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The significance of control increases with the push towards improving the overall effectiveness of the health insurance system. In order for public resources to be spent lawfully and effectively, there needs to be increased control not only from the National Health Insurance Fund (NHIF), but citizen control also needs to be incorporated in the process. Materials and Methods The goal of this survey is to analyze the opportunities for implementing citizen control over the spending of public health funds and compare them to the real conditions as far as the outpatient medical care level. Legislation and news from NHIF’s webpage related to citizen control opportunities were studied. A direct, anonymous survey was carried out on the Google forms platform amongst Bulgarian citizens past the age of majority. Results The results of the questionnaire survey carried out between 24.06.2022 and 16.10.2022 among 1045 adults with compulsory health insurance from all over the country, showed that they were poorly informed on the opportunities for citizen control which have been regulated and created in practice and don’t take advantage of them. Only 45,6% of the participants were aware of the digital services “Record review for health-insured persons”, which is found on NHIF’s webpage, and less than half of them (42,8%) used this service. The NHIF’s mobile application for feedback was used by as little as 11,8% of the respondents, and only seven patients have used it to share an opinion, while nine have used it to get notifications for data changes in their patient record. The portion of participants who have taken part in NHIF inquiries was also very small – 2,5%. Merely 2,8% have posted a complaint to the NHIF after being denied medical services. Conclusions All of this makes it evident that a change is necessary in order for citizen control to be strengthened as a mechanism. This will lead to the correction of proven deviations in reported medical activities and will make it easier to get the patients’ opinions on the medical care they have been provided with.

The objective of the present study was to investigate the opinion of the managers working in the health system concerning their attitude towards the operations of control within the system and the impact of these operations on the activity of the health-care institutions. Materials and Methods: From October 2016 till January 2017 using an anonymous questionnaire we studied the opinion of 407 medical doctors, medical and healthcare specialists working in various types of healthcare institutions for hospital care in Sofia and the countryside. Results: Only 1/5 of the respondents shared the opinion that the adequate control resulted in quality improvement of the provided medical caregiving, one in four (25,8%) believed that the control could raise the responsibilities of the officials with managerial titles; one in three (34,2%) shared the opinion it improved the responsibilities of the executives. Conclusion: The new operational terms and conditions implemented in the health insurance system do not result in improving the work quality in the hospital, which allows the conclusion that by changing only the healthcare funding the desired positive changes could not be attained. The organization, management and provision of medical care should be generally revised.