Assessing access to healthcare in Bulgaria

Assessing access to healthcare in a given country remains a challenging endeavor. Despite the frequent use of access as a dimension of the health system performance assessment frameworks, there is no agreed-upon set of indicators to evaluate it. This study aims to assess the access to healthcare in Bulgaria. The assessment is based on a set of the most commonly used indicators with publicly available data. Results show that timeliness and physical availability are not substantial barriers for obtaining health services in Bulgaria, as the values for most of the considered indicators are better than the EU average. The most significant barrier to access to healthcare in Bulgaria is the financial affordability. Data shows insufficient financial protection alongside other factors resulting in higher than the EU average level of unmet needs due to financial reasons. Policy measures focused on decreasing the share of private health expenditures ought to be exerted to reduce inequalities in access to healthcare services

Costing of healthcare services in Bulgaria – guidelines for implementing some good practices

Costing of healthcare services is one of the most severe challenges facing hospitals’ accounting and management teams.The article presents the characteristics, advantages, and limitations of three different approaches to costing medical services – Time-Driven Activity-Based Costing, Target Costing, and Micro-Costing. We provide a summary of theinternational experience in their application, and guidelines for their implementation in the Bulgarian context.Aligning the costing systems with current developments in the management accounting field has the potential to improve hospitals’ cost management and their financial condition.At a health system level, accumulating reliable information on the actual cost of medical services would facilitate theprocess of setting fair reimbursement prices and thus result in more effective ways to spend the scarce resources

Access to healthcare by the health system performance assessment

Access to healthcare is one of the most commonly used domains in conceptual frameworks for health system performance assessment. Despite that, assessing the access to healthcare remains a challenge as there is no internationally accepted methodology for its measurement. Ensuring access to care is one of the recent struggles faced by health systems and relevant measures is expected to have a significant impact on their overall performance. To be effective, policy initiatives ought to be preceded by a substantial assessment of access to healthcare.The study aims to identify the most commonly used indicators for measuring access to healthcare in the context of health system performance assessment. Through descriptive analysis of relevant scientific literature various definitions and understandings of the category have been identified and commented on. The most commonly used dimensions of access to healthcare are analysed, and the use of three of them is justified for its evaluation in Bulgaria. Based on the literature review, a total of 302 indicators that are identified for measuring access have been collected. Analyses of indicators highlight the most commonly used ones.The final set of indicators for access assessment should enable scientists and policymakers to identify the main barriers, and thus to develop adequate policies. It should reflect international experience and be in line with national specifics, as well. Finally, the indicators should also provide an opportunity for international comparisons

REVIEW OF THE DEVELOPMENT OF MASSIVE OPEN ONLINE COURSES (MOOCS) ON INTERNATIONAL LEVEL AND PERSPECTIVES FOR THEIR IMPLICATION IN BULGARIAN HIGHER EDUCATION.

Abstract: The first course that resembles what we now call MOOC was held in 2008, although the background for developing MOOCs can be traced back to the year 2000. They are often described as an evolutional step which follows the emerging movement towards Open Education. They came as an answer to the constantly growing needs of both main parties in the educational process (teachers and students) for a more easily accessible and more interactive learning environment. This paper represents a brief history of MOOCs and the perspectives for their development around the Globe. The experience of the leading providers and their university partners in developing such courses is being summarized. Based on analysis of literature and course programs, the main characteristics of MOOCs are presented. Some of the best practices, which are proven to benefit the students and teachers the most, are further discussed. The paper outlines the opportunities for implication of MOOCs in Bulgarian universities with emphasize not only on advantages from their integration in Bulgarian higher education system but also on some of the main challenges and obstacles on the way such as verification of students`, MOOCs and Bulgarian legislation and others

