Health legislation in Bulgaria

Question 1

what are the 2 documents and who are they adapted by and what is the law

Answer 1

NHS: National health strategy - council of M
NHP: National health programme- National assembly

the law: Health act

Question 2

2 types of health insurance and who is part of them

Answer 2

1. obligatory - NHIF
2. additional voluntary -private companies

Question 3

Info on insurance

Answer 3

8% of salary monthly
ratio + 60:40
60- paid by employer
40- paid by the person

if you do more than 3 months without paying you are taken off

Question 4

who is exempt from insurance and has the government budget

Answer 4

1. kids under 18
2. pensioners 65+
3. students under 26

Question 5

out of pocket payments and who is exempt

Answer 5

a type of visiting tax , where if someone visit the GP - pay 2.90 and if they visit the hospital they pay 5.80 for every day you spend in hospital

1. pensioners - only pay 1 lev but still pay 5.80
2. incapacity to work
3. children under 18

Question 6

is there a difference between medical establishment and healthcare establishment?

Answer 6

medical: diagnosis and treatment (medical staff). Medical esttablishment falls under the medical establishment act

healthcare: non medical staff, aim is promotion and protection of health and is part of the health care act examples would be opticians, pharmacies etc
healthcare establishment falls under the HEALTH ACT

Question 7

What are the 3 columns on the table (we did in class)

Answer 7

1. Health act
2. insurance
3. health care establishment act

Question 8

national framework contract

Answer 8

a contract signed by the NHIF representives and professional organisation associates like doctors, dentists etc that is signed every year up to April.

inside contract there is the price of procedures, what kind of procedures the medical staff will perform

the providers of medical care must sign individual contracts

1) the conditions to be met by the providers
2) the range, price and methodology of the price of services
3) documentation

there is more

Question 9

medical establishment

Answer 9

i think it’s part of the 3rd column (double check)

structure when doctors alone or with the assistance of other medical or non medical specialist carry out the following activities

nb ( it doesn’t matter about the 3 types of care, all will do these things)

-diagnostics, treatment and rehabilitation of patients
-care of pregnant women and provision of natal assistance
-prophylaxis of diseases and early discovery of diseases
-transplant of organs

Question 10

types of care

Answer 10

3

1. outpatient/ ambulatory
2. in patient/hospital
3. other

Question 11

types of care

Answer 11

outpatient- non stationary -ambulatory
inpatient- hospital care
other

Question 12

outpatient care

Answer 12

1. ambulatory for 1 medical care
2. ambulatory for specialised medical care
   3.independent medical diagnostic and medical technical labs
   4.dental centres

Question 13

hospital care

Answer 13

4 classification

1. BY TREATMENT

-hospital for active treatment
hospital for further treatment and continuous treatment
-rehabilitation
-hospital for final treatment
2.BY PROFILE
-multiprofile
-specialised
3.UNIVERSITY OR NON UNIVERSITY
4. AREA
-national
-regional
-local

Question 14

-UMHAT

-SHAT

Answer 14

university multiprofile hospital for active treatment

Specialised hospital for active treatmen

THESE FALL UNDER TYPES OF MEDICAL ESTABLISHMENTS

Question 15

others

Answer 15

mental health centre
centre for emergency medical care
transfusions
complex oncology centre
hospice
tissue bank
dialysis centre

Question 16

who does primary health care

Answer 16

GP
promotion of health

Question 17

what kind of activities does gp do

Answer 17

general checkups
immunizations -prophylaxis
prescribes drugs
diagnosis and treatment

Question 18

health education and health behaviour

Answer 18

• things like when to wash your hands
  -how to wash your hands
  -healthy eating,diet
  -sexual eduction
  -when is the best time for a couple to have a child

this is the role of family doctor like in primary health car e

Question 19

when is adapted the model for 1 healthcare-MCQ and first thing to mention in essay

Answer 19

in the declartaion of the international conferance on primary health care held in Alma,Ata jazakhstan in 1978

