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Bulgaria health system review
Antoniya Dimova1, Maria Rohova, Emanuela Moutafova
1Department of Health, Economics and Management, Varna University of Medicine, Bulgaria.
Health Systems in Transition
|August 17, 2012
Summary
Bulgaria faces demographic decline and health challenges, lagging behind EU averages in key indicators. Significant health system reforms are needed to address underfunding, improve equity, and enhance the population's health status.
Area of Science:
- Public Health
- Health Economics
- Demography
Background:
- Bulgaria has experienced significant demographic decline over the past 20 years, marked by low birth and fertility rates, high mortality, and an aging population.
- Despite recent economic improvements, the country generally lags behind European Union (EU) averages in mortality and morbidity indicators, with smoking being a major risk factor.
Purpose of the Study:
- To analyze the demographic trends, health status, and healthcare system in Bulgaria.
- To identify key challenges and areas for reform within the Bulgarian healthcare sector.
Main Methods:
- Analysis of demographic data, mortality and morbidity indicators, and life expectancy.
- Examination of the structure, financing, and workforce of the Bulgarian health system.
- Review of health expenditure as a percentage of GDP and out-of-pocket payments.
Main Results:
- Life expectancy at birth was 73.3 years in 2008, with circulatory diseases, neoplasms, and respiratory diseases as leading causes of death.
- The Bulgarian health system is characterized by underfunding, particularly in hospitals, and a significant reliance on out-of-pocket payments, including informal payments.
- While Bulgaria has a high number of physicians, it faces a shortage of nurses and an imbalance in services, with an oversupply of acute care beds and undersupply of long-term care.
Conclusions:
- The Bulgarian health system is economically unstable and requires substantial structural reforms to improve health outcomes and equity.
- Addressing underfunding, enhancing the nursing workforce, and rebalancing service provision are crucial for progress.
- Further reforms are essential to improve the overall low health status of the Bulgarian population.
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