Uzbekistan to introduce KPI-based hospital management from 2027

Uzbekistan has adopted a presidential decree introducing a large-scale overhaul of the healthcare system, including the creation of a Clinical Audit Inspection, new digitalization standards, KPI-based hospital management and expanded powers for the Ministry of Health aimed at improving healthcare quality and governance efficiency.

The decree, titled “On measures to improve management efficiency in the healthcare system,” is focused on strengthening public health protection, expanding access to medical services and modernizing state healthcare administration in line with international standards.

One of the key reforms includes the establishment of a new Clinical Audit Inspection with regional divisions responsible for monitoring the quality and safety of medical services in both public and private healthcare institutions. The body will oversee compliance with clinical standards, evaluate hospital performance and introduce a unified clinical supervision system.

Authorities will also establish a Population Health Analysis Research Centre under the Institute of Health and Strategic Development to analyse public health indicators, conduct research and support strategic decision-making.

In addition, a separate Content Media Centre will be launched to improve public communication on healthcare reforms and medical services, while also collecting and analyzing public feedback.

The decree significantly expands the authority of the Ministry of Health, allowing it to establish project offices, implement pilot reform initiatives, attract foreign and local specialists, and introduce unified digital standards and information systems across the sector.

A major focus of the reform package is digital transformation. The Chamber of Accounts has been tasked with conducting a comprehensive audit of healthcare digitalization projects within three months, including systems developed by UZINFOCOM. Effective projects will continue, while inefficient initiatives may be revised or cancelled.

By the end of 2026, the Ministries of Health and Digital Technologies are expected to approve unified standards for healthcare information systems, integration protocols, cybersecurity requirements and nationwide digital infrastructure development plans.

Starting from 2027, directors of national- and regional-level hospitals under the Ministry of Health will be appointed on contracts of up to five years and evaluated through key performance indicators (KPIs), including service quality, financial discipline, management efficiency, staffing policy and digitalization progress.

Hospital managers will also be required to prepare development programs and complete training in medical management and financial administration.

The decree additionally expands the role of medical associations, which from September 2026 will participate in developing healthcare standards, assessing service quality, conducting independent audits and supporting certification and retraining processes for medical personnel.

The Ministry of Health’s central office staffing level was set at 298 positions, including one first deputy minister and five deputy ministers. The newly created Clinical Audit Inspection and its regional divisions will include 128 staff positions.

The reforms also introduce greater financial flexibility for medical institutions funded through the State Medical Insurance Fund. From 2027, healthcare facilities will be allowed to retain unused budget funds at year-end and independently determine staffing structures within allocated financing limits.