Building capacity to use data for monitoring NCD-related hospitalizations and strategic purchasing in Kyrgyzstan

Nargiz Djapakova

On 27 June 2016, a workshop on building capacity and using data to monitor the hospitalization rates of patients with noncommunicable diseases (NCDs) was held in Bishkek, Kyrgyzstan. About 60 participants attended including representatives of the Mandatory Health Insurance Fund (MHIF), the Ministry of Health, regional and tertiary-level hospitals, and the Health Policy Analysis Center (HPAC) and experts on NCDs.

MHIF is interested to improve the use of administrative data to inform purchasing decisions and understand the variations among health care providers, driven by health needs and clinical practice. While data are regularly collected, their aggregation, presentation and input to decision-making needs further attention.

"In the coming years, we must begin to change current practice, which does not encourage administrative efficiency as the system still does not influence the length of hospitalization and allows significant variations between service providers. MHIF needs a tool which will open communication channels and allow us to discern savings and find the best way to redirect resources," said Dr Marat Kaliev, Director of MHIF, at the opening of the workshop.

In his welcoming speech Dr Jarno Habicht, WHO Representative to Kyrgyzstan, explained why WHO is keen to support the initiative, "Kyrgyzstan is a unique country where we have a number of studies available but now need to focus on taking the next step and acting on the results in our everyday work. Last year, HPAC prepared a study but it is important now to translate this into action and develop a practical tool that MHIF can use for strategic purchasing."

WHO has provided support to MHIF and the Ministry of Health in following up on the 2015 HPAC study and in helping to design a simple system to monitor the hospitalization rates of patients with specific conditions, including cardiovascular diseases (CVDs), at national, regional and provider levels. Dr Habicht added, "The system can be used to monitor variations in hospitalization rates, and to identify not only avoidable hospitalizations but also unmet needs, such as people who should have been hospitalized. It is about improving the health system performance."


Kyrgyzstan faces the challenge of the growing burden of NCDs as do many countries in the world. CVDs are the main cause of mortality and morbidity in the country and are a priority of different health improvement programmes in the last decade. In 2015, HPAC conducted an assessment of hospitalized patients with NCD-related diseases, such as CVD and diabetes, in response to a request from the Ministry of Health and MHIF. The survey revealed significant deviations between regions by all hospitalization indicators, a correlation between availability of hospital care and hospital admission indicators, and an inverse correlation between the number of primary health care visits and hospitalization rates.