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Health Systems and Policy Monitor (HSPM)

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Bulgaria

Health Systems in Transition (HiT) profile

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  1. Country Overview

  2. Health Systems in Transition (HiT) profile

    1. 1. Introduction
      1. 1.0. Introduction
      2. 1.1. Geography and sociodemography
      3. 1.2. Economic context
      4. 1.3. Political context
      5. 1.4. Health status
    2. 2. Organization and governance

      Updated: 29 March 2023
      1. 2.0. Introduction
      2. 2.1. Overview of the health system
      3. 2.2. Historical background
      4. 2.3. Organization

        Updated: 01 August 2022
      5. 2.4. Decentralization and centralization
      6. 2.5. Planning

        Updated: 29 March 2023
      7. 2.6. Intersectorality
      8. 2.7. Health information management

        Updated: 01 August 2022
      9. 2.8. Regulation

        Updated: 19 September 2019
      10. 2.9. Patient empowerment
    3. 3. Financing

      Updated: 29 May 2025
      1. 3.0. Introduction
      2. 3.1. Health expenditure

        Updated: 31 March 2025
      3. 3.2. Sources of revenue and financial flows
      4. 3.3. Overview of the statutory financing system

        Updated: 29 May 2025
      5. 3.4. Out of pocket payments
      6. 3.5. Voluntary health insurance
      7. 3.6. Other financing
      8. 3.7. Payment mechanisms

        Updated: 01 August 2023
    4. 4. Physical and human resources

      Updated: 01 August 2023
      1. 4.0. Introduction
      2. 4.1. Physical resources
      3. 4.2. Human resources

        Updated: 01 August 2023
    5. 5. Provision of services

      Updated: 29 May 2025
      1. 5.0. Introduction
      2. 5.1. Public health

        Updated: 29 May 2025
      3. 5.2. Patient pathways
      4. 5.3. Primary / ambulatory care

        Updated: 26 March 2024
      5. 5.4. Specialized ambulatory care / inpatient care

        Updated: 29 March 2023
      6. 5.5. Emergency care
      7. 5.6. Pharmaceutical care

        Updated: 28 March 2024
      8. 5.7. Rehabilitation / intermediate care

        Updated: 29 March 2023
      9. 5.8. Long term care

        Updated: 29 March 2023
      10. 5.9. Services for informal carers
      11. 5.10. Palliative care
      12. 5.11. Mental health care

        Updated: 01 August 2022
      13. 5.12. Dental care
      14. 5.13. Complementary and alternative medicine
      15. 5.14. Health services for specific populations
    6. 6. Principal health reform
      1. 6.0. Introduction
      2. 6.1. Analysis of recent reforms
      3. 6.2. Future developments
    7. 7. Assessment of the health system
      1. 7.0. Introduction
      2. 7.1. Stated objectives of the health system
      3. 7.2. Financial protection and equity in financing
      4. 7.3. User experience and equity of access to health care
      5. 7.4. Health outcomes, health service outcomes and quality of care
      6. 7.5. Health system efficiency
      7. 7.6. Transparency and accountability
    8. 8. Conclusions
      1. 8.0. Introduction

3.7. Payment mechanisms

Amendments to the Health Insurance Act in early 2023 stipulate inclusion in the National Framework Contract (NFC) of a new methodology for financing healthcare establishments in order to tackle labour shortages, particularly in remote and underserved areas. The measure aims at assuring medical personnel for outpatient and inpatient healthcare establishments, which provide services in remote areas, or which are the sole providers of specific services within a certain municipality. The new methodology is going to be included in the NFC for 2023–2025, which, because the state and the NHIF budgets for 2023 were adopted on 1 August 2023, is still under preparation.

In addition, in April 2023, the Ministry of Health, in collaboration with several districts and municipalities, initiated a pilot project entitled “Doctors in Small and Remote Settlements”, in which specialists from district hospitals provide services to underserved local communities. The intention is for the initiative to be further expanded by under the National Recovery and Resilience Plan through the establishment of outpatient facilities in small communities staffed by a physician and a nurse.

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Related Content
References

Health Insurance Act, https://lex.bg/laws/ldoc/2134412800

 

bntnews.bg, https://bntnews.bg/news/zapochvat-specializirani-medicinski-pregledi-v-malki-naseleni-mesta-1230585news.html

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