The study of inpatient health care utilization and its determinants provides an opportunity to manage the consumption of healthcare services and related costs. This is of great importance for hospital care in order to reduce overutilization, improve efficiency, and ensure the financial stability of the sector.
The aim of the study is to analyze the determinants of inpatient healthcare utilization in Bulgaria.
Andersen's behavioral model of health service use was applied in order to examine the factors affecting inpatient healthcare utilization. The model includes three main groups of individual factors: predisposing, enabling, and need characteristics.
An online survey was conducted among Bulgarian citizens regarding hospital admissions during the last 12 months. Descriptive statistical methods were employed, and the presence of statistically significant differences in utilization, verified using the χ2-test of independence, was investigated. Differences in mean utilization between respondent groups were also analyzed.
Statistically significant differences were found in the use of hospital care associated with age, employment status, trust in healthcare providers, household income, self-rated health status, and the presence of a chronic condition. The share of those who used hospital care was higher in the age group 45–64 years, among individuals unable to work due to a disability, respondents who trust to a very large extent in hospital facilities, respondents who have a household income of less than BGN 700, and those who have very poor self-rated health or have one or more chronic conditions. The results show a higher mean utilization of hospital care among respondents with lower incomes and those with chronic illnesses.
A comparison of these results with studies conducted during the COVID-19 pandemic shows a higher utilization of hospital care in the post-pandemic period. This could be explained by delayed and postponed care and the recovery of the volume of activities following the easing of restrictive measures.
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