site.bta Institute for Market Economics Lobbies for Fewer Hospitals, Stricter Financial Control

The Institute for Market Economics (IME) Tuesday presented an analysis titled "The Financial Status of Bulgarian Hospitals: Income and Expenditure, Assets and Liabilities of State-owned and Municipal Hospitals". Based on the findings, the IME outlined the following problems in the Bulgarian healthcare system: too many hospitals, lack of quality hospital services for people in remote areas, unfair payment for services, and lack of strict financial control over hospitals to minimize the occurrence of irregularities, among others.

The latest Eurostat data show that in 2021, Bulgaria ranked first among EU Member States in terms of the number of hospital beds relative to population size. This country had 792.3 beds per 100,000 persons, compared to the EU average of 524.8 beds per 100,000 persons. According to National Health Insurance Fund data, the hospital bed occupancy rate rarely exceeds 50%. As of 2022, Bulgaria has a total of 341 hospitals, including state-owned, municipal, and private healthcare establishments. The total number of hospitals has not changed substantially over the last 10 years, but the number of hospital beds is gradually increasing, reaching over 54,000 in 2022.

In 2022, there were 68 state-owned and 121 municipal hospitals operating in Bulgaria. There is a hospital in every region in the country and in 104 out of 265 municipalities. Sofia has the largest number of hospitals (37), followed by Varna (7), Plovdiv (6), Vratsa (5), Veliko Tarnovo (5), Burgas (5), Haskovo (4), Stara Zagora (4), Ruse (4), Blagoevgrad (4) and Pernik (3).

The hospital staff in state-owned and municipal hospitals numbered some 50,000 people as of 2022. This number includes physicians, health care professionals, assistive personnel, and administration staff.

National Statistical Institute data show that over 2.1 million hospital admissions were recorded in 2022. That is approximately one in three Bulgarians.

According to the data, the ratio between doctors and health care professionals at the national level was 1:1.2 in 2022, which is too low by medical service quality standards and compared to the rest of the EU.

The IME analysis suggests that the large number of hospitals, all operating under contract with the National Health Insurance Fund, results in a waste of resources directed to small and low-performing health care establishments, an inability to provide services in certain areas of the country, and the transfer of severe cases to large state-owned hospitals, among others.