Y. Birtanov reported that the results of the first nine months of this year continue to show positive dynamics in terms of overall mortality (decrease by 2%), infant mortality (decrease by 10.2%), maternal mortality (4.9%), mortality from malignant neoplasms (by 4.9%), accidents and injuries (by 9.1%), tuberculosis (by 17.1%) compared to the same period of the previous year.
At the same time, the minister reported on the main directions for the implementation of the State Program for Healthcare Development. So, the public health service was formed, in 11 regions public health departments were established under the health departments.
At the level of primary healthcare, in order to improve the quality of medical care for children under the age of six and reduce the burden on the general practitioner, work is underway to restore pediatric sites. In general, 23 such sites have been opened this year in the country, and another 84 are planned to open by the end of the year. In 2018, taking into account the release of interns-pediatricians, 230 pediatric sites are planned to be opened, from 2019 to 2024, more than 500 annually. Thus, by 2024 it is planned to meet 100% demand in pediatric areas.
A project is also being implemented to introduce a disease management program based on the active management of patients with chronic diseases. This year the project was implemented in all 16 regions, the number of patients participating in the project has doubled.
For improving the provision of emergency medical care and solving problems in the work of the emergency service, a differentiated approach is envisaged to provide emergency and urgent medical care. By urgency categories, calls are optimized and grouped by symptom.
In the conditions of the admission departments, it is planned to introduce a new medical specialty – a doctor of the emergency department (emergency doctor) for the timely provision of emergency medical care and, if necessary, the initial resuscitation and other measures to stabilize the patients.
As part of the implementation of the national drug policy, 53 long-term contracts have been concluded to date, including 24 in the current year. The share of domestic producers in the total purchase of a single distributor was 75% in physical terms, 30% in monetary terms. For 175 items of drugs, prices are reduced by 23%. At the outpatient level, about 2.5 million patients are provided with medications, 3.8 million patients are planned to be provided in 2018.
In the sphere of introduction of the system of compulsory medical insurance, from July 1, 2017, employers' contributions and payment of contributions of individual entrepreneurs began. Taking into account the reduction of barriers for private suppliers, measures are being taken to procure medical services for 2018. A database of healthcare subjects was established in the amount of 1 519, of which 686 are private providers.
In addition, the Ministry jointly with the regions is developing a single perspective plan for the development of the healthcare infrastructure, which calls for the transformation of the network, updating the infrastructure and training medical personnel, taking into account the rational use of resources.
To date, long-term plans to develop the infrastructure of seven regions (Aktobe, Atyrau, Zhambyl, West Kazakhstan, Karaganda, Mangistau and the city of Astana) have been considered. In general, it is planned to complete work on the Unified Prospective Plan together with the investment plans in the first ten days of November this year.
It is assumed that the adoption and implementation of a single long-term infrastructure development plan will allow in the period from 2017 to 2025 to save funds in the amount of 11.2 billion tenge.
In order to increase the level of the teaching staff of the medical sphere, the Center for Transfer of Innovative Technologies was established on the basis of the Karaganda State Medical University, a plan for further enhancing the capacity of teachers was developed, and training and development programs have been revised.
It was also noted that at present the second stage of the strategic partnership between domestic medical schools and leading foreign universities is being implemented. Seven foreign specialists from Sweden, France, Poland, Italy, Turkey were invited to manage positions and as professors of the departments. Until the end of 2017 it is planned to attract three more specialists.
New standards for the training of medical personnel in all specialties have been approved.
At the same time, the Minister of Healthcare of Kazakhstan reported that medical information systems are being introduced with the aim of digital modernization of health care and the transition to a paperless format of work.
To date, MISs have covered only 45% of healthcare organizations in the country. The coverage by MESs of republican organizations is 26%. Until the end of the year, it is planned to introduce MISs in all republican organizations, in regions – up to 64%.
In Karaganda, Akmola and Kostanay regions, a pilot project is planned to be implemented in 2018 to switch to paperless management of medical records. According to the results of the first half of 2017, computer equipment of healthcare organizations in the republic averaged 74.4%, at the beginning of 2017 – 34.3%.
53% of medical organizations in the country have an access to the Internet, at the beginning of the year this figure was 47%. By 2020, all medical organizations to the level of rural medical outpatient clinics will be connected to the Internet.