1. What kind of medical care can be obtained in polyclinics at the place of attachment?
In the polyclinic, you can get medical services for the diagnosis and treatment of diseases, prevention, rehabilitation, immunization, adherence to a healthy lifestyle, active, patronage, dynamic (dispensary) monitoring of patients with chronic diseases, drug provision, family planning, monitoring of pregnant women, maternity hospitals and newborns.
2. Is it possible to refuse medical care to a patient if he does not have an insurance status in the compulsory social health insurance?
An uninsured patient can receive services that are included in the list of guaranteed volume of free medical care, but they cannot receive medical services in the compulsory social health insurance package.
In cases of socially significant diseases, consultative and diagnostic assistance, as well as treatment is carried out within the framework of the guaranteed volume of free medical care.
What is included in the guaranteed volume of free medical care package:
• emergency medical care;
• primary health care - reception of a district doctor, diagnosis and treatment of diseases, prevention, rehabilitation, immunization, adherence to a healthy lifestyle, active, patronage, dynamic (dispensary) observation of patients with chronic diseases;
• medical care in a day hospital and a round-the-clock hospital for the treatment of chronic diseases and socially significant diseases;
• medical rehabilitation for tuberculosis;
• palliative care;
• treatment abroad;
• drug provision.
3. Providing medical assistance to children of foreigners with a residence permit.
Children of foreigners who have a residence permit in the Republic of Kazakhstan have all rights on an equal basis with citizens of the Republic of Kazakhstan. They can enter the preferential category and receive medical care in full.
How can a child get a residence permit?
• According to the approved Rules on the issuance of a residence permit in the Republic of Kazakhstan, paragraph 20 «A residence permit of a foreigner in the Republic of Kazakhstan is issued to foreigners permanently residing in the territory of the Republic of Kazakhstan from the age of sixteen for a period of ten years, but not higher than the validity period of the passport of their country of citizenship».
• The standard of public services provides for the inclusion of information about children under the age of 16 when applying from parents for a residence permit.
If the child was born after receiving the parents' residence permit, then it is necessary to submit an application for «linking» the child to the parent's/parents' residence permit to the Migration Service.
4. What kind of medical care can a district midwife (paramedic, nurse/ nurse) provide?
An average medical worker can only provide pre-medical medical care:
• reception and medical examination to determine the patient's health status, detect diseases and complications of pregnancy;
• entering data into the information system «Register of Pregnant women and women of fertile age» for health monitoring;
• emergency and emergency pre-medical care for women, including pregnant and maternity women;
• dynamic monitoring of pregnant women with chronic diseases together with district doctors and specialized specialists;
• monitoring of the fulfillment of the appointments of the obstetrician-gynecologist;
• management of physiological pregnancy and patronage of pregnant and maternity women;
• medical services at home for pregnant women, maternity women, gynecological patients and women included in the social risk group;
• screening and preventive medical examinations of women for early detection of precancerous and cancerous diseases of the female genital organs and other localizations (skin, mammary glands);
• family planning and reproductive health counseling.
5. What does the patient need to receive high-tech medical care?
To receive high-tech medical care, the patient needs to have:
• Conclusion of a profile specialist (advisory sheet)
• Positive conclusion of the high-tech medical care Commission at the regional health management
Documents for the commission are provided by a specialist of the polyclinic at the place of attachment of the patient.
If the patient is on inpatient treatment, the documents for consideration by the commission are provided by the attending physician together with the head of the department (or deputy head) by e-mail.
Package of documents provided to the high-tech medical care Commission:
• a copy of the patient's identity document
• referral to a medical organization for hospitalization in a hospital and (or) in a day hospital
• extract of the medical card of an outpatient patient or the medical card of an inpatient
• results of research and consultations of specialized specialists.
High-tech medical care is provided in a day and round-the-clock hospital. The Commission reviews the documents within 2 working days.
The date of hospitalization is determined by the clinic within 2 working days from the date of receipt of the patient's documents.
