The suspended scheduled admission and limits emptied their accounts
Gotse Delchev treats patients with the money allocated for raising the salaries of doctors and nurses
From Monday, the NHIF started paying for the activities performed
The 120 municipal hospitals in the country – those closest to the people – are in their worst financial situation in the middle of winter and a pandemic.
They represent 38% of the medical institutions in our country
The reason – they are flooded not one, but at least three waves, and not just COVID.
At the moment, the planned admission – the main source of funds – has been suspended again. For the last year and a half, they have been treating mainly patients with coronavirus, from which they are at a loss, as the funds paid by the fund do not cover the real costs for such a patient. Separately by the NHIF for December 2021 the limits were cut. The prices of medicines, consumables, food products are rising. And finally came their electricity bills, which are about 3 times higher than in December last year.
In such a situation is the largest municipal hospital in the country – Sofia Hospital “Princess Clementina” (formerly Peta).
On the one hand, prices are rising – for electricity, medicines, medical supplies, food costs for patients and staff, etc. In addition, the limits for December were cut by over 30% “, explained to” 24 Chasa “its director Dr. Boril Petrov.
Due to the accumulated problems, the mayor of Sofia Yordanka Fandakova had a first meeting with the Minister of Health Asena Serbezova. Then the directors of the municipal hospitals as well
have met with Prof. Serbezova, who is committed to solving the problem.
“The National Health Insurance Fund has taken measures and today we have already received additional payment for part of the funds for December,” Dr. Petrov stressed on Tuesday.
As of January 28, the regional health insurance funds started paying the funds in full for all activities prepared and reported by the medical institutions for hospital medical care.
The reason for non-payment of the limits are the new rules under which the NHIF operates until the adoption of the budget for 2022. The monthly budgets of hospitals are determined on the basis of what they actually made last year. At that time, however, their activities were even more reduced due to the pandemic, and there was a suspension of planned admission, which led to a reduction in patients. At the moment, the planned reception in the capital and half of the districts has been suspended again due to the peak of the omicron wave.
Annually, one covid ward in a large municipal hospital accumulates a loss of about BGN 1 million,
the metropolitan medics calculate. As “24 Hours” has already said, the clinical path does not cover all the costs of treating such patients. In addition, it is short – usually people with bilateral bronchopneumonia enter the hospital, unvaccinated, with concomitant diseases who are late in seeking treatment. Thus, huge costs were incurred for the implementation of adequate therapy, and discharge was reached only after about 2 weeks. However, the clinical path is 5 days for uncomplicated and one week for more severe cases.
The treatment cost BGN 2,300-2400 per person, and the cash register trail costs BGN 1,400, doctors explain.
Oxygen alone costs BGN 18 per minute.
Another problem is that medical institutions are still
do not yet know what their limits will be for January and
February
“We have received an assurance from the National Health Insurance Fund that they will find a way to compensate us. So far, we are able to cope without accumulating debts, but this is only because the hospital is financially stable, “said Prof. Tsvetomir Dimitrov, director of the University First Hospital in Sofia.
The Sofia Municipality provided targeted subsidies to cover the costs of electricity, water, heating, medical supplies and medicines to the 4 municipal hospitals in 2021. Separately, about BGN 150,000 were allocated for the purchase of more equipment for the treatment of patients with COVID .
But then came the electricity bills. First MHAT paid BGN 12,441 in November 2020, and BGN 37,032 in November 2021, or a jump of 198%.
In the Knyaginya Klementina Hospital, the electricity cost BGN 15,326 1 year ago, and this December – BGN 47,719, or
the increase is 211%
“We have nearly 200 suppliers. For now, we manage to cope with the help of our principal – the Sofia Municipality, but we are on the edge. It is necessary for the state to intervene and help the hospitals “, appealed Dr. Petrov.
According to the government’s decision, hospitals will also receive compensation, as is the case for all non-residential subscribers. However, Plovdiv’s Sveti Mina has received less than 20% compensation for the expensive electricity, so far only for October and November. For October – BGN 3,300 with an account of BGN 15,000, for November they transferred BGN 2,700 with an account of just over BGN 15,000, explained the manager Prof. Petar Petrov. There are no compensations for gas.
“We are trying to handle the available resources, but it is very difficult for us and we are cutting costs,” he said. Such is the picture in the other Plovdiv municipal hospital “St. Panteleimon ”. She received compensation of BGN 110 per megawatt-hour for October and November only. “We will not have to reduce salaries,” said director Konstantin Sapundzhiev.
BGN 50,000 is the electricity for December of the Complex Oncology Center in Burgas, which is part of the municipal health care – 5 times increase compared to last year. Since October, when the bills jumped, they have received a one-time compensation of BGN 13,000 from the state.
“In order to cope, we need to increase the payment on the trails
from the health insurance fund, says the manager Prof. Hristo Bozov. He reminds that the problem is also in the increase in the price of medicines and gives an example with the antibiotic “Meronem”, used in severe cases of COVID, which from 9 became BGN 14.
“We are heating with gas, but it has become more expensive and our bill is about BGN 26,000. Until last year we were heated with pellets and switched to gas for supposedly cheaper, but it turned out that it is no longer,” he commented. the manager of the hospital in Gotse Delchev Petar Filibev.
The money he has as a limit from last year’s budget is only enough for salaries. The hospital already has BGN 200,000 in costs above the limit. “We hope that the promises that our expenses will be paid will be fulfilled. If this does not happen in February, we will have paid for the treatment of 150-200 patients per month. We have a small reserve from 2021, when we made a profit and the municipal council decided to increase salaries by about 20-25%. We are currently using this payment reserve. We have a lot of sick people, and that means a lot of expenses. Drug providers tell us that we will receive the medication once we pay. They don’t want to wait anymore. The big state hospitals can afford to accumulate tens of millions of debts, but no one is waiting for us to pay, “said Dr. Filibev.
First MHAT in Sofia puts photovoltaics on the roof
Both clinics are building their system because of the high bills
The Sofia Municipal First Hospital is about to become the first with photovoltaics on the roof, 24 Chasa has learned.
“We are working on the preparation of a project for the construction of photovoltaics. The reason is the growing electricity bills that the hospital pays. We have to find a solution “, announced the director of the University First MHAT” St. John the Baptist ”Prof. Tsvetomir Dimitrov.
Engineers and consultants are already working on the preparation of the project for the construction of photovoltaics on the roof of the medical institution.
A similar idea was considered by the director of the largest municipal hospital in Bulgaria – MHAT “Princess Clementina” – Sofia, Dr. Boril Petrov. The problem, however, is the large area of the hospital. Roughly speaking, it turned out that the construction of a photovoltaic system requires an initial investment of about BGN 800,000. The amount is unaffordable for the hospital.
In 2001, the Sofia Municipal Council supported the initiative of the managers of DCC 22 and DCC 12 to purchase and build photovoltaic systems for the needs of the two clinics.
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