Out-of-Pocket Patient Payments for Public Health Care Services in Bulgaria

Frontiers in Public Health

Elka Atanasova¹ 

关键词: out-of-pocket payments;    informal payments;    health care services;    health care reform;    Bulgaria;   

DOI  :  10.3389/fpubh.2015.00175

学科分类：卫生学

来源: Frontiers

【 摘 要 】

In Bulgaria, the democratic social and economic reforms began when the new Constitution was adopted in 1991. The communist period prior to this reform was marked by the development of the health care system within an environment of centralized management (1). Health care financing was entirely based on general taxation. Medical services were provided by the state or the municipality. All health care establishments were public institutions as private medical practices were prohibited before 1989. These establishments were allocated an earmarked budget, the size of which was mainly determined on a historical basis. The key factors that determined the allocation of funds were the number of staff and beds. Large staff and a high number of beds were rewarded, and a high level of patient admissions and long hospital stays were common. The reimbursement of health care professionals was in the form of a salary based on employment contracts (2). Health care provision was free of charge at the point of service use. There were only small charges when purchasing prescribed pharmaceuticals and devices outside the health care settings (e.g., at the pharmacy).

【 授权许可】

CC BY