Financing of the Healthcare System in Kazakhstan: Current Challenges and Ways for Improvement

Abstract

Purpose of the research to analyze the problematic aspects of the current healthcare financing model in Kazakhstan, identify key institutional and economic constraints, and substantiate the feasibility of transitioning to a Unified Per Capita Payment Mechanism (UPCPM) as a tool to enhance efficiency, financial sustainability, and outcome-oriented performance of the healthcare system. Methodology the study employs comparative and retrospective analysis, a systems approach, and the examination of medical and statistical data for the period 1990-2024, as well as an institutional analysis of healthcare financing mechanisms and their comparison with international practices. Accordingly, the research focuses not on clinical outcomes, but on institutional and financial incentives and resource allocation patterns associated with the transition to the UPCPM. Originality / value of the research the study demonstrates the relationship between the configuration of financial incentives and healthcare system performance, and substantiates the advantages of transitioning to the UPCPM to strengthen primary healthcare (PHC) and promote more efficient resource use. The scientific contribution lies in the institutional interpretation of the UPCPM not merely as a capitation payment tool, but as a mechanism of strategic purchasing. Findings the study reveals that the current financing model is predominantly oriented toward budget execution rather than outcomes, which contributes to fragmented service delivery, a high share of emergency hospitalizations, overuse of diagnostic services, and low efficiency of primary healthcare. The paper proposes a transition to the UPCPM, under which PHC financing incorporates the costs of services delivered at other levels of care for the enrolled population, thereby reducing unjustified hospitalizations, strengthening prevention, and improving access to healthcare services in remote regions.