Building policy-making capacity in the Ministry of Health: the Kazakhstan experience

Chanturidze, Tata; Adams, Orvill; Tokezhanov, Bolat; Naylor, Mike; Richardson, Erica

doi:10.1186/1478-4491-13-4

Cited by 6 publications

(8 citation statements)

References 3 publications

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“…Contracting is now conducted by the Medical Service Purchasing Committee (a central government agency) at the national level. These changes which supported the introduction of DRGs required significant capacity development in new governance and accountability structures 13 . The creation of DRGs in Kazakhstan as the key payment mechanism for inpatient services under the guaranteed package of benefits, entailed the development of DRG grouping algorithm and respective costs weights, the introduction of relevant regulations to govern hospital service purchasing through DRGs, the establishment of a national DRG unit, and some capacity building initiatives for DRG coding.…”

Section: Content Of Reformmentioning

confidence: 99%

Introducing Diagnosis-Related Groups in Kazakhstan: Evolution, achievements, and challenges

Chanturidze

Esau

Hölzer³

et al. 2016

Health Policy

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In 2012, Kazakhstan introduced Diagnosis-Related Groups (DRGs), as part of a package of reforms which sought to contain costs and to improve efficiency and transparency in the health system; but the main challenge was to design and implement a DRG system in just one year.In 2011-2012, Kazakhstan developed its own DRG system. Initially 180 DRGs were defined to group inpatient cases but this number was subsequently expanded to more than 400. Because of time limits, the cost weights had to be derived in the absence of existing standard hospital cost accounting systems, and a national patient data transfer system also needed developing. Most importantly, huge efforts were needed to develop a regulatory framework and build up DRG capabilities at a national level.The implementation of DRGs was facilitated by strong political will for their introduction as part of a coherent package of health reforms, and consolidated efforts to build capacity. DRGs are now the key payment mechanism for hospitals. However the reforms are not fully institutionalized: the DRG structure is continuously being refined in a context of data limitations, and the revision of cost weights is most affected by insufficient data and the lack of standardized reporting mechanisms.Capacity around DRG coding is also still being developed.Countries planning to introduce DRG systems should be aware of the challenges in moving too quickly to implement DRGs as the main hospital reimbursement mechanism.

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Section: Content Of Reformmentioning

confidence: 99%

Introducing Diagnosis-Related Groups in Kazakhstan: Evolution, achievements, and challenges

Chanturidze

Esau

Hölzer³

et al. 2016

Health Policy

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“…Discount rates have not yet been determined in Kazakhstan. Since a number of directions in healthcare were previously adapted from United Kingdom (UK) 15 , 16 for our study discount rate of 3.5% was applied to both costs and benefits based on the National Institute for Health and Care Excellence (UK). 17 …”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness of Cardioverter-Defibrillator Implantation in Kazakhstan

Begisbayev¹,

Kosherbayeva²,

Gaitova³

et al. 2022

VHRM

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Cardiovascular disease is the leading cause of morbidity and mortality worldwide. The implementation of effective technologies such as Implantable cardioverter-defibrillator (ICD) for patients at risk of sudden cardiac death requires additional health system resources. Objective To assess the economic effectiveness of ICD in comparison with conservative tactics for preventing life-threatening rhythm disturbances in Kazakhstan. Methods A Markov model was built with a time horizon of 35 years. Mortality and utility data were obtained from the available literature. The economic parameters of the model are based on the approved tariffs for medical services in Kazakhstan and clinical protocols. Following WHO recommendations, a willingness to pay threshold of three times gross domestic product per capita was used to assess cost-effectiveness. A discount rate of 3.5% was applied to both costs and benefits. To deal with parameter uncertainties and to provide robust analysis, a probabilistic sensitivity analysis was performed, randomly varying all inputs subject to uncertainty assuming a statistical distribution. Results The total costs in the primary prevention (PP) group by ICD implantation and in the control group were 8,903,786 tenges and 3,194,414 tenges, respectively. The discounted total quality-adjusted life-years saved (QALYs) in the ICD and control groups were 6.48 and 4.98, respectively. The indicator of incremental cost-effectiveness ratio amounted to3791604 tenge, which is below the willingness to pay threshold and indicates the cost-effectiveness of using ICD as a PP strategy in patients with sudden cardiac death risk factors in the health care of Kazakhstan. Conclusion The ICD for the primary prevention of the development of life-threatening rhythm disturbances and sudden cardiac death is a cost-effective health technology from the position of a payer in the health care system of Kazakhstan.

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“…Depending on the cultural context, moral and ethical opinions can influence the process of policymaking rather than the production of empirical evidence (Carey, Crammond, & Keast, 2014;Chanturidze, Adams, Tokezhanov, Naylor, & Richardson, 2015;Engel, 2013). While it is best practice to formulate policy based on the evidence from research (Harris, Sainsbury, & Kemp, 2014), it has been acknowledged that it is costly and time consuming (Imani-Nasab, Seyedin, Majdzadeh, Yazdizadeh, & Salehi, 2014).…”

Section: Processmentioning

confidence: 99%

Integrative review; identifying the evidence base for policymaking and analysis in health care

Kennedy

O’Reilly

O’Connell

et al. 2019

Journal of Advanced Nursing

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Aim The aim of this was to identify and synthesize the evidence underpinning the health policymaking process to inform the development of a health‐related policy analysis framework. Design A mixed methods review using “Best Fit” Framework synthesis. Data Sources PUBMED and CINAHL+ databases for English language papers published between March 2013 – March 2017. Review Methods Titles were screened, data abstracted and analysed by two authors at each stage. Findings from included studies were coded against six a priori categories which had been constructed through a preliminary literature review, consultation and consensus. Results Sixty‐eight papers were included. There exists empirical support for six key domains which require to be addressed in the policymaking and analysis process: (1) Context; (2) Process; (3) Content; (4) Stakeholder Consultation; (5) Implementation; and (6) Evaluation. Failure to contextualize and integrate these six domains in problem identification, policy analysis, strategy and policy development, policy enactment and policy implementation is problematic. Conclusion There is a need to test and refine the constructs linked to the policymaking cycle taking cognizance of the context where these are developed, implemented and evaluated. Impact This review makes a novel contribution to the synthesis of evidence to inform the policymaking and analysis process. Findings illuminate the complexity of policymaking, the competing pressures involved and the importance of the local, national and international context. These findings have international relevance and provide empirical support for key criteria to guide those involved in context specific policymaking and/or the analysis of existing policy.

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Building policy-making capacity in the Ministry of Health: the Kazakhstan experience

Cited by 6 publications

References 3 publications

Introducing Diagnosis-Related Groups in Kazakhstan: Evolution, achievements, and challenges

Introducing Diagnosis-Related Groups in Kazakhstan: Evolution, achievements, and challenges

Cost-Effectiveness of Cardioverter-Defibrillator Implantation in Kazakhstan

Integrative review; identifying the evidence base for policymaking and analysis in health care

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