Does the Bulgarian Health Care System Need a Health Ombudsman?

BACKGROUND: The Office of the Ombudsman of the Republic of Bulgaria (ORB) is an independent constitutional body elected by Bul-garian Parliament in 2005. It serves to protect the rights of all citizens, including the rights of patients, children, people with disabilities, minorities, foreigners, etc. Bulgarian healthcare users complain when they feel that the healthcare system (HCS) has failed their needs or they have been recipients of an inappropriate treatment. AIM: The aim of the present study was to analyze the structure and dynamics of all complaints from Bulgarian healthcare users referred to the ORB over a 13-year period (2005 - 2018). MATERIALS AND METHODS: Retrospective documental research was used in the present study. The data included the complaints ob-tained from the official annual reports of the ORB that are available online. Bibliographic and documental searches were also used as sources. The complaints were analyzed by their annual distribution and classified by problem areas in the HCS. RESULTS: Between 2005 and 2018, there were a total of 3288 complaints filed to ORB against HCS. In 2015, 368 complaints were re-ceived by ORB from Bulgarian healthcare users and from various patient organizations concerning problems in the HCS. The filed complaints to ORB increased by 82% in 2016 (n=421). In 2017, the overall number of ORB-referred complaints amounted to 494, and in 2018 their number was as high as 607, which represents an increase by 23% compared to the number of complaints in 2017. CONCLUSION: The great number of complaints referred to ORB about the HCS over the last four years strongly suggests that the institu-tion of the Ombudsman in Bulgaria enjoys high confidence among Bulgarian healthcare users.

Survey of the curricula of public health training programs across Bulgaria and Greece: opportunities for future collaboration.

Increased communication between neighboring countries may bring to the foreground the common health hazards of the populations but it also creates opportunities for joint actions, especially in the field of public health where knowledge and expertise are critical factors for effective collaboration. In this light, a questionnaire based survey on the curricula of public health training programs in Bulgaria and Greece was conducted in order to investigate any similarities and discrepancies. The survey focused on the various characteristics of the institutions that provide training in public health, e.g., the structure and duration of each course and the evaluation procedures. The results showed that the principal subjects such as public health, epidemiology, biostatistics and health promotion are present both in the Greek and Bulgarian curricula. Similarities are observed in other subjects as well, but differences exist as to whether these subjects are core or elective. The Greek curricula are more flexible (greater number of elective subjects) whereas Bulgarian curricula are structured around a wider core. Differences were observed in the duration of the programs, the teaching methodology and the issues of evaluation/accreditation. Collected data can serve as a basis for establishing a fruitful dialogue and contribute to the achievement of consensus in public health policy planning and actions for both neighbouring countries.