Rehabilitation in Latviagetting state-funded rehabilitation and how long the wait is

Rehabilitation involves several professions, each with a distinct role.

The National Health Service states that home rehabilitation under the agreed plan is delivered by a physiotherapist, physiotherapy assistant, occupational therapist or clinical speech therapist.

The usual route to state-funded rehabilitation has two steps:

1. 1First see the family doctor, who assesses your condition and medical indications and, where needed, issues a referral to a rehabilitation doctor or physical and rehabilitation medicine doctor.
2. 2That doctor then selects patients and issues the referral for the rehabilitation services themselves.

The exception that shortens the route. Public sources state that where state-funded outpatient rehabilitation of up to 5 sessions is needed, the referral can also be issued by a family doctor who holds a National Health Service contract and can assess the patient's functional limitations.

The same sources note that there are few rehabilitation doctors in Latvia while demand is high, and that because the service is delivered within state quotas a queue is close to unavoidable. Outpatient rehabilitation, without a hospital stay, is comparatively more available across providers than inpatient rehabilitation.

Outpatient rehabilitation

Public sources name the Children's Clinical University Hospital, the National Rehabilitation Centre "Vaivari", the Latgale region rehabilitation centre "Rāzna", the "Līgatne" rehabilitation centre, the "Jaunķemeri" spa rehabilitation centre, Vidzeme Hospital, the Tērvete rehabilitation centre, the Krimulda rehabilitation centre and the "Baltezers" rehabilitation centre.

Inpatient rehabilitation

The National Health Service also names Rīga 2nd Hospital and Daugavpils Regional Hospital among inpatient providers.

Rehabilitation at home

The National Health Service publishes a list of providers delivering state-funded rehabilitation at home. Stroke patients can receive it at home within the healthcare-at-home service.

Current provider lists and queue lengths are published by the National Health Service, which notes that queue data is received from providers once a month.

The National Rehabilitation Centre "Vaivari" describes the process:

• Patients are referred for rehabilitation by a physical and rehabilitation medicine doctor.
• The centre enters the patient in a waiting register.
• When your place comes up, the centre telephones with the date to attend.
• To find out the approximate planned date, send an application signed with a secure electronic signature to rinda@nrc.lv, giving your name, personal identity number and a callback telephone number.

Public sources note that a patient's condition can change during the wait, for instance if another operation happens or a different illness begins, in which case the original referral is no longer current and the doctor must be seen again.

• Outpatient or inpatient. Outpatient rehabilitation is more available, so where the condition allows it is the faster route.
• The five-session route. If up to five outpatient sessions are needed, a family doctor can issue the referral and the wait for a rehabilitation doctor is avoided.
• Rehabilitation at home. If getting about is difficult, ask about home-based rehabilitation.
• Children. Paediatric rehabilitation has its own provider list, and the service is state-funded with a referral.
• The private route. If the queue is not acceptable, rehabilitation doctor and therapist consultations can be paid for privately.

The National Rehabilitation Centre "Vaivari" states that on arrival for state-funded rehabilitation the patient must present an extract from their medical record, form No. 027/u.

Also useful:

• The physical and rehabilitation medicine doctor's referral or e-referral.
• Previous test results and hospital discharge summaries.
• A full list of medicines taken.
• Proof of exemption from the patient co-payment, if applicable.

In the public system the patient pays the co-payment, except for exempt groups.

• Specialist visit with a referralPrice EUR: 4.00Source: NVD
• Day hospital, per dayPrice EUR: 7.00Source: NVD
• Inpatient care, from the second dayPrice EUR: 10.00Source: NVD
• Children under 18Price EUR: 0.00Source: NVD
• Rehabilitation doctor and therapist consultation without a referralPrice EUR: per provider price listSource: RC "Rāzna"

The "Rāzna" rehabilitation centre states that where a patient has no family doctor or specialist referral, no physical and rehabilitation medicine doctor referral, or declines to wait in the queue, the rehabilitation doctor and therapist consultations and other rehabilitation services can be obtained privately.

Two organisations represent the field:

• Latvijas Ārstu rehabilitologu asociācija, registration number 40008033635, contacts Anda Nulle and Uģis Beķeris, prm.lv.
• Latvijas rehabilitācijas ārstu biedrība, registration number 40008268272, contact Illa Mihejeva.

Certificates are issued by the Certification Council of the Latvian Medical Association. The sector regulator is the Health Inspectorate.

If you have doubts about the quality of care, raise them first with the provider's management. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.