Health Care Regionalisation Project: Development Plan And Implementation In Pilot Area

Present hospital development plan is the result of the activities set in motion by the Ministry of Welfare’s wish to lay the foundations for decisions on the future geographical organisation of the provision of health care in the republic of Latvia. The work has been funded by the Latvian Ministry of Welfare and by a grant from the Danish Government. A pilot area was established, after application to the Ministry of Welfare, in the districts of Cesis, Limbazi, Valka and Valmiera with a total amount of approximately 200,000 inhabitants. The project work has been performed as a cooperation between working groups comprising professionals from the involved hospitals and Latvian and Danish Technical Assistance Consultants. The following issues have been taken into consideration in the proposal: prognosis for need of beds, working group proposals, technical assistants (TAs)' knowledge about links between specialities, need for securing high standards of care, preparation of one regional hospital able to counteract the export of patients to state capital clinics, investment needs in building and equipment, supposed socio-economic situation in the urban and rural areas in 2005, supposed transportation possibilities in 2005. The project recommendations are: to implement a change in the bed allocation and specialities allocation between the hospitals in the pilot area; to establish a Regional Health Board as a decision making body consisting of politicians appointed by the hospital owners and including a regional central technical service organisation. As to the implementation, only few recommendations have been implemented. Instead of establishing the Regional Health Board, District Sickness Funds have been merged to one Regional Sickness Fund, which is the organisation responsible for the distribution of the health care budget among health care providers. It will be possible to implement other project proposals after establishing the health management organisation in the region. There are a lot of objective and subjective factors, which affect the implementation of the project recommendations.