Public-private partnership role during the pandemic : A case of COVID-19 testing in the Republic of Latvia 2020

Funding Information: The author(s) reported there is no funding associated with the work featured in this article. Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.The novelty of this research includes public-private partnerships (PPP) in emergency situations, especially during a pandemic, where there are only a few researched topics. The goal of this study is to answer the following research question: What is the role of PPP in achieving quick and effective COVID-19 testing during a new pandemic in a small country? The methods of this paper are based on a case study approach. In the beginning, a related literature review was done (keywords: public-private partnerships in COVID-19, testing of the COVID-19, health systems during the pandemic). The second step contains data collection about COVID19 in Latvia (2020). Finally, an analysis of the case and data was performed with the conclusion in the result. Results: The average number of tests in 2020 was 2355.99 (interval: 4.00–12,091.00) per day and 2141.73 (interval: 7.67–7365.77) per month. The private sector conducted around 95.78% per month to check COVID19 infection. Conclusion: The PPP role of COVID-19 testing during a pandemic in small countries contains extra resources for rapid and previously not established process organization that allows governments and the public sector to pay attention to other important questions. As a result, collaboration can decrease infection prevalence and mortality.Peer reviewe

Self-Esteem and Occupational Factors as Predictors of the Incidence of Anxiety and Depression among Healthcare Workers during the COVID-19 Pandemic in Latvia

The prevalence of depression and anxiety among healthcare workers (HCWs) during the COVID-19 pandemic is high. The aim of the study is to identify the importance of self-esteem and occupational factors in association with the incidence of depression and anxiety among HCWs through a longitudinal cohort study during the COVID-19 pandemic in Latvia. Participants received seven questionnaires during the COVID-19 pandemic on demographic parameters, work-related information, and contact with COVID-19 patients, and three standardized questionnaires that evaluated symptoms of anxiety (GAD-7), depression (PHQ-9), and self-esteem (Rosenberg’s self-esteem scale). The Generalized Linear Mixed Model (GLMM) was used to identify factors associated with the incidence of depression and anxiety among HCWs. A total of 322 participants were included in the data analysis for depression and 352 for anxiety. HCWs with low self-esteem were 83% more likely to experience depression and 76% more likely to experience anxiety. Working at a general practitioner practice is associated with twice the risk of developing depression and anxiety. A 31% increase in the odds of depression is observed among HCWs with direct contact with COVID-19 patients. The organizational and government levels must look for opportunities to facilitate the mental health of HCWs to ensure better-quality healthcare.Peer reviewe

Factors related to good asthma control using different medical adherence scales in Latvian asthma patients : An observational study

Publisher Copyright: © 2017 The Author(s). Copyright: Copyright 2018 Elsevier B.V., All rights reserved.One of the main challenges in asthma control is adherence to pharmaceutical treatment. The aim of this study was to test the association between adherence to asthma medication, control and medical beliefs, cognitive and emotional perceptions using three different validated questionnaires. Beliefs about asthma medicine, cognitive and emotional factors were determined in a cross-sectional survey of patients attending outpatient pulmonologist practices in Latvia (n = 352). The validated Beliefs about Medicines Questionnaire and the Brief Illness Perception Questionnaire were used. Adherence to asthma medication was assessed using the Morisky Medication Adherence Scale and two different versions of the Medication Adherence Reporting Scale. Several questions about necessity or concerns related to pharmaceutical treatment were able to predict poor adherence according to the Morisky scale. If the patient felt that without the asthma medication his life would be impossible, his risk to have poor treatment adherence was 46% reduced (odds ratio 0.54; 95% confidence interval 0.33-0.89). Furthermore, asthma patients who were convinced that their health depends on the asthma treatment were less likely to have poor treatment adherence (odds ratio 0.56: 95% confidence interval 0.32-0.97). In case the patient was concerned by the need to constantly use asthma medication or sometimes concerned by long-term effects of asthma medication the odds of poor treatment adherence were 1.96 (95% confidence interval 1.19-3.24) and 2.43 (95% confidence interval 1.45-4.08), respectively. In conclusion, medication beliefs, particularly concerns and necessity of asthma treatment were associated with poor treatment adherence when assessed with the Morisky or 5-item Medication Adherence Reporting Scale.publishersversionPeer reviewe

