Transition to hospital process orientation : The case of regional hospitals in Latvia

Management of processes instead of functions has growing importance into the health care. Transition to hospital process orientation (HPO) changes the way physicians and other health professionals have used to practice before. Study was performed to explore factors affecting introduction of HPO in Latvian hospitals responding to significant external pressures during the years of economic crisis to detect the best practices used for process management implementation in clinical setting. To reach the research goal dissimilarities between current performance and management of hospitals were explored. As changes in hospital reimbursement system demand improved efficiency, hospital’s performance was measured by decrease in avoidable hospitalisations, and increase in usage of more cost effective alternatives to a full hospitalisation. A regression analysis was performed to evaluate correlations of hospitalisation rates in Latvian hospitals to various outpatient health services utilisation indicators. This was done to exclude influence of external factors on hospital performance and to prove the positive impact of HPO initiatives on hospitalisation rate. Afterward the performance of all regional hospitals was compared and the two most distinct hospitals were selected for further in depth analysis. Operational data of the selected hospitals and a set of structured interviews outlined the differences between both hospital’s managerial practices and factors affecting the introduction of process oriented initiatives. The theoretical research together with comparative analysis of approaches used in both hospitals served as a basis for elaboration of recommendations towards development of HPO and facilitation of the development of self-management competence of health professionalspublishersversionPeer reviewe

Use of generic medicines in Latvia : Awareness, opinions and experiences of the population

Funding Information: Funding was provided by EEA Financial Mechanism and Latvian state (award number 2012.EEZ/DAP/MIC/183). The project is financially supported by Iceland, Liechtenstein and Norway. Publisher Copyright: © 2019 The Author(s).Background: To stimulate use of generic medicines a combination of supply and demand side mechanisms are employed in the Latvian reimbursement system. It is reported that patients have high out-of-pocket pharmaceutical spending and that they overpay by not choosing generic medicines. Patient preferences may be an important obstacle in implementing generic policy. Objective of this study was to assess awareness, opinions and experience of the Latvian population regarding use of generic medicines. Methods: Survey of representative sample of the population of Latvia (n = 1005) aged 18-74 was conducted in March 2015. The survey was distributed in Latvian and Russian languages using Computer Assisted Web Interviews. Associations between experience with generic medicines, preference for medicines, and sociodemographic variables were tested with Pearson Chi-square statistics. Associations between the previous experience and information given by different sources versus choice between medicines were tested with Spearman's correlation test. Results: 72.3% of the population were informed about generic medicines. Men (66.9%) and respondents with primary or secondary education (58.3%; 69.3%) were less informed compared to total (72.3%). From those who recalled using generic medicines (n = 441), 94.4% evaluated their experience as positive or neutral. Despite this, only 21% of the population would opt for generic medicines. The strongest preference for brand-name medicines was in the age group > 55 (40.5%). Opinion of a physician was the most important factor when choosing between generic and brand-name medicines (88.7%). The more positive the information provided by general practitioners, physician specialists, pharmacists, family members, friends and internet is perceived, the more likely respondents are to choose generic medicines (p < 0.001). Conclusion: This study demonstrates that people in Latvia are aware of generic medicines but only a minority of the population would choose them when presented with a choice. It is therefore important that health care professionals provide objective and unbiased information about generic medicines to their patients. Interventions should aim to reach groups that are less informed and to improve providers' understanding and communication with patients about generics.publishersversionPeer reviewe

Facebook communication as a marketing tool to attract new clients: the case of "MyFitness" and "Lemon Gym" sports clubs

Bakalaura darba nosaukums ir ““Facebook” komunikācija kā mārketinga instruments jaunu klientu piesaistei: “MyFitness” un “Lemon Gym” gadījums”. Darbs ir izstrādāts ar mērķi apskatīt, analizēt un salīdzināt sporta klubu “MyFitness” un “Lemon Gym” komunikāciju sociālajā tīklā “Facebook”. Darba teorētiskajā daļā ir apkopota teorija par mārketinga komunikāciju, sociālajiem medijiem un sociālo tīklu “Facebook”, savukārt metodoloģiskajā daļā ir apskatītas darbā izmantotās pētnieciskās metodes – kontentanalīze, daļēji strukturēta intervija un aptauja. Rezultātos ir aprakstīti pētījumā iegūtie dati un darba beigās ir izdarīti secinājumi. Secinājumos ir atklātas abu sporta klubu mārketinga principu kopsakarības un atšķirības sociālajā tīklā “Facebook”.The title of the Bachelor’s thesis is “Facebook communication as a marketing tool to attract new clients: the case of "MyFitness" and "Lemon Gym" sports clubs”. This work is designed to view, analyze and compare the communication between sports clubs “MyFitness” and “Lemon Gym” in the social network “Facebook”. The theoretical part of the thesis summarizes the theory of marketing communication, social media and social network “Facebook”, while the methodological part includes research methods used in the work - content analysis, semi-structured interview and survey. The results describes the data obtained in the study and conclusions are drawn at the end of the work. The conclusions reveals the similarities and differences between two sports clubs marketing principles organized in the social network “Facebook”

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