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Despite the population decline, the number of surgeries in Bulgaria is increasing. And not all medical establishments in which they are implemented meet the requirements for a minimum volume of activity. This shows the analyzes of the Hospital Index on three major surgical activities in the country - neurosurgery, cardiac surgery and orthopedics. The figures are for 2018 and reflect the funded treatment cases by the NHIF.
NEUROSURGERY
The number of surgeries in the field of neurosurgery in Bulgaria has increased with 1176 for a year, according to data from the Hospital Index. A total of 14,015 interventions were performed in 115 medical establishments last year against 12,839 in 116 clinics in the previous year. These include operations on the six major clinical pathways in this area - head trauma, oncology, diseases in vertebral problems, as well as cranial-brain nerves. Together with the conservative treatment of patients, the incidence of treatment in hospitals reached 28,086 or 1,603 more. Those who had recurrent treatment last year were 1839 or the rehospitalization rate was 6.5.
In spite of the high number of hospitals with contract neurosurgical wards, very few of them perform high-tech operations on the head - only at 12. They are concentrated in Sofia, Plovdiv, Varna, Pleven and Panagyurishte. Large spinal surgery is also done in a few places - 26.
The main part of the activities of the other medical institutions is focused on the conservative treatment of head injuries and interventions for cranial nerve problems. Despite medical standards, the number of operations performed on different clinical pathways in hospitals varies from 1 to over 1000.
ORTHOPEDICS
Over the years orthopedic surgeries have also increased. From 75,808 in 2017, they reached 76,559 in the past. They include all lower and upper limb interventions as well as alloplasty. The number of hospitals in which they were carried out increases from 95 to 98.
The largest lower limb interventions are performed in 39, and the top in 34. And in this sphere, despite the requirements of the medical standards, the volume of activity of the medical establishments is extremely uneven. In individual clinics, it ranges from 1 operation on some clinical pathways for a year to over 1000. The number of re-hospitalization last year in the field of orthopedics was 9204, or 12% of all cases.
CARDIAC SURGERY
Growth is also seen in the number of cardiac surgery in adults in the country. From 6000 in 2017 last year they have become 6276. There is no change in the health care establishments in which they took place, the number of them remains 10. More than 50% of the interventions took place only in three of the hospitals in Sofia and Plovdiv. Here, not all hospitals meet the requirements for a minimum volume of interventions per year.
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