ABSTRACT: Improving the efficiency of health care systems is a key policy objective in most European countries in order to reconcile growing health care needs with limited public (and private) budgets. Efficiency is proving to be the biggest challenge in the health system performance assessment in many countries. The aim of the report is to propose a set of indicators suitable for assessing the efficiency of the Bulgarian health care system, based on an analysis of the most used efficiency indicators in the health care system in different countries. A content analysis of national conceptual frameworks for health system performance assessment was conducted. Reports of international organizations and authors' collectives related to health system performance assessment were also studied. A total of 217 efficiency indicators were identified, of which 107 without recurrence. The most frequently used are 24 indicators. In many of the sources used, indicators were not grouped according to the types of efficiency they indicated. For the purpose of assessing the efficiency of the Bulgarian health care system, it is suggested that efficiency should be considered in three main directions - allocative, technical and inefficiency. A set of indicators is proposed to assess the corresponding directions of efficiency. The analysis of efficiency at the system-wide level should be considered only as a starting point. Efficiency needs to be analysed in a comprehensive way, including analysis at the sub-sector (meso) level as well as at the disease-based (micro) level. The development of a set of indicators to assess the efficiency of the health care system, which to be subject to continuous monitoring, analysis and disclosure, can make a key contribution to improving system-wide performance.

Keywords: indicators, efficiency, health care system

Download full text as PDF file