Despite the fact that healthcare spending in Kazakhstan increased annually from 2011 to 2020, the country’s healthcare system is seriously underfunded. For this reason, household spending in Kazakhstan plays a significant role in overall health spending. According to WHO, if the share of private spending in total health care spending does not exceed 20%, the health care system can be considered sustainable. The risk of a decrease in the purchasing power of the population increases in cases where this indicator is exceeded, which in turn leads to negative consequences for the population itself. Therefore, the Government of Kazakhstan needs to take decisive measures to reduce the “out-of-pocket expense” of the population for health care, especially the cost of purchasing medicines. Effective government policy, timely reforms and mutually beneficial cooperation with pharmaceutical market actors can reduce the level of “out-of-pocket expenses” of the population for health care to generally accepted world indicators. Based on this, the study of different views on solving problems related to public and private spending in health care, price regulation and building an effective drug pricing system is an important condition for building an effective health care system.

This article analyzes the state management of the sphere of circulation of medicines in the Republic of Kazakhstan in the context of the COVID-19 pandemic, and analyzes the reasons for the shortage of medicines in the specified period. The authors conducted a sociological survey, which made it possible to identify the main problems faced by the population during the COVID-19 pandemic. All major players in the pharmaceutical market of the Republic of Kazakhstan are analyzed. The activity of «SK-Pharmacy» during the COVID-19 pandemic was considered, and measures aimed at eliminating ineffective management identified in the work of a single distributor of medicines were analyzed. The measures of the state to reduce prices for essential medicines during a pandemic are considered. Based on domestic and foreign experience, an analysis of external reference pricing for medicines was carried out. The expenditures of the population on health care, including on medicines, were considered. The study resulted in the proposed measures to improve public administration in the sphere of drug circulation in the Republic of Kazakhstan. It is concluded that the state needs to take several measures in the field of drug circulation to prevent a possible shortage of pharmaceuticals and contain drug prices during future pandemics. It is necessary to increase funding for the health care system, including for medicines, without shifting the financial burden on the population and employers. It is necessary to build an effective system of pricing for medicines, which would consider the peculiarities of the global and Kazakhstani pharmaceutical market.

The frequent visits to doctors and their impact on healthcare providers' workload is a significant concern in many countries, including Kazakhstan, where this topic has been understudied. This research aimed to identify key socio-economic factors influencing the frequency and likelihood of individuals seeking medical care. Utilizing sociological, statistical, and comparative research methods, we conducted a survey involving 1838 participants across 20 regions in Kazakhstan. Our statistical analysis included the calculation of Pearson and Kendall correlation coefficients to evaluate relationships between variables such as the frequency of doctor visits and individuals' health assessment practices, their attentiveness to health, and their responses to illness. The findings reveal that individuals who are proactive in seeking medical advice when symptoms appear also tend to visit doctors more frequently throughout the year. Moreover, socioeconomic factors such as drug costs, demographic characteristics, and travel time to medical facilities were identified as influencing factors, albeit to a lesser extent compared to health status assessment and medical examinations. This study provides a foundational understanding of the factors driving medical visits in Kazakhstan, highlighting the interplay between personal health practices and healthcare utilization. This insight is crucial for planning and optimizing healthcare resource allocation and addressing healthcare accessibility and inequality. The study did not identify any significant limitations for future research.

The problem of spatial inequality in the regions of Kazakhstan has been relevant for many years and in recent years this problem has worsened due to socio-economic changes in the areas, the consequences of the COVID-19 pandemic, the negative impact of inflationary processes, increased internal migration and other factors. The purpose of this study is to analyze spatial inequality between 16 regions of Kazakhstan covering the period from 2001 to 2017. The following scientific methods were used in the study: historical method, and statistical method. During the research, a new class of spatial econometric models was developed, which are modifications of the Durbin spatial model. These models are characterized by variable coefficients with spatial lags of the dependent and independent variables. The models were evaluated based on information about Kazakhstan’s regions, using the regional gross domestic product per capita as a dependent variable. The findings of the study show the advantages of the SDM model with fixed effects compared to alternative models, which is confirmed by the results of the assessment using the criteria of the Akaike Information Criterion (AIC) and Bayes (BIC). According to the SDM model, a 1% increase in gross regional product per capita in the base year leads to an increase in the growth rate of gross regional product per capita, all other things being equal. It is also worth noting that an increase in the unemployment rate by 1% contributes to an acceleration in the growth rate of the gross regional product per capita by 0.451, all other things being equal. An increase in government spending per unit in the region contributes to a decrease in the growth rate of the gross regional product per capita in the neighboring region, all other things being equal. The spatial lag coefficient indicates that changes in the indicators of the domestic regional product per capita in one region have an impact on changes in the domestic regional product per capita in the neighboring region. The results of the study indicate the need to use spatial weights when evaluating regional regression models.

This article is devoted to the analysis of the Kazakhstani healthcare system in the context of the implementation of the compulsory social health insurance system. It will examine issues related to healthcare costs, the degree of satisfaction of the population with health insurance, the quality of medical services, etc. Since its introduction in 2020, the healthcare insurance system in Kazakhstan has encountered significant challenges. These include public dissatisfaction with the quality of medical services, inadequate coverage of the population with health insurance, vulnerabilities in the insurance information system, the existence of medical supplements, underdeveloped infrastructure in rural areas, and information asymmetry in the health insurance sector. President of Kazakhstan, Kassym-Jomart Tokayev, criticized the reform process of the health insurance system and addressed these issues during a meeting with the Government on February 7, 2024. This article delves into the evolution of the Kazakhstan health insurance system by analyzing financial indicators and monitoring data. Through this analysis, problematic areas were identified, and practical recommendations were developed to optimize the compulsory social health insurance system. Various scientific methods were employed in this study, including institutional analysis, synthesis, literature review, comparative and contrastive, and sociological methods. The goal of this study is to provide recommendations for enhancing the healthcare system in Kazakhstan during the implementation of compulsory social health insurance. The empirical foundation of this study consists of legislative documents in the healthcare sector, official publications, and analytical and statistical reports from the Ministry of Health of the Republic of Kazakhstan. The hypothesis of the study is that the introduction of compulsory social health insurance in Kazakhstan is intended to promote positive changes in the healthcare system, but due to existing organizational and financial barriers does not improve the availability and quality of medical services. Keywords: health, health insurance, health care system, public administration, health care costs.