What have 10 years of health insurance reforms brought about in Bulgaria? Re-appraising the Health Insurance Act of 1998

Atanasova, Elka; Pavlova, Milena; Velickovski, Robert; Nikov, Bogomil; Moutafova, Emanuela; Groot, Wim

doi:10.1016/j.healthpol.2010.12.001

Cited by 43 publications

(58 citation statements)

References 15 publications

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“…Ukraine, Romania, Lithuania and Bulgaria, paying for health services is common. Among them, Bulgaria is the only country with a universal system of formal co-payments for publicly financed health services 31 . This could explain why Bulgarian consumers most often reported small formal payments.…”

Section: Discussionmentioning

confidence: 99%

The inability to pay for health services in Central and Eastern Europe: evidence from six countries

Tambor

Pavlova

Rechel

et al. 2013

European Journal of Public Health

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Background: Out-of-pocket payments for health services constitute a major financial burden for patients in Central and Eastern European (CEE) countries. Individuals who are unable to pay use different coping strategies (e.g. borrowing money or foregoing service utilization), which can have negative consequences on their health and social welfare. This article explores patients’ inability to pay for outpatient and hospital services in six CEE countries: Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine. Methods: The analysis is based on quantitative data collected in 2010 in nationally representative surveys. Two indicators of inability to pay were considered: the need to borrow money or sell assets and foregoing service utilization. Statistical analyses were applied to investigate associations between the indicators of inability to pay and individual characteristics. Results: Patient payments are most common in Bulgaria, Ukraine, Romania and Lithuania and often include informal payments. Romanian and, particularly, Ukrainian patients most often face difficulties to pay for health services (with approximately 40% of Ukrainian payers borrowing money or selling assets to cover hospital payments and approximately 60% of respondents who need care foregoing services). Inability to pay mainly affects those with poor health and low incomes. Conclusion: Widespread patient payments constitute a major financial barrier to health service use in CEE. There is a need to formalize them where they are informal and to take measures to protect vulnerable population groups, especially those with limited possibilities to deal with payment difficulties.

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Section: Discussionmentioning

confidence: 99%

The inability to pay for health services in Central and Eastern Europe: evidence from six countries

Tambor

Pavlova

Rechel

et al. 2013

European Journal of Public Health

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“…Following the approach applied by Atanasova et al [34] for Bulgaria and Gordeev et al [35] for Russia, we reviewed the publications in peer-reviewed journals in English and Turkish; official reports of the Turkish Ministry of Health and Social Security Institution; and publications of international organizations, such as the OECD, WHO, EU and European Observatory. Cambridge Journals, Ebscohost, Elsevier Clinical, Google Scholar, JStor, Ovid Online, Oxford Journals, PubMed, Sage, Science Direct, Springer, Taylor&Francis online databases were searched using keywords "Turkey", "health"/healthcare/health sector, "reform", "General/Universal Health Insurance "Health Transformation Programme", "equity", "efficiency", "sustainability"/financial sustainability and "quality".…”

Section: Methodsmentioning

confidence: 99%

What have health care reforms achieved in Turkey? An appraisal of the “Health Transformation Programme”

Ökem

Çakar

2015

Health Policy

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“…At present, the health system is transformed into an insurance-based system funded by health insurance contributions, general tax revenue allocated by the government, and a high level of out-of-pocket payments. The limited public resources for health are coupled with major problems in the health and demographic status of the population, as well as with inefficient health system management and poor service provision [6]. While public health services, specifically prevention and health promotion, are declared to be a policy priority [1], their share in the health expenditure is only about 3-4% (see Table I).…”

Section: Health System Indicatorsmentioning

confidence: 99%

Political will against funds deficiency: Health promotion for older people in Bulgaria

Pavlova

Atanasova

Moutafova

et al. 2017

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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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What have 10 years of health insurance reforms brought about in Bulgaria? Re-appraising the Health Insurance Act of 1998

Cited by 43 publications

References 15 publications

The inability to pay for health services in Central and Eastern Europe: evidence from six countries

The inability to pay for health services in Central and Eastern Europe: evidence from six countries

What have health care reforms achieved in Turkey? An appraisal of the “Health Transformation Programme”

Political will against funds deficiency: Health promotion for older people in Bulgaria

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