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The Bulgarian country profile: The dynamics of some inequalities in health


  • Minev, Duchomir
  • Dermendjieva, Bogdana
  • Mileva, Natasha


The Bulgarian health-care system was based on the concept of equal access and treatment. In its early stages health improved and disparities between urban and rural areas and districts diminished. New problems, institutional rigidities and policy reversals led later to the concentration of health resources in the towns and cities and to a deterioration in rural health. Sharp disparities in reported health status exist between occupational, educational and income groups. Life expectancy has fallen. Some health problems arise from urbanization, industrialization and heavy internal migration. Others clearly derive from dysfunction in the health system itself, its narrow concept of health, the inability of health plans to adapt to changing problems and needs and the emergence of privilege in access and quality of care.

Suggested Citation

  • Minev, Duchomir & Dermendjieva, Bogdana & Mileva, Natasha, 1990. "The Bulgarian country profile: The dynamics of some inequalities in health," Social Science & Medicine, Elsevier, vol. 31(8), pages 837-846, January.
  • Handle: RePEc:eee:socmed:v:31:y:1990:i:8:p:837-846

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    References listed on IDEAS

    1. Temin, Peter, 1983. "Costs and benefits in switching drugs from Rx to OTC," Journal of Health Economics, Elsevier, vol. 2(3), pages 187-205, December.
    2. Foster, S. D., 1990. "Improving the supply and use of essential drugs in sub-Saharan Africa," Policy Research Working Paper Series 456, The World Bank.
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    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Balabanova, Dina & McKee, Martin, 2002. "Understanding informal payments for health care: the example of Bulgaria," Health Policy, Elsevier, vol. 62(3), pages 243-273, December.
    2. Pavlova, Milena & Groot, Wim & van Merode, Frits, 2000. "Appraising the financial reform in Bulgarian public health care sector: the health insurance act of 1998," Health Policy, Elsevier, vol. 53(3), pages 185-199, October.
    3. Nora K Markova, 2006. "How Does the Introduction of Health Insurance Change the Equity of Health Care Provision in Bulgaria?," IMF Working Papers 06/285, International Monetary Fund.


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