BackgroundSelf-rated health (SRH) has been widely studied to assess health inequalities in both developed and developing countries. However, no studies have been performed in Central Asia. The aim of the study was to assess gender-, ethnic-, and social inequalities in SRH in Almaty, Kazakhstan.MethodsAltogether, 1500 randomly selected adults aged 45 years or older were invited to participate in a cross-sectional study and 1199 agreed (response rate 80%). SRH was classified as poor, satisfactory, good and excellent. Multinomial logistic regression was applied to study associations between SRH and socio-demographic characteristics. Crude and adjusted odds ratios (OR) for poor vs. good and for satisfactory vs. good health were calculated with 95% confidence intervals (CI).ResultsAltogether, poor, satisfactory, good and excellent health was reported by 11.8%, 53.7%, 31.0% and 3.2% of the responders, respectively. Clear gradients in SRH were observed by age, education and self-reported material deprivation in both crude and adjusted analyses. Women were more likely to report poor (OR = 1.9, 95% CI: 1.2-3.1) or satisfactory (OR = 1.6, 95% CI: 1.2-2.1) than good health. Ethnic Russians and unmarried participants had greater odds for poor vs. good health (OR = 2.3, 95% CI: 1.5-3.7 and OR = 4.0, 95% CI: 2.7-6.1, respectively) and for satisfactory vs. good health (OR = 1.4, 95% CI: 1.1-1.9 and OR = 1.9, 95% CI: 1.4-2.5, respectively) in crude analysis, but the estimates were reduced to non-significant levels after adjustment. Unemployed and pensioners were less likely to report good health than white-collar workers while no difference in SRH was observed between white- and blue-collar workers.ConclusionConsiderable levels of inequalities in SRH by age, gender, education and particularly self-reported material deprivation, but not by ethnicity or marital status were found in Almaty, Kazakhstan. Further research is warranted to identify the factors behind the observed associations in Kazakhstan.

In this cross-sectional study we assessed self-perceived quality of inpatient healthcare in three Kazakhstani cities. Altogether, 923 patients admitted to the city hospitals in Almaty, Aktobe and Semey filled out an anonymous questionnaire. 63 % of them were emergency patients. Binary logistic regression and principal component analysis (PCA) were used. Adjustments for social and demographic patients' characteristics were made. Altogether, 82.9 % (95 % CI 80.3-85.2) of patients rated the quality of healthcare as good or excellent. Among emergency patients, the key factors for being unsatisfied by the quality of services were insufficient quality of hospital food (OR 4.2; 95 % CI 1.70, 10.4), poor communication between doctors and nurses (OR 6.3; 95 % CI 2.3; 17.3) and the lack of adequate explanations regarding procedures and medication (OR 3.8; 95 % CI 1.5, 9.6). Among non-emergency patients, the key factors for being unsatisfied by the quality of services were insufficient quality of hospital food (OR 2.3; 95 % CI 1.2, 4.6), poor communication between doctors and nurses (OR 6.3; 95 % CI 2.9, 13.5), situation if the physician did not pay attention to whether a patient understood information about his/her condition or treatment (OR 2.4; 95 % CI 1.0, 5.2), when the patient has not had the opportunity to discuss his/her condition with medical staff (OR 2.7; 95 % CI 1.2, 5.8), if the patient's relatives was not given a possibility to communicate with a doctor (OR 4.3; 95 % CI 1.7, 11.0), or such this possibility was limited (OR 4.8; 95 % CI 1.9; 12.2).

Background:We have analyzed the aged population disability processes to establish specifics and regularities of the causal structure of disability among the working and non-working aged population.Methods:In total, 1208 examination reports of the Medical & SocialExpert Commission have been subjected to excerption in Almaty.  Results:Persons having the second disability status prevail in the working aged contingent – 4,4%, which is much higher than the ratios for the first and second disability statuses (0,4%and 0,6%, respectively). Among the non-working population, persons having the second disability status largely prevail too - 8,1% (3,1%and 1,1%, respectively). The casual structure of disability among the non-working disabled persons includes as follows: blood circulatory system diseases (40%), malignant neoplasms (27,2%), and diseases of the eye and its appendages (10,2%). They are followed by endocrine diseases, nutritional and metabolic disturbances (7,6%), bodily injuries (3%),and urogenital system diseases with musculoskeletal system ones - 2,3% each.The data collection for the working aged populationcontingent has found out blood circulatory system diseases (47%) and malignant neoplasms (34,4%). Alongside with that, the distinctive feature among the said aged populationcohort is a substantial predominance of bodily injuries (7,4%), endocrine diseases, nutritional and metabolic disturbances (2,3%), and only 1,4% is accounted for diseases of the eye and its appendages.

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