ADMINISTRATIVE BARRIERS OF THE IMPLEMENTATIONOF SCREENING PROGRAMS FOR THE EARLY DETECTIONOF ONCOLOGICAL DISEASES

Abstract

Introduction. Within the framework of the State Programme for the Development of the Healthcare System of the
Republic of Kazakhstan “Densaulyk” for 2016 – 2019, it is provided further development of key screening programs for the
early detection of diseases with the greatest burden on public health, as well as the continuous improvement of the
standards for monitoring programs and evaluating the effectiveness of screening programs.
Purpose. Identify the barriers to the successful implementation of screening programs based on the results of economic
evaluation in Pavlodar region.
Materials and methods. In the study it is evaluated screening programs for early detection of breast, cervical and
colorectal cancer using the following pharmacoeconomic analysis methods: BIA - Budget Impact analysis, COI-cost analysis
of illness, only direct costs for diagnosing the disease are taken into account. For the comparative evaluation, budget
applications approved by the Department of healthcare of the Pavlodar region and price lists of public and private medical
organizations providing paid services were used.
Results. Compared to 2017 in 2018, the amount of funding for screening for detection of breast cancer increased by
65.6%, which totaled 4144.30 thousand KZT. The main problem of this program is the lack of funding for the first stage (a
mammography). There was an increase in the amount of funding for the screening program for the detection of cervical
cancer by 83.4%, which totaled 62,587.6 thousand KZT. The main barrier is the lack of funding for a medical service "taking
a smear from the cervix." A sharp increase in funding is associated with an increase in the number of patients and a change
of the target group. Compared to 2017 in 2018, the volume of financing for the purchase of Fecal Occult Blood Test was
reduced by 20.7%, which totaled 13,827.6 thousand KZT. The volume of funding for colonoscopy was reduced by 21.8%,
which amounted to 1128.4 thousand KZT. The reason for the decline in funding is related to a decrease in the coverage of
the target group from 70% to 25%.
Conclusions. The identified administrative and socio-economic barriers hinder the development of public-private
partnerships and improvement the indicators of screening programs.