Latvia

Health systems in transition
Latvia
The average length of hospitalization time for all the palliative care beds
in Latvia is approximately 10–12 days, and 20 of the 25 abovementioned beds
are statutorily financed. The remaining five beds at the Riga East Hospital are
financed on a fee-for-service basis.
Another example of mixed public–private financing for palliative care is at
the private Bikur-Holim Hospital in Riga. Palliative care is provided for any
patient who needs it (not only cancer patients), and this is partly financed by
the United States international aid programme HOPE at this hospital.
In 2004, nine palliative care beds were opened at the Iecava nursing house,
a social care centre near Riga for cancer, neurology and cardiology patients.
Moreover, since 2007, additional palliative care beds have also become available
in Irlava Hospital, Livani Hospital, Mazsalaca Hospital and Ventspils Hospital.
In 2004, “only” 57.4% patients were discharged from the palliative care unit
due to death. Access to palliative care is not equally distributed around the
country, as 84% of patients in 2004 were from Riga City alone.
Since 2001, outpatient consultations with a specialist in palliative care are
available at the Centre of Oncology at the Riga East Hospital for cancer patients
and their relatives, financed by public funds (with a patient fee). The number
of consultations increased from 300 in 2001 to 1026 in 2004, which indicates
the necessity of this service.
There are several activities for child specialized palliative care as well.
In 1998 an NGO for child palliative care was founded, and the first palliative
care service was offered at the Children Clinical University Hospital.
This service provides consultations for patients within various departments of
the hospital, consultations with the patient’s relatives throughout Latvia, and
home care for patients of Riga City and Jurmala. The team consists of two
medical doctors, a social worker and chaplain.
General (nonspecialized) palliative care in Latvia is provided by family
doctors. Also, patients on waiting lists for specialized care and after discharge
from hospital are in the care of these doctors. In 2003 there was a small-scale
survey of Latvian family doctors regarding oncology patient care. Questionnaires
were sent to 190 doctors with a response rate of 50%. It was concluded that there
exists an information gap between specialized oncology services and family
doctors. Also, only 37% of the respondents had attended specialized oncology
courses (with pain relief questions usually included), and 12% were not able to
cover the financing of necessary medications for their patients (allocated limits
are below actual needs, despite legislation declaring that every appropriate
patient should get the necessary pharmaceuticals free of charge).
Most Latvian specialists in palliative care completed their education abroad.
There is no recognized specialist accreditation in this field in Latvia.
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