Latvia

Health systems in transition
Denmark
Abstract
The 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)),
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