The quality of medical services is a key indicator of the health system’s success. Traditionally, it has been assessed through the accessibility and effectiveness of services provided. However, modern approaches emphasising the real impact on patient health measure it through health outcomes (clinical, CROMs, patient-reported outcomes, PROs). This shift from process-oriented to outcome-oriented models is at the heart of the concept of patient-centred healthcare. Outcome-oriented approaches are a key element in improving the quality of healthcare services. Patient-centred healthcare shifts the focus from quantitative indicators to the real impact on health, combining clinical outcomes and cost-effectiveness. By implementing strategic measurements and incentives to improve outcomes, health systems can deliver better added value for patients and contribute to sustainable development in the sector.

Albert Hirschman (1915–2012) was an economist known for his influential interdisciplinary social science models. In the 1950s, he developed the theory of unbalanced growth, which changed development theory. Hirschman argued that partial effects induced by targeted investments can have positive economic impacts on the development of national economies. In another behavioural model – exit and voice, he explains how dissatisfied individuals can react and how these reactions may affect the quality of output provided in both private and public goods. Hirschman's ideas have been incorporated into many concepts in the social sciences.

Nobel Prize laureate in economics Friedrich von Hayek (1899–1992) was interested in the way rules are formed and how they are understood. This approach is referred to as the theory of spontaneous order. It sees the evolution of social rules as the product of numerous interactions, the consequences of which are often unintended. At the same time, it investigates the spontaneous emergence of conventions concerning the ownership and division of valuable resources. Such conventions concern non-legislative rules of conduct, construed as impersonal or anonymous norms that are based on unorganised, informal sanctions. There are contexts in which coordination occurs spontaneously, without the intervention of any legal structure. A degree of assonance can be seen between Hayek’s spontaneous order and the conventional approach.

Despite the accumulated evidence that national culture influences the financial decisions of households across the European Union, there are relatively limited quantitative studies about its impact on the distribution of assets between secure deposits and riskier investments. This study examines whether Hofstede's six cultural dimensions contribute to explaining this phenomenon by analysing their effect on the financial behaviour of European households, measured by the share of investments in deposits and investment funds. Regression analysis statistically validates the claim that individualism is negatively associated with the relative share of deposits, while uncertainty avoidance has a positive effect on this share, indicating a stronger orientation towards security. Conversely, motivation towards achievement (masculinity) and individualism are positively associated with participation in investment funds, suggesting a higher propensity to take risks in individualistic and ‘masculine’ cultures. Power distance, long-term orientation and indulgence do not show any lasting effects. The results confirm the importance of cultural archetypes as factors determining the distribution of household assets and highlight the need to integrate them into the development of behavioural finance-based policies.

The article presents the results of a study on the relationship between minimum wage increases in  Bulgaria and the dynamics of the so-called "working poor". It is assumed that setting the minimum wage amount as a fixed percentage of the national average wage – and therefore imposing it centrally through administrative channels and with limited participation of social partners – weakens the potential of this policy tool to achieve a sustainable reduction of the in-work poverty rate. Applying a single-factor regression analysis of the association between the ratio of the minimum wage to the average wage in the country (Kaitz index) and the share of working poor, it was found that there is a statistically significant positive association between the two variables. In other words, the higher the Kaitz index, the higher the share of working poor. This finding is important for the debate on the procedure for determining and updating the minimum wage in the country. It also highlights the need for public authorities to make targeted efforts in promoting the development of scientific knowledge on the economic and social effects of the minimum wage in a national context.

The purpose of this paper is to trace the contemporary condition and mutual dependence of e-commerce and courier services, as well as perspectives for their development. Thus, it is necessary to examine the current state of e-commerce and courier companies faced with the challenge of working together to achieve high market shares and satisfy customer requirements, both in terms of products exchanged with sellers and services provided by couriers. Based on research carried out for the 2014–2024 period, we reach the conclusion that the trends for both e-commerce and courier services have been positive, with trade ahead in its development. The main prospects we associate with the future of courier services concern a reduction of human participation in delivery processes under the influence of technological developments in the form of robotics, artificial intelligence, big data and analytics, transport management systems, etc.

The present article addresses a problem which is an extremely important, relevant, and under-researched topic. As a whole, Europe lags behind China and other technologically advanced countries in the field of artificial intelligence (AI) and digitalization; Bulgaria is among the worst places in the EU in terms of digitalization of the economy. This research contributes to understanding the social and economic significance of digitization and AI in the EU after COVID-19. The emergence of artificial intelligence in the socio-economic landscape of EU member states, coupled with accelerated digitalization, heralds a new era in their development which is anticipated to enhance productivity, innovation, and efficiency. This article aims to study and analyse the theoretical foundations as well as empirical and legal developments concerning the socio-economic effects of Europe's "digital decade" and the applications of AI in a post-pandemic era. SWOT analysis was conducted to pinpoint the strengths, weaknesses, opportunities, and recommendations associated with the use of AI in EU countries. Conclusions and recommendations are provided for implementing suitable state interventions, transforming the pandemic's challenges into growth through new technologies, and helping to achieve a high standard of living in all EU nations.

