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 are...

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Main Author: World Bank
Format: Other Health Study
Language:English
en_US
Published: Washington, DC 2013
Subjects:
Online Access:http://documents.worldbank.org/curated/en/2013/03/17878699/bulgaria-health-sector-diagnosis-policy-note
http://hdl.handle.net/10986/16082
id okr-10986-16082
recordtype oai_dc
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
en_US
topic 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
spellingShingle 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
World Bank
Bulgaria Health Sector Diagnosis : Policy Note
geographic_facet Europe and Central Asia
Bulgaria
description 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.
format Economic & Sector Work :: Other Health Study
author World Bank
author_facet World Bank
author_sort World Bank
title Bulgaria Health Sector Diagnosis : Policy Note
title_short Bulgaria Health Sector Diagnosis : Policy Note
title_full Bulgaria Health Sector Diagnosis : Policy Note
title_fullStr Bulgaria Health Sector Diagnosis : Policy Note
title_full_unstemmed Bulgaria Health Sector Diagnosis : Policy Note
title_sort bulgaria health sector diagnosis : policy note
publisher Washington, DC
publishDate 2013
url http://documents.worldbank.org/curated/en/2013/03/17878699/bulgaria-health-sector-diagnosis-policy-note
http://hdl.handle.net/10986/16082
_version_ 1764431284423098368
spelling okr-10986-160822021-04-23T14:03:22Z Bulgaria Health Sector Diagnosis : Policy Note World Bank 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 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. 2013-10-03T20:41:47Z 2013-10-03T20:41:47Z 2012 http://documents.worldbank.org/curated/en/2013/03/17878699/bulgaria-health-sector-diagnosis-policy-note http://hdl.handle.net/10986/16082 English en_US CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank Washington, DC Economic & Sector Work :: Other Health Study Economic & Sector Work Europe and Central Asia Bulgaria