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16/04/2019   Funding and Organisation of Health Care Lack Consistency

The National Audit Institution for the first time have carried out an assessment of the health care system in which it gave an overview of audits conducted during the nine-year period and have identified the main areas of concern that should receive particular attention. The purpose of the assessment of the health care system was to provide the auditors‘ insights in achieving higher impact of audit recommendations, to urge the interested parties to undertake more active actions, and to address the most urgent challenges.

In Lithuania, life expectancy is by six years shorter than that of a statistical European, the number of deaths that could be avoided through visiting a health institution is twice as high as the EU average. Paradoxically, however, that the number of doctors is by 20 percent higher, the number of hospital beds is by 45 percent higher, and the number of visits to health care institutions is by one third higher in Lithuania compared to the EU average. In order to ensure sustainability of health insurance and quality of health care services, it is Important to take into account the conclusions repeatedly provided by the auditors and to properly implement audit recommendations.

“The assessment carried out showed that the state, under the current regulation, has undertaken commitments that do not correspond to its financial capacities - to pay for 19 groups of insured persons from the state budget funds, to allocate appropriations for the implementation of 4 state functions which, in our opinion, could be reviewed,” - says Vilma Maslauskienė, Chief Advisor of the Public Welfare Audit Department.

Auditors attract attention to the fact that it is not possible to evaluate the state’s commitments to the Compulsory Health Insurance Fund as the state provides assets free of charge for some of the health institutions, also it pays health insurance contributions for 54 percent of insured persons that are by 16 percent lower than insurance contributions paid by persons receiving minimal monthly salary. Besides, insufficient funding is allocated to the Fund for the implementation of state functions.

Analysis of previous audits showed that the scope and composition of health care services are not clearly defined, prices for health care services are not based on actual costs, and development of less costly ambulatory services is insufficient.

According to the auditors, possibilities to improve the quality of health care services are not fully used. Accessibility of services of specialist doctors is not ensured, analysis of undesirable events is not carried out, larger part of expensive equipment is not used to the full extent, payment for services is not related to the treatment results.

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Last updated on 18 June 2019

National Audit Office of Lithuania

Pamėnkalnio St 27, LT-01113 Vilnius, Phone: + 370 5 266 6793, + 370 5 266 6752, Email: