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One of the most significant characteristics on which the Bulgarian social health care system competitiveness depends is the level of decentralization. In this study the authors explain a methodology for estimating the level of decentralization by using the knowledge of the so-called performance measurement system (PMS). The established theoretical model is tested among health care managers in 78 sub-divisional units randomly chosen among the Bulgarian health care system – facilities and hospitals. There have been made several conclusions that could be a base for future research and discussion.

The Level of Decentralization Impact on the Bulgarian Social Health Care Competitiveness.