Objectives: The aim of this study was to implement health technology assessment (HA) in the First General City Hospital in Astana, Kazakhstan. Methods: We organized trainings to familiarize hospital staff with the purpose and details of HTA. An HTA committee was established, with representation from hospital physicians and managers, and criteria for prioritization of health technologies determined. Clinical departments of the hospital were asked to prepare applications for new technologies for their services. Results: The HTA committee reviewed five applications and selected a technology from one of these, on single incision laparoscopic surgery (SILS), for assessment. A short HTA report on SILS was prepared, covering its safety, clinical effectiveness, and cost effectiveness. The report was used to support a request to the Department of Health for additional funding to implement this technology within the hospital. This funding was approved and SILS was established in several hospital departments. Conclusions: This successful initial experience with HTA has paved the way for its routine use by the hospital for informing decisions on the procurement and use of new health technologies. METHODSThe overall approach to development of the HTA program is shown in Figure 1.We first studied models of hospital -based HTA that had been used in different countries, obtaining information from various databases including those available through HTAi, PubMed and INAHTA.Consultation was held with hospital physicians and administrative staff to provide them with details of the role and scope of HTA. Training workshops were organized for 5 physicians (as the experts who used new technologies in the hospital), hospital economists and managers to examine organizational aspects of technology implementation.After completion of initial training we created a hospital HTA Committee, which was comprised of senior doctors, hospital managers and hospital economists, following a model considered by an HTAi Interest Sub-Group (8). Details of each stage of the HTA process were discussed with the committee.Prioritization criteria for hospital projects were formulated in discussion with the HTA Committee, having regard to accepted HTA practice (9). The criteria selected were budget impact, clinical effectiveness, safety, and availability of alternativetechnology.An application form was developed for submitting proposals on technologies which physicians or other stakeholders wished to include or exclude from hospital services. With members of the hospital's innovative technology department (ITDH), which reports directly to the Chief of Hospital, we asked each clinical department of the hospital to prepare applications. RESULTSWithin a month, applications had been submitted for 15 technologies to provide a range of services at the hospital. Information in the applications was analyzed and brief details on the technologies were sent to members of the HTA Committee. Points considered included demands for the technology in the region, wha...

Objectives: The aim of this study was to develop criteria for the prioritization of topics for health technology assessment (HTA) in the healthcare system of Kazakhstan. Methods: Initial proposals for criteria were suggested through consultation with Ministry of Health (MoH) policy areas. These were refined through a workshop attended by HTA department staff, persons from medical universities and research institutes, and MoH policy makers. The workshop included discussion on methods used in international HTA practice. Opinions of participants on selection of criteria from those specified in a review of prioritization processes were used to define a list for inclusion in an instrument for routine use. A scoring system was established in later discussion. Results: Selected criteria for HTA prioritization were burden of disease, availability of alternative technology, clinical effectiveness, economic efficiency, budget impact, and ethical, legal, and/or psychosocial aspects. For each criterion, a health technology under consideration is given a score from 3 (High) to 1 (Low). The total score determines whether the technology is of high to medium priority or of low priority. Determination of priorities for assessment, using the instrument, should be carried out by an expert group appointed by the MoH. The process was applied in 2014 to a selection of topics, and three health technologies were chosen for full assessments. Conclusions: Criteria for prioritization have evolved with development of the HTA program in Kazakhstan. A method for HTA prioritization has been developed that is easy to apply, requires comparatively few resources, and is compatible with processes required by the MoH. Methods: Initial proposals for criteria were suggested through consultation with Ministry of Health (MoH) policy areas. These were refined through a workshop attended by HTA department staff, persons from medical universities and research institutes, and MoH policy makers. The workshop included discussion on methods used in international HTA practice. Opinions of participants on selection of criteria from those specified in a review of prioritization processes were used to define a list for inclusion in an instrument for routine use. A scoring system was established in later discussion.Results: Selected criteria for HTA prioritization were burden of disease, availability of alternative technology, clinical effectiveness, economic efficiency, budget impact, and ethical, legal and/or psychosocial aspects. For each criterion a health technology under consideration is given a score from 3 (High) to Low (1). The total score determines whether the technology is of high to medium priority or of low priority. Determination of priorities for assessment, using the instrument, should be carried out by an expert group appointed by the MoH. The process was applied in 2014 to selection of topics and three health technologies were chosen for full assessments. ConclusionCriteria for prioritization have evolved with development of the HTA pro...

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).

В данной статье дана оценка эффективности лечения больных туберкулезом и научно литературный обзор факторов, влияющих на эффективность его лечения. Проблема туберкулеза с каждым годом приобретает все большее внимание. Показано, что это связано с ростом заболеваемости, возникновением тяжелых заболеваний с летальным исходом.Всемирной организации здравоохранения (ВОЗ) была вынуждена констатировать, что туберкулез попрежнему является международной и национальной проблемой здравоохранения не только в развивающихся странах, но и в экономически высокоразвитых странах. The article provides an assessment of treatment effectiveness of patients with tuberculosis and scientific literature review of the factors afecting the treatment effectiveness. The problem of tuberculosis is gaining more and more attention every year. It is shown that this is associated with an increase in morbidity, the occurrence of severe diseases with a fatal outcome.The World Health Organization (WHO) was forced to state that tuberculosis is still an international and national health problem not only in developing countries, but also in economically highly developed countries

В сфере здравоохранения во избежание стагнации во время пандемии необходимо максимально обезопасить медицинский персонал и проводить большое количество профилактических мероприятий. Как доказано во многих научных статьях, главной мерой защиты медицинских работников от заражения и смерти является не только полное и своевременное обеспечение средствами индивидуальной защиты, но и подготовка специальных специалистов, которые научат, как правильно их применять. In the healthcare sector, in order to avoid stagnation during a pandemic, it is necessary to protect medical personnel as much as possible and carry out a large number of preventive measures. As proved in many scientific articles, the main measure to protect medical workers from infection and death is not only the full and timely provision of personal protective equipment, but also the training of special specialists who will teach how to use them correctly.