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With the growing number of patients, the East Hospital improves efficiency and optimises costs amid limited funding in 2024
In 2024, the number of patients receiving inpatient care at the Riga East Clinical University Hospital (East Hospital) increased by nearly 1800 patients, while the number of inpatient surgeries rose by more than 8000, and the number of outpatient consultations and visits grew by almost 114 000. According to the hospital’s operational report 2024, the number of outpatient surgeries and all types of examinations also increased, while hospital specialists actively contributed to improving treatment efficiency and implementing innovations. The financial situation of the East Hospital remained challenging in 2024, as the state-allocated funding was insufficient to fully cover the actual costs of patient treatment, which, in turn, prompted the implementation of several cost-optimisation measures. Meanwhile, the East Hospital continues its progress towards implementing the ‘Hospital of the Future’ concept, ensuring the execution of key projects essential for long-term development.
In 2024, a total of 62 547 patients received inpatient care at the East Hospital, marking an increase of 3% or 1796 patients during the reporting period compared to 2023, which is a considerable increase. During this period, the East Hospital performed 60 491 surgeries, which represents an increase of 8191 surgeries or 15.7% more than in 2023. The Emergency Medicine and Patient Admission Clinic provided care to nearly 92 000 patients, which is the highest increase in the hospital’s history – 8960 more patients or 10.8% more than in 2023.
The number of patients has also grown in East Hospital’s various specialised day-care facilities which continue to expand the range of procedures and examinations, significantly reducing treatment time. The number of patients admitted to day-care facilities had reached 37 200 by 2024 – an increase of 4058 patients or 12.2% compared to 2023, while the number of surgeries performed in those facilities also grew by 4.4%, totalling 35 716 surgeries. The ophthalmology, chemotherapy, surgery, and haemodialysis day-care facilities accounted for the highest number of patients in 2024.
A total of 840 215 outpatient visits / remote consultations and examinations were provided, reflecting an increase of 15.6% or 113 615 more visits/consultations and examinations compared to 2023. Compared to 2023, the number of remotely provided consultations has increased by 62.1%, reaching a total of 70 227 consultations. During the reporting period, the number of laboratory examinations performed on outpatients, including those receiving treatment in day-care facilities, increased by 16% compared to 2023, reaching a total of 1 270 812 examinations.
A total of 3 856 416 laboratory examinations were performed at the East Hospital during the reporting period, which translates to an increase by 9% compared to 2023. The number of examinations performed at the Radiology Centre, on the other hand, has increased by 5.5%, reaching a total of 238 658 examinations.
As for the trends in the past year, the Chairman of the Board of the East Hospital, Normunds Staņēvičs, points out: “Over the past year, we have faced a significant increase in the number of patients, highlighting public health challenges and the vital role our hospital plays in addressing them. Despite limited financial resources, our team has demonstrated exceptional professionalism to ensure that each and every patient receives the necessary treatment and care. Therefore, I would like to extend my heartfelt gratitude to our patients for their trust and to our team for their remarkable work. Our goal remains to provide the highest quality services while making meaningful use of available resources and implementing innovative solutions to promote public health and well-being. However, we recognise that to effectively respond to the growing demand, it is crucial to reassess the healthcare funding model and ensure adequate support for our hospital and the healthcare system as a whole.”
In 2024, the specialists of the East Hospital preformed a series of unique surgeries and innovative procedures, and they initiated four pilot projects that were selected from an initial pool of 124 submissions in an open competition held by the National Health Service’s ‘Healthcare Service Model Development Laboratory’ under the EU Recovery and Resilience Facility (RRF) Plan and aim to introduce cutting-edge solutions in Latvia’s healthcare system, ensuring targeted and personalised high-precision services for the diagnosis and treatment of oncological diseases.
During the reporting period, the East Hospital also launched active efforts to implement the innovative pilot project ‘Hospital in Home Setting’. The project aims at providing the necessary treatment and care for a segment of chronic patients in home setting, while maintaining the highest medical standards. This includes remote consultations, monitoring, and home visits by physicians and nurses based on the patient’s needs and the developed health care plan. It is expected to launch the project at the beginning of 2025.
