Promocijas darbs

Promocijas darbā izpētīti pacientu rīcības un piesaistes faktori pacientvērstas pārrobežu veselības aprūpes kontekstā, uz kā pamata autore izveidojusi ārvalstu pacientu piesaisti noteicošo faktoru novērtēšanas sistēmu un modeli. Piesaisti ietekmējošo faktoru novērtējums liecina, ka ārstniecības iestāžu iespējas piesaistīt ārvalstu pacientus Latvijā ietekmē ārējie politiskie un ekonomiskie faktori, bet iekšējo faktoru grupā izšķiroša loma ir vadības faktoriem, investīciju un personāla pieejamībai. Kopējā ārvalstu pacientu apmierinātība ar saņemto veselības aprūpes pakalpojumu Latvijā ir augsta un ir saistīta ar vispārējiem ceļošanas, komunikācijas un pakalpojuma izvēles faktoriem. Visās faktoru grupās pastāv pozitīva plaisa starp gaidīto un saņemto aprūpes rezultātu, bet ir ievērojams informācijas trūkums par Latviju kā veselības aprūpes pakalpojumu saņemšanas galamērķi. Atslēgvārdi: pacientu piesaiste, pārrobežu veselības aprūpe, pacientu pieredze un apmierinātībaThe dissertation investigates the factors of patients' behavior and acquisition in the context of patient-centered cross-border health care. Author has developed a system of factors and model for the acquisition of foreign patients. The study shows that the opportunities of medical institutions to attract foreign patients in Latvia are influenced by external political and economic factors, but in the group of internal factors, management factors, investment and staff availability play a decisive role. The study confirms that the overall satisfaction of foreign patients with the received health care service in Latvia is high and is related to the general travel, communication and service choice factors. In all factors groups there is a positive gap between the expected and perceived service, but there is a significant lack of information about Latvia as a destination for receiving health care services. Keywords: patient acquisition, cross-border healthcare, patient experience and satisfactio

An Evaluation of Health Care Service Provider Websites in Latvia – a Medical Tourism Perspective

The prospective health care consumers are increasingly using the Internet websites for communication with potential health care service providers and decision-making regarding choice of the travel destination for receiving particular health care services. Therefore, it is important for health care providers to present themselves and their services efficiently online in order to attract foreign patients and thus facilitate medical tourism. The objective of this study is to evaluate the website content of Latvian health care providers who offer services to medical tourists in order to evaluate their status-quo and identify opportunities to improve website design. Authors used the framework by Huerta et al. (2016) as a basis to develop a modified framework suited for medical tourism-related website evaluation. 21 active websites associated with a medical tourism and provision of health care services to foreign patients were identified and selected for analysis. Each website was evaluated using a 10-factor assessment on 4 dimensions that include website accessibility, content, marketing, technology on a scale ranging from 0 to 10. Results: Scores of 21 website evaluation ranged from 54 to 91 point across all 4 dimensions with 80 and above points being considered as excellent result. Conclusions: Study findings indicated that the main improvements should be related to accessibility dimension and enabling text resizing function for improving experience for patients with poor sight, information dimension in terms of developing a separate main level section with information exclusively for foreign patients, and marketing dimension to improve effectiveness of search engine optimization (SEO) for medical tourism related keywords.publishersversionPeer reviewe

Palliative care in Latvia : availability and the role of the family doctor

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Factors determining competitiveness in healthcare institutions in Latvia - Results of the EKOSOC-LV national research programme

Competitiveness as a factor of a company selling its services in the market is becoming more relevant in the healthcare sector. The number of institutions that offer their services to international patients is growing. Research shows that the development of medical tourism is country-specific. The main objective of this publication is to discover positive and negative factors for engagement in the provision of services to non-residents. The data was obtained from a cross-sectional study in which 86 managers of health care institutions in Latvia completed a questionnaire. A total of 80.2% of health care institutions had provided services to non-resident patients in the previous year while 19.8% did so regularly. Institutions mainly used websites to advertise their services. Only a small number of institutions employed a marketing specialist or had a strategy to attract non-resident patients. Heads of institutions pointed to a number of internal and external barriers in this connection, including lack of staff, low motivation, limited language skills, inadequate infrastructure, insufficient state-level support to promote the export of services, the social environment, and problems in the health system itself. The study revealed areas that need to be improved regarding future policies to attract non-resident patients and to increase global competitiveness.publishersversionPeer reviewe

Latvian health care competitiveness in relation to its infrastructure and available resources

Resources are one of the essential indicators for the functioning of the health care system. Better health care provision is an essential prerequisite for the export of services. Traditionally a competitive health care system is linked to a number of factors (price, quality, reliability, products and services) largely determined by the new technologies, innovations and implementation the new methods. The authors of this article analyzed and collected data from the European Commission Eurostat and OECD data. Current situation in health care in Latvia is characterized by populations’ restricted access to health care services, high out-of-pocket payments and poor health outcomes of the population. More than 10% of Latvian population can’t afford medical care. The ratio of public funding for healthcare in Latvia is among the lowest in EU countries. Latvia spends 5.3% (USD PPP 1217) of GDP on health, lower than the OCED country average of 8.9% (USD PPP 3453). Latvia is facing a dramatic gap between the availability of hospital beds and long term care beds and the lowest prevalence of general medical practitioners among all Baltic States 321.6 per 100 000. These mentioned factors may hinder the development of health care in Latvia and reduce the ability to participate in international health service market.publishersversionPeer reviewe

A mixed-method study on the provision of remote consultations for non-communicable disease patients during the first wave of the COVID-19 pandemic in Latvia : lessons for the future

