (United Nations Development Programme, 2019; World Health Organization, 2019)

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