Bulgaria Health Sector Diagnosis : Policy Note

World Bank

Bulgaria Health Sector Diagnosis : Policy Note

The health system in Bulgaria has undergone significant transformations since the transition and it continues to evolve. This policy note updates a similar document prepared in 2009. It highlights some positive developments, particularly in the area of public health, but continues to find gaps that recent reforms have been unable to reverse. In particular: i) health status in Bulgaria is improving at a slower pace than in other European Union (EU) countries, and the burden of non-communicable diseases is particularly high; ii) coverage of preventive services is low and Bulgarians are much more frequently hospitalized than other Europeans, a sign that the system may not be producing the right mix of services; iii) Bulgarians are among the least satisfied Europeans when it comes to their health system; and iv) total health expenditure is comparable to that of countries with similar income, but the out-of pocket share is disproportionately large and has grown over time, and the financial protection provided by the system is incomplete. Whilst more public expenditure on health will be needed in the medium to long-term, any increases should be accompanied by improvements in efficiency and effectiveness in order to make the best use of resources and ensure the delivery of better health outcomes. This policy note thus primarily focuses on three areas where decisive and prompt action could rapidly bring results and improve the experience of Bulgarian citizens: hospitals, outpatient care, and drug policies. These issues are closely interlinked and tackling them is a key to the modernization of service delivery in all European countries. Indeed, in order to face the challenges brought about by ageing and non-communicable diseases and to meet the population's needs and expectations, new models of health and social care need to emerge that enable patients to stay out of hospital. This is possible through technological change, but can only happen if the outpatient sector delivers more and patients can manage diseases and risk factors through access to appropriate services and medicines.

