Problems and tendencies in management optimisation of hospital sector within health care system of Republic of Bulgaria

The aim of the article. The purpose of this article is to analyze the specifics, priorities and tendencies of the reforms in hospital sector management within the health care system of Republic of Bulgaria, the hospital care organization practices in relation to the National discussions on issues of hospital sector of the health care system.The results of the analysis. The accession of Republic of Bulgaria to the EU has created new conditions in defining the priorities in the area of public health care, including hospital medical aid. Summarizing, accumulation and transfer of experience in reforming of health care systems of the European Union member states, development of unified requirements, harmonization of legislation, financing, structure of functioning and management of hospital care within the health care system, lead to the need of deep analysis of situation, strategic priorities renewal, management optimization of whole health care system, and in particular the hospital care system in Republic of Bulgaria.In the article the author analyses the research and publications of some major materials, regulations and documents, which provided the basis for the reforms in the health care management system in Republic of Bulgaria in its continuing integration into the pan-European system. Illustrating current situation analysis, the author shares the opinion that the most important part in the organization of common management system in health care is the sector responsible for the development of hospital financing.The author pays special attention to the issues of economic activity of health care institutions.The author cites a number of documents of the National Centre for Medical Information (NCMI) noting that leading specialists of the Centre: .Dikov, R.Kolarova, T.Hundurzhievhave prepared detailed reports on economics 2001-2008 and comparative analysis of the medical institutions operation as well as those for outpatient care in Republic of Bulgaria over the period 2001-2009, published in NCMI Bulletin No10. The analysis of the published report coincides with the general development trend in the area of health care in the EU and corresponds to the hospital care development forecasts in theRepublic of Bulgaria to 2014. The priorities of financing hospital care in the EU and theRepublic of Bulgaria are discussed by G.Komitovand, S.Genev.Considerable attention is paid to health care issues in the hospital sector of Bulgaria. These are analyzed in the context of European reality and priorities, discussed at regular scientific and practical forums. As an example, directly relating to this publication, the author speaks of the Fifth national conference Information technologies and relations in health care challenges of the 21st century, held in Sofia in 2009.The author notes that the major role is played by the Government and the National Assembly of Republic of Bulgaria in the process of reforming health care and expresses its agreement on the importance of issues related with economy in health care. Regular documents on national and institutional level analyse the condition and the perspectives of development and restructuring of the hospital sector in Bulgaria.Analysing dynamics of hospital inpatient care in the European countries and RB the author finds similar tendencies, coinciding with data given by other authors [8; 13] and demonstrates analogous trends, connected with cost reduction in the hospital sector over the past 20 years by 55% to 30-35%. The author agrees with other researchers, that the tendencies are determined by the following major macro- and microeconomic changes: restructuring of medical services;reduction of the hospitals number (except for Bulgaria and Romania, where an increase is found related to the increased demand for certain hospital services); reduction of budget expenses for hospitals financing; increased efficiency and rationality of hospital medical care; improved hospital management, mainly due to increased responsibility and competence.Conclusions and directions of further researches. The article presents data on innovation priorities and tendencies in the European systems and the reforms in the sphere of health care in choosing a National health care strategy for the period of 2008-2013. The provided material gives us a clear and comprehensive idea of the documents regulating the management and the discussions, held on this issue, thus ultimately allowing the definition of future perspectives in reformation of hospital care in Bulgaria and its synchronization with the European practice.