Web-economic-crisis-health-systems-and-health-web
Web-economic-crisis-health-systems-and-health-web Web-economic-crisis-health-systems-and-health-web
Country profiles of health system responses to the crisis | Lithuania 431 % Lithuania: Fig. 1 Economic and fiscal indicators 2000–2007 and 2008–2011 60 55 50 45 40 35 30 25 20 15 10 5 0 −5 −10 −15 −20 −25 −30 _ _ _ _ ● ● _ _ _ _ _ _ _ _ ● _ ● ● _ _ Real GDP per capita growth _ _ ● ● _ _ _ _ _ _ _ ● ● ● _ _ _ Deficit/surplus (% GDP) _ _ _ _ _ _ _ _ _ _ ● ● _ _ _ ● _ ● _ ● _ _ _ _ _ Government spending (% GDP) _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Government health spending (% total government spending) _ _ _ _ _ _ _ ● _ ● ● ● ● _ _ _ 10−year bond rates _ _ _ _ _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Unemployment rate Notes: Deficit/surplus: Eurostat; 10-year bond rates: European Central Bank; Other indicators: WHO Health for All. Year 2000−2007 2008 2009 2010 2011 Lithuania: Fig. 2 Trends in per capita spending on health, 2000–2011 1000 Public spending per capita OOP spending per capita Non−OOP private spending per capita Per capita spending $, PPP 750 500 250 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 100 Growth % 50 0 −50 30 Growth % 20 10 0 −10 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Public spending per capita growth OOP spending per capita growth Note: Spending calculated from WHO Health for All. Non−OOP private spending per capita growth
432 Economic crisis, health systems and health in Europe: country experience Changes to health coverage Population (entitlement) • Changed contribution rules to extend statutory coverage (2009) for the selfemployed and those in other forms of employment (sportsmen, those receiving income from copyright, business owners, agricultural workers, etc.) and improved tax collection mechanisms. The benefits package • Reduction of the reimbursement rate for temporary sick leave benefits from 85% of wages to 40% of wages in the first seven days and 80% after the eighth day (2009). • Introduction of a new version of the catalogue of pharmaceuticals reimbursed by SHI (positive list for drugs) (2009) based on expanded reference pricing and more strict requirements for generic pricing. User charges • Introduction of the option for patients to choose drugs with lower user charges (2009). Changes to health service planning, purchasing and delivery Prices of medical goods • First-line generics to be priced 30% below the original in order to be covered and second- and third-line generics to be priced at least 10% less than the first-line generic (2009). • Introduction of price-volume agreements with producers (2009–2010). • The reference price to be set based on the average of an expanded group of eight European countries minus 5% (2009–2010). • Drugs to be prescribed based on active ingredient (2009). • Patients allowed to choose the drug with the lowest user charge (2009). Salaries and motivation of health sector workers • Health sector worker salaries decreased by 13% between 2008 and 2010, with gradual recovery to 2009 levels in 2011 and moderate increase in 2012. Payment to providers • Reduction of health service reimbursement tariffs by 11% in 2009 and by a further 8% in 2010. The tariffs subsequently increased but by the end of 2012 they were still 9% lower than in 2008.
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Country profiles of <strong>health</strong> system responses to the <strong>crisis</strong> | Lithuania<br />
431<br />
%<br />
Lithuania: Fig. 1 Economic <strong>and</strong> fiscal indicators 2000–2007 <strong>and</strong> 2008–2011<br />
60<br />
55<br />
50<br />
45<br />
40<br />
35<br />
30<br />
25<br />
20<br />
15<br />
10<br />
5<br />
0<br />
−5<br />
−10<br />
−15<br />
−20<br />
−25<br />
−30<br />
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_ _<br />
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_ _<br />
_ _<br />
_ _ _<br />
_<br />
●<br />
_<br />
●<br />
●<br />
_ _<br />
Real GDP<br />
per capita growth<br />
_ _<br />
● ●<br />
_<br />
_ _ _ _<br />
_ _<br />
●<br />
● ●<br />
_ _ _<br />
Deficit/surplus<br />
(% GDP)<br />
_ _ _ _ _ _ _ _<br />
_ _<br />
●<br />
●<br />
_ _<br />
_<br />
● _ ●<br />
_<br />
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Government<br />
spending<br />
(% GDP)<br />
_ _ _ _ _<br />
● ● ● ● ●<br />
_ _ _ _ _<br />
Government<br />
<strong>health</strong> spending<br />
(% total government<br />
spending)<br />
_ _ _ _ _<br />
_ _ ● _ ●<br />
●<br />
●<br />
●<br />
_ _ _<br />
10−year<br />
bond rates<br />
_ _ _ _<br />
_ _<br />
_ _<br />
_<br />
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●<br />
●<br />
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_ _ _ _ _<br />
Unemployment<br />
rate<br />
Notes: Deficit/surplus: Eurostat; 10-year bond rates: European Central Bank; Other indicators:<br />
WHO Health for All.<br />
Year<br />
2000−2007 2008 2009 2010 2011<br />
Lithuania: Fig. 2 Trends in per capita spending on <strong>health</strong>, 2000–2011<br />
1000<br />
Public spending per capita OOP spending per capita Non−OOP private spending per capita<br />
Per capita spending $, PPP<br />
750<br />
500<br />
250<br />
0<br />
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011<br />
100<br />
Growth %<br />
50<br />
0<br />
−50<br />
30<br />
Growth %<br />
20<br />
10<br />
0<br />
−10<br />
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011<br />
Public spending<br />
per capita growth<br />
OOP spending<br />
per capita growth<br />
Note: Spending calculated from WHO Health for All.<br />
Non−OOP private spending<br />
per capita growth
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