Lithuania has made remarkable progress in reshaping its health system since the 1990s. The institutional and legal framework for providing health services is solid and well-functioning. An important component is the social health insurance system, partly funded by general budget resources to cover the non-active population, which has proven resilient in the face of the financial crisis and provides broadly adequate and equitable access to health services. Despite spending only 6.5% of GDP on health, admission rates and physician visits are well above OECD averages and unmet needs are just below the OECD average.

Lithuania has also developed a primary care system with many features which deserve to be recognised as examples for other OECD countries, including expanded nurses’ practice and primary care centres with an effective gatekeeping role. Although there is still excess hospital capacity, the reform agenda for the hospital sector, involving clustering and concentration of services into larger units to raise the quality and efficiency of delivery is promising. The same is true for recent efforts to strengthen public health through policies to curb risk factors, in particular the harmful and exceptionally high alcohol consumption.

Nevertheless, Lithuania needs to decisively address a number of challenges. Life expectancy is rising slowly, but remains almost six years below the OECD average, with a large gender gap. Data on the health status of the population show that if more effective public health and medical interventions were in place, fewer people would die prematurely in Lithuania. In other words, the mix and quality of interventions delivered must improve.

Greater use of performance data to increase accountability would support these objectives. Decisive implementation of health reforms needs to be accompanied by systematic evaluations to understand how to achieve better results quickly. Deepening the use and analysis of the already rich data available in the country and further efforts to foster a culture of transparency of results would help in holding stakeholders accountable for performance, and help Lithuania building further on its already significant achievements.

This review was prepared by the OECD Secretariat to support the OECD Health Committee’s evaluation of Lithuania’s health system, undertaken as part of the process for Lithuania’s accession to the OECD (see Roadmap for the Accession of Lithuania to the OECD [C(2015)92/FINAL]). In accordance with paragraph 14 of the Roadmap, the Health Committee agreed to declassify the review and publish it in order to allow a wider audience to become acquainted with the issues raised in the review. Publication of this document and the analysis and recommendations contained therein, does not prejudge in any way the results of the ongoing review of Lithuania as part of its process of accession to the OECD.