Integrated Cancer Care in Bulgaria: the Cancer Networks

Key Contextual Factors

• In the 1960s, oncological care was provided only by oncological dispensaries, coordinated by the Ministry of Health.
• The oncological dispensaries were distributed on a regional base throughout the whole country.
• The oncological dispensaries served as specialized medical facilities providing the whole spectrum of oncological care services for patients.

Key Components/Steps

• Due to political decisions, the current Cancer Network was established in the 2000s, including the seven CCCs, the University Specialized Hospital for Active Treatment in Oncology in Sofia, as well as cancer clinics at multidisciplinary hospitals (some of which are private ones).
• There are no fundamental differences in terms of medical services within the CCCs, the specialized hospitals and the cancer clinics at multidisciplinary hospitals. All of them are coordinated by the Ministry of Health, with most of the funding coming from the National Health Insurance Fund.

Main Impacts / Added Value

• The new Cancer Network ensures key oncological service delivery settings (i.e., CCCs, specialized oncological hospitals) are geographically spread among all the 28 regions in the country (one centre for 2-3 regions).
• The Network improves cancer patients’ access (in terms of availability of services and time) to the healthcare system.
• Patients have the right to choose the oncological service delivery setting throughout the country where they want to be treated.

Lessons Learned

• The Cancer Network aims to provide timelier and more convenient access to oncological care for all cancer patients.
• However, the interaction between the different types of care (e.g., hospital care and social institutions) is still weak, which is mainly due to their different status, responsibilities and subordination to different departments.
• All oncological service delivery settings within the Cancer Network need to continue to develop the network such that it can operate more effectively and efficiently for cancer patients.

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