Inequalities in the access to medical-diagnostic services in outpatient medical practice in Northeastern Bulgaria

Abstract

Introduction Territorial inequality in health-care services is an important problem worldwide. A complete study of the correlation between the inequalities and the territorial disproportion of the health services is required, as this will ensure a scientifically based model for improvement of the access to health services. The aim of the current work is to analyze the patients` satisfaction with the territorial distribution of medical-diagnostic services and to prepare a cartogram of the observed differences in the northeastern region of Bulgaria. Material and methods Between July and September 2015 we studied 502 patients from 30 municipalities situated in Northeastern Bulgaria about their opinion for the number of accessible medical diagnostic laboratories. We also drew a visual presentation of the spatial distribution of medical diagnostic laboratories in the region. Results Laboratories in Northeastern Bulgaria are unequally distributed and mainly concentrated in the regional centers and larger towns. Accordingly, most of the patients living up to 3 km from a medical diagnostic laboratory were satisfied from the number of available labs, while people living 3-10 km apart thought that laboratories are not enough. Conclusion The main reason for health inequalities in Bulgaria is the territorial imbalance between health care units. The increased need of health care and social assistance requires new resources to provide laboratory services via mobile lab offices and home visits. A better infrastructure of the outpatient health care in Northeastern Bulgaria and new players in the lab service market will assure equal access and favorable concurrent environment.