Keyword: Social Care

ABSTRACT: Digital technologies are increasingly used to support healthcare and social care for older adults, yet their effects on access and satisfaction depend on technological, individual, and organizational conditions. This structured narrative review synthesized current evidence on the impact of digital technologies on access to and satisfaction with health and social care among older adults. A comprehensive literature search was conducted iteratively from February 2025 through May 2026 in seven international and regional databases and search platforms. English- and Russian-language publications addressing older adults, digital health technologies, healthcare or social care access, satisfaction, and related implementation outcomes were considered. Forty-eight publications were included. Because study designs, populations, technologies, and outcomes were heterogeneous, findings were synthesized narratively and organized thematically. Evidence most consistently suggested that telemedicine, electronic health technologies, mobile health technologies, remote monitoring, mobile applications, and wearable devices may reduce geographical and mobility-related barriers, support continuity of care and chronic disease management, and improve satisfaction when services are usable, trusted, and adequately supported. Satisfaction findings were more context-dependent than access outcomes. Digital literacy, connectivity, affordability, interface usability, privacy concerns, technophobia, and access to technical or professional support repeatedly influenced adoption. Evidence specifically addressing social care, long-term care, and integration between healthcare and social services was comparatively limited. Digital technologies may complement conventional care for older adults, but age-appropriate design, digital-literacy support, privacy safeguards, non-digital alternatives, and integration into existing care pathways are important for equitable implementation.

ABSTRACT: This article presents a comprehensive analysis of the health system of the Republic of Kazakhstan, its current state, key achievements and remaining challenges. Using the Harvard “Five Control Knobs” analytical framework (financing, payment, organization, regulation and behavior), as well as analysis of the dynamics of the main medical and demographic indicators and human resources for 2017-2023, the article seeks to fill the gap in the systemic understanding of the effectiveness of the ongoing reforms and their impact on the health of the population. Particular attention is paid to the relationship between the various components of the system and the identification of priority areas for further improvement.
Our findings indicate a moderate improvement in population health, with average life expectancy increasing from 72.9 to 75.1 years and overall mortality returning to pre-pandemic levels. However, noncommunicable diseases continue to account for approximately 84% of all deaths. Total health expenditure remained low at 3.8% of GDP in 2023, while out-of-pocket spending accounted for 27.7% of current health expenditure, reflecting persistent gaps in financial protection. Although the introduction of mandatory social health insurance has expanded pooled financing, significant weaknesses persist in provider incentive structures, workforce distribution, and regulatory enforcement.
Overall, the results suggest that while gradual progress has been achieved, chronic underfunding, system fragmentation, and governance challenges continue to constrain equity and efficiency, underscoring the need for coordinated, evidence-based reforms.