Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 0 0 2026 06 25 1659 1659 Adenova Gulzhan Kazakhstan Medical University “KSPH”, Almaty, Kazakhstan. Kausova Galina Kazakhstan Medical University “KSPH”, Almaty, Kazakhstan. Brukhanov Alexander Diagnostic Center of the Altai Territory, Kazakhstan Juvashev Almaz Almaty City Emergency First Aid Hospital, Almaty, Kazakhstan. Utaganov Bakyt Almaty City Emergency First Aid Hospital, Almaty, Kazakhstan. Lyazzat Ayaganova Almaty City Emergency First Aid Hospital, Almaty, Kazakhstan. Zhanna Dyusembayeva Stroke Unit at City Clinical Hospital No. 7, Almaty, Kazakhstan. Sabina Medukhanova Republican Coordination Center for Stroke in the Republic of Kazakhstan, Kazakhstan. Konstantin Bulygin Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan. Tazhiyeva Aigul Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan. 2025 09 23 2026 05 01 Objective: The study aimed to evaluate the accessibility and performance of emergency medical service (EMS) in Kazakhstan, with a focus on regional disparities and implications for health system development. Methods: A retrospective study on ambulance services in Kazakhstan for 2024 used data from the medical information system. The study found that the ambulance service has 100% automated call management in cities like Astana, Almaty, Shymkent, and 17 regions. The dispatcher processes calls within 5 minutes, categorizing challenges into four types: direct threats to life, potential threats, potential health threats, and acute conditions without danger. The time of arrival for ambulances varies between 10 minutes and 60 minutes. Results: The ambulance service has 20 stations, 96 urban substations, and 195 district offices. 1,499 mobile EMS teams operate in one shift, with a ratio of 18/82. In 2024, 914 city and 585 district brigades operate consultations without team departure, accounting for 10.27% of calls. Kazakhstan has a high proportion of urgent category one calls, accounting for 86% of the total number. This raises concerns about the accuracy of the assessment of urgency, as it may indicate system errors in triage or overloading ambulances with tasks not within their competence.  The Ulytau region, North Kazakhstan, East Kazakhstan, Mangystau, Kyzylorda, and Karaganda regions have the highest percentages of urgent calls (94-96%). The study recorded 8,531,652 calls, with 70.8% coming from urban areas and 29.2% of rural regions. The highest urbanization rates were found in republican significance towns like Almaty, Shymkent, and Astana. In all regions, the distribution of calls between urban and rural areas differs significantly from the overall structure for the country (χ² = 3,210,171.3, P< 0.001). Conclusion: The study shows that Kazakhstan's EMS system has fully automated call management, but regional disparities persist. Urgent category one calls are predominant, with urban areas like Almaty, Astana, and Shymkent generating the majority. This highlights structural imbalances in EMS utilization and calls need improvement in triage protocols, resource allocation, and health system capacity. https://fem.tums.ac.ir/index.php/fem/article/view/1659 https://fem.tums.ac.ir/index.php/fem/article/download/1659/550