SURGICAL TREATMENT OF BREAST CANCER –A STUDY ON THE MARKET SEGMENT OF THE PRIVATE SECTOR IN BULGARIA
SURGICAL TREATMENT OF BREAST CANCER –A STUDY ON THE MARKET SEGMENT OF THE PRIVATE SECTOR IN BULGARIA

Summary/Abstract: This article aims to explore the market segment of private hospitals in Bulgaria, providing operational activities to health insured persons on the occasion of breast cancer. Methodology: the Pareto principle. Results: Thirty-nine private hospitals were studied in the following aspects: concluded contracts with the health insurance fund for treatment of breast cancer and volume of operative activity. Discussion: Contracts between private hospitals and the health fund for breast cancer surgery account for thirty-three percent and their activity for sixteen percent of other hospitals. Applying the Pareto principle, it was found that twelve hospitals, from university cities, make up twenty percent of the vital few where the activity is concentrated. Twenty-seven hospitals make up eighty percent with an operating volume between one and ninety operations. The most important "twenty percent of twenty percent" for breast surgery are formed by private hospitals in university cities. Eighty percent are hospitals that have performed about one hundred or one hundred and twenty surgical interventions in the four-year period, which corresponds to thirty operations per year or two and a half operations per month. Conclusion: The market segment of the private sector for providing surgical treatment of breast cancer is characterized by inefficient contractual process, distorted form of territorial organization, uneven distribution of financial resources (small private structures) and unreliable guarantees for the quality of surgical activity in the latter. The managerial connection between the two main elements of the health system is broken: "doctor (hospital) - patient".

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