According to the annual report of Health Consumer Powerhouse, an European organization that offers consumer information on healthcare, The Bulgarian healthcare system is offering the lowest quality of healthcare services in Europe.
In 2008, Bulgaria was also included with the poorest healthcare systems in the Health Consumer Index. However, it was still ahead in front of Croatia and Macedonia, both countries climbed up the 2009 list leaving Bulgaria to go further down the list. The index is made based on the quality of healthcare services on several aspects, among them are the observation of patients' rights, the application of IT, the waiting time at the clinics, treatment outcomes and the access to medications. In the 2009 ranking report, Bulgaria was ranked at the bottom of the list of between 33 countries according to four criteria, all associated with the access to medication. The poor results were also a result of the lack of a law for the protection of patients' rights and the fact that there was no existence of mechanisms regulating compensation for victims of medical errors. However, Bulgaria occupied the first rank regarding the number of doctors per capita. For the second successive year, The Netherlands came on top of the health quality ranking.