Latvia

Health systems in transition
Latvia
now for the most part rented out by independent primary care practitioners, or
alternatively they have become self-managing health centres, while hospitals
have similarly become self-managing institutions. Local governments are
now mainly responsible for ensuring access to health care services, promoting
healthy lifestyles, controlling alcoholism, maintaining old-age health facility
buildings, establishing and maintaining shelters for homeless people and orphan
children, as well as education. In addition, local governments reimburse health
care expenses incurred by low-income patients, exempting them from patient
fees.
Health care legislation does not define specific functions and responsibilities
for local governments, but rather notes that they have a general responsibility
with respect to health care.
Institutions of health services
Inpatient and outpatient health care in Latvia is provided by state- and local
government-owned institutions, private clinics and hospitals, and individuals.
Independently of the type of property, all providers who provide services within
the statutory system are financed and regulated by government institutions
according to the same principles. Health care is subdivided into the three
conventional levels, as listed here.
• PHC is the level at which the patient has the first contact with health
care providers. PHC is provided by family doctors, paediatricians, PHC
internists and PHC nurses or doctors’ assistants. Every inhabitant of Latvia
must register with one PHC doctor, who serves as gatekeeper to the health
care system (Section 6.2 Patient pathways). PHC is financed according to
mixed weighted capitation principles (Section 3.7 Payment mechanisms).
PHC practitioners can be independent (private) providers or can work
within private or public outpatient clinics (Section 6.3 Primary ambulatory
care).
• Secondary health care involves outpatient and inpatient care, which includes
emergency, acute or planned diagnostics, treatment and rehabilitation up to
the point where successive treatment can be pursued at the PHC level; it
is provided by state, local government or private institutions (Section 6.4
Specialized ambulatory care/inpatient care).
• Tertiary health care is highly specialized, using high technologies for serious
health conditions with high-risk treatments and for rare diseases, and is
provided by public institutions at state level.
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