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As of 2019 [update] Lithuanian life expectancy at birth was 76.0 (71.2 years for males and 80.4 for females) [1] and the infant mortality rate was 2.99 per 1,000 births. [2] This is below the EU and OECD average. [3]
Lithuania has seen a dramatic rise in suicides in the 1990s. [4] The suicide rate has been constantly decreasing since, but it still remains the highest in the EU and the OECD. [5] Suicide in Lithuania has been a subject of research. As of 2019, the suicide rate is 20.2 per 100,000 people. [4] As of 2017, 4.3% of deaths in Lithuania are caused by accidents. [6]
In 2018, Lithuania ranked 28th in Europe in the Euro health consumer index, a ranking of European healthcare systems based on waiting time, results and other indicators.
After independence in 1918 a health care system based on the Bismarck model began to develop.[ citation needed ] In 1949, when it was absorbed into the USSR, it was reorganized according to the centralised Semashko system. It was relatively well funded and the population's health status was better than in other parts of the USSR.[ citation needed ] Lithuania moved away from a system funded mainly by local and state budgets to a mixed system, predominantly funded by the National Health Insurance Fund in the late 1990s. [7] The deterioration in health which occurred during the first phase of social reforms was halted in 1994 and the standardized death rate decreased from 12.06 (per 1000 population) in 1994 to 10.16 in 1998. [8]
The National Health Concept was adopted in 1991 by the Supreme Council – Reconstituent Seimas. It introduced health insurance, and prioritised disease prevention and primary care. In 1998 the Lithuanian Health Programme was adopted by the Seimas. This set as priorities the reduction of mortality and increased life expectancy, improvements in the quality of life, and increases in health equity. The National Health Insurance Fund was established. [9]
By 2000 the vast majority of Lithuanian health care institutions were non-profit-making enterprises and a private sector developed, providing mostly outpatient services which are paid for out-of-pocket. The Ministry of Health also runs a few health care facilities and is involved in the running of the two major Lithuanian teaching hospitals. In 2012 there were 52 fewer hospitals than there had been in 1990. There were 66 general hospitals, 26 secondary hospitals, 49 nursing hospitals, and 4 rehabilitation hospitals. The ministry is responsible for the State Public Health Centre which manages the public health network including ten county public health centres with their local branches. The ten counties run the county hospitals and specialised health care facilities. [10]
Total expenditure on healthcare per head of the population was $1,579 in 2013, 6.2% of GDP. There were 12,191 physicians in the country in 2009, 36.14 per 100,000 population. [7]
There is now Compulsory Health Insurance for Lithuanian residents. There are 5 Territorial Health Insurance Funds, covering Vilnius, Kaunas, Klaipėda, Šiauliai and Panevėžys. Contributions for people who are economically active are 9% of income. [11] In 2016 225,510 people, about 8% of the population, had not paid their contributions to the National Health Insurance fund, but it was thought many were actually not in the country. The insurance scheme does not cover adult dentistry or, for most people, outpatient prescription medicines. Only about 1% take out additional voluntary health insurance. [12]
Emergency medical services are provided free of charge to all residents. Access to hospital treatment is normally by referral by a General Practitioner. [13] Prescribable medicines are listed in the Lithuanian State Medicines Register.
A health system, health care system or healthcare system is an organization of people, institutions, and resources that delivers health care services to meet the health needs of target populations.
Publicly funded healthcare is a form of health care financing designed to meet the cost of all or most healthcare needs from a publicly managed fund. Usually this is under some form of democratic accountability, the right of access to which are set down in rules applying to the whole population contributing to the fund or receiving benefits from it.
Health care in Ireland is delivered through public and private healthcare. The public health care system is governed by the Health Act 2004, which established a new body to be responsible for providing health and personal social services to everyone living in Ireland – the Health Service Executive. The new national health service came into being officially on 1 January 2005; however the new structures are currently in the process of being established as the reform programme continues. In addition to the public-sector, there is also a large private healthcare market.
The health care system in Japan provides different types of services, including screening examinations, prenatal care and infectious disease control, with the patient accepting responsibility for 30% of these costs while the government pays the remaining 70%. Payment for personal medical services is offered by a universal health care insurance system that provides relative equality of access, with fees set by a government committee. All residents of Japan are required by the law to have health insurance coverage. People without insurance from employers can participate in a national health insurance program, administered by local governments. Patients are free to select physicians or facilities of their choice and cannot be denied coverage. Hospitals, by law, must be run as non-profits and be managed by physicians.
Health in Cuba refers to the overall health of the population of Cuba. Like the rest of the Cuban economy, Cuban medical care suffered following the end of Soviet subsidies in 1991; the stepping up of the US embargo against Cuba at this time also had an effect.
Healthcare in Europe is provided through a wide range of different systems run at individual national levels. Most European countries have a system of tightly regulated, competing private health insurance companies, with government subsidies available for citizens who cannot afford coverage. Many European countries offer their citizens a European Health Insurance Card which, on a reciprocal basis, provides insurance for emergency medical treatment insurance when visiting other participating European countries.
