Latvia faces important challenges to improve the performance of its health system


21/9/2016 - Latvia has successfully consolidated its hospital sector and strengthened primary care since the financial crisis. But persistent barriers to accessing high quality care need to be removed, according to a new OECD report.


OECD Reviews of Health Systems: Latvia 2016 says life expectancy – at 73.9 years old – is more than 6 years shorter than the OECD. Smoking and harmful alcohol consumption are becoming more common, rather than being tackled as in a number of OECD countries.


Despite such challenges, public investment in health care is low, at just 3.4% of GDP in 2015. Substantial out-of-pocket spending brings total national expenditure on health to 5.6% of GDP, well below the OECD average of 9%. Although the number of doctors is close to the OECD average, there are far fewer practicing nurses – just 4.9 per 1 000 population, compared to the OECD average of 9.1. Nearly 1 in 7 Latvians (or, worse, 1 in 3 of those with low incomes) report going without health care because of the cost, distance or waiting times, compared to 3% across the OECD.


Strong commitment by Latvian authorities to improve the performance of the health system is encouraging. Concerted efforts have been made to improve access to care, including incentives to open primary care practices in rural areas, provision of a second nurse in primary care, and free hotel-accommodation to help poorer patients access specialist care. Quality initiatives are also underway, with the introduction of a pay-for-performance scheme in primary care, incentives for early cancer detection, and the imminent launch of electronic health records. Efforts to reduce hospital use and focus on outpatient care and the introduction of a centralised emergency triage system should also promote better value-for-money.


These recent initiatives should be welcomed as steps to address the health challenges Latvia is facing, but to make a real difference on the ground, further investment is required. The OECD report recommends that Latvia:

  • Improve access to health care by re-introducing cost-sharing exemptions for vulnerable and low-income populations and patients with chronic conditions;
  • Make health care a data-driven system by developing key performance indicators across the system, provider-level performance measures, with open publication and benchmarking;
  • Engage GPs, pharmacists and practice nurses in delivering preventive care;
  • And drive efficiency gains by pursuing more strategic hospital contracting, building-in quality and efficiency incentives.


For more information on OECD Reviews of Health Systems: Latvia 2016, go to


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