The Ministry of Health (MoH) will request a total of 8,428,604 euros from the state’s contingency funds for Pauls Stradiņš Clinical University Hospital (PSKUS) and Riga East Clinical University Hospital (RAKUS) to ensure the continuity of healthcare services and cover rising costs, the LETA news agency reports.
According to the MoH, €4,136,089 of this amount is intended as a one-time allocation in 2025 to partially restore the diagnosis-related group (DRG) base tariff for both hospitals to its 2024 level, while €1,107,193 is needed to maintain the continuity of planned inpatient services. Additionally, €3,185,322 is required to ensure emergency medical care.
Hospital funding from the state is calculated under the so-called DRG system. This system is used to record, analyze, and pay for state-funded healthcare services provided in hospitals. It is based on each treatment case, recording the diagnosis, performed procedures, and patient data such as age, sex, and length of stay. This information is analyzed using specific coefficients that determine how much the state will pay the hospital for a particular treatment.
The MoH notes that the aging population and the prevalence of chronic diseases are placing increasing pressure on inpatient care, while the current case-based payment rate at PSKUS and RAKUS does not cover the actual treatment costs.
To address this situation and ensure the sustainability of the healthcare system,
it is necessary to increase one of the key components forming the tariff for a single hospital treatment episode
– the bed-day payment rate, gradually aligning it to 94%. This would ensure stable hospital operations, better resource planning, as well as patient safety and uninterrupted access to emergency and inpatient services, the MoH explains.
The ministry acknowledges that at the beginning of this year, both hospitals were assigned a reduced DRG base coefficient of 91.5%, compared to 94% in 2024.
The reduced tariff was applied because, under the Health Care Services Organization and Payment Regulations, in conditions of limited funding, the DRG base tariff must be lowered for PSKUS and RAKUS, the ministry explains.
The one-time allocation would partially compensate for this difference, reaching a 92.7% level, and would ensure continuity of treatment for approximately 90,000 patients, according to the ministry.
Additional funds for paying planned and emergency care overruns are necessary for hospitals
to continue treating patients whose conditions require longer hospitalizations or more complex treatments. The MoH emphasizes that particularly in tertiary cardiology, treatment is resource-intensive — requiring expensive medications, technology, and a multidisciplinary approach.
The ministry warns that without additional funding, waiting times for services could increase by the end of the year, and healthcare services could be significantly restricted.
It further explains that both hospitals have already reached their contracted service volumes with the National Health Service (NHS), and the excess workload generates additional expenses not covered by the current budget. The MoH reiterates that the current tariff for a single inpatient treatment episode at PSKUS and RAKUS does not cover the actual treatment costs, leading to financial deficits for the hospitals.
This affects their ability to ensure continuous and high-quality healthcare across all inpatient care areas — particularly in emergency care, where services must be provided immediately and regardless of available funding, and in the long-term treatment of chronic patients, the number of whom continues to grow due to the aging population.
The ministry also stresses that insufficient cost coverage in the long term increases hospital debt obligations and complicates resource planning, while simultaneously jeopardizing patient safety and timely access to necessary healthcare services.
The MoH states that it will prepare and submit a funding request to the Ministry of Finance.
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