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– According to him, the fund decides whether to conclude a contract.
– NHIF and insurance companies will compete
– Small and inefficient hospitals are becoming
in treatment centers and observation up to 48 hours
The Ministry of Health proposes to create a rating system for hospitals, which should reflect the effectiveness of their activity, to evaluate the introduction of new technologies and good practices, the evaluation of patients from their medical care and the resources spent, in a draft National Health Strategy until 2030 г.
The ranking will guide patients which hospitals are good for their diseases so they can choose. Depending on the system, the NHIF will decide whether or not to enter into a contract with a specific hospital. Therefore, a system for
pay of
hospital
exercise,
based on
Outcome
Among the main priorities established in the strategy are
l directing efforts and resources to prehospital care in order to improve patient care at the earliest stage and facilitate hospital care;
l Better remuneration for doctors, but also promotion of lifelong learning
l Increase the use of generic and biosimilar medicines
l Improve the ability to detect organ donors
l Improve the quality of psychiatric care and care for people with chronic diseases.
It is planned to change the health insurance model: it will become a pillar of two with the inclusion of private competitors of the health insurance fund.
“Initiating a public debate to change the health insurance model by introducing forms of competition between the NHIF and insurers” is one of the measures outlined by the Ministry of Health. Former Health Minister Kiril Ananiev has already held similar discussions in 2018 and 2019, but no public consensus has been reached.
Bulgaria remains the country with the highest direct out-of-pocket payments, and health spending per capita of € 1,311 is the fourth lowest in the EU. Mortality also remains high, which in 2019 was 15.5 per thousand compared to 10.3 per thousand in the EU. The main reasons for this remain diseases of the circulatory system and tumors.
For the first time
The infirmary
is mortality
5.65%, which is
the lowest level
in the history of Bulgaria. However, it is still higher than the EU average of 3.7 per thousand.
The trend of unequal distribution of medical professionals continues in 2019. Although the number of nurses is low, that of doctors is above the EU average – 42.6 per 10,000 inhabitants in our country, and in Europe – 35, 1 . The average age of doctors remains high, but there has been a decline in emigrants.
However, coordination between emergency, pre-hospital and hospital care has been disrupted.
More funds for the salaries of doctors and municipalities to provide scholarships during training, departmental accommodation, the opportunity to enroll in kindergarten or school for families with children, to help in the formation of a spouse, etc., proposed by the Ministry of Health. against the shortage of doctors. In order to follow correct and successful policies to provide the necessary medical specialists, a unified information system for the registration of healthcare workers should be introduced.
Apart from the number, the strategy also focuses on improving the qualifications of doctors.
The continuum
training is essential
to become the norm
in working life, which is required by the employer himself, who is obliged to provide the conditions to maintain and improve his skills.
Bulgaria is among the EU countries with
at least personal
doctors per person
of the population
If in 2018 there were 1,690 health insured persons per jeep, in 2019 there were 1,718, which shows that their number is decreasing.
“At the same time, the lack of adequate economic incentives for participation in health promotion and disease prevention activities, as well as the high burden of unusual administrative activities, generate inconsistencies between the activities carried out and the requirements to ensure access to quality primary health care “. indicated by the Ministry of Health. That’s why they offer to reveal themselves
specialized
centers for
prevention,
diagnosis, treatment, monitoring and rehabilitation of patients with specific diseases in one place. This will ensure continued medical care, increase the patient’s quality of life, and reduce the need for hospitalization.
To do this, very small and inefficient hospitals can be used, which can be rebuilt with beds for follow-up and treatment for up to 48 hours. In some of them, lighter operations can be performed, such as increasing the percentage of outpatient surgeries; even up to 30% will save around 2 million beds a year and allow patients to recover at home, argued the Ministry of Health. .
It is the large number of hospitals, their uneven distribution and the constant increase in the cost of treatment are the other problems that affect the strategy. We have 5.2 hospitals for every 100,000 inhabitants compared to the EU average of 2.9, with active treatment prevailing in our country at the expense of long-term care. Among the measures to regulate the hospital sector is to ensure the implementation of the National Health Card, which currently does not exist. To improve the quality of services, it is proposed to develop performance indicators, which should be monitored and disclosed regularly.
E-health is the basis for the implementation of the strategy objectives, one of which is its development. The others are: creation of a national electronic immunization system to determine the population at risk of vaccine-preventable diseases and effective allocation of resources to achieve high immunization coverage. Development of the TEMP system, which “must follow the European principle of rehabilitation, integration and return to the labor market of people with chronic diseases, instead of a disability pension.
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