{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T21:29:58Z","timestamp":1769462998364,"version":"3.49.0"},"reference-count":42,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Ongoing healthcare and medical education reforms in Kazakhstan have been accompanied by persistent workforce shortages and reduced inpatient capacity in pediatric care. Therefore, this study aimed to assess and forecast selected healthcare system indicators using acute mastoiditis (AM) as a sentinel condition while also describing its clinical and epidemiological characteristics. Materials and Methods: This study combined an analysis of national healthcare and demographic statistics in Kazakhstan from 1998 to 2024 with a retrospective review of pediatric AM patients treated at a tertiary referral center. Long-term trends in healthcare resources were assessed, and future needs were projected via average annual percentage change (AAPC) and time series forecasting methods. Clinical, laboratory, and radiological data were extracted from medical records. Statistical analyses were performed via SPSS version 24.0 (IBM Corp., Armonk, NY, USA). Results: From 1998 to 2024, the number of pediatricians and ENT hospital beds declined, whereas the density of ENT physicians remained relatively stable, and the proportion of ENT surgical procedures increased. Projections to 2030 suggest continued constraints in pediatric and ENT workforce capacity and further reductions in inpatient beds despite sustained growth in surgical demand. Among 95 pediatric AM cases, complications, most commonly subperiosteal abscess and zygomatic abscess, were identified in 40% of patients. Conclusions: AM may be considered a contextual indicator of pressures within specialized pediatric ENT services rather than a direct measure of healthcare system performance. These findings highlight the need for further studies to validate these observations and better inform healthcare planning.<\/jats:p>","DOI":"10.3390\/children13020170","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T10:24:36Z","timestamp":1769423076000},"page":"170","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A National Forecast and Clinical Analysis of Pediatric Acute Mastoiditis in Kazakhstan"],"prefix":"10.3390","volume":"13","author":[{"given":"Nazik","family":"Sabitova","sequence":"first","affiliation":[{"name":"Higher School of Public School, Kazakhstan Medical University, Almaty 050060, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timur","family":"Shamshudinov","sequence":"additional","affiliation":[{"name":"Medical and Diagnostic Center of Otorhinolaryngology, Almaty 050000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Assiya","family":"Kussainova","sequence":"additional","affiliation":[{"name":"Department of General Medical Practice with a Course of Evidence-Based Medicine, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4341-1956","authenticated-orcid":false,"given":"Dinara","family":"Toguzbayeva","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, NEI Kazakh-Russian Medical University, Almaty 050000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5322-2948","authenticated-orcid":false,"given":"Bolat","family":"Sadykov","sequence":"additional","affiliation":[{"name":"Center of Pediatric Otorhinolaryngology, General Hospital #5, Almaty 050000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yevgeniya","family":"Rahanskaya","sequence":"additional","affiliation":[{"name":"Department of Traumatology and Pediatric Surgery, Semey Medical University, Semey 071400, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Kassym","sequence":"additional","affiliation":[{"name":"Department of General Medical Practice with a Course of Evidence-Based Medicine, Astana Medical University, Astana 010000, Kazakhstan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Glushkova, N., Semenova, Y., and Sarria-Santamera, A. 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