In-patient, out-patient and other health care establishments as of 31.12.2024

1. Health establishments and beds in health establishments

The number of health establishments for hospital aid as of 31.12.2024 was 341 with 56 061 beds as the number of establishments had not changed, and the number of beds had increased by 337, or by 0.6% compared to the previous year.

The number of hospitals was 319 with 53 806 beds, as for 203 of them the type of ownership was public and for 116 - private. The distribution of hospitals by form of ownership had remained relatively constant in the recent years. However, there was an increase in the beds in privately-owned establishments and as of December 31, 2024, 30.4% of the beds were in such hospitals.

The number of multi-profile hospitals was 181 with 39 801 beds. These establishments represented 56.7% of all hospitals, and in them were concentrated 74.0% of the total number of hospital beds in the country.

The number of specialized hospitals was 138 with 14 005 beds in them. Their distribution by type was as follows:

• For active treatment - 72 with 4 412 beds;
• For long-term medical treatment - one with 145 beds;
• For long-term medical treatment and rehabilitation - 18 with 2 131 beds;
• For rehabilitation - 35 with 5 460 beds;
• Psychiatric hospitals - 12 with 1 857.

 The number of hospital beds at the end of 2024 was 870.9 per 100 000 persons of the total population.

The highest values of that indicator were registered in the districts Pleven (1 351.9 per 100 000 persons of the population), Smolyan (1 190.7) and Plovdiv (1 110.2), and the lowest - in Pernik (406.8), Yambol (428.7) and Vidin (439.5) (See Figure 1).

As of 31.12.2024, the number of out-patient health establishments was 2 289 with 1 283 beds for short-term treatment.

Among out-patient health establishments with activities in clinical medicine, the largest was the number of medical centers - 846 establishments with 929 beds, followed by diagnostic-consultation centers - 114 with 276 beds. There were 68 dental centers with 3 beds, and 70 medical-dental centers with 75 beds.

At the end of 2024, the number of other health establishments was 149 with 1 849 beds in them.

2. Medical personnel

At the end of 2024, 30 149 physicians were in practice under a basic labour contract in health establishments (See Table 2). The dentists were 7 784, as 6 740 of them worked in practices that had signed а contract with the National Health Insurance Fund. The health care professionals and other medical specialists who worked on a basic labour contract in health establishments were 44 554, as 28 393 of them were nurses and 3 254 - midwives.

• 18 114 physicians and 40 dentists practiced in in-patient health establishments (hospitals and centres with stationaries). The health care professionals and other medical specialists were 25 965, 17 996 of which were nurses.
• 10 118 physicians and 7 342 dentists worked under basic labour contract in out-patient health establishments. This group covers all physicians (6 548) and dentists (6 740), which were working in individual or group practices under agreement with the National Health Insurance Fund. The health care professionals and other medical specialists were 7 071, with 70 of them working on a main contract in outpatient establishments for individual and group healthcare.
• 1 917 physicians and 402 dentists worked in other health care establishments (incl. crèches and medical consulting rooms in the schools) under a basic labour contract.

Practicing physicians by sex and age

The distribution of practicing physicians by sex as of 31.12.2024 is as follows - 13 371 (44.3%) were males and 16 778 (55.7%) - females.

In the structure of physicians by age, the highest number and share of physicians was in the age group 55 - 64 years - 9 375 persons, or 31.%. At second place was the group of young practicing physicians, aged up to 35 years - 5 781 persons, or 19.2%. The elderly physicians (aged 75 and over) were 1 441, or 4.8%. (See Тable 3).

The distribution of practicing physicians by age groups and types of establishments (See Figure 2) shows that the largest share of young doctors practicing under a basic labour contract was in health establishments for hospital aid (27.5%), and the smallest - in out-patient health establishments (4.8%). More than two-thirds of the physicians practicing under a basic labour contract in out-patient health establishments were over 55 years old (74.3%).

Practicing physicians by specialties

In the structure of physicians by specialties¹, the highest was the share of ‘General practitioners’ - 3 750 persons, or 12.4% of all physicians practicing in the country, followed by specialists practicing: ‘Cardiology’ - 6.5%, ‘Obstetrics and Gynecology’ - 5.9%, ‘Anesthesiology’ - 5.8%, ‘Surgery’ - 5.0%, ‘Neurology’ - 4.8% and ‘Pediatrics’ - 4.6%.

