Are all elderly in Kazakhstan equally satisfied with public healthcare? A cross-sectional study from Almaty

Tuesday, 19 August 2014
Exhibit hall (Dena'ina Center)
G Aimbetova , Kazakh National Medical University, Almaty, Kazakhstan
B Turdalieva , Kazakh National Medical University, Almaty, Kazakhstan
F Bagiyarova , Kazakh National Medical University, Almaty, Kazakhstan
G Kashafutdinova , Kazakh National Medical University, Almaty, Kazakhstan
B Mussaeva , Kazakh National Medical University, Almaty, Kazakhstan
V Baisugurova , Kazakh National Medical University, Almaty, Kazakhstan
Zh Buribayeva , Kazakh Research Institute of Eye Diseases, Almaty, Kazakhstan
Andrej M Grjibovski, PhD , Northern State Medical University, Arkhangelsk, Russia
Sundetgali Kalmahanov , Kazakh National Medical University, Almaty, Kazakhstan
INTRODUCTION:  Our prevision research revealed considerable variations in self-rated health (SRH) among Kazakhstani adults. Elderly have poorer health and use public health care more often than other age groups. However, the level of satisfaction by health care among Kazakhstani elderly remains unknown. We assessed the proportion of Kazakhstani elderly who are dissatisfied with public health care, described the main reasons for dissatisfaction and studied whether all socioeconomic- and ethnic groups are equally satisfied with public health care in Almaty (former Alma-Ata), Kazakhstan.

METHODS: A cross-sectional study. A random sample of 591 individuals aged 60 years or older (60.7% women) participated in the study and filled out an anonymous questionnaire. Associations between socioeconomic factors, ethnic background, self-rated health and dissatisfaction were studied using multiple logistic regression. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated.

RESULTS:  Altogether, 57.0% (95% CI: 53.0-61.2) were dissatisfied with public health care. The most common reasons were too long waiting time (reported by 33.7%), superficial attitude of the personnel (29.2%) and dissatisfaction with treatment (13.6%). In crude analysis only the index of economic deprivation (p=0.010) and SRH (p<0.001) were associated with dissatisfaction. After all variables were entered to the model, only SRH remained significantly associated with dissatisfaction by health care. Individuals with good (OR=0.38, 95% CI: 0.20-0.71) and satisfactory (OR=0.51, 95% CI: 0.31-0.84) health were less likely to be dissatisfied than those who reported poor health.

CONCLUSIONS: More than a half of the elderly are dissatisfied with public health care in the city of Almaty – the largest and the wealthiest city in Kazakhstan. However, there is no evidence on socioeconomic-, gender- or ethnic variations in the level of dissatisfaction. Factors that may explain the findings will be discussed.

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