Academic journal article Business: Theory and Practice

Quality of Medical Services: Problems, Evaluation and Regulation

Academic journal article Business: Theory and Practice

Quality of Medical Services: Problems, Evaluation and Regulation

Article excerpt

1. The problem of quality of care

Modern medicine is characterized by substantial accomplishments and advances in new technologies, diagnosis and treatments. At the same time, the problem in quality of medical services is still considered at the national level not only in Kazakhstan but also in many CIS countries and around the world.

According to our and many other studies, inadequate level of quality health care services for many years retains as epidemic. After conducting surveys and evaluations from patient examinations in five stationary clinics, we found that 45-50% of patients admitted to hospitals during exacerbation were not examined or poorly examined in clinics.

Herewith, there is no guarantee that even in the hospital; patients will get good quality examination and proper treatment. About 50% of patients during treatment in a hospital are not fully examined. Particularly high proportions (60-65%) of patients are diagnosed with peptic ulcer, coronary heart disease, hypertension and cholecystitis.

Similar pattern can be seen in other CIS countries, including Russian Federation (Murzova, Senina-Volzhskaya 2012; Paykov, Ishmetov 2012; Shal'nova et al. 2012) and other countries (American College ... 2010; Gleason et al. 2004).

Primarily, medical treatment is pharmacotherapy. In the structure of treatment defects and provided medical care, incorrect pharmacotherapy happens in more than half of the cases (Ryzhova, Moroz 2010; Meyer-Massetti, Conen 2012). Moreover, those errors are often characterized as "dangerous" for patient's health. In many cases, safety principle of treatment fails which contributes negatively to the overall condition of the patient and increases the risk to his health and likelihood of recovery.

There are some circumstances, not dependent on the doctor which may affect the assessment of the quality of medical services. For instance, when patients do not adhere to the prescribed course of treatment, this may interfere with the study and it is difficult to identify. For example, in the US, each year about 125 thousand cases of coronary deaths which could have been prevented if patients complied with the prescribed medical treatment (McCarthy 1998).

Such factors as negligence from patients do not help the efficiency of health services. Population still has a low culture and knowledge of how to manage medical services efficiently and seek treatment during advanced stages of a disease and the process of medical treatment is very complicated. At the same time, this factor does not influence the assessment of quality of medical services since the evaluation is performed by the treatment of detected disease and the dynamics with respect to the identified level.

Low level of preventive medicine occupies an importance place among other facts in low level of health care. This particularly applies to cardiovascular, oncological diseases and its irrational pharmacotherapy during the early stages of development.

Health is a strategic category and the state of medicine directly reflects on all socio-economical indicators of the country's development.

Significantly, this affects the demographic situation in the country. As of today, among Central Asian states, Kazakhstan has a high mortality rate 8.5 per 1 000 people. Even if overall indicator of mortality rate by half depends on the patient's themselves, their lifestyle, then such indicator as maternal mortality rate is fully dependent on the quality of medical care.

The same indicator is directly dependent on the level of medicine development and quality of medical services is infant mortality rate, in Kazakhstan equals to 13.5 per 1 000 born infants. The main cause of infant mortality are conditions which happen during perinatal period (asphyxia, sudden death syndrome), only in 2012 more than a half (57.3%) from the total number of deaths happened among infants. …

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