OECD Reviews of Public Health
Latvia sees high rates of obesity, smoking and alcohol consumption. In turn, this results in a high incidence of preventable diseases, such as heart disease, diabetes and many cancers. This puts a burden on a health system which is already operating on a very tight budget as compared to other OECD c...
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| Autor Corporativo: | |
| Formato: | Libro electrónico |
| Idioma: | Inglés |
| Publicado: |
Paris :
OECD Publishing
2020.
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| Materias: | |
| Ver en Biblioteca Universitat Ramon Llull: | https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009703621706719 |
Tabla de Contenidos:
- Intro
- Foreword
- Acknowledgements
- Acronyms and abbreviations
- Executive summary
- Assessments and recommendations
- Latvia's public health system
- Latvia has a centralised health system with a limited role for local governments
- Spending on health promotion and prevention is low but increasing
- The well-established primary care sector in Latvia is an advantage for improving public health, but the system is under-resourced and over-loaded
- There is scope to strengthen policies to reduce harmful alcohol consumption
- The Latvian Government should involve the industry in supporting healthier lifestyles, for example by promoting reformulation and extending advertising regulations
- Tackling obesity
- Obesity and overweight reduce life expectancy by an estimated 3.6 years, and cost the Latvian economy around EUR 91 million a year if nothing is done
- Policies introduced by the Latvian Government mostly focus on diet rather than promoting physical activity
- Latvia should create a comprehensive obesity policy package by expanding or redesigning current policies
- The health system needs to play a more significant role in preventing and treating obesity
- Sustainable obesity prevention and reduction requires future-proofing existing public health programmes
- Strengthening secondary and tertiary prevention
- Health check-ups for chronic disease and chronic disease management falls mostly to General Practitioners
- Pre-filled appointment times for cancer screening could increase rates which remain well below the OECD average
- Latvia should promote more proactive chronic disease management through organisational and payment incentives
- Improving health literacy for the population and health professionals should be a priority.
- Create more capacity in primary care for patient education, disease management, and disease detection
- Effective use of pharmaceuticals
- The building blocks of an effective and efficient pharmaceutical system are in place in Latvia
- Pharmaceutical expenditure is rising, but weak financial support for outpatient medicines reduces access to care
- Latvia needs to improve financial protection for patients for outpatient medicines
- The efficiency of Latvia's pharmaceutical expenditure is limited
- While more public investment is needed to increase access to pharmaceuticals, efficiency gains are possible
- Adjustments to the regulation of the distribution chain can contribute to better control over public spending on medicines
- References
- 1 The Public Health System in Latvia
- 1.1. Introduction
- 1.2. The public health picture in Latvia
- 1.2.1. Health status of the Latvian population
- 1.2.2. Burden of disease
- 1.2.3. Health risk factors
- 1.3. Organisational structure
- 1.3.1. Primary care
- 1.3.2. Secondary care
- 1.3.3. Delivery of essential public health operations in Latvia
- Vaccination programmes
- Tackling Antimicrobial resistance (AMR)
- Food safety
- 1.4. Leadership and governance
- 1.4.1. Key actors in the Latvian health system
- 1.4.2. Management of public health emergencies and the COVID-19 crisis
- 1.5. Partnerships and collaboration
- 1.5.1. Ministries that have a role in public health policy
- 1.5.2. Public involvement in policy making for public health
- 1.5.3. Engagement with representatives of industry
- 1.6. Financial resources
- 1.6.1. The case for investing in health promotion and disease prevention
- 1.6.2. Latvia had one of the lowest levels of health spending in the OECD
- 1.6.3. High levels of cost-sharing reduces access to health care.
