In Bulgaria, the quality management system in healthcare does not work and is not functioning. This was stated in “Face to Face“ on bTV by Andrey Markov, a member of the Management Board of the Bulgarian Hospital Association. The conversation is a continuation of the topic of the number of medical institutions in our country, the financing of the system and the quality of medical care.
Former Minister of Health Petar Moskov stated that of the existing 340 hospitals in our country, no more than 100 are needed to ensure quality, continuity and urgency.
“The number 100, in my opinion, is quite coincidental. It would be a good solution, but with the current system, there is no way this will happen“, commented Andrey Markov.
According to Markov, one of the main reasons why patients do not feel an improvement in the medical service is the lack of an effective quality control system.
“Why are patients not satisfied with the quality of the service? Because the quality is not good. Fact“, he said.
According to him, in Bulgaria a common quality standard is used for hospital accreditation, while in a number of countries there are specific standards for healthcare aimed at patient safety.
“Those hospitals that implement them manage to achieve guarantees for quality and patient safety. The rest is just wishful thinking,“ Markov pointed out.
According to the representative of the Bulgarian Hospital Association, the claim that healthcare funds in our country are abundant is a myth.
“As funds needed for modern medical services and modern healthcare, they are half of what we spend as a nation and as a state“, said Markov.
According to him, public funds cover about 51% of total healthcare costs, and the rest is paid by patients. This, according to him, puts people with chronic diseases, the disabled and patients who need complex interventions and long-term treatment in the most difficult situation.
As a possible solution, Markov pointed to a change in the financial model.
“This question has two possible answers. One is an increase in healthcare contributions. The other is the development of additional health insurance,“ he explained.
According to him, similar models work in a number of European countries, including Germany, France and the Netherlands.
“We want the quality of European healthcare, but we are not creating the basis on which this system can stand“, said Markov.
Another problem, according to him, is the way in which the healthcare system in our country is organized.
“Hospitals are interested in hospitalizing everyone who shows up at the door“, commented Markov. He also raised the question of why patients seek medical care mainly in medical institutions, instead of in pre-hospital care. “Why do we go to a hospital for tests? There is no such situation in developed countries“, he said.
Markov also gave an example with the so-called one-day surgery. According to him, in a number of countries, patients are admitted in the morning and leave the hospital a few hours later. "In our country, they stay for three days, because that's how long the clinical pathway is. Some clinical pathways require a minimum stay, which is not necessary," he explained.
The issue of the large differences in the prices at which medical institutions buy medicines was also touched upon. Markov said that he supports electronic auctions.
“We are firmly “in favor“. Here again, the problem is in the management of the system,“ he pointed out.
According to him, when the regulatory framework allows a hospital manager to save or receive more funds, he will use this opportunity.
“The one who gives the pie is the culprit. And this is the law and the deputies who made it,“ said Andrey Markov.