Patient payments and the problems in medical services provision in Bulgaria

Elka Atanasova,

Emanuela Moutafovа,

Todorka Kostadinova,

Milena Pavlova

Abstrakt

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

Słowa kluczowe: opłaty pacjentów, system opieki zdrowotnej, udziałowcy, Bułgaria
References

Dimova A., Rohova M., Popov M., The Health Care Reform in Bulgaria: Analysis. Open Society Institute, Sofia 2007.

Health Insurance Law. „National Newspaper” 1998; Number 70.

Avdeeva O., Georgieva L., Salchev P., Dimitrova R., Dimova A., Bulgaria–Health system review. Health System in Transition. European Observatory of Health System and Policies, 2007.

World Bank Report, Bulgarian Healthcare system, 2009.

Report of the Committee on Health. Report on the state of public health – primary investment in the future of the nation 2005–2007. National Assembly, 2009

National Employment Agency. www.az.government.bg

Open Society Institute, Informal payments in the healthcare system. Sofia 2008.

Pashev K., Corruption in Healthcare in Bulgaria. Center for the Study of Democracy, Sofia 2007.

Institute for Social and Trade Union Studies, Reforms and privatization of healthcare – social and economic consequences. Global Policy Network – GPN, 2005.