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Bibliographic Details
Main Author:	World Bank
Language:	English en_US
Published:	Washington, DC 2012
Subjects:	AGED, AGING, AMBULATORY SECTOR, BASIC NEEDS, BASIS FOR ACTION, BEDS, BURDEN OF DISEASE, CAPITAL COSTS, CAPITATION, CARDIOVASCULAR DISEASES, CARE PERFORMANCE, CAUSES OF DEATH, CERVICAL CANCER, CHRONIC DISEASE, CIRCULATORY SYSTEM, CITIZENS, CLINICAL GUIDELINES, CLINICAL SERVICES, COMMUNICABLE DISEASES, COMPLICATIONS, COST CONTROL, DEATH RATE, DEATH RATES, DEATHS, DEBT, DECISION MAKING, DEMOGRAPHIC TRANSITION, DEMOGRAPHIC TRENDS, DEPENDENCY RATIO, DIABETES, DIET, DISABILITIES, DISPARITIES IN HEALTH, DOCTORS, EARLY DETECTION, ELDERLY, ESSENTIAL DRUGS, FERTILITY, FERTILITY RATES, FINANCIAL CONSTRAINTS, FINANCIAL INCENTIVES, FINANCIAL MANAGEMENT, FINANCIAL PRESSURE, FINANCIAL PROTECTION, FIXED COSTS, FUTURE GROWTH, GENERAL PRACTITIONERS, GLOBAL BUDGETS, GLOBAL HEALTH, GROSS DOMESTIC PRODUCT, GROSS NATIONAL INCOME, HEALTH CARE, HEALTH CARE COSTS, HEALTH CARE PROVIDERS, HEALTH CARE SECTOR, HEALTH CENTERS, HEALTH EXPENDITURE, HEALTH EXPENDITURE PER CAPITA, HEALTH FOR ALL, HEALTH IMPACTS, HEALTH INDICATORS, HEALTH INEQUALITIES, HEALTH INFORMATICS, HEALTH INFORMATION, HEALTH INSURANCE FUNDS, HEALTH INTERVENTIONS, HEALTH MINISTRIES, HEALTH ORGANIZATION, HEALTH OUTCOMES, HEALTH PROFESSIONALS, HEALTH SECTOR, HEALTH SECTOR REFORM, HEALTH SERVICES, HEALTH SPECIALIST, HEALTH SPENDING, HEALTH STATUS, HEALTH STATUS INDICATORS, HEALTH SYSTEM, HEALTH SYSTEMS, HEALTH SYSTEMS IN TRANSITION, HEALTH WORKFORCE, HEALTH-CARE, HIGH BLOOD PRESSURE, HOME CARE, HOSPICE, HOSPITAL, HOSPITAL AUTONOMY, HOSPITAL BEDS, HOSPITAL BUDGETS, HOSPITAL CAPACITY, HOSPITAL CARE, HOSPITAL COST, HOSPITAL COSTS, HOSPITAL FINANCING, HOSPITAL FUNDING, HOSPITAL MANAGEMENT, HOSPITAL SECTOR, HOSPITAL SERVICES, HOSPITALS, HOUSEHOLD EXPENDITURE, HUMAN DEVELOPMENT, HUMAN RESOURCES, HYPERTENSION, ILLNESS, IMMUNIZATION, IMPACT ON HEALTH, INCOME, INEQUITIES, INFANT, INFANT DEATHS, INFANT MORTALITY, INFANT MORTALITY RATE, INFANT MORTALITY RATES, INFLUENZA, INFORMAL PAYMENTS, INFORMATION SYSTEMS, INTEGRATION, INTERNATIONAL COMPARISONS, INTERVENTION, LABOR MARKET, LEADING CAUSES, LEADING CAUSES OF DEATH, LEGAL STATUS, LIFE EXPECTANCY, LIFE EXPECTANCY AT BIRTH, LIVE BIRTHS, LIVING CONDITIONS, LIVING STANDARDS, LOCAL CAPACITY, LOCAL GOVERNMENTS, LONG-TERM CARE, MARKETING, MEDIA ATTENTION, MEDICAL BILLS, MEDICAL CARE, MEDICAL CONTACTS, MEDICAL EDUCATION, MEDICAL EQUIPMENT, MEDICAL SERVICES, MEDICINES, MINISTRY OF HEALTH, MODERNIZATION, MORBIDITY, MORTALITY, NATIONAL HEALTH, NATIONAL HEALTH INSURANCE, NATIONAL HEALTH INSURANCE FUND, NUMBER OF PEOPLE, NURSES, OBESITY, OPEN SOCIETY, OUTPATIENT CARE, OUTPATIENT SERVICES, PACEMAKERS, PATIENT, PATIENT RIGHTS, PATIENT SATISFACTION, PATIENTS, PERSONS WITH DISABILITIES, PHARMACEUTICAL MARKETING, PHARMACEUTICAL POLICIES, PHARMACEUTICAL SECTOR, PHARMACIES, PHARMACISTS, PHYSICIAN, PHYSICIANS, POCKET PAYMENT, POCKET PAYMENTS, POLICY DEVELOPMENTS, POLICY DIALOGUE, POLICY GOALS, PRICE CONTROL, PRIMARY CARE, PRIMARY CARE DOCTORS, PRIMARY CARE SECTOR, PRIMARY HEALTH CARE, PRIVATE HOSPITALS, PRIVATE SECTOR, PROFESSIONAL ASSOCIATIONS, PROGRESS, PROVIDERS OF HEALTH CARE, PUBLIC CONTRACT, PUBLIC EXPENDITURE, PUBLIC EXPENDITURE ON HEALTH, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC HEALTH EXPENDITURE, PUBLIC HEALTH STATISTICS, PUBLIC HOSPITALS, PUBLIC SECTOR, QUALITY ASSURANCE, QUALITY IMPROVEMENT, QUALITY OF CARE, QUALITY OF HEALTH, QUALITY OF HEALTH CARE, QUALITY OF LIFE, QUALITY SERVICES, REIMBURSEMENT RATES, RESEARCH INSTITUTIONS, RESPECT, RESPITE CARE, RICHER COUNTRIES, RISK FACTORS, RURAL AREAS, SCREENING, SERVICE DELIVERY, SERVICE PROVISION, SMOKING, SOCIAL POLICY, SOCIAL WORKERS, SURGERY, TEACHING HOSPITALS, TRAUMA, TREATMENT SERVICES, TUBERCULOSIS, USE OF RESOURCES, VACCINE COVERAGE, VASCULAR DISEASES, WORKERS, WORLD HEALTH ORGANIZATION, YOUNG PEOPLE,
Online Access:	http://documents.worldbank.org/curated/en/2013/03/17878699/bulgaria-health-sector-diagnosis-policy-note https://hdl.handle.net/10986/16082
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