Question 20

what is 1 health care -

Answer 20

ESSENTIAL HEALTH CARE which makes universal healthcare accessible to individuals and families and communities

involves al areas such as environment, healthcare services and lifestyle

Question 21

Ambulatory for specialised medical care

Answer 21

a. individual e.g cardiologist
b. group - more than 2 specialist
c. medical centre - at least three different doctors in different specialities
d. Diagnostic consultative Centre 10 different doctors in different fieldsand labs, radiolofgy labs, clinical labs and a director qualified in health management

Question 22

how many patients can the gp see

Answer 22

its predetermined by the RHIF, on a monthly basis

Question 23

specialised medical care

Answer 23

-1. indivual practice for specialised medical cared
2. group practice for specialised medical care
-3.medical centre/dental centre- at least 3 diff doctors/denti in 3 separte fileds
-4. medical diagnostics- at least 10 physyican in speertae fields, with a lab and imaging sections and a manager with a qualification in health management.

Question 24

what are the NHS and NH prohgramme based on

Answer 24

they are based on the assessment of health status and health needs of citizens , demographic tendencies and resource capacities of the national system of healthcare

Question 25

what does the national system of health care consist of

Answer 25

1. medical establishments under the law of medical establishments 2. health care establishments 3. the state, municipal and public bodies and insitiutions for orgnanisation

Question 26

who manages the helath policy

Answer 26

council of M

Question 27

management of the national health care system

Answer 27

1. minister of health 2. supreme medical council 3. R3egional health inspectorate 4. health care service at the municipal administration

Question 28

state health control

Answer 28

1. chief state health inspector of republic of bulgaria 2. national centre for radiobiology and radiation protection 3. RHI

Question 29

DEF healthcare establishment

Answer 29

healthcare establishments are structures of the national health care system where medical and non medical specialities provide activities for the promotion and the protection of health

Question 30

example of specialsied hospital

Answer 30

selena

Question 31

what is a patient

Answer 31

any patient who has sought or is receiving medical aid

Question 32

what are patients rights and which law do they fall under whar are patient obligations

Answer 32

FALL UNDER THE HEALTH ACT 1. respect for social, political, economic,cultural religious rights 2. accessible and high quality medical aid 2. more than one medical opinion on the diagnosis, treatment and prognosis of a disease 3. protection of the data related to their condition 4. remuneration for the work he/she performs the same as if they were healthy 5. clear and accessible information on the health condition of the patients 1. take care of his/her own health 2. not harm the health of others 3. assist the providers of medical aid in the performance of activities related to the improvement/recovery of their health 4. observe the order established at healthcare and medical establishments

Question 33

where does palliative medical care fall into and definition

Answer 33

health act maintain quality of life by eliminating/reducing some of the immediate signs of the disease as well as the related adverse psychological and social effects

Question 34

what does palliative care mean who provides it

Answer 34

1. medical observation 2. healthcare aimed at providing care to the patient, removing pain and the psycholigcal and social effects 3. moral support to the patients and relatives GP, medical establishments for outpatients and hospital care and hospices

Question 35

medical aid in emergcnecy

Answer 35

1. prevent death 2. prevent severe or irreversible damage to the organs and systems of the body 3. prevent complications in women at childbirth with thhreatenes the life of mother and fetus

Question 36

who runs the oblgatory health insurance fund and what is the function s

Answer 36

NHIF which is further divided into regions (bulgaria has 27 ) provides a basic level of healthcare package budgeted by the NHIF. gives you free choice of a provider as long as they have a contract with the RHIF

Question 37

additonal voluntary insurance

Answer 37

carried out by shareholders companies registered according to commercial law and who have a liscence !

Question 38

RIGHTS OF THE obligatory insured person

Answer 38

1. to medical care within the range of the insurance package 2.to emergency medical care whenever its needed 3. to receive info from the RHIF about the contracts it has made with medical care executives

Question 39

examples of heathcare establishments

Answer 39

National centres for public health affairs Opticians, pharmacies, health and dental med offices at kindergarten/schools and specialised social welfare institutions. National expert medical commission (NEMC)