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This study aims at verifying relationships between the perception of medico-legal risks involved in the professional activity of Republic of Kazakhstan healthcare professionals (HCPs), defensive medical behavior and their understanding of healthcare professional liability (HCPL) insurance. The current paper also analyzes the experience of some foreign countries based on a study which suggests the ways of improving the medical liability, defensive medicine and introduction to HCPL insurance in the Republic of Kazakhstan. Additionally, the identified advantages to introduction insurance and mediation as an extra-judicial regulation of disputes, the authors point out the identified shortcomings of the matter in the legal acts of the Republic of Kazakhstan. Relevance of the topic is reasoned to the fact that complaints about medical malpractice have increased over time in Kazakhstan, as well as other countries around the world. The costs arising from medical liability lawsuits weigh not only on individual HCPs but also on the budgets of healthcare facilities, many of which in Kazakhstan are supported by public funds. A full understanding of the phenomenon of medical malpractice appears necessary in order to manage this spreading issue and mechanism of HCPL insurance in the Republic of Kazakhstan.

Background Healthcare professionals, public committees and leaders, as well as and people in positions of responsibility, deeply apprehensive with improving patient safety in Kazakhstan. Patient attitude towards of medical error is relatively well studied in developed countries of the world, but little is known about Central Asian countries, especially post-soviet space. This study aimed to analyze the attitude towards medical errors, depending on whether the respondents themselves or their relatives had this experience in the Republic of Kazakhstan from 2019 to 2021. Methods The study included two hundred sixty-seven participants. The statistical analysis of data on medical error was performed for the whole country. Data on medical error from public were retrieved for the period 2019-2020. Respondents were asked about the causes of and solutions to the challenge of preventable medical errors and what the consequences of medical error should be. Results A total of 40.8% (109/267) of respondents confirmed that they had experienced problems regarding medical errors while 59.2% (158/267) had not encountered any medical errors in their life experience. Nearly one in three Kazakhstan's adults agree that cause of medical errors is lack of professional qualifications of health professionals 36.3% (97/267). The respondents noted that hospital administration 47.6% (127/267) should be held accountable for medical errors, followed by the health professionals 25.5% (68/267). Conclusions There were significant differences between the regions of the country in the causes of medical errors in the opinion of public, as well as in indicators of the degree of responsibility for and response to medical errors. There is a need for further study of the causes and attitudes of public, which may have helped to better understand the challenge of medical errors in Kazakhstan. Key messages There is a need to performing regular analysis and evaluation to find out the cause of the problem and taken into account in deciding regarding the medical error. We recommend raising awareness about medical errors and the need for incident reporting, introducing training and learning workshops, and improving medical error reporting.