Glutathione reductase is associated with the clinical outcome of septic shock in the patients treated using continuous veno-venous haemofiltration

Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Background and objectives: At present, there is insufficient evidence to support the use of continuous veno-venous haemofiltration (CVVH) in the early treatment of septic shock. This study focuses on the association between survival and different parameters of oxidative stress (RedOx). Thereby, we evaluated whether RedOx markers are associated with the outcome of septic shock in patients under early-initiated CVVH treatment. Materials and Methods: We conducted a prospective observational study of 65 patients with septic shock who started CVVH within 12 h after hospital admission. Blood samples were taken from each patient prior to the start of CVVH. The following RedOx markers were measured: glutathione peroxidase, glutathione reductase (GR), total antioxidant capacity, superoxide dismutase, nitric oxide, malondialdehyde and 4-hydroxynonenal. The odds ratio (OR) was calculated using binary logistic regression and stepwise multivariable regression. Results: The 65 patients had a median age of 66 years and 39 were male. Based on the outcome, the patients were divided into two groups—non-survivors (n = 29) and survivors (n = 36)—and the levels of RedOx markers were compared between them. Of all the markers, only higher GR activity was found to be significantly associated with the fatal outcome; 100.3 U/L versus 60.5 U/L, OR = 1.027 (95% CI, 1.010–1.044). Following adjustment for the sequential organ failure assessment score and other parameters, GR activity still presented a significant association with the fatal outcome, OR = 1.020 (95% CI, 1.002–1.038). Conclusions: GR activity is associated with in-hospital fatal outcomes among septic shock patients under early-initiated CVVH treatment. Septic shock patients who have a lower GR activity at hospital admission may have a favourable outcome of the early initiation of CVVH.publishersversionPeer reviewe

Healthcare financing reform in Latvia : Switching from social health insurance to NHS and back?

Publisher Copyright: © 2014 The Authors.In the 1990s, Latvia aimed at introducing Social Health Insurance (SHI) but later changed to a National Health Service (NHS) type system. The NHS is financed from general taxation, provides coverage to the entire population, and pays for a basic service package purchased from independent public and private providers. In November 2013, the Cabinet of Ministers passed a draft Healthcare Financing Law, aiming at increasing public expenditures on health by introducing Compulsory Health Insurance (CHI) and linking entitlement to health services to the payment of income tax. Opponents of the reform argue that linking entitlement to health services to the payment of income tax does not have the potential to increase public expenditures on health but that it can contribute to compromising universal coverage and access to health services of certain population groups. In view of strong opposition, it is unlikely that the law will be adopted before parliamentary elections in October 2014. Nevertheless, the discussion around the law is interesting because of three main reasons: (1) it can illustrate why the concept of SHI remains attractive - not only for Latvia but also for other countries, (2) it shows that a change from NHS to SHI does not imply major institutional reforms, and (3) it demonstrates the potential problems of introducing SHI, i.e. of linking entitlement to health services to the payment of contributions.publishersversionPeer reviewe

