Factors Limiting Access to Surgical Treatment of Focal Epilepsy in Kazakh Population

<b>Background/Objectives:</b> Effective management represents a real opportunity to reduce the economic burden of focal epilepsy, which leads to the withdrawal of at least 0.7% of the working-age population from the labor force. The aim of this retrospective observational cross-sectional study is to identify barriers that limit access to surgical treatment for epilepsy among patients with focal epilepsy in Kazakh population. <b>Methods:</b> Medical reports from epileptologists on 3112 patients of the Epilepsy Center (Astana) in 2024 were reviewed. The study included original information on 1361 patients with a confirmed diagnosis of focal epilepsy, in accordance with ICD-10 codes G40.0-G40.2. <b>Results:</b> Timely detection of focal epilepsy was not associated with socio-demographic or regional factors in our sample. Logistic regression analysis showed that sex and social status did not affect whether patients underwent surgery. However, marital status, employment, and region were significant factors. Married and employed patients had higher odds of remaining non-operated. Among candidates for surgical treatment, 38.68% underwent surgery. <b>Conclusions:</b> The markedly higher odds of remaining non-operated outside Astana point to gaps in referral pathways and service availability, emphasizing the need for a comprehensive approach to managing focal epilepsy in countries undergoing rapid technological development.