- 1.6.4. Spending on health promotion and prevention is low but increasing, but funding sources may not be sustainable
- 1.7. Knowledge development
- 1.7.1. Most public health information is centralised and analysed by the CDPC
- 1.7.2. Latvia is developing its eHealth system but further progress is needed
- 1.7.3. Heath information to citizens increased substantially in recent years but health literacy remains low
- 1.8. Workforce
- 1.8.1. Latvia reports fewer health professionals than the OECD average
- 1.8.2. The regional repartition of the health workforce is very imbalanced
- 1.8.3. GPs are a strong feature of the Latvian primary health care system
- 1.8.4. Training of public health professionals in Latvia is well-established
- 1.9. Conclusion
- References
- 2 Tackling obesity in Latvia
- 2.1. Introduction
- 2.2. Obesity in Latvia
- 2.2.1. Over a quarter of the Latvian population is obese, and more than half is overweight
- 2.2.2. Both diet and physical inactivity contribute to the obesity epidemic in Latvia
- 2.2.3. Obesity has a considerable impact on health and the economy
- 2.3. Latvia's approach to tackling obesity
- 2.3.1. The government has implemented a range of population-level policies to encourage healthier behaviours
- 2.3.2. Local governments promote healthy lifestyles under the Healthy Municipalities Network, but have limited resources and expertise
- 2.3.3. Schools will soon teach health education as part of a new curriculum, and some have additional health promotion activities
- 2.3.4. The health system should play a more significant role in preventing and treating obesity
- 2.3.5. The industry has committed to voluntary advertising regulations and engages with the Ministry on food policy
- 2.4. Recommendations.
- 2.4.1. Expand or redesign existing activities and policies to create a comprehensive policy package
- Healthy food procurement
- Food and menu labelling
- Reformulation
- Marketing restrictions
- Workplace programmes
- 2.4.2. Ensure the long-term sustainability of project-funded programmes
- 2.4.3. Empower the health system to play its part in obesity prevention and treatment
- 2.5. Conclusion
- References
- Annex 2.A. Data on obesity and overweight
- Notes
- 3 Strengthening Latvia's secondary and tertiary prevention policies
- 3.1. Introduction
- 3.2. Burden of chronic disease in Latvia
- 3.2.1. Non-communicable diseases are the leading cause of death in Latvia
- 3.2.2. Treatable mortality in Latvia is amongst the highest in the EU
- 3.3. Screening, health checks, and disease management approaches in Latvia
- 3.3.1. Cancer screening and detection in Latvia
- 3.3.2. Health check-ups for chronic disease and chronic disease risks
- 3.3.3. Chronic disease management in Latvia
- 3.4. Strengthening secondary and tertiary prevention
- 3.4.1. Improving health literacy for the population and health professionals should be a priority
- 3.4.2. Latvia should strengthen cancer screening with pre-filled appointment times
- 3.4.3. Promote chronic disease management through organisational and payment incentives
- Development of clinical guidelines or disease management pathways
- Development of chronic care management programmes led by dedicated multi-disciplinary teams
- Development of bundled payments for chronic conditions
- 3.4.4. Create more capacity in primary care for patient education, disease management, and disease detection
- 3.5. Conclusion
- References
- 4 Effective use of pharmaceuticals
- 4.1. Introduction
- 4.2. General organisation of the Latvian pharmaceutical sector.
- 4.2.1. The State Agency of Medicines is responsible for all regulatory activities
- 4.2.2. Reimbursement decisions are the responsibility of the NHS
- 4.2.3. The positive list is divided into four categories
- 4.2.4. Prices are regulated at all levels of the distribution chain
- 4.2.5. The pharmaceutical retail sector is quite concentrated
- 4.3. Despite a solid legal framework, the outpatient pharmaceutical sector in Latvia has significant flaws
- 4.3.1. Pharmaceutical consumption in Latvia is not commensurate with the burden of disease
- 4.3.2. Spending on pharmaceuticals is low but represents a growing share of the health system's budget
- 4.3.3. High out-of-pocket payments on outpatient medicines constitute a major barrier in access to care
- 4.3.4. Expenditure on pharmaceuticals is not very efficient
- 4.3.5. The current structure of the community pharmacy sector raises concerns
- 4.4. Reforming certain features of the Latvian pharmaceutical sector would improve patient access and safeguard public spending
- 4.4.1. Adjustments to the pricing system should be considered
- 4.4.2. The reimbursement system needs to be substantially revised
- 4.4.3. While more public investment is required, some efficiency gains could be made
- 4.5. Conclusion
- References
- Notes.
