55 research outputs found
Patient payments - painful but indispensable tool of health policy: A review of a book by Elka Atanasova titled „Patient Payments in the Health Sector`
Get PDFThis is a review of a book by Elka Atanasova titled `Patient Payments in the Health Sector`, which is the first comprehensive study in Bulgaria of patient payments: their overall context, theoretical underpinning, effects and importance as well as application in different health systems in 14 European countries
Formal and informal patient payments for public health care services in Bulgaria : Dissertation to obtain the degree of Doctor at Maastricht University
No full textANALYSIS OF INCOME AS A „GENERATION OF INCOME“ ACCOUNT COMPONENT
Get PDFСметка „Формиране на дохода“ съдържа информация за елементите на добавената стойност: компенсация на наетите лица, данъци върху производството и вноса, субсидии, брутен опериращ излишък, брутен смесен доход. Тя допълва информацията на сметка „Производство”, като дава възможност да се анализира равнището на заплащането на труда по сектори и икономически дейности на икономиката. Данните от тази сметка позволяват да се обвържат доходите от производствената дейност с постигнатите резултати по сектори и икономически дейности. В статията е извършен статистически анализ на информацията, съдържаща се в сметка „Формиране на дохода“ за периода 2000-2012 г., за да се установят формиралите се макроикономически тенденции. „Generation of income" account contains information on value added components: compensation of employees, taxes on production and imports, subsidies, gross operating surplus, gross mixed income. It complements the information of "Production" account, allowing analysis of the level of wages in sectors and industries of the economy. Data from this account allow committing the income from productive activity to the results achieved by sectors and economic
activities. This article provides an analysis of the statistical information contained in the "Generation of income" account for the period 2000-2012, to identify the formation macroeconomic trends
Formal and informal patient payments for public health care services in Bulgaria // Формални и неформални потребителски плащания за публични здравни услуги в България
No full text[EN] During the past two decades of transition from a state-planned to a market economy, the Bulgarian health care sector experienced radical reforms. In particular, the development of a private health care sector was accompanied by the introduction of social health insurance, which brought about important changes in the organization and funding of the Bulgarian health care system. Among other issues, the reform included the introduction of formal patient charges for public health care services. However, these charges were implemented in a situation of informal patient payments. Thus, the dissertation is focusing on the financial burden of formal and informal patient payments in the Bulgarian public health care sector. The aim of this dissertation is to analyze the propensity, magnitude and affordability of formal and informal patient payments for public health care services in Bulgaria, as well as the attitudes of health care stakeholders towards these payments. The study applies a complex methodology combining three research methods: systematic literature review (desk research), quantitative data analysis (survey method) and qualitative study (focus-groups discussions and semi-structured interviews). The dissertation provides clear evidence on the affordability problems in the Bulgarian public health care sector. The impact of out-of-pocket payments on access to health care is underlined by the high percentage of people who avoid visits or hospitalizations namely because of inability to pay. Moreover, patients are still weakly informed about the formal user charges for hospitals. Some of the suggested measures in this regard could be improving and updating the available information about official user fees and free-of-charge services as well as their accessibility to patients. A stronger regulatory framework, higher and regular salaries for health workers, more developed patient rights are also incentives for the improvement of the relations between health care stakeholders.[BG] През последните двадесет години на преход от централизирана планова към пазарна икономика българската здравна система претърпява съществени реформи. Едновременно с развитието на частния сектор в здравеопазването се въвежда и система на социално здравно осигуряване, която води до значителни промени в организацията и финансирането на българската здравна система. Освен всичко друго, реформата включва и въвеждане на официални потребителски такси за публичните здравни услуги. Те обаче, са въведени успоредно със съществуващите неформални плащания. Във връзка с това, дисертацията се фокусира върху финасовата тежест на формалните и неформалните потребителски плащания в публичния здравен сектор на България. Целта на дисертацията е да се анализират склонността към плащане, размера и достъпността на формалните и неформалните плащания за пациентите, както и нагласите на различните участници в здравната система към тези плащания. Проучването използва комплексна методология, като комбинира три изследователски метода: систематичен обзор на литературата, количествен анализ на данни (представително национално проучване сред 1003 респондента, участвали през 2010 г., и 817 респондента, участвали през 2011 г.) и качествено изследване (дискусии във фокусни групи и полу-структурирани интервюта). Настоящата дисертация предоставя ясни доказателства за съществуващи проблеми с достъпността до публичния здравен сектор. Влиянието на директните плащания върху достъпа до здравни услуги е подчертано от високият процент на хората, които се въздържат от посещение при лекар или хоспитализация именно поради неспособност за плащане. Освен това, пациентите са все още слабо информирани за формалните потребителски такси при постъпване в болница.Някои от предложените мерки в това отношение могат да бъдат подобряване и актуализиране на наличната информация за официалните потребителски такси и услугите, освободени от такси, както и осигуряване на достъпност на информацията за пациентите. По-строга регулаторна рамка, по-високи и редовни заплати за здравните работници, по-развити права на пациентите са също стимули за подобряване на отношенията между заинтересованите страни в здравеопазване
A novel, thermostable manganese-containing superoxide dismutase from Bacillus licheniformis
No full textInternational audienceA new, thermostable superoxide dismutase (SOD) from M20, isolated from Bulgarian mineral springs, was purified 11-fold with 11% recovery of activity. From native PAGE and SDS-PAGE, the enzyme was composed of two subunits of 21.5 kDa each. The SOD was inhibited only by NaN, which suggested that this SOD is of the manganese superoxide dismutase type. The purified enzyme had maximum activity at pH 8 and 55°C. The half-life of the SOD was 10 min at 95°C
UNMET NEEDS FOR HEALTH CARE SERVICES IN BULGARIA
No full textBackground: In all European countries, an important policy objective is the equity of access to health care. The factors that affect access to health care can differ as the demand- and supply-side factors. Moreover, there are many tools to assess the extent of inequity in access to services. One simple tool is the assessing reports of unmet needs for health care.
