Healthy People in a Small Country: How the Lithuanian Health Care System Works
Text and photo by Glib Bitiukov, Patriot Defence instructor
First of all, it should be noted that Lithuania launched reforms in 2005 replacing feldshers with paramedics on ambulances. However, the radical advances Lithuania made is forcing them to take a few steps backwards. Feldshers were removed absolutely as a profession or educational specialisation that resulted in a gap between the paramedics and doctors. The profession of feldsher is now returning.
But Lithuanians quickly learned how to estimate the financial justification of medical facilities and services. For instance, it became clear that there is no need to have ambulance dispatch centres in each city or region. Modern communication systems allow one dispatch centre to cover a large area, so mall communities are exempt from spending money on creating their own. Also, all systems can substitute one another, and in case of failure of one station, a different one, even situated on the other side of the country, can pick up its work.
Generally, the maintenance of the emergency service costs the country nearly 44 million euros per year due to "health insurance", i.e. public health insurance. Each resident spends nearly 40-70 euros per month depending on salary.
If four years ago there were 56 ambulance dispatch centres, then today that number is reduced to 8 and will be further reduced to 2.
On average, each ambulance makes 15-18 calls per day and is 24 hours on duty. Almost every call ends with hospitalisation. As for the scoop-and-run model selected in Kaunas County, all patients are evacuated to a level 3 trauma centre, which is relatively new and one of the best in Europe. It was built in 2015 and is part of a large medical cluster with other clinics.
It is a modern centre with well-targeted planning and infrastructure. Ambulances are able to drive directly into the building - in a special hangar with heating and safe from the environment.
Corridors and doors are spacious and comfortable for stretchers. There is enough space for patients’ medical examination and operating room is right there ON THE GROUND FLOOR! So it takes few minutes to get on to the operating table after arrival of ambulance.
Children's admission room as well as for adults are also right there on the spot. It’s not necessary to take children to another hospital.
The trauma centre is connected to other buildings through underground corridors, which are sometimes so long that medical personnel use electric skateboards or scooters to move through them.
On the one hand I wonder how could such a small country, with population less than in Kyiv (the entire population of Lithuania is nearly 3 million people) can maintain its health care system at such a high level, and on the other hand it’s clear that it is easier to provide quality health care to a small population.
Roughly 12 years ago, the country was almost where we are today. This is a good example of how you can change your own country if the core issue is to value life.