Search

Government efforts and reforms in health financing systems in various countries are aimed at achieving universal health coverage. Household spending on healthcare plays a very important role in achieving this goal. The aim of this systematic review was to assess out-of-pocket health expenditure inequalities measured by the FIA across different territories, in the context of achieving UHC by 2030. A comprehensive systematic search was conducted in the PubMed, Scopus, and Web of Science databases to identify original quantitative and mixed-method studies published in the English language between 2016 and 2022. A total of 336 articles were initially identified, and after the screening process, 15 articles were included in the systematic review, following the removal of duplicates and articles not meeting the inclusion criteria. Despite the overall regressivity, insurance systems have generally improved population coverage and reduced inequality in out-of-pocket health expenditures among the employed population, but regional studies highlight the importance of examining the situation at a micro level. The results of the study provide further evidence supporting the notion that healthcare financing systems relying less on public funding and direct tax financing and more on private payments are associated with a higher prevalence of catastrophic health expenditures and demonstrate a more regressive pattern in terms of healthcare financing, highlighting the need for policy interventions to address these inequities. Governments face significant challenges in achieving universal health coverage due to inequalities experienced by financially vulnerable populations, including high out-of-pocket payments for pharmaceutical goods, informal charges, and regional disparities in healthcare financing administration. [ABSTRACT FROM AUTHOR]

Background: The growing concern for the faculty's well-being is allied with the emotionally demanding nature of teaching, which has an adverse effect on physical and mental health. There is abundant evidence that academic medicine faculty are subjected to high rates of dissatisfaction, distress, burnout, and turnover among medical educa- tors. This study is dedicated to the exploration of the association between job satisfaction and psychological distress among academic medicine faculty in Kazakhstan. Methods: The observational cross-sectional study was conducted among medical educators in Kazakhstan between 1 October and 25 December. The survey was completed by 715 representatives of academic medicine staff. The sample size was calculated by Epi Info Sample Size Calculator, version 7.0. Multinomial logistic regression analysis using the forced entry procedure was applied to identify the factors associated with job satisfaction. Results: The prevalence of job satisfaction, depression, anxiety, and stress was 19.2%, 40.6%, 41.3%, and 53%, respectively. Three variables were significantly associated with job satisfaction: having a partner (AOR=0.20; 95% CI 0.04-0.90), having work experience of 5-10 years (AOR=0.32; 95% CI 0.14-0.74), and holding a Ph.D. degree (AOR=0.40; 95% CI 0.18-0.91). Job satisfaction was significantly associated with depression (p=0.005) and stress (p<0.001). Conclusions: Compared to previous research in this area, our findings reported a higher prevalence of psychological distress and dissatisfaction. Potential reason for higher rates of dissatisfaction may be the global disruption due to COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Psychological distress refers to a set of painful mental and physical symptoms of anxiety and depression, which often coexist and coincide with common somatic complaints and chronic conditions. In Kazakhstan, mental disorders are the second leading cause of years lived with disability. Currently, medical education in Kazakhstan is undergoing comprehensive reform, which creates an additional burden on faculty, fostering mental health concerns., Methods: A quantitative observational cross-sectional study was conducted in 6 large medical universities in Kazakhstan. Data were obtained from 715 faculty academics by using an online self-reported DASS-21. Statistical analysis was performed using the SPSS version 20.0. Bivariate and multivariate logistic regression analyses were applied to evaluate the relationship between predictor and outcome variables., Results: The total prevalence of depression, anxiety, and stress was 40.6%, 41.3%, and 53.0%, respectively. Younger age (p = 0.002), female gender (p = 0.001), being single (p = 0.044) or in a relationship (p = 0.001), having chronic diseases (p < 0.001), holding Master (p = 0.036) or PhD degree (p = 0.040), employment status (p = 0.034), and being involved in additional activities (p = 0.049) were significantly associated with different dimensions of distress., Conclusions: Nearly half of the study population reported symptoms of depression, anxiety, and stress. Due to the higher prevalence of psychological distress amongst academic medicine faculty, determined risk factors must be taken into consideration in developing policies for mental issues prevention., Competing Interests: The authors declare no conflict of interest., (©2023 Pacini Editore SRL, Pisa, Italy.)

Objectives: This investigation aimed to estimate reliability of the WHOQOL-BREF questionnaire and quality of life of patients after PCI or CABG surgery., Methods: In this cross-sectional study, 268 patients after PCI or CABG surgery were studied in East Kazakhstan and Pavlodar regions of Kazakhstan from September to December 2019. The Russian version of the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) was used to measure their quality of life. Cronbach's alpha coefficient, Pearson's correlation coefficient, paired t-test, independent t-test, and linear regression model were used to analyze the data., Results: The mean age of the participants was 60.8 ± 9.2 years, while most of them were male (75.0 %). The overall observed Cronbach's alpha coefficient for the WHOQOL-BREF was 0.842, ranging from 0.668 to 0.764 in its four domains. The total mean score of the respondents on the WHOQOL-BREF was 13.97. The highest and lowest mean scores were observed in the environmental domain (15.22) and the physical health domain (13.00), respectively., Conclusions: The WHOQOL-BREF questionnaire has a good reliability in characterizing the quality of life of patients after PCI or CABG surgery. Patients after PCI or CABG surgery had a relatively moderate quality of life (Tab. 6, Ref. 23).

Competing Interests: Conflict of interest The authors declare that there is no conflict of interests.

Background: Breast cancer (BC) is the top cancer among women worldwide and has been the most frequent malignancy among Kazakhstan women over the past few decades. Information on clinical and histopathological features of metastatic breast cancer (MBC), as well as the distribution of molecular subtypes is limited for Kazakh people. Materials and Methods: The present observational retrospective study was carried out at Regional Oncologic Dispensaries in the North-East Region of Kazakhstan (in Semey and Pavlodar cities). Сlinical and histopathological data were obtained for a total of 570 MBC patients in the 10 year period from 2004-2013, for whom data on molecular subtype were available for 253. Data from hospital charts were entered into SPSS 20 for analysis by one-way ANOVA analysis of associations of different variables with 1-5 year survival. Pearson correlation and linear regression models were used to examine the relation between parameters with a p-value < 0.05 considered statistically significant. Results: No significant relationships were evident between molecular subtype and survival, site of metastases, stage or ethnicity. Young females below the age of 44 were slightly more likely to have triple negative lesions. While the ductal type greatly predomonated, luminal A and B cases had a higher percentage with lobular morphology. Conclusions: In this select group of metastatice brease cancer, no links were noted for survival with molecular subtype, in contrast to much of the literature.