The polyclinic, after receiving the date of hospitalization, must inform the patient about the date (within 1 day):
• via SMS notification
• through an electronic notification in the user's account in the Portal «Bureau of Hospitalization» in the medical information system.
The polyclinic should inform the patient about the possibility of an alternative choice of a medical organization according to the appropriate profile of medical services (the Order can be found at the link https://adilet.zan.kz/rus/docs/V2000021746).
6. In what cases can I call a health worker at home?
In acute conditions or exacerbation of chronic diseases, if you have no signs of sudden and pronounced organ disorders, you can call a local doctor or an ambulance of the 4th category of urgency (up to 1 hour of waiting) by calling the registry.
A call to the home of a medical worker can be made by phone through the registry, a district nurse or a paramedic
Indications for calling a district nurse or paramedic:
• increase in body temperature above 38°C;
• increased blood pressure without feeling ill;
• conditions, diseases, injuries (without loss of consciousness, without signs of bleeding, without a sharp sudden deterioration of the condition) that require medical care and consultation at home.
Indications for calling a district doctor:
• conditions assessed by the polyclinic registry when receiving a call, a district nurse or a paramedic who served the call as requiring a medical examination at home;
• deterioration of the condition after vaccination.
7. Early detection of tuberculosis
Early detection of tuberculosis is carried out by medical workers of all specialties of clinics when patients apply for a professional examination, immunization, medical care.
For early detection of tuberculosis is carried out:
1. Sputum smear studies in patients with signs of tuberculosis
3. Tuberculin Mantoux Skin test, a test with tuberculosis allergen for children.
In polyclinics, patients with cough complaints are served out
of turn and provided with medical disposable masks.
In cases where there are clinical symptoms of tuberculosis, the patient is referred for examination according to the Protocol of diagnosis and treatment of tuberculosis.
If a patient has contact with a tuberculosis patient and there are suspicions of the disease, such a patient is referred to a phthisiologist's consultation to clarify the diagnosis.
If the results of the studies are positive, the patient should be referred to the centers of phthisiopulmonology.
The population from risk groups who need to undergo an annual fluorographic examination:
1. Contact with a tuberculosis patient, regardless of bacterial excretion;
2. Persons registered at the dispensary with chronic obstructive pulmonary diseases, diabetes mellitus, alcoholism, drug addiction, HIV/AIDS and receiving immunosuppressive therapy;
3. Persons with residual phenomena in the lungs of any etiology;
4. Persons released from places of deprivation of liberty.
8. The route of a patient with HIV and co-infection «Chronic viral hepatitis C».
Patients with HIV infection who are observed in AIDS centers periodically undergo tests, including immunochromatographic analysis (IHA) or enzyme immunoassay (ELISA) to detect hepatitis C virus RNA. If the result is positive, a PCR (qualitative) analysis is performed.
In case of a positive result of the tests, the patient from the AIDS center is sent to the polyclinic at the place of attachment for registration at the dispensary - for further dynamic observation of his chronic disease - chronic viral hepatitis C.
When contacting the polyclinic, the patient should have positive PCR (qualitative) results for Chronic viral hepatitis C and an extract from the outpatient card.
Based on these results, even in the absence of the patient's insurance status, a general practitioner can put him on the dispensary register for further medical care and provision of medicinal assistance for a guaranteed amount of free medical care.
If additional examinations are required for dynamic observation, then for this the patient needs the status of insurance in the compulsory social health insurance system.
9. Hospitalization of the patient in a hospital for round-the-clock observation.
Hospitalization of the patient to the hospital for round–the-clock observation is carried out as planned - in the direction of the polyclinic:
• for the treatment of the disease, including surgery;
• to receive medical rehabilitation;
• to receive palliative care;
In an emergency – regardless of whether there is a referral from the polyclinic. Emergency hospitalization is carried out around the clock, including weekends and holidays.
