ABSTRACTSince regaining independence, Latvia’s health care system has been reformed many times; efforts have been made to pass laws for mandatory health insurance and for elements of the system to be financed by the national budget. One of the most essential signs of the health care system’s quality and effectiveness is its availability to citizens, therefore the aim of this study is to examine how health care reforms in Latvia have influenced this availabilit
This sociological study, which surveyed 1000 citizens of Riga, Kurzeme, and Southern Latgale, showed that a third of the respondents were forced to refuse necessary health care services mainly due to a lack of finances. Problems with the availability of medical help are most often found in those regions of Latvia where citizens’ health is the poorest. This proves the findings of studies conducted in other countries, which maintain that the availability of health care system services and the health of citizens are very closely related.
The study also brings to light and analyses the models of patient compensatory behaviour in situations when medical services are not available, as well as other factors that create the backdrop for the problem of availability. These factors are: the use of various medical services, documents that verify health insurance obtained on a voluntary basis, reasons for visiting a family physician or private practice physician, the realisation of a healthy lifestyle, citizens thoughts about the national health care system, as well as their political views in relation to health care in Latvia.
Taking into account the health care traditions that came into being during the soviet period and citizens’ capacity to take on financial risk in the event of illness, health care reformers must carefully analyse the outcome of the introduction of the market mechanism in health care. Experience has proven that solutions, which originally seemed economically effective, have been very expensive. The treatment of neglected, epidemic or socially dangerous illnesses demand more funds than primary health care services for all citizens.
A many-sided analysis of the problem of health care service availability allows one to realize that the further reduction of availability (especially when taking into account Latvia’s wide-spread poverty) can result in a situation wherein the national health care system cannot fulfil its primary function – providing health care for all citizens, independent of age, income, sex, education, and social standing.
The Accessibility of Health Care Services