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(2021)
Evaluation of the control over the execution of contracts for the provision of primary outpatient medical care. Dissertation work, Sofi a
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News sectionVeterinary Record, 180
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SG No. 56 of 13.07.1991, last amended and supplemented, SG No. 100 of 18
To study and present the opportunity for exercising citizen control over the spending of health-care funds, including at the PHC level
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on the conditions and procedure for carrying out control under Art. 72, para. para. 2, 3, 4, 5, 6, 7 and 8 of the Law on Health Insurance, issued by the manager of the NHIF -www
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AbstractThe significance of control increases with the push towards improving the overall effectiveness of the health insurance system. In order for public resources to be spent lawfully and effectively, there needs to be increased control not only from the National Health Insurance Fund (NHIF), but citizen control also needs to be incorporated in the process.Materials and MethodsThe goal of this survey is to analyze the opportunities for implementing citizen control over the spending of public health funds and compare them to the real conditions as far as the outpatient medical care level. Legislation and news from NHIF’s webpage related to citizen control opportunities were studied. A direct, anonymous survey was carried out on the Google forms platform amongst Bulgarian citizens past the age of majority.ResultsThe results of the questionnaire survey carried out between 24.06.2022 and 16.10.2022 among 1045 adults with compulsory health insurance from all over the country, showed that they were poorly informed on the opportunities for citizen control which have been regulated and created in practice and don’t take advantage of them. Only 45,6% of the participants were aware of the digital services “Record review for health-insured persons”, which is found on NHIF’s webpage, and less than half of them (42,8%) used this service. The NHIF’s mobile application for feedback was used by as little as 11,8% of the respondents, and only seven patients have used it to share an opinion, while nine have used it to get notifications for data changes in their patient record. The portion of participants who have taken part in NHIF inquiries was also very small – 2,5%. Merely 2,8% have posted a complaint to the NHIF after being denied medical services.ConclusionsAll of this makes it evident that a change is necessary in order for citizen control to be strengthened as a mechanism. This will lead to the correction of proven deviations in reported medical activities and will make it easier to get the patients’ opinions on the medical care they have been provided with.
Acta Medica Bulgarica – de Gruyter
Published: Jun 1, 2023
Keywords: control; National Health Insurance Fund; compulsory health-insured people; primary outpatient medical care
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