PUBLIC HEALTHCARE UNDER THE PRESSURE OF DEMOGRAPHIC AGING
PUBLIC HEALTHCARE UNDER THE PRESSURE OF DEMOGRAPHIC AGING

Summary/Abstract: In worrisome days of the Covid-19 pandemic that humanity is experiencing, national health systems are under great trial. In the foreground are questions that cannot be delayed. Some of them relate to the organization andcapabilities of health care to adequately reflect the needs of aging people as one of the largest and most vulnerable population groups. Undoubtedlythe world is experiencing a period of dynamic demographic changes and aging population on the planet. Globally, half a century the number of people aged over 60 has increased more than three times to reach almost 2 billion in 2050, according to the UN expert's report. Naturally, the rates of aging vary across countries and regions. In this connection, the national health systems today are facing great challenges: the population grows older, healthcare becomes more effective, but more expensive, the requirements of patients to the quality of health services raise more and more. Support healthy aging means both maintaining health throughout life to prevent health problems and disabilities from an early age, and address inequities in social, economic and environmental factors. Bulgaria is ranked 6th in the world for its rate of population aging. The country has a high relative share of residents aged 65+ approximately 21.3%. Three main demographic factors are contributing to the rapid population aging: emigration, high death rates and low birth rates. Those demographic factors have created numerous political, socialand economic challenges for Bulgaria. In order to overcome them was developed a National Strategy for Demographic Development of Bulgaria for the period of 2012-2030. Positive fact is, that the gerontological and geriatric research in country has increased over the years. Large-scale studies, undertaken by our team of the Faculty of Public health in the Medical University-Sofia, referring to the different aspects of health cares for old persons, reveal major problem spheres in this direction. Purposeof the article is to analyze, summarize and indicate the priority actions to optimize the geriatric care in Bulgaria, based on results of this studies in the period 2007-2019year. Methodology:Included respondents are 2973 people, as follows: 1240 healthcare professionals; 1510 persons over 60 years, consumers of health care, 223 family members and nurses from12 nursing homes. Information was collected about their medical-social, educational and psychological problems. The following methods were used: documentary method; inquiry method; interview; statistical methods. Results: On the base of a critical analysis of the summarized results, we determined imperfections in the field of health care for older adults. There are considerable problems posed in front of the health services and social security institutions.Insufficient presence of gerontology and geriatrics in the academic spheres makes the development of adequate, modern geriatric structures difficult. Determined are the main reasons for the difficulties of health professionals in taking care for their patients. Medical specialists often lack the necessary knowledge and understanding into medico-social questions and problems posed by their older patients.Conclusions: The tendency is to increase needs and demands of society for quality health and social care of adults, carried out by competent professionals. The need for long-term services and supports in Bulgaria will continue to increase as the population ages.Health problems of older adults require new organizational approaches in health policy and practice. Recommendations: It is necessary to ensure appropriate conditions for achieving diversity in structures and levels of health care and the applicationof integrated approaches to prevention and treatment in order to achieve a better quality of life for aging population in Bulgaria.Approaches to addressing the challenges of geriatric care in Bulgaria are discussed.

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