Ensuring Healthcare Efficiency in the Context of the Medical and Pharmaceutical Staff Regulation

Guzal G. Galiakbarova, Yenlik N. Nurgaliyeva, Elmira B. Omarova, Svetlana B. Zharkenova, Muslim K. Khassenov


This article aims to substantiate the impact of socio-economic labor protection for healthcare professionals based on developing legislative regulations in some OECD and EAEU countries and identifying their relationship with the efficiency of healthcare systems. The methodology includes general scientific methods (systemic analysis, synthesis, comparison, abstraction, induction, deduction, and modeling) and special research methods (formal logical, structural, and functional). The results of international rankings evaluating healthcare systems were used to determine the list of states for comparative legal analysis. Also, empirical methods were used: meetings, questionnaire surveys, and interviews held in 2021 with medical and pharmaceutical workers in Kazakhstan. The research results showed that states with special labor regulations for medical and pharmaceutical personnel occupy stable leading positions in international rankings regarding healthcare evaluation. On the other hand, based on the example of the EAEU countries with an insufficient level of specialization in labor regulation for these categories of workers, some states occupy weak positions in similar international ratings. This paper is novel because previously, there was no debate in the literature justifying the finding that specifics in the labor regulation of medical and pharmaceutical staff, along with other factors, influence the healthcare system's efficiency and development.


Doi: 10.28991/ESJ-2022-06-06-05

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Sustainable Growth; Socio-Economic Security; Health Care System; Efficiency; Special Labor Regulation.


Gavurova, B., Kocisova, K., & Sopko, J. (2021). Health system efficiency in OECD countries: dynamic network DEA approach. Health Economics Review, 11(40), 1-25. doi:10.1186/s13561-021-00337-9.

Köppen, J., Achstetter, K., Blümel, M., & Busse, R. (2020). Measuring efficiency of the German health care system from the population perspective. European Journal of Public Health, 30(Supplement_5). doi:10.1093/eurpub/ckaa165.930.

Zhou, L., Ampon-Wireko, S., Dauda, L., Xu, X., Antwi, M. O., & Larnyo, E. (2021). Empirical analysis of factors influencing healthcare efficiency among emerging countries. Healthcare (Switzerland), 9(1), 31. doi:10.3390/healthcare9010031.

Organization for Economic Cooperation and Development (2019). Health at a Glance 2019. OECD Indicators, OECD Publishing, Paris, France. doi:10.1787/4dd50c09-en.

Tikkanen, R. & Abrams, M. (2021). U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes? The Commonwealth Fund, New York, United States. Available online: https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019 (accessed on April 2022).

European Commission. (2017). European semester thematic factsheet: Health systems. European Commission, Brussels, Belgium. Available online: https://ec.europa.eu/info/business-economy-euro/economic-and-fiscal-policy-coordination/eu-economic-governance-monitoring-prevention-correction/european-semester/thematic-factsheets/social-protection-and-cohesion_en (accessed on June 2022).

Gupta, I. (2020). International Health Care System Profiles India. The Commonwealth Fund, New York, United States. Available online: https://www.commonwealthfund.org/international-health-policy-center/countries/india (accessed on June 2022).

Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., Wharton, G.A. (2020). China. The Commonwealth Fund, New York, United States. Available online: https://www.commonwealthfund.org/international-health-policy-center/countries/china (accessed on June 2022).

Macri, J. (2016). Australia’s health system: Some issues and challenges. Journal of Health & Medical Economics, 2(2), 1–3. doi:10.21767/2471-9927.100015.

Great Britain: The National Health Service (2016). Available online: https://sites.psu.edu/smithcivicblog/2016/01/16/great-britain-the-national-health-service/ (accessed on June 2022).

World Health Organization. (‎2006). Working together for health: the world health report 2006: overview. World Health Organization, Geneva, Switzerland. Available online: https://apps.who.int/iris/handle/10665/69256 (accessed on March 2022).

Zakon News. (2022). Concept for the development of human resources for healthcare for 2012-2020 (Project). Available online: https://online.zakon.kz/Document/?doc_id=31141521#pos=12;-33 (accessed on April 2022). (In Russian).

Blanpain, R. (1993). Comparative Labour Law and Industrial Relations in Industrialised Market Economies. Springer, New York City, United States.

Constitution of the Republic of Kazakhstan (1995). Available online: https://www.akorda.kz/en/official_documents/constitution (accessed on July 2022).

World Health Organization. (2021). Health and inequality decreasing. World Health Organization (WHO), Geneva, Switzerland. Available online: https://apps.who.int/iris/bitstream/handle/10665/341012/WHO-EURO-2021-2451-42206-58207-rus.pdf (accessed on March 2022). (In Russian).

