General practitioners’ opinions on additional financing for work in the conditionsof an announced epidemiological situation

Medical Review (Med. pregled), 2023, 59(2), 49-55.

M. Djuglarska, T. Zlatanova, N. Popov, T. Petrova-Gotova, R. Yaneva, D. Shtereva-Tzоuni, E. Naseva, M. Lazarova

Faculty of Public Health, MU – Sofia

Abstract. The unprecedented restrictions placed in connection with controlling the COVID-19 pandemic lead to less activities being performed in primary health care (PHC), which lowered the National Health Insurance Fund’ contractual payments to the providers of PHC. In practice, the general practitioners (GPs) were one of the providers at the front of the fight with COVID-19. Additional financing for working in the unfavorable conditions of an announced epidemiological situation was negotiated to compensate the measured drop and the extraordinary workload in PHC. This was done with the Methodology of the National Health Insurance Fund (NHIF) from 2020. In this regard, the goal of the current research is to study the opinions of GPs on the additional financial stimulation introduced in the practice of PHC for work done in case of an announced epidemiological situation. The results of the questionnaire survey conducted among 394 GPs from the whole country – contractual partners of the NHIF – during the June 2022-October 2022 period, show that a share of respondents, who are happy with the measures taken for financial help in PHC practice, is small. As little as 12.2% of them find the rules about a payment of up to 85% of the determined base price in PHC to be fully adequate. The share of GPs, who are fully satisfied with the additional pay they received in the period November 1 2020-April 30 2022, is smaller (10.4%). A predominant number of GPs report an overall displeasure (dissatisfaction) with the compensation mechanism for the lowered workloads in PHC and the additional pay. A little over half the PHC practices covered (52.3%) have hired specialists in „Healthcare”, who were also financially stimulated with additional monthly pay for the period November 1 2020-April 30 2022. The rest (47.7%) work without hiring such specialists which further burdens the GPs. All of this necessitates policies to stimulate the work of GPs, both in financial and professional terms.

Key words: financial stimulation, epidemiological situation, PHC practices

Address for correspondence: Miroslava Djuglarska, e-mail: m.djuglarska@foz.mu-sofia.bg