Healthcare in Bulgaria in 2011

1. Healthcare in Bulgaria in 2011

2. After years of lumbering reforms in Bulgaria's health care system, hospitals and the health insurance fund have reached the point of quickly running out of cash, dooming patients to suffering.A number of governments have failed to implement reforms, a series of major reshuffles at the health ministry over the last few years have failed to make a difference and plug the holes in the system. As a result Europe-wide polls show that the lowest levels of satisfaction with health care are reported in Bulgaria, which even lags behind Albania and Macedonia.

3. Mass Exodus of Bulgaria Doctors AbroadMore than 500 Bulgarian doctors left the country to go work abroad in 2010, according to the Secretary General of the Bulgarian Doctors Union, Dimitar Lenkov.He announced the data, established by the Union on the basis of issued certificates for good medical practice, required for working abroad. Mostly anesthesiologists and surgeons left Bulgaria in 2010, followed by urologists, orthopedists, traumatologists, obstetrician-gynecologists, pediatricians, and pathoanatomy specialists.According to Lenkov, the number of doctors who left Bulgaria in 2009 was 400, while the number in 2008 was 380. He noted that most of the doctors head to Germany, France, England, North Ireland, Denmark and Sweden.He explained that some regions of Bulgaria, mostly mountain areas that are difficult to reach, some areas in Northwestern Bulgaria and the Rhodope Mountains, lack general practitioners. The data from the Bulgarian Doctors Union showed that the number of nurses is also below the minimum. At present, they are about 30,000.A huge number of specialists in internal diseases also left Bulgaria because the National Health Insurance Fund (HNIF) does not sign contracts with them, but rather with doctors on narrow specialties.

4. Over Half Million Bulgarians Deprived of Doctors CareOver half million Bulgarians or a total of 582 809 people don't have the option of selecting a general physician in the village where they live. The data is based on an inquiry with the Health Ministry.The most common reason is that the village is remote and/or located in a poor area. Residents of such places are forced to seek medical care in the closest town or city.There are 424 job openings for doctors in the country, which no one wants to take. 51 are in the Kardzhali Region, the regions of Targovishte and Silistra have 27 each; Plovdiv and Varna – 26, Razgrad and Ruse – 25. There are no untaken doctor's positions in Vratsa and Gabrovo.The State is attempting to solve the problem by offering through the NationalHealth Insurance Fund (NZOK) additional benefits with monthly bonuses starting at BGN 150 and reaching BGN 1 200, but very few doctors, especially those with families and young children, take advantage of them.

5. Majority of Bulgarians Unaware of Patient RightsThe large majority of Bulgarians are unaware of their patient rights, according to a poll of the Center for Protection of Patients' Rights (CZPZ). The poll has been conducted in all 28 regional centers among 241 respondents.The results show that 99% of the polled cannot tell the number of referrals an individual with health insurance is entitled to every year. Only 4% know what dental services paid by the National Health Insurance Fund (NZOK) they can use. 45% believe their patient rights are completely unprotected while 42% - that they are only partially protected. 94%, however, know the amount of their health insurance and co-pay fees.15% are convinced they are entitled to free health care even if they don't havehealth insurance. 35%, on the other hand side, say an uninsured pregnant woman cannot receive medical help.The most complaints received by CZPZ are against hospitals – 308. They are mainly for poor treatment of patients and low quality of medical help. There were also 182 complaints over the lack of certain medications and 52 complaints from people who have been refused medical help.

6. Less Than 5% of Bulgarians Trust Healthcare SystemAs few as 4.8% of all Bulgarians trust in the country's healthcare system, with half of the nation seeking professional help only when a severe health problem is in place.Some 48% of all Bulgarians believe the healthcare is in a bad condition, according to Prof. Lilia Dimova from the Agency for Social Analyses think-tank.Dimova says that 20% of Bulgarians try treating themselves before seeking professional medical help. A total of 75% of Bulgaria's patients are convinced that thehealthcare system in the country is not functioning properly, while 82% declare that not only reforms but very significant changes are necessary.On the other hand side, Bulgarians e are not the sickest nation in Europe with 82% not hindered in their daily routines by severe illnesses, a percentage higher than the average for the EU (74%). Countries like Finland, Slovenia, the Netherlands, Norway, Germany and France are worse than Bulgaria in this aspect.Even though Bulgarians generally distrust the healthcare system in the country, they also believe that Bulgaria's doctors and nurses are unrightfully underpaid, Dimova says, citing data from a survey on the relations between patients and health professionals.

7. Young Bulgarians Suffer from Depression, Psychosis, Alcohol AbuseThe mental health of young Bulgarians is facing increasing challenges that are staying unrecognized, according to a key Bulgarian psychiatrist. Dr. Nina Tashkova from First Sofia Hospital explains that Bulgarians aged 25-40 are facing constant strains from a deteriorating economic situation and growing social alienation, which do not fail to affect negatively their psychic lives.According to her, the number of cases of clinical depression, panick attacks, anxiety disorders, and serious psychoses has been on the rise for the last few years and the group of people affected by these disorders is continually expanding its lower age barrier. The doctor further reports that the number of young people abusing alcohol is also rising, and with an especially strong rate among women.Tashkova points out to what she saw as an inadequate attention given to psychiatric help in Bulgaria's healthcare and educational system. She nevertheless says that Bulgaria's youth are relatively open to talking about their mental health problems, an attitude that according to her is not always shared by their older compatriots.