Volkov, V. (2020). How did the second wave of coronavirus change Kazakhstan? Deutsche Welle, Bonn, Germany. https://www.dw.com/ru/kak-izmenila-kazahstan-vtoraja-volna-koronavirusa/a-54559893 (accessed on March 2022). (In Russian).

Chettri, M. (2022). New jobs, new spatialised patriarchy: creating factory workers in a Himalayan pharmaceutical hub. Gender, Place & Culture, 1–21. doi:10.1080/0966369x.2022.2099351.

World Health Organization. (2016). Global health workforce development strategy: workforce 2030. World Health Organization, Geneva, Switzerland. Available online: https://apps.who.int/iris/handle/10665/253394?locale-attribute=en& (accessed on June 2022). (In Russian).

World Medical Association. (2021). WMA Declaration of Cordoba on Patient-Physician Relationship. Adopted by the 71st WMA General Assembly (online), October 2020, Cordoba, Spain. Available online: https://www.wma.net/policies-post/wma-declaration-of-cordoba-on-patient-physician-relationship (accessed on March 2022).

World Medical Association. (2018). WMA Declaration of Geneva. Adopted by the 2nd General Assembly of the World Medical Association, September 1948, Geneva, Switzerland. Available online: https://www.wma.net/policies-post/wma-declaration-of-geneva (accessed on April 2022).

World Medical Association. (2018). WMA International Code of Medical Ethics. Adopted by the 3rd General Assembly of the World Medical Association, October 1949, London, United Kingdom. Available online: https://www.wma.net/policies-post/wma-international-code-of-medical-ethics (Accessed on March 2022).

World Medical Association. (2018). WMA Declaration of Lisbon on the Rights of the Patient. Adopted by the 34th World Medical Assembly, September/October 1981, Lisbon, Portugal. Available online: https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient (accessed on March 2022).

Belokolodova, T. I. (2017). The modern labor law status of a medical worker and its features. PhD Thesis. Saint-Petersburg State University, Saint-Petersburg, Russia.

Galiakbarova, G.G. (2021). Development of a legal mechanism for regulating the labor of medical and pharmaceutical workers: Report on research work. Research Work, the Law Faculty, Eurasian National University, Nur-Sultan, Kazakhstan. Available online: https://yur.enu.kz/subpage/nauchnyj-proekt-razrabotka-pravovogo-mehanizma-regulirovaniya-truda-medicinskih-i-farmacevticheskih-rabotnikov- (accessed on June 2022).

Tyulyush, A. M. (2018). Legal regulation of labor relationships for medical workers in Russia at the modern stage. Concept, 4. Available online: https://cyberleninka.ru/article/n/pravovoe-regulirovanie-trudovyh-otnosheniy-meditsinskih-rabotnikov-v-rossii-na-sovremennom-etape (accessed on July 2022). (In Russian).

Ivanov, A. I. (2007). Features of medical workers’ employment contracts. PhD Thesis. Academy of Labor and Social Relationships, Moscow, Russia. Available online: https://www.dissercat.com/content/osobennosti-trudovogo-dogovora-s-meditsinskimi-rabotnikami/read (accessed on March 2022). (In Russian).

Astrakhantseva, E. V. (2008). Some features of work legal regulation and social security for healthcare workers. PhD Thesis. Moscow State Legal Academy, Moscow, Russia. Available online: https://www.dissercat.com/content/nekotorye-osobennosti-pravovogo-regulirovaniya-truda-i-sotsialnogo-obespecheniya-rabotnikov-/read (accessed on March 2022). (In Russian).

Ivanova, N. A. (2012). Legal regulations for medical workers’ labor in the circumstances of the healthcare reforming. PhD Thesis. Omsk State University named after F.M. Dostoevsky, Ekaterinburg, Russia. Available online: https://viewer.rusneb.ru/ru/000199_000009_005009605?page=1&rotate=0&theme=white (accessed on March 2022). (In Russian).

Zhelomeeva, N. V. (2018). Legal regulation of medical workers’ salary. Law PhD Thesis. Ural State Law University, Ekaterinburg, Russia. Available online: https://search.rsl.ru/ru/record/01008709143 (accessed on June 2022). (In Russian).

Galiakbarova, G., & Saimova, S. (2016). Mediation of labour disputes in Kazakhstan in comparative context. Russian Law Journal, 4(2), 96–111. doi:10.17589/2309-8678-2016-4-2-96-111.

Chikhaoui, E., Alajmi, A., & Larabi-Marie-Sainte, S. (2022). Artificial Intelligence Applications in Healthcare Sector: Ethical and Legal Challenges. Emerging Science Journal, 6(4), 717–738. doi:10.28991/esj-2022-06-04-05.

