Who Gets Quotas for Medical Services?

Instead of the preface

Over the past two decades, the health of the Republic of Kazakhstan has undergone great changes. Only here the system of obtaining quotas, unfortunately, this process did not affect. Quotas are an opportunity to receive treatment in a high-quality medical center at home or abroad.

The most surprising thing is that there is no system for allocating quotas at the moment. This is said by officials from the Ministry of Health. The unified national health care system in this country is arranged in such a way that, in fact, for the population, quotas are inaccessible. Any resident of the country has the right to receive medical assistance in any institution of the country. And only his choice determines the place of treatment.

Let's try to understand

The patient chooses the hospital, in which it is more convenient for him to undergo treatment. He receives a referral from the treating specialist, and also applies. These two documents are entered in a common database. As soon as the queue approaches, the patient is invited for treatment.

According to statistics, most patients receive an invitation in 3 days, some (30%) have to wait for ten days. The waiting times are gradually decreasing, as any clinic is interested in curing qualitatively as many patients as possible. The more patients they cure, the more income hospitals get.

But it's not so simple. It would seem that there are no obstacles here. But local regional and district medical commissions are blocking the movement of statements. As small regional and city clinics improve their technical base, their capabilities increase, there is no need to send patients to the capital. On the other hand, sometimes there are no places in district clinics. In such cases, patients are also referred to the center. Thus, in the capital clinics you can be treated at your own choice and in the direction of the local medical commission.

What about the quotas?

They are provided only for the case of very complicated and expensive procedures. For example, this applies to in vitro fertilization. One treatment session costs one million tenge. Of course, such money can pay a unit. About 6 hundred quotas for IVF are allocated per country per year.

Of course, a small part of the needy gets to foreign treatment. Medical officials explain this not by the fact that the state allocates less money for quotas, but for the fact that today many kinds of treatment are available in Kazakhstan itself. Here, liver, bone marrow and kidneys are already successfully transplanted, and not only that. The issue of donor organs is acute. Since religion does not encourage the use of bodies of the dead or dead for medical purposes.

Is this really the case?

A clear and beautiful picture depicted by employees of the Ministry of Health is destroyed by members of charitable and public organizations. It turns out that everything that was described in the article earlier is just a model that is not always used in practice.

Indeed, everything is thought up wonderful, only here is how it is done? Often doctors send sick children and their parents home, claiming that the disease is incurable. This happens in most cases from lack of competence. After all, medical science is constantly evolving. But if the doctor received a diploma twenty years ago and has not improved his qualification since then, he is hopelessly behind the modern realities.

A big problem in Kazakhstan with diagnostics. Sometimes doctors for some reason do not give directions for research in the capital or regional clinics. In some cases, they receive instructions from their bosses to treat patients on the spot. Redirection of patients to the center can have sad consequences for small clinics - they are being cut back by financing, their rating is deteriorating.

Sometimes the direction is not issued only because there is not enough money to diagnose and treat the patient. But what business is the local doctor up to the money? His problem is to cure the patient. Unfortunately, in practice everything is a little different.

Many doctors do not dare to send patients to treatment for quotas, so as not to be accused of squandering them. With such a vicious practice, only parents who seek and pierce the walls can get a quota for their child for treatment abroad. But Mom and Dad, who are sufficiently well informed about their rights, very little. The overwhelming majority believe in doctors, and their children remain without help. And to bring information to the public is not beneficial to the medical workers themselves.

Health workers do not agree

According to the Ministry of Health, any patient ultimately chooses the place of treatment. The doctor's business is only to determine the disease. But the whole process is limited primarily to the ignorance of patients. There is practically no information on the possibility of treatment abroad. No instructions on the topic: "How to achieve a quota for treatment?" Does not exist either. Of course, it is impossible to obtain this information in local medical institutions and even on Internet sites. No one is trying to convey to patients (many of whom are elderly and seriously ill people) information about the possibility of cure.

The problem is that the instructions for doctors, on the basis of which they send patients for treatment, are not compiled correctly. They mean a lot of tricks and opportunities to deny a patient to hospitalization.

Where does the money go?

Even the most debugged mechanism can fail. One of these cases will be told later.

The girl at the age of two and a half months survived a hemorrhage in the brain. Doctors did not find any violations and sent the child for vaccination. Five days after the vaccination, the child jumped to a fever, the parents called the therapist at the house, which gave directions to the infectious disease clinic. The girl was in a coma in the intensive care unit for a week. And only after 7 days in the hospital, parents were informed that the baby had a hemorrhage. The whole year the Kazakh doctors tried to cure the child.

The girl's parents had no idea about the availability of quotas and the possibility of treatment abroad. Local doctors, however, set parents up for the fact that the child is not a tenant. Someone from friends advised to try to treat a child in Urumqi. Parents took the child there at their own expense.

Only after the journalists drew attention to the case, parents were called from the medical department and reported that they were given a quota. Only now they did not specify - where to turn now, and what papers are needed for departure. The quota was for treatment in Israel. During the preparation for the departure, it turned out that the doctors of the clinic to which the girl was being taken had no specialization in the treatment of brain atrophy. Parents contacted officials from the Ministry of Health, and they received an answer: they got a quota - go to therapy. There was no intelligible answer to the questions about how much money was allocated, which doctor would treat the child. Upon arrival for treatment in Israel, the child was kept in hospital for 10 days and diagnosed. The result was: the child does not have a convulsive syndrome and epileptic phenomena, so he should be discharged and sent to rehabilitation treatment at the place of residence. And in this clinic in Israel such treatment is not carried out. That's the total spent 50 thousand dollars. This is not a unique case - the Internet is full of similar stories of residents of Kazakhstan.

What to do?

Employees of the Ministry of Health should think about how to convey information about quotas and treatment options to each patient. People should know that they can be treated not only in a rural hospital, but also in the capital or regional. It is very convenient to use the Internet for this purpose. It would be possible to develop a website that provides all the comprehensive information on treatment options.

However, the main work with patients should be performed by the attending physicians in the field. The contact between the patient and the doctor is very important, it is the doctor's appointment that the patient should get maximum information about where and how to be effectively treated in the country or abroad.