Lithuania: health system review.

This analysis of the Lithuanian health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance since 2000.The Lithuanian health system is a mixed system, predominantly funded from the National Health Insurance Fund through a compulsory health insurance scheme, supplemented by substantial state contributions on behalf of the economically inactive population amounting to about half of its budget. Public financing of the health sector has gradually increased since 2004 to 5.2 per cent of GDP in 2010.Although the Lithuanian health system was tested by the recent economic crisis, Lithuanias counter-cyclical state health insurance contribution policies (ensuring coverage for the economically inactive population) helped the health system to weather the crisis, and Lithuania successfully used the crisis as a lever to reduce the prices of medicines.Yet the future impact of cuts in public health spending is a cause for concern. In addition, out-of-pocket payments remain high (in particular for pharmaceuticals) and could threaten health access for vulnerable groups.A number of challenges remain. The primary care system needs strengthening so that more patients are treated instead of being referred to a specialist, which will also require a change in attitude by patients. Transparency and accountability need to be increased in resource allocation, including financing of capital investment and in the payer provider relationship. Finally, population health,albeit improving, remains a concern, and major progress can be achieved by reducing the burden of amenable and preventable mortality.

Lithuania: health system review

This analysis of the Lithuanian health system reviews the developmentsin organization and governance, health financing, health care provision,health reforms and health system performance since 2000. TheLithuanian health system is a mixed system, predominantly funded from theNational Health Insurance Fund through a compulsory health insurance scheme,supplemented by substantial state contributions on behalf of the economicallyinactive population amounting to about half of its budget. Public financingof the health sector has gradually increased since 2004 to 5.2% of GDP in2010. Although the Lithuanian health system was tested by the recent economiccrisis, Lithuania’s counter-cyclical state health insurance contribution policies(ensuring coverage for the economically inactive population) helped the healthsystem to weather the crisis, and Lithuania successfully used the crisis as alever to reduce the prices of medicines. Yet the future impact of cuts in publichealth spending is a cause for concern. In addition, out-of-pocket paymentsremain high (in particular for pharmaceuticals) and could threaten healthaccess for vulnerable groups. A number of challenges remain. The primarycare system needs strengthening so that more patients are treated instead ofbeing referred to a specialist, which will also require a change in attitude bypatients. Transparency and accountability need to be increased in resourceallocation, including financing of capital investment and in the payer–providerrelationship. Finally, population health, albeit improving, remains a concern,and major progress can be achieved by reducing the burden of amenable andpreventable mortality.

The psychosocial factors at work related to depression among female white-collar workers in Vilnius (Lithuania).

OBJECTIVES: The aim of this study is to establish which psychosocial factors at work are related to depression among female white-collar workers in Vilnius. MATERIALS AND METHODS: The data was collected in a case-control study in 2002-2004. The cases were selected from patients treated at Vilnius mental health centers. The controls were randomly selected from employed Vilnius residents. A descriptive statistic and logistic regression was applied. RESULTS: 3 psychosocial factors and possible confounders within the evaluated model were statistically reliable (model χ(2): 44.47, p < 0.05 ). The adjusted odds ratio for uneven work distribution was 2.17 (95% CI: 1.38-3.51, p < 0.005), the odds ratio for possibility to control was 10.81 (95% CI: 2.13-54.71, p < 0.005), and the odds ratio for family esteem was 2.13 (95% CI: 1.01-4.59, p < 0.005). CONCLUSION: This study suggests that work distribution, possibility to control and family esteem, together with stressful life events and mental health disorders in the family, are related to depression among female white-collar workers.

Lithuania mental health country profile.

As a part of international mental health policy, programmes and services project, the 'country profile' instrument was used for assessment of mental health policy and services in the Republic of Lithuania. Analysis of contextual factors revealed high levels of social pathology (including violence, suicide and other self-destructive behaviour) with stigmatizing approaches by the general population to mentally disturbed persons and other vulnerable groups. Analysis of existing data about resources invested in the mental health care system raises questions for policymakers about the effectiveness of this traditional way of investment. The largest proportion of physical and human capital is concentrated in psychiatric institutions, with large numbers of beds, psychiatrists and increasing funding for medications, while other components of care--such as housing, psychosocial and vocational rehabilitation, community-based child mental health services--are not being developed. Statistical accounts keep the tradition of presenting processes as outcomes, while modern assessment of outcomes of services, programmes and policies are lacking. The findings from this country profile may be very useful in the development of modern mental health policies in the countries of Eastern and Central Europe, which have been deprived for decades from the opportunity to introduce evidence-based mental health policies and services.