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Health Economics and Management

Partnerships in Bulgarian Hospital Sector – Practice and Development

Boncho Mitev


Introduction. In recent years, hospitals in Bulgaria have been operating in resource constraint and highly
competitive environment, which hindered their operations. Collaboration in the hospital sector provides opportunities to
address environmental challenges and facilitates the access to resources and new markets. The aim of this article is to
analyze the partnerships between hospitals and other organizations and to evaluate their development in Bulgaria.
Materials and Methods. The study was conducted in 2016 among senior managers of 71 hospitals in Bulgaria. Using
the survey, the previous experience of hospital managers in the implementation of partnerships, attitudes and motives for
cooperation with other organizations is analyzed.
Results and Discussion. The results of the survey indicate that all hospitals participate in some form of partnership with
other healthcare and health establishments or organizations outside the healthcare system. Most often, they cooperate
with external service providers, other Bulgarian healthcare establishments, as well as with providers of medical equipment
and supplies. Hospitals cooperate with other hospitals mainly to share necessary resources (specialists and equipment)
for their medical activities. They tend to have limited cooperation with their direct competitors mainly to exchange
staff and have more patients. Hospital managers define their partnerships as successful in terms of results achieved.
Conclusion. In the hospital sector in Bulgaria, co-operation is widely used as an opportunity to share resources and
risks with other organizations. Partnerships with foreign hospitals that have the potential to improve the competitiveness of Bulgarian hospitals have not yet been sufficiently developed.


hospitals; partnership; motives for cooperation

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