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Patient payments and the problems in medical services provision in Bulgaria

100%
Atanasova E., Moutafovа E., Kostadinova T., Pavlova M.
Zdrowie Publiczne i Zarządzanie
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2010
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vol. 8
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issue 1
PL
During the past decade, the reform in the Bulgarian health care sector was in the focus of policy and research discussions at national and international level. In spite of the great expectations after the introduction of social health insurance in 2000, efficiency, equity and quality problems in health care provision in Bulgaria continue to exist. The unequal start of the reform in outpatient and hospital care (namely the delay in restructuring the hospital sector) is one of the causes of these problems. Among other issues, the reform also included the implementation of formal patient charges. At present, formal patient charges are applied to all levels of medical services with the exception of emergency care. Nevertheless, informal patient payments continue to exist. The aim of this paper is to present the attitudes of health care stakeholders toward patient charges from the perspective of the state of the Bulgarian health care system. The data are collected via focus group discussions and in-depth interviews carried out in Bulgaria in May-June 2009. The results are used to out-line recommendations for policy related to patient payments
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Political will against funds deficiency: Health promotion for older people in Bulgaria

64%
Pavlova M., Atanasova E., Moutafova E., Sowa A., Kowalska-Bobko I., Domagała A., Golinowska S., Groot W.
Zdrowie Publiczne i Zarządzanie
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2017
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vol. 15
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issue 1
108-115
EN
In Bulgaria, health promotion and health education have received less attention in comparison to other public health areas, which has resulted in a small health promotion budget and consequently, in limited health promotion initiatives. This country report draws upon several national reports focused on the Bulgarian health system, and other country specific sources in order to outline the major institutional and financing challenges for health promotion in Bulgaria, and specifically for health promotion for older adults. As evident from this review, the programs and activities oriented toward health promotion for older adults are inconsistent and incomprehensive. The existing programs are mostly in the form of isolated small-scale projects aimed at enabling older workers to reach the statutory retirement, or supporting retired citizens to maintain their health and well-being. Effective strategic vision, coordination and stable funding in the area of health promotion for older adults is indispensable for helping Bulgarian seniors to live longer and healthier.
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