SELF-REPORTED HEALTHCARE SYSTEM FACTORS AND QUALITY OF LIFE IN ELDERLY PATIENTS WITH ISCHEMIC HEART DISEASE: A PILOT STUDY IN ALMATY AND ALMATY REGION OF KAZAKHSTAN

Introduction. Ischemic heart disease (IHD) remains a leading cause of mortality and disability among the elderly. Beyond clinical characteristics, self-reported healthcare system factors may be associated with quality of life, but Kazakhstan evidence is limited. Aim. To assess the relationship of self-reported healthcare system factors and quality of life in elderly patients with IHD in Almaty and Almaty Region. Materials and methods. The cross-sectional pilot study included 75 elderly patients with a verified IHD from four facilities. Data were collected via questionnaires and medical records. Healthcare system factors and quality of life were self-assessed using a 5-point Likert scale, angina functional class by CCS (Canadian Cardiovascular Society). Spearman’s correlation, multiple linear regression (unadjusted/adjusted for sex, age, CCS class) were used; significance – p<0.05 (SPSS 26.0). Results. Mean age was 66.6 years, 53.3% were female, and 54.7% had CCS class III. Mean body mass index – 30.1 ± 5.4 kg/m², total cholesterol – 5.86 ± 1.48 mmol/L. Among self- reported healthcare system factors, screening participation (64.0%) and healthcare accessibility (61.3%) were most often rated as high. Self-reported medication availability was more often rated as low (40.0%). Quality of life correlated with several self-reported healthcare system factors, including screening participation (ρ=0.496; p<0.001), cardiovascular risk-factor awareness (ρ=0.464; p<0.001), treatment adherence (ρ=0.355; p=0.002), and healthcare accessibility (ρ=0.338; p=0.003). However, self-reported risk-factor awareness was the only independently associated factor (B=1.655; p=0.012), remaining significant after adjustment (B=1.395; p=0.035). Conclusion. In elderly IHD patients, quality of life was associated with self-reported healthcare system factors. Self-reported risk-factor awareness was the only independently associated factor, remaining significant after adjustment. Prospective studies exploring the implications of findings for patient education are warranted.