THE PRICE OF EFFICIENCY: URBAN-RURAL DIVIDES IN LITHUANIA’S PATIENT-ORIENTED APPROACH DURING HEALTHCARE REFORM

Abstract

Healthcare systems face ongoing challenges that require reforms to enhance innovation, accessibility, and efficiency. Lithuania’s healthcare reform aims to enhance equity, quality, and sustainability by reorganising its service network. However, implementation has revealed unintended effects, including “network compression”, where large hospitals absorb services from smaller regional facilities, deepening regional inequality and limiting accessibility for rural populations. A qualitative research method with 22 informants was employed. Healthcare professionals are reporting growing fatigue, increased administrative burdens, and a decline in empathy in patient care. These outcomes highlight how efficiency-oriented policies can unintentionally depersonalise services and marginalise regional healthcare providers. Based on interviews with healthcare professionals, this study examines how reforms transform everyday clinical practices and local service delivery. The findings underscore the need to balance efficiency-driven reforms with empathy, professional autonomy, and equitable access to healthcare.

Keywords: unintended consequences; urban–rural divide; health service; reform.