Latvia

Healthcare System

Latvia operates under a form of universal healthcare system, overseen by the Latvian National Health Service (NHS), a body under the Ministry of Health. The NHS implements healthcare policy, purchases services, and administers healthcare funding. However, access to care sometimes presents challenges due to the geographical distribution of health professionals, user charges, and long waiting lists.

Healthcare benefits are funded primarily through general taxation, with additional financing coming from social security contributions, the rate of which was increased in 2018. While residents receive coverage for a range of services, the publicly-funded health benefits package is somewhat limited. It covers a predetermined number of services each year provided by NHS-contracted providers and institutions but excludes adult dental care, most rehabilitation and physiotherapy, and some other services.

Access to Latvia's healthcare benefits requires formal residency, social security contributions, and registration with a General Practitioner. Despite this, the proportion of out-of-pocket payments is high due to limited state financing, and there has been a rise in privately financed health care services.

Local governments play a role in ensuring geographical access and, depending on budget and local priorities, maintain hospitals and long-term social care facilities. The national parliament, the Saeima, has significant influence over health policy and approves the national and NHS budgets.

Latvia has been advancing in the digitization of health data, with claims data, registries, and electronic health records managed by the NHS through the Latvian eHealth system. It enhances coordination of care by allowing the sharing of patient data across healthcare providers, and also enables patients to access their personal health records.

Administrative or Claims Data

Database: Inpatient Healthcare

Sponsor, manager or home institution: Slimību Profilakses un Kontroles Centrs (SPKC).

Primary purpose: Provide information about inpatient health care.

Type of information: The form used to acquire data from hospitals can be found in Appendix 7. [1].

Available type of information: Number of treated patients, the proportion of treated patients, number of days spent by discharged patients (per 1000 inhabitants), the average duration of treatment, patient mortality; filtered by diagnosis and age group. Other indicators include the number of adult and children oncology beds used in the year, the number of admitted patients, the number of patients transferred within the hospital to and from other departments, and the number of discharged patients.

Source of Information: Information is submitted by medical institutions using the form available in Appendix 7 of this document [2].

Data level: Patient level.

Available data level: National level.

Number of Records: Unknown.

Date Range: 2011 onwards.

Cancer Areas of Interest: Tumors (C00-C48); Malignant neoplasms (including lymphoid and hematopoietic) (C00-C97).

Open data access: Partially publicly available [3]. Instructions to request data for restricted content [4].

Information/Contact for data request: Contact information [5].

Registries

Database: VSD Cancer Registry

Sponsor, manager or home institution: Slimību Profilakses un Kontroles Centrs (SPKC)

Primary purpose: Provide information about cancer incidence and epidemiology.

Available type of information: Number of registered cancer by region, administrative territory, gender, age group, location and stage at time of diagnosis, among other metrics. More information about the variables can be found here.

Source of Information: Data collected from hospital data sources, population registries, cause of death databases, and registers for other diseases that contain oncological data.

Data level: Patient level.

Available data level: Administrative territory, regional and national level.

Number of Records: Unknown.

Date Range: 2010 to 2019.

Cancer Areas of Interest: Malignant tumors (C00-C97); Lips, oral cavity, pharynx oropharynx (C00-C10); Esophagus (C15); Stomach (C16); Colon (C18); Colorectal part (C18-C21); Sigmoid-rectal junction, rectum (C19-C20); Anus (anus) and anal canal (canalis analis) (C21); Liver and intrahepatic bile ducts (C22); Liver and intrahepatic bile ducts (C22); Pancreas (C25); Varyncs (C32); Bronchi and lungs (C34); Bones, articular cartilage (C40-C41); Cutaneous melanoma (C43); Other malignant neoplasms of the skin (C44); Chest (C50); Female external genitalia, vagina (C51-C52); Cervix (C53); Body of uterus (C54-C55); Ovaries (C56); Prostate (C61); Testis (C62); Kidney (C64); Bladder (C67); Brain (C71); Thyroid (C73); Imprecisely marked, secondary and non-localized (C76-C80); Hodgkin lymphoma (C81); Lymphoid, hematopoietic and related tissues (C81-C96); Non-Hodgkin lymphoma (C82-C85); Multiple myeloma and malignant plasma cell neoplasms (C90); Lympholeicosis (C91); Mielokeikoze (C92); Acute myeloblastic leukemia (C92.0); Chronic myelogenous leukemia (C92.1). Diagnoses staged according to TNM classification (C00-C69, C73-C80); Meninges, brain, cranial nerves and other parts of the central nervous system (C70-C72).

Open data access: Data is partially publicly available. Data can be found here. Information on how to access the full database can be found here.

Information/Contact for data request: Contact information can be found here.

Database: VSD Mortality Registry

Sponsor, manager or home institution: Slimību Profilakses un Kontroles Centrs (SPKC)

Primary purpose: Provide information about mortality incidence and epidemiology.

