National Statistical Institute

"Health and Justice Statistics" Department

Evelin Yordanova

Head of department

2, P. Volov Str.; 1038 Sofia, Bulgaria

[email protected]

+359 2 9857 459

Data on health network by type of health establishments, types of beds and their regional distribution, according to Nomenclature of territorial units for statistics (NUTS 2 and 3) are presented, and also distribution by form of ownership (public and private).

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

· The health network has been worked out according to the Law on Health Establishments;

· Classification of Territorial Units for Statistical Purposes in Bulgaria (NUTS);

· The beds in in-patient health establishments are presented according to the Eurostat statistical grouping (till 2014) and Revised Eurostat statistical grouping;

The survey covers all of health establishments - in-patient, outpatient health establishments and other health establishments. Health establishments attached to other offices are included in the total number but not included in the distribution by districts.

Health establishments for hospital aid include all hospitals and centres with beds (former dispensaries).

Outpatient health establishments include medical centres, dental centres, medical-dental centres, diagnostic and consulting centres, medical-diagnostical and medical-technical laboratories.

Other health establishments include centres for urgent medical aid, centres for transfusion haematology, hospices, national centres without beds, regional health inspections, homes for medico-social care for children, tissue banks and integrated care centres for children with disabilities and chronic illnesses.

Data on beds in health establishments refer to the all de facto operating beds as well as beds temporary out of use for a period of less than six months. The number of beds for temporary use is excluded.

When analyzing the data the following has to be taken into consideration some specific particularities on medical servicing. The health establishments are not directly connected to the servicing of population of a given settlement or even of 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 - oncological, dermato-venereological, psychiatric, pulmonary and other service the population of 2 or 3 regions. The establishments under central administration, regardless of their location, serve the population from the whole country.

Data on beds in health establishments refer to the all de facto operating beds as well as beds temporary out of use for a period of less than six months. The number of beds for temporary use is excluded.

According to harmonized methodology applied by Eurostat, WHO and OECD till 2014, beds in in-patient health establishments (hospitals and medical centres with beds) are grouped in statistical grouping, as follow:

• Curative (acute) care beds;
• Psychiatric care beds;
• Long-term care beds (excl. psychiatric beds);
• Other hospital beds.

Detailed statistical data on the number of beds in hospitals by types from annual statistical surveys, conducted by the National Centre for Public Health and Analysis are provided as these surveys are included in the National Statistical Programme.

Psychiatric care beds - All disclosed beds in Mental health hospitals and Mental health centres are included.

The number of beds in hospital facilities for long term treatment in all health establishments, including these in specialized hospitals for further and long-term medical treatment and Specialized hospitals for further and long-term medical treatment and rehabilitation, are included in the number of Beds for long term care.

The group Other beds covers beds for physiotherapy and rehabilitation, beds for day care and home care.

Since 2015 a revised statistical grouping is applied:

• Curative care beds,
• Rehabilitative care beds,
• Long term care beds,
• Other hospital beds.

In accordance with the new statistical grouping, all psychiatric care beds in all health establishments are included in the distribution by type of beds.

Curative care beds – all curative care beds and psychiatric curative care beds in all health establishments are included.

Rehabilitative care beds – all rehabilitative care beds in all health establishment are included.

Long term care beds – all long term care beds and psychiatric long term care beds in all health establishment are included.

Other hospital beds - other hospital beds not elsewhere classified.

Since 2016, according to the amendments of Ordinance No. 49 of the Ministry of Health in 2010, "Places for short stay" are introduced.

The application of statistical methodology with respect to statistical grouping of types of beds in hospitals is validated by Eurostat for all member states.

Indicators Hospital beds per 100 000 of the population are calculated based on the number of the population as of 31.12. of the relevant year.

The number and structure of the population at the end of each year are calculated on the basis of the previous year's data and the data on natural movements and migration of the population in the current year. The population estimate as of 31 December 2022 reflects the changes in population numbers and structure recorded in the Census 2021. In this regard, there is a break in the time series for all coefficients for 2022.

Statistical units are health establishments.

All health establishments covered by the survey.

Covered by territory of the Republic of Bulgaria. The regional data is according to administrative-territorial division of the country as of 31.12. of the relevant year.

2001 - 2025

Not applicable.

Number

31.12. of the reference year.

· Regulation (EC) No 1338/2008 of the European Parliament and of Council of 16 December 2008 on Community statistics on public health and health and safety at work;

· Regulation (EU) 2022/2294 of the Commission as regards statistics on healthcare facilities, healthcare human resources and healthcare utilisation;

· Law on Statistics;

· Law on Health;

· Law on Health Establishments;

· Ordinance № 1/27.02.2013 of the Minister of Health for the provision of medico-statistical information and information on health establishments medical activities.

Since 2010, Eurostat, the Organisation for Economic Co-operation and Development (OECD) and the World Health Organization (WHO) started procedure of joint data collection on non-monetary health care statistics (health care activities).

· Law on Statistics;

· Regulation (EC) No 223/2009 on European statistics (recital 24 and Article 20(4)) of 11 March 2009 (OJ L 87, p. 164), stipulates the need to establish common principles and guidelines ensuring the confidentiality of data used for the production of European statistics and the access to those confidential data with due account for technical developments and the requirements of users in a democratic society.

