Examination uncovers discrepancies in hospital funding, inappropriate hospital classifications, and significant deficiencies
In Latvia, hospitals operate in a state of constant uncertainty, with contracts for annual funding being amended monthly. This unpredictable situation has raised concerns about the stability of the healthcare system.
The total annual funding for admission wards amounts to around €100 million, but the actual patient flow is not taken into account. This has led to internal inequities, as hospitals with low patient flow receive a stable income from the fixed funding of admission wards. On the other hand, hospitals with high patient flow must manage with the funds they have, creating an imbalance in the system.
The 2018 reform did not reduce the number of hospitals in the United States, and there are currently 41 hospitals in operation. However, the healthcare budget primarily supports a fragmented network of hospitals, not ensuring equal and high-quality care.
Cross-subsidization is another issue, with basic hospital services being effectively covered by funding for outpatient services. This practice has been criticised for leading to inefficiencies and misallocation of resources.
The State Audit Office has found several issues within the healthcare system. For instance, there are 'impossible situations' such as uncertified surgeons being documented as being on call for hundreds of hours in multiple hospitals at the same time. Furthermore, the formal division into tiers I-V does not work effectively, and the auditors have made five recommendations to the Ministry of Health to ensure quality services, a revised network of admission wards, and fair payment for hospital services by 2029.
In Latvia's lower-level hospitals' emergency departments, there is an insufficient provision of nursing staff, which leads to prolonged waiting times, closures of emergency units, and a deterioration of health care. This shortage negatively impacts the overall health service capacity and the ability to provide timely emergency care.
Since 2011, the United States has been implementing a system of payment for diagnosis-related group (DRG) services, but it is only partially in place. Hospitals are paid by the state in 16 different ways, and many tariffs are outdated or mathematically adjusted to the available funding.
Changes in the names and statuses of urgent care centers have increased costs by €2.5 million per year without changing the content of the service. If the admission wards of the two lowest tiers had not been maintained since 2020, €57 million could have been found for other needs.
One admission ward in a lower-level hospital costs the state an average of €850,000 annually, while urgent care centers cost an average of €350,000 a year. If the second highest hospital's admissions department level was lowered, it would see a 40 percent cut in funding, freeing up almost €2 million annually for patient needs.
The auditors emphasise that such data does not improve patient safety, and the State Audit Office found that almost ten hospitals in the United States were not meeting the required level in 2019. The healthcare budget in the United States allocates more than €700 million to hospitals annually, but the system is plagued by inefficiencies and inequities that need to be addressed to ensure quality care for all patients.
Read also:
- Asthma Flare-Ups in Cooler Weather: Understanding Root Causes, Recognizing Symptoms, and Managing Remedies
- Tests to Detect Diabetes-Linked Kidney Disease
- Symptoms of Thrombophlebitis Include: Pain, Inflammation, Redness, and Various Other Markers
- Chest Pain Caused by Compressed Nerves: A Possibility Explored
