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Национална здравна карта - правно регулиране и реалност

E. Aтанасова, M. Вълканова, M. Рохова


Introduction: According to the Health Care Establishments Act the planning and distribution of health care establishments are based on a territorial principle outlined in the National Health Map and district health maps. The National Health Map is a strategic planning tool whose adequate implementation should guarantee both accessibility of health care services and efficient resource use.

Aim: The aim of this study is to explore and follow the development in the regulations on the National Health Map and to analyse the disproportions between real health care professionals and envisaged needs of health care workers in the six planning regions of the country.

Materials and Methods: We have applied a documentary method for analysing the regulatory framework. The study uses data from the elaborated district health maps according to a Decision of the Council of Ministers 202 of 2016.

Results and Discussion: Over the years, various attempts have been made to update the National Health Map. In 2015, the new Methodology for elaboration of district health map was approved and published on the website of the Ministry of Health. The analysis of district health maps shows that the largest shortage of general practitioners is in the eastern part of the country (Northeast and Southeast regions). Regarding the specialists, there is no deficit in the regions. The nurses in all regions are significantly below the needs defined by the new methodology.

Conclusion: The National Health Map determines only the distribution of physicians and health care establishments by district, but does not provide the mechanisms under which they can be secured. The decision of the Supreme Administrative Court of 12.05.2017 denies the validity of the National Health Map as a normative administrative act and proclaims its nullity. This poses new questions whose answers are forthcoming.


National Health Map; health professionals; needs; access; Bulgaria

Full Text


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Определение № 417 от 13.01.2017 г. по адм. д. № 11752/2016 г., vі отд. на ВАС 5. Определение № 7447 от 21.06.2016 г. по адм. д. № 6342/2016 г., 5 чл. с-в на ВАС

Решение № 1193 от 18.09.2013 г. на Комисията за защита на конкуренцията

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Решение № 5935 от 12.05.2017 на ВАС

Рохова М. Намаляване на неравенствата в достъпа до регионална здравна мрежа. Дисертационен труд. ИУ-Варна, 2014.


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