Germany has a universal multi-payer health care system paid for by a combination of statutory health insurance and private health insurance.
Healthcare in Russia is provided by the state through the Federal Compulsory Medical Insurance Fund, and regulated through the Ministry of Health. The Constitution of the Russian Federation has provided all citizens the right to free healthcare since 1993. In 2008, 621,000 doctors and 1.3 million nurses were employed in Russian healthcare. The number of doctors per 10,000 people was 43.8, but only 12.1 in rural areas. The number of general practitioners as a share of the total number of doctors was 1.26 percent. There are about 9.3 beds per thousand population—nearly double the OECD average.
Healthcare in Taiwan is administered by the Ministry of Health and Welfare of the Executive Yuan. As with other developed economies, Taiwanese people are well-nourished but face such health problems as chronic obesity and heart disease. In 2002 Taiwan had nearly 1.6 physicians and 5.9 hospital beds per 1,000 population. In 2002, there were 36 hospitals and 2,601 clinics in the country. Per capita health expenditures totaled US$752 in 2000. Health expenditures constituted 5.8 percent of the gross domestic product (GDP) in 2001 ; 64.9 percent of the expenditures were from public funds. Overall life expectancy in 2019 was averaged at 81 years.
Healthcare in Turkey consists of a mix of public and private health services. Turkey introduced universal health care in 2003. Known as Universal Health Insurance Genel Sağlık Sigortası, it is funded by a tax surcharge on employers, currently at 5%. Public-sector funding covers approximately 75.2% of health expenditures.
Healthcare in Finland consists of a highly decentralized three-level publicly funded healthcare system and a much smaller private sector. Although the Ministry of Social Affairs and Health has the highest decision-making authority, specific healthcare precincts are responsible for providing healthcare to their residents as of 2023.
Healthcare in Georgia is provided by a universal health care system under which the state funds medical treatment in a mainly privatized system of medical facilities. In 2013, the enactment of a universal health care program triggered universal coverage of government-sponsored medical care of the population and improving access to health care services. Responsibility for purchasing publicly financed health services lies with the Social Service Agency (SSA).
Healthcare in Denmark is largely provided by the local governments of the five regions, with coordination and regulation by central government, while nursing homes, home care, and school health services are the responsibility of the 98 municipalities. Some specialised hospital services are managed centrally.
Healthcare in the United States is largely provided by private sector healthcare facilities, and paid for by a combination of public programs, private insurance, and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare, and a significant proportion of its population lacks health insurance. The United States spends more on healthcare than any other country, both in absolute terms and as a percentage of GDP; however, this expenditure does not necessarily translate into better overall health outcomes compared to other developed nations. Coverage varies widely across the population, with certain groups, such as the elderly and low-income individuals, receiving more comprehensive care through government programs such as Medicaid and Medicare.
Examples of health care systems of the world, sorted by continent, are as follows.
A new measure of expected human capital calculated for 195 countries from 1990 to 2016 and defined for each birth cohort as the expected years lived from age 20 to 64 years and adjusted for educational attainment, learning or education quality, and functional health status was published by The Lancet in September 2018. Latvia had the twenty-first highest level of expected human capital with 23 health, education, and learning-adjusted expected years lived between age 20 and 64 years.
Healthcare in Luxembourg is based on three fundamental principles: compulsory health insurance, free choice of healthcare provider for patients and compulsory compliance of providers in the set fixed costs for the services rendered. Citizens are covered by a healthcare system that provides medical, maternity and illness benefits and, for the elderly, attendance benefits. The extent of the coverage varies depending on the occupation of the individual. Those employed or receiving social security have full insurance coverage, and the self-employed and tradesmen are provided with both medical benefits and attendance benefits. That is all funded by taxes on citizens' incomes, payrolls and wages. However, the government covers the funding for maternity benefits as well as any other sector that needs additional funding. About 75% of the population purchases a complementary healthcare plan. About 99% of the people are covered under the state healthcare system.
Modern Mongolia inherited a relatively good healthcare system from its socialist period. A World Bank report from 2007 notes "despite its low per capita income, Mongolia has relatively strong health indicators; a reflection of the important health gains achieved during the socialist period." On average Mongolia's infant mortality rate is less than half of that of similarly economically developed countries, its under-five mortality rate and life expectancy are all better on average than other nations with similar GDP per capita.
Healthcare in Slovakia has features of the Bismarck, the Beveridge and the National Health Insurance systems. It has public health system paid largely from taxation. The cost of national health insurance is shared between the employees and the employers. The part of these taxes are paid by the employees as a deduction from theirs wages and the remaining part of these taxes is paid as compulsory contribution by employers. Sole traders pay the full amount of these taxes.
The National Health Insurance Fund or VLK is a key part of the healthcare system in Lithuania. It was established in 1993.