Individual data are not published in accordance with article 25 of the Law on Statistics. The publishing of individual data can be performed only in accordance with article 26 of the same law.

The date of the statistical information release is shown in the Release Calendar presenting the results of the statistical surveys carried out by the National Statistical Institute.

The calendar is available on the NSI website: https://www.nsi.bg/en/calendar

Data on Health establishments is published on the NSI website, section Health in accordance with the Law on Statistics and the European Statistics Code of Practice respecting the professional independence and aimed at objectivity, transparency and equal treatment of all consumers.

Annually.

Annual press release.

· Health Services;

· Statistical yearbook;

· Statistical Reference Book;

· Brochure "Bulgaria";

· Regions, Districts and Municipalities in Bulgaria.

Data on Health establishments are available to all users of the NSI website under the heading Health - In-patient, out-patient and other health care establishments - Health establishments: https://www.nsi.bg/en/statistical-data/241/782

Online database of Eurostat:

https://ec.europa.eu/eurostat/web/main/data/database

Not applicable.

Information service on request, according to the Rules for the dissemination of statistical products and services in NSI.

· Healthcare non-expenditure statistics manual and Guidelines for completing the Joint questionnaire on non-monetary healthcare statistics (2023 edition);

· Methodological notes;

Not available.

The completed online forms are validated at the regional level by the Regional Health Inspections, and the reporting forms submitted on paper are collected and entered by the same experts, which guarantees the full scope and quality of the data received.

Reporting forms are collected by the Regional Health Inspections, which guarantees full coverage and quality of data. Data on beds in health establishments are verified by those of special statistical surveys, conducted by the National Centre for Public Health and Analysis.

Integrated quality and security management system has been implemented in accordance with the requirements of BDS EN ISO 9001: 2015 and BDS EN ISO 27001: 2017. The certificate fully meets all international requirements and guarantees the quality of the processes and information security of the entire statistical and information infrastructure of the NSI, both at national and regional levels.

Data on main non-monetary indicators on health care statistics (health care activities) are provided annually to Eurostat, World Health Organization (WHO) and Organisation for Economic Co-operation and Development (OECD) via joint annual questionnaire filled-in in strict compliance with the prescribed terms and forms of presentation of the data in accordance with the Regulation (EU) 2022/2294. Within these annual questionnaires filled data are also provided to other European and international organizations.

The data are provided annually to National Centre for Public Health and Analysis, Ministry of Health and its territorial units - Regional Health Inspections, whose functions are to formulate policies in the field of health care at national and regional level.

Data users of health information at national and regional level are the National Assembly of the Republic of Bulgaria, the executive and local authorities, National Health Insurance Fund.

Upon request data is provided to research institutes, universities, NGOs and other users in conformity with the rules established in NSI.

Not applicable.

Data are exhaustive, by type of health establishments and the number of beds in them.

Exhaustive survey.

Not applicable.

Not applicable.

T+5 months

Data are disseminated according to the Release Calendar presenting the results of the statistical surveys carried out by the National Statistical Institute.

The data are comparable for all regions of the country. When analyzing the data the following has to be taken into consideration some specific particularities on medical servicing. The health establishments are not directly connected to the servicing of population of a given settlement or even of 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 - oncological, dermato-venereological, psychiatric, pulmonary and other 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 data are comparable from 2001 year.

For all coefficients, the data are comparable to 2021.

There is a break in the time series for all coefficients for 2022. The indicators per 100 000 of the population are calculated based on data on total population as of the end of the year.

The number and structure of the population at the end of each year are calculated on the basis of the previous year's data and the data on natural movements and migration of the population in the current year. The population estimate as of 31 December 2022 reflects the changes in population numbers and structure recorded in the Census 2021. In this regard, there is a break in the time series for all coefficients for 2022

Not applicable.

Not applicable.

Not applicable.

It is possible to revise the data in case of change of the methodology or the applied methods of the survey, as well as in case of change of the applied classifications and nomenclatures.

Data source is the online form filled in by health establishments, which are covered by the study.

Data source for number of Homes for medico-social care for children and beds in them is the survey "Homes for medico-social care for children" conducted by NSI.

Data source for the distribution of hospital beds in accordance with the statistical grouping applied by Eurostat are surveys conducted by the National Centre for Public Health and Analysis.

Annually

The process of collection of reporting forms is carried out by the National Statistical Institute and Regional Health Inspections online or through a paper documents. Data entry is carried out online by the respondents or by the RHIs (for the paper documents).

Data on hospital beds are validated with those from the specialized survey on the activity of the health establishments, conducted by the National Center for Public Health and Analysis.

The application of statistical methodology with respect to the statistical grouping of types of hospitals beds for all member states are validated by Eurostat.

Data entry is carried out online by the respondents or by the RHIs (for the paper documents).

The data is consolidated at national level, by adding information from the survey "Homes for medico-social care for children" as well as information on health establishments and medical personnel attached to other ministries.

Not applicable.