Population perspectives on health system performance: preliminary findings from Latvia
A Villerusa, K Kukoja, I Stars, G Briģis, D GrinbergaAbstract
Background
While the healthcare system in Latvia is publicly regulated and financed through general state tax revenues, there is also a significant private sector. Patients pay a high proportion of healthcare costs directly. The People’s Voice Survey is the first to capture the views of the general population on the use, experience and quality of healthcare.
Methods
The cross-sectional study involved Latvian residents aged 15 and over, and used a random, representative panel sample of 2460 individuals, according to territorial and demographic distribution. Fieldwork was conducted from October 2025 to January 2026, using a combined CAWI and CATI approach.
Results
Overall, 80.7% of respondents indicated that they have one regular service provider, most often a family doctor. Distance, the quality of service and the fact that it is the only option play an important role in their choice. 29.7% of respondents indicated that they have additional voluntary health insurance. Insurance is more prevalent among employed with higher income. Overall, 12.8% of respondents, and 21.2% of those with disabilities, did not receive the necessary healthcare services when needed in the last year. The most common reasons were long waiting times (43%), additional out-of-pocket payments (18.7%), and poor previous experience. Those who did not receive the service were twice as likely to report poor or very poor health and a long-term illness, have lower incomes and no additional health insurance. 14.3% of respondents indicated that they had borrowed money to pay for healthcare. 82% believe that significant changes are needed to the healthcare system in Latvia.
Conclusions
The Latvian healthcare system is characterized by socio-demographic and geographical inequalities in access, utilization and experience, leading to low public trust in the system. The survey reveals problems that require political and practical interventions to address.