DISCUSSIONS ON LONG-TERM CARE IN BULGARIA - RESULTS OF THE FOCUS-GROUP STUDY
Background: Global and national health bodies are developing standards, norms and guidebooks to introduce programs to meet the challenges faced by health systems in providing efficient services to patients with long-term conditions. The ongoing supervision of chronically ill people in Bulgaria is called ‘dispensary treatment’. The purpose of this research was to study the experience and opinion of providers and users of medical services on the dispensary treatment – its organization, advantages and disadvantages.
Material and method: Qualitative research was conducted using focus groups of providers and users of medical services. Discussions were held in five groups, and the total number of participants was 60.
Results: Initially, the discussion concentrated on the current system for long-term care, but also considered how it could be improved. Particular attention was paid to the position of general practitioners, who are often viewed by patients as the most appropriate coordinators, around whom functional and multidisciplinary teams are formed. The groups also discussed lack of active participation by nurses and insufficient interaction between doctors and social services. The lack of a unified register was mentioned. The groups also considered inappropriate allocation of resources by the financing institution, which limits the number of consultations within particular timeframes, without flexibility.
Conclusion: The Bulgarian model for long-term care has kept its name since before reform of the health system. It was considered positive that dispensary treatment is organized nationally, but its monitoring is largely administrative at that level.
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