Lithuania has made strong progress in reshaping its health system since the 1990s but further reforms are needed to urgently improve the quality of health services and make spending more efficient, according to a new OECD report.
OECD Reviews of Health Systems: Lithuania 2018 says that although health spending, at 6.5% of GDP, is low, the system provides broadly adequate access to care. A well-run health insurance fund covers virtually the entire population and admission rates and physician visits are well above OECD averages.
“Lithuania’s reforms over the past 30 years have created a modern, financially sustainable health system,” said Agnès Couffinhal, Senior Economist in the OECD Health Division, launching the report in Vilnius, with Lithuania’s Minister for Health Aurelijus Veryga and EU Commissioner Vytenis Andriukaitis. “The focus now must be on improving quality and efficiency. Additional resources should be directed to where they will have the most impact on health outcomes.”
Life expectancy is rising slowly, but remains almost six years below the OECD average, with a larger gender gap than in any other OECD country. Women live nearly 11 years longer than men.
Chronic conditions account for the majority of deaths, and excess mortality due to cardio-vascular diseases and suicide are more than double the OECD average.
Fewer adults in Lithuania report being in good or excellent health than in most OECD countries. Only 43% of the population aged 15 years and above reports good or very good health while the OECD average is 68%. Elderly people report particularly poor health.
Many of the deaths which occur before the age of 65 could have been prevented altogether or are due to diseases that could be better treated to avoid fatal outcomes.
The health system remains too centred on hospitals, according to the report. Lithuania is still one of the countries with the highest number of beds and hospitalisations per capita in the OECD, and the bed occupancy ratio is below the OECD average in 85% of hospitals. Further restructuring hospitals to ensure complex services are delivered more safely in fewer facilities would improve quality and efficiency.
The modern primary care system already in place must be further challenged to deliver effective interventions which prevent and help manage non-communicable diseases, including poor mental health, and to coordinate care.
Throughout the health care system, the quality assurance culture must be strengthened and stakeholders deliver measurable improvements.
Recent policies to curb harmful drinking go in the right direction but all stakeholders must be more effectively held accountable for progress on public health initiatives.
Greater use of performance data and fostering a culture of policy evaluation of impact would help identify the most efficient way to deliver progress.