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Wednesday 20.03.2019 | Name days: Made, Irbe

State Audit: development of medical rehabilitation is present only on paper

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Baltic news, News from Latvia, BNN.LV, BNN-NEWS.COM, BNN-NEWS.RUShortage of data on patient needs in medical rehabilitation and accomplished results denies the option to assess the efficiency of state financed rehabilitation and satisfaction of residents’ needs with state budget capabilities.

Without a clear picture for rehabilitation sector to develop, as well as goals and priorities, it is not possible to discuss the quality of rehabilitation services in the country, as concluded by State Audit.

«Many of the development measures found in Healthcare Ministry’s policy documents remain implemented on paper. As long as this is reality, patients will continue to suffer without necessary assistance. For example, in a time when we hear more and more about labour force shortage, medical rehabilitation is not provided to people of working age. In two years’ time, the number of work inability cases for people has increased 15%. Not a single objective to improve rehabilitation services for people with cancer or cardiovascular diseases,» State Auditor Elita Krūmiņa comments.

Working people are getting sicker and sicker

Early commencement of rehabilitation is one of the ways it is possible for people to return back to work as soon as possible. However, it was discovered in the audit that patients of working age do not receive rehabilitation services all that quickly. Additionally, only 8% of people receiving daycare rehabilitation services continue working. The number of people receiving sick leave benefits and whose sick leave lasts longer than six months and whose sick leave certificate mentions occupational disease continues increasing.

Results of the audit point that currently rehabilitation does not focus on preservation and improvement of human health. For example, a quarter of employed people diagnosed with disability suffer from motor function disorders. Specialists say rehabilitation in initial stages plays a major role in shortening the period of work inability. However, 75% of people suffering from motor function diseases receive no rehabilitation whatsoever.

Patients suffering from cancer and cardiovascular diseases – valued on paper

From 2014 to 2017 state funding for rehabilitation had grown by approximately 30%. Healthcare Ministry had initially planned to improve services specifically for patients suffering from cancer and cardiovascular diseases. However, it was uncovered in the audit that not a single objective in this field has been accomplished. Service accessibility for cancer patients has not been increased and no cardiology rehabilitation programme has been developed to improve the quality of life for patients, preserve or improve their health and prevent the need for them to stay in daycare.

The number of cancer patients receiving rehabilitation services does not reach even 1% of their total number. Healthcare Ministry does not even have data on the total number of stroke patients in need of daycare and home care medical rehabilitation. But it is this early rehabilitation that can provide stroke patients with effective treatment. Without coordination on a national level, the search of proper care is in the hands of patients and their relatives.

To reduce the amount of time stroke patients spend in hospitals, it is possible to provide certain rehabilitation services at home. But the shortage of specialists in far-away rural regions and the poor tariff system for healthcare institutions limits the accessibility of these services.

Family physicians should become key people in improving the rehabilitation process

Family physicians play the central role for Latvia’s healthcare model. However, results of the audit show that Healthcare Ministry has not sufficiently strengthened family physicians role in patient rehabilitation. Family physicians are the ones who have to identify disability risks and actively urge patients to undergo rehabilitation to reduce the risk of disability and use healthcare resources more effectively. If the need for patient rehabilitation is not identified in time, they might receive the much-needed rehabilitation too late, which means more resources will be needed to restore their health.

Patients’ participation in resolution of health problems also plays a major role. Interviewed specialists told auditors that patients’ understanding of rehabilitation is insufficient. Sometimes, they said, people lack motivation to participate. State Audit believes family physicians are the ones who should supervise the rehabilitation process, helping patients reach positive results.

Quality, effective and accessible services are needed

Rehabilitation should become a fully-fledged part of healthcare. To accomplish this, State Audit has provided Healthcare Ministry with multiple recommendations to improve the rehabilitation sector. State Audit believes it is necessary to improve family physicians’ understanding of the importance of rehabilitation, as well as assess the opportunity to set up priorities for state-finances medical rehabilitation services.

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