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SCIENCE TIME
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DYNAMICS OF THE AGE-RELATED SURVIVAL RATE IN
THE REPUBLIC OF KAZAKHSTAN
Tochiyeva Zorina, Al-Farabi Kazakh National University, Almaty, Kazakhstan
E-mail: zarina.zt@mail.ru
Abstract. This article presents the results of the analysis of the dynamics of the age survival rate in the Republic of Kazakhstan in the period 2018-2020. Using the Kaplan-Meier method, the average and median survival rates were calculated in the Republic as a whole (including by regions) and separately for male and female populations.
Key words: dynamics, age-related survival, survival analysis, Kazakhstan.
Introduction
One of the objective criteria for the activity of the medical service is the medical and statistical survival rate. This indicator makes it possible to assess the state of medical and preventive care provided to the population, and to a certain extent to assess its availability ("equality/inequality") in different localities [1].
The review of the issue under study revealed a shortage of scientific papers on the assessment of population survival in the Republic of Kazakhstan. The works on the assessment of age-related survival in certain regions [2, 3] and/or for certain groups of diseases [4] are presented. The purpose of this study was to study the dynamics of the age-related survival rate in the Republic of Kazakhstan (population study).
Materials and methods
The main source of information was the official data on fatal cases (the PR database, the "Registry of Death Certificates") for the Republic of Kazakhstan. Period of research 2018-2020
The Kaplan-Meier method was applied to perform the survival analysis. The temporary variable is age (age survival). All cases of deaths were uncensored. The peculiarities of survival in the Republic and regions of the country were studied, depending on the year of death pronouncement, by gender, taking into account nosological entities (according to lCD-10). The comparative analysis was carried out using the Log Rank test.
Results
Table 1 presents the data on the average indicators of age-related survival of the entire population of the Republic of Kazakhstan. These indicators have not changed in
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dynamics: Log Rank statistics is at the level of p>0.05. The average age of survival in the Republic in the period 2018-2020 was about 67 years, and the median survival time was 70 years.
Table 1
Average and median survival (by RK, gender blind)
Averages and medians for survival time
Year Average Median
estimation 95% confidence interval estimation 95% confidence interval
lower upper lower upper
2018 66,764 66,649 66,880 70,000 69,864 70,136
2019 66,708 66,593 66,823 70,000 69,876 70,124
2020 66,994 66,900 67,089 70,000 69,900 70,100
The analysis of the structure of age-related survival showed significant differences (about 10 years) in survival by gender (Table 2). It should be noted that the age-related survival rate in the female population is significantly higher in comparison with the male population. Log Rank statistics are significant at the level of p<0.001.
Also, it should be emphasized that in dynamics, both in male and female populations, the average rate of age-related survival have shifted: survival in the male population has increased and survival in the female population has decreased.
Table 2
Average and median survival (by RK, taking into account gender)
Averages and medians for survival time
Year Gender Average Median
estimation 95% confidence interval estimation 95% confidence interval
lower upper lower upper
2018 male 62,476 62,318 62,634 65,000 64,840 65,160
female 71,277 71,119 71,435 77,000 76,853 77,147
2019 male 62,474 62,318 62,631 65,000 64,844 65,156
female 71,228 71,069 71,388 77,000 76,798 77,202
2020 male 63,274 63,146 63,402 66,000 65,867 66,133
female 71,052 70,919 71,185 75,000 74,817 75,183
The average rates of the age-related survival of the population of the Republic of Kazakhstan, taking into account nosological entities, are analyzed.
The lowest age-related survival rates of Kazakhstani residents (gender blind) are characteristic of the following nosological entities (X for 2018-2020): 1) diseases associated with pregnancy, childbirth and the postpartum period ("O"), 2) external causes of injuries in accidents ("W"), 3) infectious and parasitic diseases ("A"), 4-5) external causes of mortality ("V" and "Y"). In turn, the highest rates of age-related survival of residents of the Republic of Kazakhstan are typical for such nosological entities as: 1) diseases not elsewhere classified ("R"), 2) mental and behavioral
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disorders ("F"), 3) diseases of the musculoskeletal system and connective tissue ("M"), 4) diseases of the nervous system ("G") and 5) diseases of the genitourinary system ("N").
In the male Kazakhstani population, the highest rates of age-related survival (X for 2018-2020) are characteristic of such nosological entities as: 1) mental and behavioral disorders ("F"), 2) diseases not elsewhere classified ("R"), 3) diseases of the musculoskeletal system and connective tissue ("M"), 4) diseases of the nervous system ("G") and 5) diseases of the genitourinary system ("N"). The lowest age-related survival rates in the male Kazakh population are typical for the following nosological entities (X for 2018-2020): 1) external causes of injuries in accidents ("W"), 2) infectious and parasitic diseases ("A"), 3-4) external causes of mortality ("V" and "Y") and 5) infectious and parasitic diseases ("B").
In the female Kazakh population, the highest rates of age-related survival (X for 2018-2020) are characteristic of such nosological entities as: 1) diseases not elsewhere classified ("R"), 2) mental and behavioral disorders ("F"), 3) diseases of the nervous system ("G"), 4) diseases of the musculoskeletal system and connective tissue ("M") and 5) respiratory diseases ("J"). The lowest rates of age-related survival in the female Kazakh population are typical for the following nosological entities (X for 20182020): 1) external causes of injuries in accidents ("W"), 2) diseases associated with pregnancy, childbirth and the postpartum period ("O"), 3-4) external causes of mortality ("X" and "Y") and 5) infectious and parasitic diseases ("B").
Along with the republican rates, the average rates of regional age-related survival were analyzed.
The differences in the mean values (min=63 years, max=70 years) and median survival time (min=66 years, max=74 years) of the population (gender blind) in the regions of the Republic of Kazakhstan were revealed. The highest age-related survival is observed in the city of Almaty, Akmola region and Karaganda region, and the lowest - in Mangystau region, the city of Nur-Sultan and Turkestan region. In dynamics (in 2020 compared to 2018), the age-related survival rate in Kyzylorda region, Mangystau region has increased by more than 1.5 times and decreased in the city of Shymkent. In the regions with the highest age-related survival, the average and median survival (X for 2018-2020) in the male population are 65-66 years and 67-69 years, respectively, and in the female population - 73 and 78 years, respectively, in the regions with the lowest survival, the average and median survival (X for 2018-2020) in the male population are 60-61 years and 63-65 years, respectively, and in the female population - 66-67 years and 70-72 years, respectively.
Conclusion
In general, in Kazakhstan in the period 2018-2020, there has been a stable situation in terms of age-related survival (without significant shifts). At the same time, the level of survival varies considerably by gender. The differences in survival by nosological entities are characteristic, as well as the differences by regions of the country.
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References:
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