Available type of information: Cause of death by month, age group, COVID-19 vaccination status; cause of infant and child mortality by age group; potentially lost years of life by region, gender, and sex; as well as other information.

Source of Information: Data collected from death certificates and other populational databases.

Data level: Patient level.

Available data level: Administrative territory, regional and national level.

Number of Records: Unknown.

Date Range: Varies depending on the variable.

Cancer Areas of Interest: Tumors (C00-D48); Malignant tumors (C00-C97); Malignant tumors of lips and oral cavity (C00-C10); Malignant neoplasm of oesophagus (C15); Malignant tumor of stomach (C16); Malignant tumors of the colorectal part (C18-C21); Malignant tumor of colon (C18); Malignant neoplasm of sigmoid and rectal junction, malignant neoplasm of rectum (C19-C20; Malignant neoplasm of liver and intrahepatic biliary tract (C22); Malignant neoplasm of pancreas (C25); Malignant neoplasm of larynx (C32); malignant neoplasm of bronchi and lungs (C34); malignant tumors of bones and articular cartilage (C40-C41); Malignant neoplasm of skin (C43); Other malignant neoplasms of the skin (C44); Malignant neoplasms of mesothelial and soft tissue (C45-C49); Malignant neoplasm of breast; Malignant neoplasm of cervix (C53**); Malignant neoplasm of uterine body (C54**); Malignant tumor of ovary (C56**); Malignant neoplasm of prostate (C61***); Malignant neoplasm of kidney, excluding renal pelvis (C64); Malignant neoplasm of bladder (C67); Malignant tumor of brain (C71); Malignant neoplasm of thyroid gland (C73); Unsoecified and unlocalized malignant neoplasms (C76-C80); Malignant neoplasms of lymphoid, hematopoietic and related tissues (C81-C96); Hodgkin's disease (C81); Non-Hodgkin's lymphoma (C82-C85); Leukosis (C91-C95).

Open data access: Data is partially publicly available. Data can be found here. Information on how to access the full database can be found here.

Information/Contact for data request: Contact information can be found here.

Databases for Clinical Trials, Surveys and Biobanks

Survey: Study of habits affecting the health of the population of Latvia, 2020

Sponsor, manager or home institution: Slimību Profilakses un Kontroles Centrs (SPKC).

Primary purpose: Collect information about the health habits of the adult population of Latvia (15-74 years old)

Type of information: Sociodemographic characteristics (gender, age, nationality, place of residence, marital status, number of children in the family, level of education, occupation, income level), health condition (self-assessment of health, frequency of visits to doctor, diagnosed diseases, individual disease symptoms and complaints, medication use, preventive health activity), health care and access to health care services and satisfaction with them, health habits (diet, physical activity, smoking, alcohol and drug use, compliance with traffic safety requirements) and efforts to change them, attitudes towards health, health and safety promotion.

Source of Information: Responses to the survey question conducted all over Latvia.

Data level: Respondent level.

Number of Records: 3,505.

Date Range: 2020. Similar surveys were also conducted every 2 years since 1998.

Cancer Areas of Interest: All.

Open data access: Data is not publicly available. Reports can be found here. Information on how to access the data can be found here.

Information/Contact for data request: Contact information can be found here.

Cancer-related Patient Associations and Resources

Compilation: ESMO Patient Guides

Sponsor, manager or home institution: European Society for Medical Oncology

Primary purpose: To translate complex medical language into understandable information for patients.

Available guides: Side Effects of Immunotherapy.

Type of information: Information on each guide varies for each cancer type. Generally, guides provide definitions, explanations of causes, diagnosis, treatment, treatment options, care after treatment, among others.

Access to information: List of guides [1].

Clinical Practices Guidelines

Compilation: SPKC Clinical Guidelines

Sponsor, manager or home institution: Slimību Profilakses un Kontroles Centrs (SPKC).

Primary purpose:' Provide guidelines on how to diagnose and treat several medical conditions.

Type of information: Clinical practices guidelines containing information about diagnosis, staging, treatment and follow-up for a number of diseases, including several types of cancer such as cervical, skin, prostate, breast and rectal cancer.

Access to information: Information can be found here.

Latest Policymaking Initiatives

Compilation: SPKC Reports

Sponsor, manager or home institution: Slimību Profilakses un Kontroles Centrs (SPKC).

Primary purpose:' Provide reports on the research conducted by the institute.

Type of information: Reports on smoking habits and analysis on public health data, which includes cancer data.

'Level: National level.

Access to information: Information can be found here.

Report: Study on the Health Habits of School-Aged Children

Sponsor, manager or home institution: Slimību Profilakses un Kontroles Centrs (SPKC); Riga Stradins University.

Primary purpose: Report on the results of the International Study on Health Behavior in School-Aged Children.

Type of Information: Information on school-aged children's health behavior, including smoking habits by gender, age, among other measures.

Level: National level.

Access to information: Reports from multiple years can be found here.