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202 Economic crisis, health systems and health in Europe: country experience
In 2010, 13.5% of the Latvian population admitted having foregone care
because it was too expensive (Fig. 6.5). In comparison, this number was below
1% in Estonia, Lithuania and Slovenia, and approximately 2% in most other
EU27 Member States (Eurostat, 2012b). When examining the trend over time,
it is clear that the percentage of people not obtaining care because of costs
increased greatly since the start of the crisis in Latvia (Mitenbergs et al., 2012).
Fig. 6.5 Percentage of self-reported unmet need for medical examination or treatment
because it was “too expensive” in Latvia and selected comparators, 2004–2010
18
16
14
12
European
Union
Estonia
Unmet need (%)
10
8
6
4
Latvia
Lithuania
Poland
2
Slovenia
0
2004 2005 2006 2007 2008 2009 2010
Note: EU25 to December 2006, EU27 from January 2007.
Source: Mitenbergs et al., 2012.
Limitations on the number of secondary outpatient visits (specialist
consultations, clinical evaluations) affect access to care, particularly for people
with low incomes as they are not able to purchase VHI or pay the full price
for visits. Protection offered within the Social Safety Net Strategy safeguarded
access to care for the poor, but it is likely that middle class citizens with relatively
low incomes (but not poor) were affected negatively.
4.3 Impact on hospital sector efficiency
The overreliance on hospital care was successfully tackled by the restructuring of
hospitals and prioritizing ambulatory and home care, and this will likely result
in a more efficient allocation of resources. The strong financial restrictions were
a clear message for hospitals to manage with less, limit hospitalizations and