This study examines the entrepreneurial attitudes, intentions, and activities of students in Bulgaria based on data from the global empirical research project GUESSS 2023. A total of 1,742 students from 31 Bulgarian universities participated in the survey. The analysis focuses on young people's career preferences, the factors influencing their entrepreneurial motivation, and the role of the university environment. The results show that 22% of students intend to start their own business immediately after graduation, with this share increasing to 37% within five years. Special attention is given to the impact of entrepreneurship education, institutional support, and family entrepreneurial background. The article also includes a comparative analysis of Bulgaria in relation to both global and European trends, along with specific recommendations for promoting student entrepreneurship.

This study analyses the economic and agroecological efficiency of sustainable agricultural practices within the context of industrial grain production in Bulgaria, in alignment with the objectives of the European Green Deal. Using a case study approach over two cropping seasons (2022–2024), the impact of implementing three innovative practices were assessed: (1) stabilized urea with urease and nitrification inhibitors (NBPT and DCD), (2) cover crops (vetch, clover, radish), and (3) minimum tillage (no-till). The research was conducted under real production conditions on a farm with a strategic crop rotation – wheat, maize, and sunflower – applied across 270 hectares of experimental land annually. The methodology incorporates economic indicators (profitability, ROI, NR), agronomic parameters (yield, protein, starch, oil content), and environmental metrics (organic matter, microbial activity, NUE) using quantitative analysis, statistical processing, and data triangulation. The results show that the application of inhibited urea leads to the highest nitrogen fertilization efficiency (up to 64.4 kg/kg N) and profitability (up to 217.1%), while cover crops and no-till improve soil fertility and reduce costs. The studied practices demonstrate a high degree of adaptability and economic viability in the Bulgarian context, offering strong potential for transitioning our agricultural systems toward a sustainable model with reduced emissions, optimized resource use, and enhanced soil function.

There is a growing need to update labour processes in leading Bulgarian enterprises. This has become a vital condition for their sustainability and prosperity and involves integrating tailored new approaches, including management methods such as "design thinking" to make use of the human capital available in the country (young employees, new users and partners). It has provoked the search for and creation of a model highlighting the impact of "design thinking" in all business endeavours wherein the activities of relevant stakeholders and managers are a decisive factor influencing the degree of design integration with business practices in the company as a whole. Based on a detailed review of the literature on the topic, definitions of the "design thinking" concept were systematized from the point of view of its practical application in corporate management. Successful methodological practices were studied, resulting in the development of six tools appropriate for resolving various business issues and supporting the activities of managers. The developed model regarding the impact of "design thinking" on business outcomes was tested, and the formulated hypotheses were verified through correlation analysis. Conclusions based on the testing of this model which could be useful to businesses are summarized at the end of this paper.

 The paper uses a methodological approach based on W. S. Jevons and A. L. Chizhevsky. The years of solar cycles were numbered according to the order established in solar astrophysics, grouped and compared with the arithmetic mean values of the effective US federal funds rates and the geomagnetic index Ap. The Fed rate is minimal either in the year of the geomagnetic index Ap extremum (this is the first year of the solar cycle) or in the year following it (these are the seventh and twelfth years of the solar cycle) as a reaction to the Ap index extremum. The forecast value of the effective federal funds rate for 2025 is 3.92%, and for 2026 it is 2.81%.

The concept of equitable remuneration paid to performers for the use of sound recordings containing their works was introduced by international treaties in the field. The Rome Convention for the Protection of Performers, Producers of Phonograms and Broadcasting Organisations of 1961 introduced the "right to remuneration", replacing the exclusive right of the performer to authorise the secondary use of their recorded performances.

The article examines the transition from an "exclusive right" to the "right to remuneration" in the context of Bulgaria’s cultural industry. The author proposes a categorisation of the phases during which creative products are made and brought to fruition while also tracing the role of performers’ rights throughout each stage of this process. From a business standpoint, achieving equitable remuneration is often put to the test since it is possible for both sides to agree on a lump sum payment. With regard to the perceived weaker position of performers compared to producers, the author critically analyses the scope of performers’ exclusive rights in the Bulgarian Copyright and Neighbouring Rights Act. It is concluded that this law prevents the effective collection and distribution of equitable remuneration for performers in cases of live performances when sound recordings are made and broadcasted on radio or television channels.