Financial analysis of university hospitals in Bulgaria

Improving the financial condition of university hospitals is a high priority for their owners and stakeholders. One of the most common problems for state-owned hospitals in Bulgaria is their financial instability. The stable financial state of these hospitals is imperative for their increasing development and ensures the success of their socially required functions.The study aims to analyse the financial health of university hospitals in Bulgaria and draw conclusions regarding the hospitals' long-term solvency and level of financial stability.The study covers a period of five years, from 2017 to 2021. Key financial indicators are observed to assess the financial state of the predominantly government-owned university hospitals. The primary information source for this study is the annual financial statements published in the Commercial Register.Results indicate a contrast in the values of financial indicators between hospitals in good and improving financial states and those in deep financial distress. In the latter, there is a high level of dependence on creditors and financial support by the owner. There is a clear correlation between low liquidity and profitability ratios and changes in capital structure, leading to increased indebtedness and deepening processes of reducing owner's equity.The results of the financial analyses are crucial to the hospital management boards. They provide detailed information on the current financial health and have high predictive value. Every responsible health manager should be familiar with the indicators for assessing the financial status of the structure they manage and take measures when alarming trends are present. The financial analysis should be used as a basis for better-informed management decisions

EVALUATION OF MANUFACTURING AND AGRICULTURAL PRODUCTION BY THE END OF THE FINANCIAL PERIOD

This article is dedicated on the matter of evaluation of manufacturing and agricultural production after the initial appraisal. Accounting standards and regulations, concerning the reappraisal of production, are discussed with emphasis on the key and most disputable requirements. The most commonly met difficulties in the process of reappraisal of production are pointed out. A research is done over the leading manufacturing and agricultural entities in Bulgaria. The point of the research is to study the degree on witch entities met the requirements and regulations of accounting standards when they reevaluate their production by the end of the year. The results of the research are shown and analyzed. Conclusions are made along with some recommendations in order to improve the quality of reappraisal of manufacturing and agricultural production

Excise duty on tobacco products - tax policy and health effects in Bulgaria

Introduction: Alongside the fiscal role, the taxation over cigarettes is expected to reduce smoking. The need for effective excise duty is particularly substantial in Bulgaria as it is the county with the biggest share of active smokers in Europe. Our aim is to test the effectiveness of some aspects of the cigarette tax policy in Bulgaria and to suggest ways for its improvement.Materials and methods: A literature review and a quantitative sociological survey have been per­formed. We conducted a survey using a questionnaire among 120 active smokers in December 2017. The vast majority of the respondents are between twenty and fifty years old, mostly living in Varna.Results: Despite the increase in the excise duty and the prices of tobacco products, around 70% of re­spondents continue to smoke the same price-class cigarettes. Around 30% of the passionate smokers, who are influenced by the price of cigarettes, prefer to switch to lower-priced cigarettes rather than to quit smoking. The new alternative, heated tobacco products are proven to be a good substitute for current tobacco products and around 40% of the respondents are likely to switch to them.Conclusion: Results show that the current cigarette tax policy in Bulgaria fails to provide the expect­ed effectiveness. It should be considered that the sole measure of increasing excise rates does not sig­nificantly change the behaviour of the smokers. More active campaigns to address the disadvantages of smoking and the benefits of a healthier lifestyle are requested. The revenue from excises should be invested primarily in preventive activities and various non-smoking campaigns

A comparison of health system responses to COVID-19 in Bulgaria, Croatia and Romania in 2020

This article compares the health system responses to COVID-19 in Bulgaria, Croatia and Romania from February 2020 until the end of 2020. It explores similarities and differences between the three countries, building primarily on the methodology and content compiled in the COVID-19 Health System Response Monitor (HSRM). We find that all three countries entered the COVID-19 crisis with common problems, including workforce shortages and underdeveloped and underutilized preventive and primary care. The countries reacted swiftly to the first wave of the COVID-19 pandemic, declaring a state of emergency in March 2020 and setting up new governance mechanisms. The initial response benefited from a centralized approach and high levels of public trust but proved to be only a short-term solution. Over time, governance became dominated by political and economic considerations, communication to the public became contradictory, and levels of public trust declined dramatically. The three countries created additional bed capacity for the treatment of COVID-19 patients in the first wave, but a greater challenge was to ensure a sufficient supply of qualified health workers. New digital and remote tools for the provision of non-COVID-19 health services were introduced or used more widely, with an increase in telephone or online consultations and a simplification of administrative procedures. However, the provision and uptake of non-COVID-19 health services was still affected negatively by the pandemic. Overall, the COVID-19 pandemic has exposed pre-existing health system and governance challenges in the three countries, leading to a large number of preventable deaths