Spatial analysis of the healthcare system at a regional level: A case study of the Kyustendil district

Healthcare is an activity of great humanitarian and social importance. Good health is a right of every human being, an asset and a source of economic and social stability. The health status of the population is crucial for reducing poverty and at the same time contributes to sustainable territorial development. Despite the established principles of accessibility and equality in the use of medical assistance and the existence of a valid health card, our research has shown that the population has different access to facilities and centers for medical assistance at the regional and local level. The localization and concentration of healthcare facilities and all other elements of the healthcare system in the studied Nomenclature of territorial units for statistics (NUTS) 3 area—the Kyustendil region, Bulgaria—are tied to the largest  ities in the region and the administrative centers of the municipalities. This poses a problem for the population from the remote settlements of the district, which has considerable difficulties in obtaining medical care even in emergency cases and in accessing specialized hospitals, laboratories, etc. The geographical characteristics of the area have a significant impact on the time needed to cover the distance between the villages and the towns where the health facilities are located. Hence the specific case study to solve this problem at the local and regional level. The conducted research tries to solve this case study, which was made in the studied area, but is also relevant for many other areas in Bulgaria. It is important to note that the Kyustendil region has very good indicators of health infrastructure and supply of health professionals, which make it one of the leading places in Bulgaria. However, part of the population of the district has very difficult access to the healthcare system, which is the main reason for the higher premature mortality due to diseases, especially among the population living in the villages. An in-depth spatial analysis of the territorial location of all elements of the health system and the provision of specialist doctors was carried out. The results obtained are visualized through graphics and a map created with GIS software.