Perceived quality and confidence in the healthcare system: People’s Voice survey results in Latvia

Background

Perceived quality of the healthcare system (HCS) and trust in it can serve as drivers of reforms aimed at improving HCSs, enhancing adherence to treatment and prevention and encouraging individuals to seek help earlier. This can lead to better health outcomes and lower HCS costs. This study reports on the Latvian population’s confidence in and perceived quality of the Latvian HCS, along with the associated factors.

Methods

A cross-sectional People’s Voice survey was conducted from October 2025 to January 2026 using a nationally representative panel in Latvia. A total of 2,460 respondents aged 15 years and older participated. Survey weights were applied to ensure national representativeness.

Results

41,5% of the respondents reported being somewhat or very confident that they could get good-quality care if very sick, and 26,8% being able to afford it. Additionally, 24.3% of respondents rated the quality of public and 58.4% rated the quality of private HCS (provided by private institutions) as very good or good. Further analysis showed that lower levels of education, higher income, and living in a capital city are associated with greater confidence in HCS. Higher income and lower education levels regarding public healthcare, and higher income, higher education levels and private healthcare insurance regarding private healthcare are associated with higher HCS quality ratings. However, self-rated health status showed the strongest associations, particularly regarding respondents’ confidence in affording care: respondents with poor or very poor health had 5.69 times higher (unadjusted) odds of low confidence (p < 0.001) than those with good or very good health.

Conclusions

Confidence in Latvia’s HCS and the rating of public HCS quality are relatively low, especially among respondents with a poor or very poor self-reported health status. Additionally, a person’s education level, income, and health insurance status are associated with perceived HCS quality.

Key messages

• Latvian population’s overall confidence in the healthcare system and perception of public HCS quality is relatively low, especially among respondents reporting poor health status.

• There is a gap between perceived public and private HCS quality in Latvia, and factors such as self-rated health status, education level, income level, and health insurance status contribute to it.