Beyond Direct Savings: Administrative Productivity, Dual Workflows and Risk-Adjusted Assessment of Healthcare Digitalization in Kazakhstan
Year: 2026
Type: preprint
Abstract: Digital health investments are often justified by the expectation of direct cost savings, faster administrative processing and lower paper-based document flows. Hospital-level evidence from transition economies, however, may show a more complex pattern: digital systems expand, service volumes grow, technical support costs increase and paper-based procedures continue. This article analyses healthcare digitalization in the University Hospital of NJSC Semey Medical University in Kazakhstan for 2019–2025 as a public-sector digital transformation case. The study uses aggregated institutional data and separates three types of evidence: observed accounting shifts, observed administrative productivity and scenario-based monetization of potential staff time savings. Administrative productivity increased from 460 to 670 treated cases per administrative employee, while electronic medical records, laboratory tests and diagnostic examinations also expanded. At the same time, the accounting data do not support a simple claim of direct financial savings: total administrative expenditures, archive expenditures, registry expenditures and paper-based document-flow costs increased during the observation period. This mixed pattern is interpreted as a dual-workflow effect, where digital and paper-based processes coexisted rather than fully replacing one another. Total IT and digitalization expenditures amounted to KZT 182.6 million. The modelled value of potential staff time savings is KZT 240.1 million under baseline assumptions, but it is treated strictly as a scenario estimate, not as audited savings. The baseline scenario produces a conditional ROI of 31.5%, whereas risk-adjusted and pessimistic scenarios become negative. The article contributes to digital health governance by showing that hospital digitalization may improve administrative productivity without immediately producing direct budgetary savings.
Source: Research Square
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204475579