The increasing budget financing of primary health care (PHC) in Kyrgyzstan brings no improvement into workforce indicators that establishes risks to sustainability of family medicine system. The purpose of the study was to assess impact of financing parameters on family medicine efficiency and to justify necessity of reforming system of remuneration of labor. The cross-sectional retrospective analytical study (2013–2023) was based on data from 12 Family Medicine Centers in Southern Kyrgyzstan. The data from MHIF, NatStatCom, and MoH KR were analyzed. The survey included 180 medical workers and 420 patients. The statistical analysis was performed using software SPSS v.25 to calculate the Student's t-test, Pearson correlation, linear regression). The post-hoc power analysis confirmed adequate sample size (power ≥ 0.80 at α = 0.05). The PHC funding increased by 94.5% (from 2.56 to 4.98 billion soms), yet physician supply decreased by 22.9% (from 4.8 to 3.7 per 10,000 population). The direct correlation was established between funding and patient satisfaction (r = 0.48; p < 0.05). The inverse relationship was established between physician workload and medical care accessibility (r = –0.61; p < 0.01). The current capitation model fails to stimulate preventive activities: its share in physicians' working time is 14–18% versus 35–40% in EU countries. The transition to combined payment system (fixed salary + 15–20% incentive payments for quality and prevention) is required. The implementation of regional coefficients for PHC system sustainability is needed too. The article was prepared in accordance with STROBE guidelines for observational studies.

Pay-for-Performance, family medicine, financing, capitation, Pay-for-Performance, quality of care, accessibility, Kyrgyzstan.