10. What kind of medical care can people with chronic diseases receive?
In order to receive medical care for chronic diseases, it is necessary that the patient has a diagnosis. The volume of medical services and their frequency are approved by the Order of the Ministry of Health of the Republic of Kazakhstan No. 149. In this order, chronic diseases are divided into 3 groups, these are:
1. Chronic diseases that are observed in the attachment clinic within the guaranteed volume of free medical care. This includes chronic infectious diseases, diseases of the blood and hematopoietic organs, diseases of the circulatory system, respiratory organs, digestive organs, musculoskeletal system and connective tissue, endocrine system, eating disorders and metabolic disorders, diseases of the nervous system, genitourinary system, as well as certain conditions in the perinatal period and congenital anomalies (malformations), deformities and chromosomal disorders in children.
2. Chronic diseases that are observed by specialized specialists within the guaranteed volume of free medical care. These are 37 groups of diseases, including infectious diseases, malignant and benign neoplasms, endocrine and neurological diseases, traumatological profile, etc.
3. Chronic diseases that are observed by specialized specialists within the guaranteed volume of free medical care in the system of compulsory social health insurance.
These are 80 groups of diseases, including the consequences of infectious and parasitic diseases, diseases of the blood and hematopoietic organs, diseases of the endocrine system, eating disorders and metabolic disorders, diseases of the genitourinary system, diseases of the nervous system, eye diseases, diseases of the hearing organs.
11. Who can get medicines at the attachment clinic at the expense of the guaranteed amount of free medical care and compulsory social health insurance?
Medicines and medical devices can be received by patients if they have diseases defined in the order of the Ministry of Health of the Republic of Kazakhstan No. 75 dated August 5, 2021. These are patients with chronic diseases who are registered at the dispensary, as well as patients who have certain diseases or conditions.
To receive medicines, the patient needs to contact his local doctor (nurse). Medications are given according to the frequency of their intake. The district doctor / nurse prescribes a prescription for medicines, then the patient independently goes to the pharmacy of the polyclinic. To receive medicines, you need to present a document certifying the identity of the patient.
Medicines can also be obtained by patients who do not have the status of insurance in the compulsory social health insurance system. These are medicines purchased at the expense of the guaranteed volume of free medical care.
Patients who are registered at the dispensary in specialized centers receive the necessary medications at the place of observation.
12. What kind of rehabilitation can be obtained at the polyclinic level?
To receive medical rehabilitation services, you need to contact your local doctor. After collecting the anamnesis and clarifying the details, the district doctor will issue a referral to a rehabilitologist or send the patient's documents for consideration by a multidisciplinary group (MDG).
In the polyclinic, you can get rehabilitation at the outpatient level, in cases where round-the-clock monitoring and treatment are not required. It depends on the equipment of the polyclinic, the patient's condition and his disease.
At the outpatient level, only the third stage of rehabilitation is possible, if the patient's condition allows, this can only be determined by a doctor or MDG.
The main volume of medical rehabilitation services can be obtained in the package of compulsory social health insurance. The guaranteed volume of free medical care includes medical services for the rehabilitation of patients with tuberculosis.
13. Is it possible to get vaccinated in the package of Compulsory social health insurance?
Preventive vaccinations are included in the guaranteed amount of free medical care. The category of the population that is included in the target groups for receiving vaccinations and the frequency of their implementation are established by Order of the Ministry of Health of the Republic of Kazakhstan No. 612 dated September 24, 2020.
Citizens of Kazakhstan, permanent residents of foreigners and stateless persons can receive vaccinations within the guaranteed amount of free medical care (confirmed by the presence of a residence permit).
14. What kind of emergency care can a patient receive in a polyclinic?
The patient can receive emergency medical care, which is included in the 4th category of urgency, for those diseases and conditions in which there is no threat to life and health.
The patient can independently visit the medical organization by contacting the pre-medical office or the filter office.
If the patient cannot come to the polyclinic, then he can call a doctor at home or an ambulance team.
To call a doctor at home, you need to make an application by phone, through the e-government portal or through a medical information system.
To call an ambulance team, you need to call the short number 103 and the dispatcher will transfer the call to the nearest medical organization.
Emergency and emergency medical care is provided to patients at their location (on the territory) regardless of the patient's attachment.