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Journal of the Union of Scientists - Varna. Medicine and Ecology Series

The clinical pathway in Bulgaria - the disappearance of management processes

Darina Stefanova Mineva


The problem of assessing the quality of services is becoming more urgent due to the fact that in economically developed countries the share of services in the gross domestic product is increasing. This trend is a consequence of the change that the economy and society are undergoing, namely: the transition from a 'capital economy' to a 'knowledge economy', where the most important resource is qualification and experience, and in relation to the quality of health services and their evaluation.

This article aims to present a change in the algorithm of the clinical pathway tool, years after it was introduced as a quality tool, and thus to answer the question "Is it possible to evaluate the quality of the hospital process by the funding body (National Health Insurance Fund in Bulgaria), nineteen years after the beginning of the reform of hospital care?”

The modern and basic assumptions in quality management are considered: what is meant by quality today, what is the process and its importance, the evolution of the algorithm in the clinical pathway from a management process to simple instructions, to define the factors and the reasons for the change in the clinical pathways in Bulgaria and the disappearance of clinical processes.

An analogy was drawn between the set quality requirements in the clinical pathway structure with the established quality standards, namely: the quality triad. Attention is paid to the change in the management of the clinical process and its disappearance under the influence of the evolution of a reform.


reform, clinical pathway, processes, quality of medical service

Full Text


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