Physicians and dentists per 10 000 persons of the population

The number of physicians per 10 000 persons of the total population at the end of 2024 was 46.8 and the number of dentists per 10 000 persons of the total population was 12.1.

The number of physicians per 10 000 persons of the population² by districts varied from 25.1 to 80.3 per 10 000, as the highest values of that indicator were registered in districts with Medical universities and Universities’ hospitals (See Figure 3) - Pleven (80.3 per 10 000 persons of the population), Sofia (stolitsa) (57.7), Plovdiv (57.4) and Varna (52.0). The lowest values were registered for the districts: Kardzhali (25.1 per 10 000 persons of the total population), Yambol (29.3) and Haskovo (29.8).

¹ The distribution of physicians by specialties is in accordance with their practicing specialty. The physicians in practices for specialized medical care are also included. The physicians practicing more than one specialty has been included in the total number but has been not distributed by specialities.

² The indicator for the country is calculated by taking into account the total number of physicians practitioners working in individual or group practices under a contract with the National Health Insurance Fund in more than one district. 

The number of dentists per 10 000 persons of the total population³ was 12.1. The highest values were registered in the districts: Plovdiv (19.5 per 10 000 persons), Varna (15.8), Sofia (stolitsa) (15.5) and Pernik (14.2). The lowest values of the number of general practitioners per 10 000 persons of the total population were registered in districts: Sofia (6.0), Razgrad (6.3), Montana and Silistra (6.6 per 10 000 persons of the total population) (See Figure 4).

³ The indicator for the country is calculated by taking into account the total number of dentists practitioners working in individual or group practices under a contract with the National Health Insurance Fund in more than one district.

Methodological notes

The statistical survey on in-patient, out-patient and other health establishments provides data on health network by type of health establishments, their regional distribution as well as on medical personnel by specialties and categories. It is carried out in accordance with the Regulation (EU) 2022/2294 of the Commission as regards statistics on healthcare facilities, healthcare human resources and healthcare utilisation, in strict compliance with the definitions laid down in the regulatory document.

Data are presented according to the status as of 31^-st of December of the year.

Data on hospital beds include all de facto operating hospital beds as well as hospital beds temporary out of use for a period less than six months. Hospital beds for temporary use are excluded.

The place for short stay is specifically defined in the regulations for the structure, activity and internal order of the Health establishments for hospital aid, a separated and designated area/territory/space in a clinic/ward with or without beds for patient accommodation, specially equipped with the necessary household and technical equipment for carrying out certain medical activities of diagnosis and treatment, which require a stay of the patient no longer than 12 hours.

When analyzing the health network data the following has to be taken into account: the number of health establishments and hospital beds has changed not only as a result of the opening or closure of establishments, but also because of the reorganization or merging of establishments.

When analyzing medical service by districts, some specific particularities on medical servicing have to be taken into consideration. The health establishments are not directly connected to the servicing of population of a given settlement or even of a municipality. A great part of health establishments serve the population of a given region or a group of municipalities, and the specialized health care establishments service the population of 2 or 3 regions. The establishments under central administration, regardless of their location, serve the population from the whole country.

The number of medical personnel (individuals working under basic labour contract) includes persons, practicing at healthcare establishments regardless of their ownership and subordination. Data on medical specialists working outside of the country, as well as on medical specialists practicing outside of the health establishments (for example, doctors working for the pharmaceutical industry) are excluded.

In the territorial distribution of the medical specialists working in practices under a contract with the NHIF, which served the population in more than one district, respectively municipality has been included in the total number for the country (district) but not distributed by districts (municipalities).

The distribution of the physicians by specialties is based on the national nomenclature in accordance with the Ordinance № 1 of 22 January 2015 of the Ministry of Health (amended and supplemented, State Gazette No. 65 of 2 August 2024) and it is according to their practicing specialty. Those who are working in practices under a contract with the NHIF practicing more than one specialty are included in the total number of physicians but not distributed by specialty.