Both of these figures suggest a more intensive use of hospital resources in Latvia compared to the OECD average. The number of inpatient procedures, however, is generally lower than the OECD average. For example, there were 106 hip replacement surgeries and 46 knee replacement surgeries per 100 000 population in Latvia, compared with the OECD average of 161 and 121 respectively in 2013. This may signal a lack of access due to actual services (as opposed to the hospital infrastructure) because of the annual quota system discussed earlier.