Introduction: Financial analysis is a fundamental tool in the management of healthcare institutions,supporting strategic decision-making and the assessment of financial health. Objective: This study evaluates the profitability of university hospitals in Bulgaria. Materials and Methods: The financial statements of 13 university hospitals were analyzed for the period 2017–2023, applying the three-step DuPont model. Results and Discussion: The average profitability indicator for the entire period was -7.43, with values varying significantly among different healthcare institutions. Nine hospitals reported improvement, while four experienced a decline in return on equity. Nevertheless, the median value improved from 0.02 in 2017 to 1.49 in 2023. Conclusion: The significant variations in the indicator’s values highlights challenges in maintaining sustainable financial performance. Integrating financial analysis into management practices can enhance efficiency and contribute to the long-term growth of healthcare institutions.
Koeva-Dimitrova et al. (Fri,) studied this question.