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The National Health Insurance Fund is trying to restrain unnecessary hospitalization through implementation of delegated budgets. However, the budgets do not register which admissions to hospital have been necessary. Photo by BGNES
The Bulgarian National Health Insurance Fund has announced that the payments for hospital care have increased by 60% in the past five years.
Analysis data from the fund, released Wednesday, showed that the fund paid for hospital care an average of BGN 62 049 000 per month in 2006 and in 2009 the expenses reached BGN 96 206 000.
The biggest increase of funds was of 21% in 2009, in comparison to 2008.
According to the National Health Insurance Fund (NZOK), the main reason for the ill-controlled increase of the expenses for hospital care is the admission of patients who could undergo a treatment at home. Another problem is the repeated hospitalization.
The data has shown that about 300,000 people have been hospitalized more than once for a period of one year and only 3% of them had a medical reason. In the other cases, the hospitalization aimed at "utilizing of financial resource".
According to NZOK, another reason for the increase of expenses was the selective negotiation and the goal of the hospitals to work and declare expensive clinical pathways.
In 2006, the fund paid funding for 1,300,226 hospitalizations, while in 2009 the number was 1,769,594. According to experts, the tendency for increase will continue in 2010, when the number of hospitalizations is expected to reach 2,080,000 by the end of the year.
This also affects the records of the hospitals to NZOK. In 2010, the average amount of funding, declared by the hospitals, was BGN 101,106,000, while in 2006, the amount was BGN 62,049,000, in 2007 – BGN 73,384,000, in 2008 – 79,526,000, and in 2009 – 96,206,000.
The National Health Insurance Fund has announced that based on this data it has taken actions to control the expenses of the hospital care through the implementation of delegated budgets for the hospitals.
NZOK has stated that the goal was to restrain the unnecessary hospitalizations which generate expenses in the hospital sector. The delegated budgets, however, do not register which hospitalizations have been necessary and pays a defined amount of money to the hospitals.
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