Pflueger, D., & Pedersen, K. Z. (2022). Assembling Homo Qualitus: Accounting for Quality in the UK National Health Service. European Accounting Review, 1–28. doi:10.1080/09638180.2022.2035789.

Behluli, A., Qerimi, F., Pula, F., & Shabani, L. (2022). The Impact of Graduates' Skills on Facing Challenges in the Labor Market. Emerging Science Journal, 6(2), 399-417. doi:10.28991/esj-2022-06-02-014.

Bazyleva, M. N., & Rusinovich, M. V. (2001). Forming national models of labor relationships during the transition period. Belorus State Economic University, Minsk, Belarus. Available online: http://www.bseu.by:8080/bitstream/edoc/5612/2/ Bazyleva%20M.%20Formirovanie%20nats.%20modeley%20trud.%20otnosheniy.pdf (accessed on March 2022). (In Russian).

Potocka-Sionek, N., & Aloisi, A. (2021). ‘Festina Lente’: The ILO and EU Agendas on the Digital Transformation of Work. International Journal of Comparative Labour Law and Industrial Relations, 17(1), 35–63. doi:10.54648/ijcl2021002.

Doskeyeva, G. Z., Rakhimbekova, A. E., Zhamkeyeva, M. K., Saudambekova, I. D., & Bekova, R. Z. (2018). Health Care Financing System in the Republic of Kazakhstan. European Research Studies Journal, 21(2), 282–288. doi:10.35808/ersj/1002.

Regnum (2019). A survey was held in South Korea about work load and conditions of nurses. Rengum, Moscow, Russia Available online: https://regnum.ru/news/society/2627078.html (accessed on March 2022). (In Russian).

Kjellström, S., Avby, G., Areskoug-Josefsson, K., Andersson Gäre, B., & Andersson Bäck, M. (2017). Work motivation among healthcare professionals. Journal of Health Organization and Management, 31(4), 487–502. doi:10.1108/jhom-04-2017-0074.

Tanner, M. (2022). Comparative analysis of healthcare systems in various countries. InLiberty, Government of the Russian Federation. http://www.inliberty.ru/library/49-sravnitelnyy-analiz-sistem-zdravoohraneniya-v-raznyh-stranah (accessed on March 2022). (In Russian).

Rafferty, A. M., Busse, R., Zander-Jentsch, B., Sermeus, W., & Bruyneel, L. (2019) Strengthening health systems through nursing: Evidence from 14 European countries. Health Policy Series, 52, European Observatory on Health Systems and Policies, Copenhagen, Denmark. Available online: https://www.ncbi.nlm.nih.gov/books/NBK545724/ (accessed on March 2022).

Hamscho, V. (2019). Reassessing the Physician-Hospital Relationship. Health Law and Policy Brief, 13(1). Available online: https://digitalcommons.wcl.american.edu/hlp/vol13/iss1/2 (accessed on March 2022).

Zakon News (2015). Law of Kazakhstan Republic: About mandatory social medical insurance (2015). Available online: https://online.zakon.kz/Document/?doc_id=32908862 (accessed on March 2022). (In Russian).

Auelbekova, Zh. B. (2012). Assessment of human resource policy regarding middle medical specialists. Bulletin of Kazakh National Medical University. Available online: https://articlekz.com/article/24084 (accessed on March 2022). (In Russian).

Zakon News. (2022). Decree by Government of Kazakhstan Republic No 1193 “About the system of salaries for civil servants, employees in organizations funded with federal budget, and state enterprise workers” (2015). Available online: https://online.zakon.kz/Document/?doc_id=38093321 (accessed on March 2022). (In Russian).

Labor Code of the Republic of Kazakhstan no. 414-V (2015). Available online: https://adilet.zan.kz/eng/docs/K1500000414 (accessed on July 2022).

Branch agreement between Ministry of Healthcare of Kazakhstan Republic, trade union of medical industry workers and National house of healthcare for 2020-2022 (2012). Available online: https://adilet.zan.kz/rus/docs/D20RR000001 (accessed on July 2022).

Code of honour of medical and pharmaceutical workers in Republic of Kazakhstan № ҚR DSM-319/2020 (2020). Available online: https://adilet.zan.kz/rus/docs/V2000021890 (accessed on July 2022).

Code of the Republic of Kazakhstan «On Public Health and Healthcare System» No. 360-VI ЗРК (2020). Available online: https://adilet.zan.kz/eng/docs/K2000000360 (accessed on July 2022).

World Health Organization. (2011). Increasing access to health workers in remote and rural areas through improved retention: global policy recommendations. World Health Organization, Geneva, Switzerland. Available online: https://apps.who.int/ iris/bitstream/handle/10665/44369/9789241564014_eng.pdf?sequence=1&isAllowed=y (accessed on April 2022).