8. 50% of Bulgarians Believe Health Is at Risk - PollLack of funding, corruption and unreasonable distribution of money in Bulgaria's health care system are the top problems in the sector, according to a 2011 poll.The poll included Bulgarians with health insurance from the capital and the largest cities, ages 18 to 70, and was conducted by the research agency Noema on the request of "Philips."23% of those polled believe the lack of funding is the main problem in the healthcare sector; 22% - corruption and unreasonable distribution of money; another 20% - incompetent and dishonest doctors.According to 17%, poor cabinet policies are to blame and the same percentage sees as a problem the high price of health services. There were fewer respondents complaining of shortage of medications, poor facilities and equipment, and inadequate staffing.Half of the respondents said their health is at risk. 14% of females and 18% of males worry about heart disease in the next five years; 3% of women and 0% of men worry about getting cancer. These attitudes are highly optimistic, considering data from the National Statistics Institute, NSI, showing a 51% death rate from heart disease and 28% from cancer.20% of Bulgarians worry about losing their eyesight and 17% about motor nerve issues. Over half of Bulgarians believe the country lacks medical equipment for early diagnosing while 20% said they have no opinion; the remaining others thing the equipment is adequate.Nearly 50% of those over the age of 56, and 20% of those between the ages of 46 and 55, have chronic diseases. The global forecast is that by 2050, 50% of the entire world population will suffer from such chronic ailments over its ageing.

9. WHO Ranks Bulgaria 30th in Europe by Use of AlcoholBulgaria ranks 30th in Europe by alcohol consumption, according to a study of the World Health Organization (WHO). Estonia is first with 16 liters per person a year, followed by the Czech Republic, Ireland and France – between 14 and 15 liters.The average consumption of alcohol in Bulgaria is 12 liters a year, according to the WHO data. 45% of Bulgarians use hard liquor, 22% drink wine and 32% - beer; about one third do not consume alcohol. Turkey is last with less than 2 liters a year, which is attributed to the Muslim religion.The WHO study shows that alcohol consumption in Mediterranean countries, former leaders in similar rankings is down, and they have been replaced by countries such as Moldova, Estonia, the Czech Republic, and Ireland. The average consumption in Europe is 9.5 liters of alcohol a year per person 15 years of age or over.

10. Majority of Bulgarians Favor Immediate Full Smoking BanA large majority of Bulgarians – 72.3% are in favor of a full smoking ban in public spaces, according to a Health Ministry poll. These respondents say the ban must be implemented immediately.The poll has been conducted among 1 862 Bulgarians from January 24 to February 21. 22% are against a smoking ban in indoor public spaces; 2.6% support delaying the ban by one year while 3.1% want the ban to be postponed for two and more years.

11. Staggering Majority of Bulgarians Avoid Fitness, SportsOnly 6% of all Bulgarians in employment age (18-65) are actively engaged in fitness and sports, according to a study of the country's Ministry of Sports and Youth. In years past, this percentage has been as high as 45%.The study is titled "It Is Never Late for a New Beginning," and is part of the Ministry's program to spark interest in sports activity. The institution plans to provide hours for free fitness and sports at 28 facilities across the country, whose list will be published online next week.The poll involved 802 individuals in employment age – 72% of them reported feeling tired at work; 39% work sitting at a desk, while 68% were affected by stress. They walk an average of 40-50 minutes a day or 3.7 km, but half say they spent their free time passively.Smoking, alcohol drinking, and the use of too much salt are serious problems, the study found. 34% of the respondents were overweight; 21% - obese and 2% severely obese.Those polled were subject to several tests, one of which was to run 50 meters – the average result was about 13 seconds, which is twice higher than what is considered normal for a healthy person. This is the second such poll of the program.The Ministry is expected to absorb BGN 3.4 M in European funding with half of them already spent and about BGN 200 000 registered as savings. All funding is used for the information campaign and rent of the 28 facilities.

12. Bulgaria Can Boost Its Medical Tourism - StudyBulgaria is among the countries that can provide low-cost medical services and health professionals with considerable experience, which can turn it into an attractive tourist destination, a new study has shown. Countries such as Poland and Bulgaria will experience a rush of Britons seeking cheap medical treatment abroad, an Economist Intelligence Unit report predicts, according to The Independent.As cost pressures in the healthcare systems of rich countries rises, developing countries have the chance to develop a medical tourism industry to boost revenues and develop healthcare expertise. Figures suggest more than 50,000 people in the UK a year go abroad for treatment and the report said outbound medical travel from the UK had been growing far faster than inbound over the past decade.

13. Thank you! Made by: Krasimir RusevCountry: BulgariaCity: PlovdivUniversity: Plovdiv University “Paisii Hilendarski”Graduated: International Economic Relations (bachelor degree)Studying: International Trading (master degree)Age: 24