• Kamelia Bogdanova Medical University – Sofia, Faculty of Public Health
  • Dimitrina Milikina Medical University, Sofia, Faculty of Public Health


nurse, healthcare, quality, management, skills


In our time, health services are in the focus of the public attention. Healthcare development depends on socio-economic condition and reflects the quality of life in different countries and regions around the world. Primary care is an important part of the national healthcare system, which is the first level of access for the patient. It is characterized by accessibility for the population, and its tasks are to provide health care, preventive care and health education. Primary care is essential for improving the population health and reducing the disparities in health status between different social groups. The functioning of outpatient medical establishments – diagnostic, consultative and medical centers providing primary care depends on the quality and efficiency of health services, as an important part of them is healthcare. Their management determines the level of work organization and depends on the professional skills and competencies of the managers. Healthcare managers must be able to exercise leadership and control in accordance with current socio-economic conditions and the nurse qualification. Clear determination of the activities, rights and responsibilities of healthcare managers is an important condition for increasing their motivation and the healthcare quality. Present paper discusses issues related to the healthcare management in primary medical care and required competencies and skills of managers for qualitive and effective health service. The aim of the study is to investigate healthcare management in primary health care. The object of the study is healthcare establishments for outpatient care. A sociological research method has been used, based on a direct individual survey among managers, healthcare professionals and patients. The results show a relation between staff motivation and the opportunities for qualification enhancing and career development. The organization and planning of medical examinations are the most important factor for patient satisfaction with the quality of primary care. Ensuring the necessary number of qualified healthcare professionals and clear regulation of the rights and responsibilities of managers is a prerequisite for provision of health services in conformity with patient requirements. Patient recommendation for increasing the number of healthcare professionals is confirmation for the nurse role in the healthcare system. In accordance with this, healthcare institutions should conduct events and create conditions for continuous improvement of the qualification of health care managers and professionals. All of this, directly or indirectly, affects patients' satisfaction with the healthcare services provided by the hospital and determines its economic stability under free patient choice and a market economy.




How to Cite

Bogdanova, K., & Milikina, D. (2020). HEALTHCARE MANAGEMENT IN THE PRIMARY MEDICAL CARE AS A FACTOR FOR QUALITY AND SUSTAINABLE DEVELOPMENT. KNOWLEDGE - International Journal, 40(4), 807–814. Retrieved from

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