Latvia: Health system review
Brigis G, Karaskevica J, Rurane A, Stuburs A, Zusmane E, Avdeeva O and
|Verlag||Health Systems in
Transition. 2008; 10(2):
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- © .
Health Systems in Transition (HiT) profiles are country-based reports
that provide a detailed description of a health system and of policy
initiatives in progress or under development. HiTs examine different
approaches to the organization, financing and delivery of health
services and the role of the main actors in health systems; describe
the institutional framework, process, content and implementation of
health and health care policies; and highlight challenges and areas
that require more in-depth analysis.
The life expectancy in Latvia has improved over the last two decades and was 71.1 years in 2005. This value is comparable to those in other eastern European and former Soviet Union countries but is the lowest among the Baltic and Nordic countries. Health care services in Latvia are financed mainly by taxation through the state budget as well as by out-of-pocket (OOP) payments, voluntary health insurance (VHI) and other direct payments. Although entitlement to health care services is universal in Latvia, equity in access to services it compromised due to high levels of OOP payments by consumers. Health care services at the primary level are provided mainly by general practitioners (GP) who work independently and act as gatekeeper for specialized services.
Latvia’s health care system has undergone major changes since the country achieved independency in 1991. Reform policy since then has included amongst others: adoption of a Public Health Strategy in 2001 (which aims at developing an integrated approach of prevention and treatment at all levels of the health care system), reform of health care financing (e.g. payment for hospital services, introduction of a primary health care payment system based on capitation and fund holding, pooling and channelling of almost all funds for health care through the centralized State Compulsory Health Insurance Agency (SCHIA)),
Health systems in transition Latvia regulations of the pricing system for pharmaceuticals and introduction of a centralized health management information system. However, patients and health care consumers are concerned with regard to quality of the health care services, long waiting lists and access to specialized care.