Pandemic and policy effects on hepatitis C and diabetes: Insights from Kazakhstan using interrupted time series analysis
Keywords:
hepatitis c, diabetes, interrupted time series, Kazakhstan, social health insurance, COVID-19, lockdown, health policy impact, chronic disease trendsAbstract
Background and aim: This study assesses the impact of the COVID-19 pandemic and compulsory social health insurance system (CSHIS) on hepatitis C and diabetes dispanserization rates in Kazakhstan from 2018 to 2023, using Interrupted Time Series (ITS) analysis.
Methods: Dispanserization data for hepatitis C and diabetes were collected for Kazakhstan from 2018 to 2023. The effect of COVID-19 lockdown was analyzed using four models: unadjusted lockdown effect, adjusted for monthly population size, adjusted for CSHIS, and adjusted for both.
Results: The unadjusted ITS analysis revealed a significant negative impact of the COVID-19 lockdown on diabetes dispanserization rates (estimate = –8 511.2, SE = 1 883.7, p < 0.001), but not for hepatitis C (estimate = –812, SE = 778, p = 0.3). There was a significant upward trend over time for both conditions. After adjusting for population size and CSHIS implementation, the negative lockdown effect remained significant for both hepatitis C (estimate = –3,590, SE = 1,100, p < 0.01) and diabetes (estimate = –10,500, SE = 3,210, p < 0.01), while the effect of CSHIS remained insignificant.
Conclusions: The COVID-19 pandemic had a significant negative impact on dispanserization rates for both hepatitis C and diabetes in Kazakhstan. In contrast, our analysis demonstrates that the dispanserization rates for these chronic diseases were not significantly affected by the implementation of CSHIS. These findings emphasize the importance of implementing policies that can prevent the disruption of essential healthcare services during pandemics or other crises, ensuring that patients continue to receive the medical care they need.
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Copyright (c) 2025 Manzura Baimukhanova, Sholpan Sadykova, Gaukhar Kurmanova, Bayan Nurgaliyeva, Zhanay Akanov, Anna Shin, Assem Kazbekova
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