The modern state provides public goods, redistributes income and wealth, and ensures macroeconomic stability. It incurs expenses for this purpose which are financed (mainly) through taxation. In this sense, the scale and structure of public expenditures are key indicators of the state's participation in the economic life of its society. This article is devoted to the dynamics of public expenditure in Bulgaria over the last ten years (2014–2023): its total amount, current and capital expenditures, and expenditure by function.

The purpose of this paper is to construct a macroeconomic model of capital accumulation of a two-sector economy, building upon the Marxian model of expanded reproduction with which the factors of economic crises can be derived. Its methodology involved the simple generalization and formalization of the relations between the two economic sectors laid out by Marx in Capital, Vol. 2. On top of that, a time variable was added to make the system dynamic and so that it would evolve over time. The model has succeeded in covering some of the gaps in both Goodwin’s and Foley’s models by accounting for various parameters which Foley and Goodwin assumed to be constant. After the model was developed mathematically, a sensitivity analysis was run on it in which technical changes, wage fluctuations and other variables were introduced. Not only was the model found to be consistent with Marxist theory, but four causes of crises were also found following a sensitivity analysis. The model has its limitations, which are discussed in the conclusion, yet it can certainly be built upon in the future.

Governments around the world turned to public-private partnerships (PPPs) to design, finance, build and operate infrastructure projects in the 1980s and particularly the 1990s. This increased cooperation between the public and private sectors for the development and operation of infrastructure in a wide range of economic activities was provoked primarily by the limitations of public funds to cover investment needs but also by efforts to increase the quality and efficiency of public services. During the global financial crisis of 2008–2010, interest in PPP models for delivering public services significantly decreased worldwide. Still, there has been sustained attention towards this form of cooperation for the implementation of projects benefitting society on the part of international institutions. Public–private partnership as a management tool entails a paradigm shift from paying for public services to focusing on delivering better services. The present study examines and analyses the essence of PPP. The need for PPP in infrastructure sectors is justified, while its characteristics and main models are also examined. The mechanism of its implementation is described, and the role of the various stakeholders is discussed. Finally, the necessary business environment conditions are formulated, and conclusions regarding the successful implementation of PPPs are drawn.

When Bulgaria joined the EU, given the membership-related liberalization of trade both within the Community and towards third countries, competitiveness was defined as the main challenge for our country. In this regard, it is of particular interest to trace whether or not Bulgaria's membership in the EU has led to higher competitiveness. The main aim of the research paper is to present, in absolute and relative terms (compared to the other EU member states and countries in the process of accession) the state and the change in competitiveness level of our country at the macro level after the accession to the EU. This is achieved by examining the state and change of macroeconomic competitiveness in absolute and relative terms through the results in the most extensive comparative study on competitiveness in which Bulgaria is periodically present throughout the period of European membership, namely: the World Competitiveness Yearbook of the International Institute for Management Development. Among the key research findings, our country’s lagging position in the main international rankings and unsatisfactory performance in terms of competitiveness compared to the other EU member states and the countries in the process of accession stand out; Bulgaria has failed to benefit from EU membership and competitiveness remains a major challenge for the development of the Bulgarian economy.

Compliance rules existed even before the earliest modern financial and banking regulations. This paper aims to compare compliance systems in terms of the principles of Islamic finance with those of conventional finance and to determine whether they can exist “under one roof”. It focuses on the importance of Shari’ah compliance in Islamic corporate governance and the main body for its assurance – the Shari’ah Supervisory board, which takes various shapes in different legal and regulatory systems. Using the content analysis method, Shari’ah compliance among European Islamic banks (or Islamic windows) was investigated and on this basis the conclusion was drawn that, with the help of internal and external efforts, an effective framework for Shari’ah compliance can be ensured even in traditional financial institutions. Such a framework is needed mostly for the clarification of Shari’ah rules and norms in societies with a vested interest in Islamic financial markets and products.

Risk management regarding excise duties is essential to achieving the goals of the revenue administrations under the Ministry of Finance in Bulgaria, namely the Customs Agency and the National Revenue Agency (NRA). It is crucial for the fiscal stability of the country. The article examines the current state of the excise tax compliance risk management framework in the context of the Bulgarian Customs Agency, which is responsible for its administration, as well as opportunities for its improvement in accordance with best practices from national and European tax and customs administrations. It presents the essence of the excise risk arising from non-compliance with legislation by taxpayers and how to manage this risk. The results of a survey conducted in December 2024 and January 2025 among a total of 238 experts in the fields of financial control in Bulgaria, working at the NRA and the Customs Agency, as well as lecturers at the University of National and World Economy in Sofia, the Dimitar A. Tsenov Academy of Economics in Svishtov, the University of Economics in Varna and other universities, mainly from finance and accounting faculties, are also presented. The results of the survey show that the risk management framework for excise tax compliance in Bulgaria has conceptual weaknesses when compared with best practices elsewhere. The need to rethink some basic components, elements and activities of risk management are outlined in the formulated recommendations.