Publisher Copyright: © 2022, The Author(s).Background: The COVID-19 pandemic has challenged the ability of healthcare systems to ensure the continuity of health services for patients with non-communicable diseases (NCDs). The issue of remote consultations has emerged. Before the COVID-19 pandemic, remote consultations were not routinely provided or covered by public health funding in Latvia. This study aimed to describe the dynamics of consultations and the volume of remote consultations provided for patients with particular NCD and explore clinicians' experiences of providing remote consultations during the first wave of the COVID-19 pandemic in Latvia. Methods: A mixed-method study focusing on the first wave of the COVID-19 pandemic in Latvia in Spring 2020 was conducted. Quantitative data from the National Health Services were analysed to assess the dynamics of consultations for patients with selected NCDs. Qualitative data were collected through 34 semi-structured interviews with general practitioners (GPs) and specialists and were analysed using an inductive thematic analysis. Purposive maximum variation sampling was used for participant selection. Results: During the period with the strongest restrictions of scheduled on-site consultations, a decrease in the total number of consultations was observed for a variety of NCDs. A significant proportion of consultations in this period were provided remotely. GPs provided approximately one-third of cancer-related consultations and almost half of consultations for the other selected conditions remotely. Among specialists, endocrinologists had the highest proportion of remote consultations (up to 72.0%), while urologists had the lowest (16.4%). Thematic analysis of the semi-structured interviews revealed five themes: 1) Adjusting in a time of confusion and fear, 2) Remote consultations: safety versus availability, 3) Sacrifice and loss of privacy, 4) Advantages and disadvantages of communication technologies, and 5) Different form of communication and a health literacy challenge. Conclusions: During the first wave of the COVID-19 pandemic in Latvia, disruptions to health care services decreased the total number of consultations for patients with NCDs provided by both GPs and specialists. In this period, remote consultations proved to be an important instrument for ensuring the continuity of health care for patients with NCDs, and the necessity to develop a well-designed system for telemedicine in Latvia was highlighted.publishersversionPeer reviewe

Lessons learned from the Baltic countries' response to the first wave of COVID-19.

The Baltic countries of Estonia, Latvia, and Lithuania shared a similar response to the first wave of the COVID-19 pandemic. Using the information available on the COVID-19 Health System Response Monitor platform, this article analyzed measures taken to prevent transmission, ensure capacity, provide essential services, finance the health system, and coordinate their governance approaches. All three countries used a highly centralized approach and implemented restrictive measures relatively early, with a state of emergency declared with fewer than 30 reported cases in each country. Due to initially low COVID-19 incidence, the countries built up their capacities for testing, contact tracing, and infrastructure, without a major stress test to the health system throughout the spring and summer of 2020, yet issues with accessing routine health care services had already started manifesting themselves. The countries in the Baltic region entered the pandemic with a precarious starting point, particularly due to smaller operational budgets and health workforce shortages, which may have contributed to their escalated response aiming to prevent transmission during the first wave. Subsequent waves, however, were much more damaging. This article focuses on early responses to the pandemic in the Baltic states highlighting measures taken to prevent virus transmission in the face of major uncertainties

Testing Cost Containment of Future Healthcare with Maintained or Improved Quality—The COSTCARES Project

Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies

Public preferences for vaccination campaigns in the COVID-19 endemic phase:insights from the VaxPref database

Objective: Despite widespread perceptions that SARS-CoV-2 (COVID-19) is no longer a significant threat, the virus continues to loom, and new variants may require renewed efforts to control its spread. Understanding how individual preferences and attitudes influence vaccination behaviour and policy compliance in light of the endemic phase is crucial in preparation for this scenario. Method: This paper presents descriptive data from a global stated choice survey conducted in 22 countries across 6 different continents between July 2022 and August 2023, and reports the methodological work developed to address the need for comparable data. Results: This study included 50,242 respondents. Findings indicated significant heterogeneity across countries in terms of vaccination status and willingness to accept boosters. Vaccine hesitancy and refusal were driven by lower trust in public health bodies, younger age, and lower educational levels. Refusers and hesitant people reported lower willingness to take risks compared to those fully vaccinated (p&lt;0.05). Lower mental health levels were found for the hesitant cohort (p&lt;0.05). Conclusions: Insights from this database can help public health authorities to gain a new understanding of the vaccine hesitancy phenomenon, support them in managing the transition from the pandemic to the endemic phase, and favour a new stream of research to maximise behavioural response to vaccination programs in preparation of future pandemics.</p

Public preferences for vaccination campaigns in the COVID-19 endemic phase: insights from the VaxPref database

Objective Despite widespread perceptions that SARS-CoV-2 (COVID-19) is no longer a significant threat, the virus continues to loom, and new variants may require renewed efforts to control its spread. Understanding how individual preferences and attitudes influence vaccination behaviour and policy compliance in light of the endemic phase is crucial in preparation for this scenario. Method This paper presents descriptive data from a global stated choice survey conducted in 22 countries across 6 different continents between July 2022 and August 2023, and reports the methodological work developed to address the need for comparable data. Results This study included 50,242 respondents. Findings indicated significant heterogeneity across countries in terms of vaccination status and willingness to accept boosters. Vaccine hesitancy and refusal were driven by lower trust in public health bodies, younger age, and lower educational levels. Refusers and hesitant people reported lower willingness to take risks compared to those fully vaccinated (p<0.05). Lower mental health levels were found for the hesitant cohort (p<0.05). Conclusions Insights from this database can help public health authorities to gain a new understanding of the vaccine hesitancy phenomenon, support them in managing the transition from the pandemic to the endemic phase, and favour a new stream of research to maximise behavioural response to vaccination programs in preparation of future pandemics