URBAN-RURAL DIFFERENCES IN PATIENT SATISFACTION WITH EMERGENCY OPHTHALMOLOGICAL CARE IN THE ABAY REGION, KAZAKHSTAN: A CROSS-SECTIONAL STUDY

Introduction. Worldwide, cataracts, glaucoma, age-related macular degeneration (AMD) and dry eyes remain the main causes of vision loss, and up to 80% of cases can be prevented with timely medical care. However, access problems and the growing number of emergency department visits for non-urgent eye diseases continue to put strain on health systems. In Kazakhstan, the hospital accreditation system has been developing since the early 2010s, but differences in infrastructure and access - especially between urban and rural areas - remain a problem for the provision of emergency ophthalmic care. The purpose of this study was to assess the provision and quality of emergency ophthalmological care in the Abai region of Kazakhstan, comparing urban and rural populations from the perspectives of patients. Materials and methods. A structured 37-item questionnaire was developed and pilot-tested to assess emergency ophthalmologic care in the Abay region. A prospective descriptive study was conducted from January to June 2025 using continuous sampling. Data were analyzed using Pearson's chi-square test and univariate and multivariate logistic regression to identify factors associated with patient satisfaction. Analyzes were conducted in Stata 15.1 (p < 0.05). Results. The survey included 221 respondents—123 urban (55.7%) and 98 rural (44.3%). Urban participants were younger, better educated, and more frequently employed, while rural respondents were older, more often female, and had lower income and education levels. Although urban patients reported slightly higher satisfaction with staff professionalism, hygiene, and attentiveness, most differences were not statistically significant. Rural patients were more likely to report clear explanations from doctors (63.4% vs. 53.1%, p = 0.034). Overall satisfaction was significantly linked to timely access to medication, higher monthly healthcare spending, and patients’ understanding of the reasons behind their treatment. Conclusion Urban and rural patients in the Abay region show significant differences in demographics and satisfaction with emergency eye care, with urban patients generally reporting higher satisfaction due to better access and communication. To improve equity, policymakers should focus on enhancing rural service accessibility, timely medication delivery, and strengthening patient-provider communication to boost overall satisfaction and outcomes.