Factors related to poor adherence in Latvian asthma patients

Background The problem of nonadherence to therapy is a key reason of insufficient asthma control. Evaluating the beliefs about asthma medication, cognitive and emotional perceptions may help to identify patients with poor adherence to treatment in clinical practice which need additional attention in order to increase the likelihood of them taking their asthma medication according to the prescribed treatment protocol. The purpose of this study is to assess whether beliefs about asthma medication, cognitive and emotional factors are related to poor treatment adherence of asthma medication in a sample of asthma patients in Latvia. Methods Study subjects were asthma patients attending outpatient pulmonologist consultations in Latvia during September 2013 to December 2015. Beliefs about asthma medicine, cognitive and emotional factors related to asthma were determined in a cross-sectional, self-administered survey. The validated Beliefs about Medicines Questionnaire (BMQ) and the Brief Illness Perception Questionnaire (brief IPQ) were used. Treatment adherence was assessed using 5-item version of the Medication Adherence Reporting Scale (MARS). The total sample size was 352 patients. Logistic regression models were used to predict poor adherence to asthma treatment. The validity of each logistic regression model was assessed by the Hosmer/Lemeshow test. The main outcome measure was self-reported adherence to treatment. Results The more the patients agreed with the statement "My future health depends on my asthma medication" the lower the possibility of poor adherence to asthma treatment (OR 0.42; 95% CI 0.24-0.74). The more concerned the patients were in regard to long-term effects of their medication (OR 2; 95% CI 1.22-3.27), the higher the probability of poor treatment adherence. Conclusions Screening asthma patients using the BMQ may help to identify those to benefit from interventions targeting their concerns and medication beliefs in order to improve adherence to asthma medication.Peer reviewe

Factors related to poor asthma control in Latvian asthma patients between 2013 and 2015

Objectives: To investigate whether beliefs about asthma medication, cognitive and emotional factors are related to poor asthma control in a sample of Latvian asthma patients in 2015. Design: Cross-sectional, self-administered survey. Subjects: Three hundred and fifty two asthma patients (mean age 57.5 years) attending outpatient pulmonologist consultations in Riga, Latvia during September 2013 to December 2015. The sample size was calculated to detect a prevalence of poor asthma control of 50% with a margin of error of 5% and a power of 95%. Main outcome measures: The validated Beliefs about Medication Questionnaire (BMQ) and the Brief Illness Perception Questionnaire (brief IPQ) were used. Good asthma control was assessed using the asthma control test (ACT), a validated five-item scale that reliably assesses asthma control over a recall period of four weeks. Logistic regression models were used to predict poor asthma control. Results: Patients who had a good control of asthma medication (OR 0.70; 95% CI 0.61–0.79) or were confident that their asthma medication improves illness (OR 0.84; 95% CI 0.74–0.95) had a reduced risk of poor asthma control. The more symptoms (OR 1.63; 95% CI 1.44–1.84) the asthma patients perceived or the more their illness affects their life, the higher the probability of poor asthma control (OR 1.47; 95% CI 1.31–1.65). Some beliefs of necessity and concerns of asthma medication were also statistically significantly related to poor asthma control. Conclusions: Beliefs of necessity of asthma medication, cognitive and emotional illness perception factors correlate well with poor asthma control in Latvian patients

The Prevalence of Viral Hepatitis C in Latvia: A Population-Based Study

Background and Objective: Chronic viral hepatitis C (VHC) is one of the most discussed infectious diseases worldwide. The number of infected persons worldwide is approximately 170 million, and in Europe, it exceeds 9 million. The aim of this study was to determine the prevalence of antibodies to hepatitis C virus (anti- HCV prevalence) and prevalence of HCV viremia (HCV-RNA prevalence) in Latvia. Material and Methods: A multistage randomized selection was used. A total of 42 primary care physicians (PCPs) were randomly selected from the register of PCPs from different regions of Latvia. From each PCP register, 60 subjects were selected (1651 individuals in total) and invited for the anti-HCV test with a screening method (ELISA). In case of positive results, antibodies were confirmed by the Western blot test, and all these subjects were tested for HCV-RNA by polymerase chain reaction. Results: Of the 1459 subjects tested, 57 were positive for anti-HCV (3.9%; 95% CI 3% to 5%); 35 of them were positive for anti-HCV with a confirmatory test (2.4%; 95% CI, 1.7% to 3.3%): 19 men and 16 women (3.8% and 1.7%, respectively; P=0.011). The results of HCV RNA test were positive in 25 subjects (1.7%; 95% CI, 1.2% to 2.5%): 15 men and 10 women (3% and 1% respectively, P=0.019). Conclusions: The prevalence of anti-HCV and HCV-RNA in Latvia was found to be 2.4% and 1.7%, respectively. The prevalence of anti-HCV and HCV-RNA was higher in men than women.Peer reviewe