Purpose: The study has two objectives: to examine the evidence of self-reported unmet needs and to analyze the relationship between foregone medical care and both type of residence and socioeconomic status.
Materials and Methods: We use data from the European Union Statistics on Income and Living Conditions. The access to health care is measured using the concept of unmet need for medical examination or treatment during the last 12 months. The relationship between foregone medical care and both type of residence and socioeconomic status is examined through the representative survey conducted in 2014.
Results: The Eurostat results show that treatment costs are the most common reason for foregone medical care in Bulgaria. We observe a gradual decrease in the share of people who reported having unmet needs due to being too expensive. According to the 2014 survey, significant differences between urban and rural areas as well as among the income groups are identified. The results show the problems in access to health care services mainly in small towns and villages.
Conclusion: Although major essential changes were made in the Bulgarian health care system, the equity problems remain an important challenge to policy-makers
Seroprevalence of anti-HAV total antibodies among workers in wastewater treatment plants
No full textObjectives
Data on high frequency of hepatitis A virus (HAV) antibodies for wastewater treatment staff is contradictory. Literature lacks data on the seroprevalence of antibodies to HAV (anti-HAV) among workers in wastewater treatment plants (WWTPs) in Bulgaria. The aim of this study is to establish a specific humoral immune response to hepatitis A virus – anti-HAV total antibodies among staff in WWTPs.
Material and Methods
A complex study of health and working conditions included 110 subjects working in 3 WWTPs in Bulgaria (74% of all workers in the 3 studied WWTPs and 20% of all employees in Bulgaria registered in 2014 under the wastewater collection, discharge and treatment code of economic activity). Workers had been differentiated in 3 groups on the basis of their occupational work: operators, support staff and other workers exposed to biological agents. Venous blood from all 110 subjects was tested once for carriers of HAV antibodies.
Results
Anti-HAV total antibodies were found for 52.7% of workers in WWTPs. There is a positive association between activity performed in WWTPs (operators, maintenance personnel and others exposed) and a positive one for the presence of anti-HAV (Chi 2 = 6.882, df = 2, p = 0.032). Odds ratio (OR) for hepatitis A increases 2.9 times in the group of operators vs. others exposed to biological agents in WWTPs (OR = 2.914, 95% confidence interval (CI): 1.149–7.393, Fisher’s p = 0.039). Odds ratio for hepatitis A increases 4.3 times in the group of support staff from WWTPs vs. others exposed to biological agents in WWTP (OR = 4.295, 95% CI: 1.075–17.167, Fisher’s p = 0.049).
Conclusions
Higher frequency of anti-HAV antibodies among operators and maintenance personnel at WWTPs has been established as compared to other workers exposed to biological agents in WWTPs. There is a positive association between increasing age of the workers and the presence of anti-HAV. Int J Occup Med Environ Health 2018;31(3):307–31
Attitude change due to an intercultural experience in Israel
No full textThis thesis was scanned from the print manuscript for digital preservation and is copyright the author.
Researchers can access this thesis by asking their local university, institution or public library to
make a request on their behalf. Monash staff and postgraduate students can use the link in the References field
Socio-economic health inequalities in use of health care services in Bulgaria
Get PDFВъведение: Различни изследвания показват, че по-бедните хора от населението имат по-големи здравни потребности, докато използването на здравни услуги е концентрирано сред по-богатите прослойки на обществото. Целта на настоящата статия е да се изследват социоикономическите здравни неравенства в използваемостта на различни видове здравни услуги в България.Материал и методи: В изследването са използвани данни от проведено социологическо проучване чрез анкета. Проучването е проведено в периода март-юни 2014 г. сред 618 граждани на Североизточния район на планиране.Резултати: От стойностите на коефициента на поляризация се вижда, че по-висока е използваемостта на здравни услуги от хората с по-ниски доходи. Изключение правят само денталните услуги. Емпиричните стойности на t-критерия на Стюдент по видове лечебни заведения показват, че статистически значими различия между групите с най-ниски и най-високи доходи съществуват при ползването на общопрактикуващ лекар, лекар-специалист и при приема в болница.Дискусия: Резултатите от нашето изследване показват, че статистически значими различия се наблюдават в използването на здравни услуги от респондентите с различни равнища на доход. Финансовата тежест на разходите за здравеопазване създава сериозни бариери в достъпа до здравни услуги, особено за по-бедните домакинства, неосигурените лица и другите уязвими групи.Заключение: Въпреки задълбочаването на проблема с неравенствата в използването на здравни услуги, мерките от страна на здравните власти са все още твърде ограничени.Introduction: Different studies show that those at the lower end of the income distribution have the greatest needs for health care but usually those in higher income groups use more health care services especially specialised ones. The aim of this article is to investigate socio-economic health inequalities in the utilisation of health care services in Bulgaria. Material and Methods: Data from inquiry are used to analyse the socio-economic health inequality. The inquiry is conducted in 2014 among 618 citizens of Nord-East region in Bulgaria.Results: Values of odds ratio show that people at the lower end of the income distribution use more health care services except in the dental care. Differences in utilization of outpatient and inpatient services are measured at different income groups through Student t-test.Discussion: Our analyses suggest that income inequalities are related with health inequalities in the utilisation of health care services in Bulgaria. Financial burden of private health expenditure creates barriers in access to health care services especially for poorer part of the population, uninsured people and other vulnerable groups. Conclusion: Although the health sector faces serious challenges with income-related health inequalities, the policy measures are still inadequate
- …
