site.btaAnalysis Shows Limited or No Control over Hospitalizations in Bulgaria

There is limited or no control over the number of hospitalizations in Bulgaria, the Institute for Market Economics (IME) says in an analysis presented at a forum here on Tuesday. According to the study, hospitalizations in Bulgaria exceed many times those in European Union countries for most of the most common diagnoses, such as heart failure.

The problem was discussed during a forum on mechanisms and practical limits of control over hospital care costs. The IME analysis was presented by Dr. Petya Georgieva, senior economist at IME, and IME senior expert Ekaterina Baksanova.

Dr. Georgieva said that there is often discussion about what should happen in the system, but without clarity about what is meant by control. It is important to know how hospital care costs can be controlled, she commented. Georgieva cited data according to which there are 341 hospitals in Bulgaria, and hospitalizations number 2.6 million per year.

The IME notes that the control over the implementation of contracts with the National Health Insurance Fund (NHIF) for the provision of medical and/or dental care is carried out through inspections by officials - employees of the NHIF, designated by order of the Fund manager or by an official authorized by him, and by officials from the corresponding regional health insurance fund. The data show that abuses are either not the main problem of healthcare in Bulgaria, or that they are difficult to catch, punish and fine, the analysis also reads.

After reviewing international experience, the IME recommends introducing budget restrictions for individual medical institutions, public reporting of health outcome indicators for each hospital, as well as refusals to conclude contracts in cases of proven and repeated violations. To improve cost control, the Institute says efforts should also be directed at a serious consolidation of the public hospital network. Among the recommendations is also the maximum automation of the process between identifying violations and imposing sanctions for repeated violations.