The prevalence of viral hepatitis C in Latvia : A population-based study

Background and Objective: Chronic viral hepatitis C (VHC) is one of the most discussed infectious diseases worldwide. The number of infected persons worldwide is approximately 170 million, and in Europe, it exceeds 9 million. The aim of this study was to determine the prevalence of antibodies to hepatitis C virus (anti- HCV prevalence) and prevalence of HCV viremia (HCV-RNA prevalence) in Latvia. Material and Methods: A multistage randomized selection was used. A total of 42 primary care physicians (PCPs) were randomly selected from the register of PCPs from different regions of Latvia. From each PCP register, 60 subjects were selected (1651 individuals in total) and invited for the anti-HCV test with a screening method (ELISA). In case of positive results, antibodies were confirmed by the Western blot test, and all these subjects were tested for HCV-RNA by polymerase chain reaction. Results: Of the 1459 subjects tested, 57 were positive for anti-HCV (3.9%; 95% CI 3% to 5%); 35 of them were positive for anti-HCV with a confirmatory test (2.4%; 95% CI, 1.7% to 3.3%): 19 men and 16 women (3.8% and 1.7%, respectively; P=0.011). The results of HCV RNA test were positive in 25 subjects (1.7%; 95% CI, 1.2% to 2.5%): 15 men and 10 women (3% and 1% respectively, P=0.019). Conclusions: The prevalence of anti-HCV and HCV-RNA in Latvia was found to be 2.4% and 1.7%, respectively. The prevalence of anti-HCV and HCV-RNA was higher in men than women.publishersversionPeer reviewe

Pre-existing diabetes mellitus and all-cause mortality in cancer patients: a register-based study in Latvia

<p><b>Background:</b> Most studies from high income countries consistently report that preexisting diabetes reduces overall survival of cancer patients. We examined this association in a retrospective cohort study using two nation-wide population-based data sets in Latvia.</p> <p><b>Material and methods:</b> The Cancer Register, linked with the Diabetes Register and Causes of Death Database, was the first data source used to select 22,936 men and 25,338 women with cancer diagnosed from 2009 to 2013. The follow-up period ended on 28 February 2015. The National Health Service data served as a second data source, which was used to select 10,130 men and 13,236 women with cancer as the main diagnosis, who were discharged from oncology hospitals from 2009 to 2012. Prescriptions of reimbursed antidiabetic medications indicated prior diabetes status. The follow-up period started at the date of discharge and ended on 31 December 2013. A Cox proportional hazards model was used to assess association between preexisting diabetes and all-cause mortality, adjusted for age.</p> <p><b>Results:</b> Men with preexisting diabetes had better overall short-term survival: the age-adjusted hazard ratios (95% CI) were 0.86 (0.79–0.93) for the first year and 0.89 (0.80–0.98) for the first two years after cancer diagnosis according to the disease register and health service data, respectively. After three full follow-up years, their relative mortality increased, with an age-adjusted hazard ratio of 1.60 (1.28–1.99). Among women, preexisting diabetes was associated with slightly higher all-cause mortality during the entire follow-up period, with age-adjusted hazard ratios of 1.17 (1.10–1.24) for the disease register data and 1.11 (1.02–1.21) for the health service data.</p> <p><b>Conclusion:</b> Interestingly, we found better overall survival of diabetic men during the first years after cancer diagnosis. We hypothesize that access to health services may be advantageous to diabetic patients who are in close contact with the healthcare system.</p