In the opinion of the East Hospital’s Board, in 2024, the hospital’s financial situation remained challenging, as the state-allocated funding was insufficient to cover the actual costs. Despite the increase in all types of expenses, on average, only 87% of the actual cost per inpatient was funded. The hospital provides emergency medical assistance according to the actual number of patients beyond the initially planned funding framework but does not receive adequate compensation for those services. This is associated with the current payment model, which prioritises quotas for specific services rather than treatment outcomes and patient recovery, preventing university hospitals from taking decisions about patient treatment based on medical needs.
During the reporting period, the risks previously identified by East Hospital specialists materialised, particularly those related to the tight deadlines for financing the project of the planned new infection disease wing under the RRF Plan, even more so given that those deadlines were further constrained by external factors. However, the hospital’s targeted efforts resulted in positive progress after the reporting period. The construction procurement process for the new building attracted four bidders, including large and well-known construction companies in Latvia. The received bids confirm that the project is moving forward, ensuring that the planned scope of work is completed within the set timeframe and that the RRF funding is used efficiently.
Despite the challenging circumstances, the East Hospital managed to increase efficiency, foster a cohesive team, strengthen collaboration with other university hospitals, and implement Latvia’s first-ever joint health insurance procurement for hospital employees. Carried out in partnership with Pauls Stradiņš Clinical University Hospital and the Children’s Clinical University Hospital, this initiative allowed to reduce social inequality, enhance the employer rating of university hospitals, and improve employee recruitment and motivation.
To adapt to the limited funding, several cost-optimisation measures were implemented. For instance, the average length of hospital stay was reduced through treatment process improvements, which contributed to the reduction of the hospitalisation costs and will allow for more efficient management of the growing patient numbers in 2025. The volume of medical supplies and medications per patient was reduced, ensuring that, despite rising prices, overall costs remained at 2023 levels. Several efficiency analysis mechanisms were introduced, along with clear performance targets for process optimisation and financial management. This includes evaluating clinics’ performance in terms of patient numbers, medication usage, and length of hospital stay.
At the same time, the East Hospital implements a series of large-scale development projects, such as the establishment of a new Day-Care Radiology and Surgery Centre and the reconstruction of two wings at the Gaiļezers inpatient facility. Once completed, this will pave the way for the renovation and reconstruction of treatment departments and shared spaces at the Latvian Oncology Centre, including the reconstruction of the surgical unit.
The East Hospital continues its progress in line with the ‘Hospital of the Future’ concept, which includes the introduction of innovative healthcare services, such as the ‘Hospital in Home Setting’ initiative, as well as the development of modern infrastructure and the implementation of cutting-edge technological solutions within the scope of the available funding. Additionally, it plans to further develop and elevate the nursing profession, focusing on the implementation of a nurse-led hospital model. The hospital also plans to continue the training of orderlies, recognising their vital role in healthcare, their integration in achieving the common goals of the hospital, and to employ a unified approach to healthcare standards.
The reporting period showed that, despite the limited resources, the East Hospital is capable of adapting to challenges, as well as seek, find, and make use of the most efficient solutions. However, in order to ensure sustainable development and prevent similar situations in the future, the regulatory framework and the healthcare financing model require significant changes.
About the East Hospital
Riga East Clinical University Hospital is the largest and strategically significant multi-profile hospital in the country. The hospital consists of five inpatient facilities – Gaiļezers, Latvian Oncology Centre, Biķernieki, Tuberculosis and Lung Disease Centre, and Latvian Infectious Diseases Centre, along with various specialised centres and clinics. The hospital provides highly specialised inpatient and secondary outpatient healthcare, offering multidisciplinary tertiary-level treatment and care in line with modern technology and medical knowledge. Approximately 80% of all cancer patients in Latvia are treated at the hospital. It serves as a practical training base for both Latvian educational institutions and foreign students, providing further education and knowledge transfer to healthcare specialists within and beyond the country. The hospital engages in scientific research and develops innovative methods for patient treatment. As the third-largest employer in the country, the hospital employs around 5000 staff members.
