Latvia

More documents

Recommendations

Info

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. 43
Health systems in transition Latvia PHC is provided mainly in: • primary care practices run by practitioners (family doctors) who work independently, either as self-employed individuals or as private sector agents; • health centres (former polyclinics), employing GPs for PHC provision. Inpatient secondary and tertiary care in Latvia is provided by: • • • • • 44 multi-profile emergency hospitals and regional/district/central hospitals; local-level hospitals (which also provide social care); hospitals and centres of medical rehabilitation; single-profile hospitals for acute care and long-term treatment hospitals for TB, psychiatry and narcology patients; specialized single-profile hospitals in oncology, obstetrics, traumatology and infectious diseases. Emergency care is provided by: • • • emergency medical assistance (EMA) teams, or ambulances; emergency departments of hospitals; the Centre of Emergency and Disaster Medicine (CEDM), an organization under the Ministry of Health, which is a state-level specialized medical service that covers only cases where a CEDM specialist is called in by a hospital. Public health services are provided by several organizations under the Ministry of Health. • The State Sanitary Inspectorate has taken over the “police” functions of the former Sanitary Epidemiological (sanepid) Stations established during the Soviet period. • The Public Health Agency investigates outbreaks, gathers case reports from service providers, plans and regulates vaccination programmes and reports results. Occupational health services are not offered by the public sector, and all activities in this sphere are undertaken privately by employers. The State Labour Inspectorate (under the Ministry of Welfare) is responsible for monitoring developments. Mental health care is provided in both outpatient and inpatient settings. Outpatient settings include psychiatric assistance centres in Riga, outpatient departments at psychiatric hospitals, psychiatric consulting rooms in municipal primary care centres, and a number of psychiatric private practices. Inpatient settings include a number of psychiatric hospitals. Day care centres and facilities for chronic patients are only provided to a limited extent.
Page 1 and 2:
Health Systems in Transition Vol. 1
Page 3 and 4:
Keywords: DELIVERY OF HEALTH CARE E
Page 5 and 6:
Health systems in transition Latvia
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 16 and 17: Health systems in transition Denmar
Page 18 and 19: Health systems in transition Denmar
Page 20 and 21: Health systems in transition Latvia
Page 22: Health systems in transition Latvia
Page 52 and 53: 2. Organizational structure 2.1 Ove
Page 116 and 117:
Page 118 and 119:
Page 120 and 121:
Page 122 and 123:
Page 124 and 125:
Page 126:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 152 and 153:
5. Physical and human resources 5.1
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Page 162 and 163:
Page 164 and 165:
Page 166 and 167:
Page 168 and 169:
Page 170 and 171:
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 186 and 187:
6. Provision of services 6.1 Public
Page 188 and 189:
Page 190 and 191:
Page 192 and 193:
Page 194 and 195:
Page 196 and 197:
Page 198 and 199:
Page 200 and 201:
Page 202 and 203:
Page 204 and 205:
Page 206 and 207:
Page 208 and 209:
Page 210 and 211:
Page 212 and 213:
Page 214 and 215:
Page 216 and 217:
Page 218 and 219:
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Page 232:
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
Page 255 and 256:
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
Page 264 and 265:
9. Conclusions In the early years o
Page 266 and 267:
10. Appendices 10.1 References Apin
Page 268 and 269:
Page 270 and 271:
Page 272 and 273:
Page 274:
show all

Latvia

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?