The Astana Audit Commission identified 5,261 cases of repeat ambulance calls after patients were examined by polyclinic doctors. In 61 cases, patients died before the medics arrived. The inspection covered the period from 2023 to March 2026 and revealed problems with determining the urgency of calls.
WHAT THE AUDITORS FOUND
As reported by BES.media, citing the audit commission's conclusion of 8 October 2026, the auditors studied the work of Astana's ambulance service for the period from 1 January 2023 to 31 March 2026.
Dispatchers passed 379,510 fourth-category urgency calls to polyclinics. After examination, doctors left patients at home in 327,288 cases.
However, 5,261 patients required an ambulance again within the following 12 hours. The repeat calls were assigned a higher urgency category.
The auditors recorded the following statistics:
- 2023 — 1,626 repeat calls and 27 deaths.
- 2024 — 1,099 calls and 16 deaths.
- 2025 — 1,961 calls and 13 deaths.
- First quarter of 2026 — 575 calls and five deaths.
The share of repeat calls rose from 1.25% in 2023 to 3.7% in the first quarter of 2026.
PATIENT WITH AN ASTHMA ATTACK DIED AFTER WAITING FOR AN AMBULANCE
On 26 November 2025, a dispatcher assigned a call for a patient with bronchial asthma the fourth urgency category and passed it to City Polyclinic No. 14.
The doctor who arrived found the patient in a critical condition and requested emergency assistance. The urgency category was raised to the first. The ambulance arrived five minutes after the repeat call, but the patient had already died.
34 minutes had passed since the first call. The auditors linked the loss of time to the initial determination of the urgency category.
PATIENT WITH HEART FAILURE WAS LEFT AT HOME
On 23 March 2025, a dispatcher registered a call due to acute urinary retention associated with chronic diseases of the urinary system. The call was assigned the fourth urgency category.
A doctor from City Polyclinic No. 11 identified urinary retention, a skin abscess and concomitant heart failure in the patient, but decided to leave him at home.
Several hours later, the patient was found unconscious. The ambulance that arrived pronounced him dead.
The auditors established that the doctor knew about the heart failure but did not organise further observation and did not refer the patient to hospital.
POLYCLINICS PROVIDED CONTRADICTORY INFORMATION
The inspection revealed discrepancies between the official responses of polyclinics and the data of the electronic Komek system.
Some medical organisations reported the absence of repeat calls, although the system contained different information.
The auditors allowed that individual polyclinics may have understated the figures in order to avoid administrative and reputational consequences. However, deliberate concealment of data was not established.
An additional inspection of three city hospitals identified patients who had initially been assigned low urgency categories, despite illnesses that required emergency assistance.
WHAT CHANGES THE AUDITORS RECOMMENDED
The audit commission recognised the system of passing fourth-category calls to polyclinics as ineffective.
The inspectors recommended improving data exchange between the ambulance service and hospitals, and also, by 20 January 2027, considering the introduction of artificial intelligence to determine the urgency of calls.
At the same time, the 61 deaths before the ambulance arrived do not prove the guilt of medical workers. Establishing the causes of each fatal outcome requires a separate clinical review.
The conclusion contains no information on whether such inspections were carried out or on disciplinary measures.