World Economic Forum. (2019). The Global Competitiveness Report 2019. World Economic Forum, Geneva, Switzerland Available online: https://www.weforum.org/reports/how-to-end-a-decade-of-lost-productivity-growth (accessed on June 2022).

Legatum Prosperity Index (2021). Creating the Pathways from Poverty to Prosperity. LEGATUM Institute, London, United Kingdom. Available online: https://www.prosperity.com/rankings (accessed on March 2022).

Ireland, S. (2021). Revealed countries with the best health care systems. Ceoworld Magazine, New York, United States. Available online: https://ceoworld.biz/2021/04/27/revealed-countries-with-the-best-health-care-systems-2021/ (accessed on July 2022).

Organization for economic Cooperation and Development (2019). Health at a Glance 2021: OECD Indicators. OECD Publishing, Paris, France.

Law Commissions. (2015). Regulation of health care professionals. Regulation of social care professionals in England. The Government’s response to Law Commission Report, Williams Lea Group, Department of Health, London, United Kingdom. Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/399020/ Response_Cm_8995.pdf (accessed on April 2022).

Professional Standards Authority for Health and Social Care. (2022). About regulators. Professional Standards Authority for Health and Social Care, London, United Kingdom. Available online: https://www.professionalstandards.org.uk/what-we-do/our-work-with-regulators/about-regulators (accessed on July 2022).

Pickett, L. (2017). Professional regulation in health and social care. Briefing Paper, Number CBP8094. House of Commons Library, London, Unite Kingdom. Available online: https://researchbriefings.files.parliament.uk/documents/CBP-8094/CBP-8094.pdf (accessed on March 2022).

General Medical Council. (2022). What we do and why. General Medical Council (GMC), London, United Kingdom. Available online: https://www.gmc-uk.org/about/what-we-do-and-why (accessed on June 2022).

Regan Peggs Solicitors (2022). Disciplinary procedures for doctors. Regan Peggs Solicitors, Birmingham, United Kingdom. Available online: https://www.reganpeggs.com/disciplinary-procedures-for-doctors/ (accessed on March 2022).

Gemeinsamer Bundesausschuss. (2022). The Federal Joint Committee: Who we are and what we do. Gemeinsamer Bundesausschuss, Berlin, Germany. Available online: https://www.g-ba.de/english/structure/ (accessed on July 2022).

Gemeinsamer Bundesausschuss. (2022). Responsibilities and methods. Gemeinsamer Bundesausschuss, Berlin, Germany. Available online: https://www.g-ba.de/english/responsibilities-methods/ (accessed on June 2022).

Prutting, Y. (2018). “Germany”. International Encyclopaedia of Laws: Medical Law. Kluwer Law International, Alphen am den Rijn, Netherlands.

Wattad, M. S. (2018). “Israel”. International Encyclopaedia of Laws: Medical Law. Kluwer Law International, Alphen am den Rijn, Netherlands.

Lemmens, T., Bergman, J., Ghimire, K. M., &Shahid, M. (2020). “Canada”. International Encyclopaedia of Laws: Medical Law. Kluwer Law International, Alphen am den Rijn, Netherlands.

Buchler, A., & Gachter, T. (2016). “Switzerland”. International Encyclopaedia of Laws: Medical Law. Kluwer Law International, Alphen am den Rijn, Netherlands.

Herman, N. (2018). “Netherlands”. International Encyclopaedia of Laws: Medical Law. Kluwer Law International, Alphen am den Rijn, Netherlands.

Sovig, T. H. (2019). “Norway”. International Encyclopaedia of Laws: Medical Law. Kluwer Law International, Alphen am den Rijn, Netherlands.

Harbitz, M. B., Stensland, P. S., & Abelsen, B. (2021). Medical malpractice in Norway: frequency and distribution of disciplinary actions for medical doctors 2011–2018. BMC Health Services Research, 21(1). doi:10.1186/s12913-021-06334-2.

Kai, K., Sato, Y., & Nagamizu, Y. (2020). Japan. International Encyclopaedia of Laws: Medical Law. Kluwer Law International, Alphen am den Rijn, Netherlands.

Leishner-Lenzhofer, Uranues, S., Lindner, C., & Kopetzki C. (2018). Austria. International Encyclopaedia of Laws: Medical Law. Kluwer Law International, Alphen am den Rijn, Netherlands.

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DOI: 10.28991/ESJ-2022-06-06-05


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Copyright (c) 2022 Guzal Gazinurovna Galiakbarova, Yenlik Nurgaliyevna Nurgaliyeva, Elmira Bakirovna Omarova, Svetlana Bakhytovna Zharkenova, Muslim K. Khassenov