Geriatric care in Bulgaria: current status, systemic challenges and reform potential in the context of digital transformation

Abstract

Abstract. Geriatric care in Bulgaria is undergoing a complex transformation driven by accelerated ageing of the population, increasing multimorbidity, and a growing need for long-term support. The analysis identifies major systemic barriers, including fragmentation between health and social services, the absence of a unified regulatory framework, insufficient development of home and community-based care, workforce shortages, and limited digital infrastructure. The lack of interdisciplinary teams and standardized comprehensive geriatric assessment (CGA) contributes to inefficiency, frequent hospitalizations, and reduced continuity of care. Despite these constraints, Bulgaria demonstrates emerging efforts in active ageing policy, community services, and digital health tools, although their impact remains limited. Digitalization and artificial intelligence present significant opportunities for improving access, coordination, and quality of services, but their implementation requires strong ethical, legal, and human-centered foundations. A transition towards an integrated care model, expansion of community-based services, professional training, quality regulation, and support for informal caregivers is crucial to ensure equitable, humane, and sustainable geriatric care in Bulgaria.