Bulgaria's healthcare is four spots (30th) before the last one in Europe in the 2013 ranking of the Euro Health Consumer Index (EHCI).

Bulgaria has collected 528 points out of the maximum 1 000, but has moved up from its 33rd position in 2012, when it had 456 points.

After Bulgaria, Poland, Latvia, Romania and Serbia are at the bottom of the ranking.

Dr Arne Bjornberg, Chairman of the Health Consumer Powerhouse (HCP) and author of the report, says the Bulgarian healthcare system reflects the overall grim reality in the country, explaining that there was some positive development regarding access to treatment and reduced waiting time, but medical results have worsened even further.

He further stresses the situation in Bulgaria, Romania, and Serbia is alarming.

The Index champion is again the Netherlands, gaining 870 points. The Dutch are followed by Switzerland, Iceland, Denmark and Norway.

The financial crisis has led to increasing inequity in healthcare services across Europe, is one of the key findings of the 2013 EHCI, presented in Brussels by the Health Consumer Powerhouse.

The results show that there is now a 'two speed' delivery of healthcare, depending on the consumers' country. The quality of care that consumers can expect is discernibly higher in richer countries than in poorer. In addition, the gap is widening.

Bjornberg also said: "Healthcare decision makers are concerned by the impact of the economic crisis. Today's report demonstrates they are right to have these concerns. Our 2013 ranking indicates that wealthier countries are clustered towards the top of the Index, and this is more marked than in previous years."

For the first time since EHCI was launched in 2005, there is now a clear gap in healthcare provision between the affluent, financially strong parts of Europe and the less affluent, crisis-struck countries.

Although treatment results such as cancer and infant survival keep improving all over Europe, there are almost no medium-income countries in the top half of the Index in 2013.

The Euro Health Consumer Index (EHCI) 2013 is the seventh study made on European healthcare systems. The Index takes a consumer and patient perspective. EHCI, like the 16 other Health Consumer Powerhouse Indexes, offers reality checks for policy makers, empowerment to patients and consumers and an opportunity for stakeholders to highlight weak and strong aspects of healthcare.

The study ranks 34 national European health care systems on 42 indicators, covering five areas that are key to the health consumer: Patients' rights and information, Accessibility of treatment (waiting times), Medical outcomes, Range and reach of services provided and Pharmaceuticals.

The Index is compiled from a combination of public statistics, patient polls and independent research conducted by HCP.

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