Summary: Several management models for quality improvement are known: Teilor’s model (quality control), Feigenbaun’s model (quality assurance), Deoning’s model (quality optimization). Quality management of medical assistance is directly related to socioeconomic concepts for country development and organizational structure of health care: professional model, bureaucratic model, industrial model, and analize quality appraisal – external and internal audit, institutional and ministerial control. The authors present arguments for a new quality management model – the complex quality system, the P-D and P-S-P-D clinical cyclical ways. The need of health system restructuring is argned in the article.