Bulgaria’s rural hospitals hit hardest by decreasing number of nurses

The uneven distribution of health care personnel is becoming a problem as the decreasing number of nurses in Bulgarian health care is hitting hospitals in smaller towns hardest, macroeconomist Arkadiy Sharkov, whose expertise is in the field of healthcare economics, told EURACTIV.

“The uneven distribution of health care specialists is a problem. They are concentrated in large regional cities, and nurses are becoming fewer and fewer in the periphery. This is a problem in the Bulgarian hospital system regarding medical specialists. The health care system and those working in it is a system of connected vessels”, Sharkov said.

He explained that if there are fewer specialists in one of them, it affects everyone in the chain. “Unfortunately, unfavourable working conditions in terms of pay, as well as the risk of violence that weighs on medical professionals, are factors that lead to less and less production of personnel,” he added.

Bulgaria, Latvia and Greece are the countries in the EU with the lowest number of nurses per 100,000 population. In Bulgaria, the ratio is 421 nurses per 100,000 population in 2021, while the EU average is around 900 nurses per 100,000 people.

“The average age of a Bulgarian nurse is 58 years, which has an impact on the dynamics, work capacity and logistics possibilities in the territory of Bulgaria. The average ratio of nurses to doctors should be 2:1, and in Bulgaria, they are 0.9 nurses to 1 doctor.”

The number of doctors in Bulgaria has remained relatively constant since the end of the totalitarian period in 1989 until now, but the number of nurses has almost doubled during this period.

Other medical professionals, such as medical and X-ray laboratory technicians, dental technicians and others, are increasing, albeit slightly. Despite this disproportion, hospitalisations in Bulgaria have not decreased, nor has the number of hospitals increased in the last 30 years.

(Emiliya Milcheva, Krassen Nikolov | EURACTIV.bg)