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Background/Objectives: One contemporary problem in health economics is the measurement and interpretation of socioeconomic inequalities in outcomes, utilisation, and resource distribution. This article aims to estimate socioeconomic inequality in the regional allocation of health resources in Bulgaria during 2019–2023. Methods: A year-by-year database was created. It includes regions (n = 28), population, GDP per capita, and the numbers of practicing physicians, dentists, nurses, midwives, hospital beds, and outpatient facilities. Income inequality is analysed using decile ratios, the Gini coefficient, the Generalised Entropy index, and the Atkinson index. Socioeconomic health inequality is quantified using the concentration index (CI) and the coefficient of variation (CV) of the absolute number and of resource density (per 1000 inhabitants). The socio-economic variable is a regional gross domestic product (GDP) per capita fractional rank and a frequency-weight approach to account for population size is used. The analysis is extended with the relative and slope indices of inequality. The CI of hospital beds, practicing physicians, and nurses is decomposed using the age dependency ratio and the number of hospitalisations by districts. Results: The Gini index levels remain stable, with no significant fluctuations, in the narrow range of 29.6–29.7. The highest inequality of the absolute resource’s quantity is among midwives (Mean CI = 0.498, CV = 0.018), and the lowest among nurses (Mean CI = 0.442, CV = 0.024). For material resources, a greater concentration of outpatient organisations in richer areas is observed (Mean CI = 0.481, CV = 0.035) than for hospital beds (Mean CI = 0.427, CV = 0.034). The dynamics and descriptives of inequality of resources’ density follow the same pattern, but with lower average rates, ranging from 0.045 to 0.112. The obtained estimates are statistically significant (p < 0.05). The analysis of the regression-based measures confirms, without any doubt, both the magnitude and the direction of the development of inequalities in the territorial distribution of health resources. Conclusions: Inequality measures vary by resource group. Significant inequality exists in the distribution of health resources between poorer and richer regions, particularly in material resources, in the outpatient sector. For most resource groups, a very slight decrease in inequality is observed midway through the analysed period. The most significant part of this inequality can be explained by differences in hospital care and income across richer and poorer regions.
Nikolay Atanasov (Thu,) studied this question.