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Health systems in transition Latvia Fig. 1.3 Reasons for refusal of medical care, by income per one household member, 1999 100 LVL+ 51.2% 24.4% 24.4% 61–100 LV 43–60 LVL 41.0% 31.7% 27.3% 22.1% 38.0% 39.9%
Health systems in transition Latvia urban areas compared to LVL 22.19 in rural areas; and in the case of expenses for outpatient care it was LVL 14.38 in urban and LVL 6.61 in rural areas (Section 3.4 Revenue collection/sources of funds, Subsection Out-of-pocket payments). Lower spending on health care in rural areas tends to be associated both with lower incomes and with reduced access to services due to lack of availability. Poor access to health care services delays diagnosis of illnesses, resulting in complications and higher treatment expenses. The survey “Latvian population income level and health care access” has shown that low income levels are associated with higher hospitalization rates, and therefore higher treatment costs than timely outpatient diagnosis and treatment (Karaskevica 2003). Health challenges for people with disabilities Latvian public organizations struggle for the rights of disabled people with regard to social and environmental accessibility. The association “Apeirons” focuses on different problems faced by disabled people, organizes activities, takes part in the education of society in general and submits proposals to decision-makers. At the time of writing in Latvia there are no effective measures for reducing disability, due to insufficient funding for health care, for reimbursed drugs and for medical and social rehabilitation. While there have been some improvements, limited progress has been made to date. In June 2005 the Government adopted a document entitled “Basic statements for a policy to reduce disability and its consequences”, developed by the Ministry of Welfare. The main emphasis is on prevention of disability and promotion of a well-equipped, stable and friendly environment in order to favour the integration of disabled people into society. This includes the basic principles of disability prevention and social protection policy, along with key aims and priorities for the next 10 years. Participants in the Health Survey of the Population of Latvia 2003 were asked about long-term limitations to activity, lasting more than 6 months. The most common health problems causing long-term limitations to activity included musculoskeletal illnesses (34% of respondents), impaired eyesight (33.2%) and illnesses of the heart, blood vessels and lungs (31.3%). In addition, women mentioned illnesses of the nervous system (Central Statistical Bureau of Latvia 2004). 24
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6. Provision of services 6.1 Public
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9. Conclusions In the early years o
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