Health policies and data


OECD Reviews of Health Systems: Costa Rica 2017

This report puts forward policy recommendations for strengthening the performance and sustainability of the health care system in Costa Rica. There is much to praise in Costa Rica’s health care system: institutional stability; a closely integrated but well-differentiated provider arm, with strong primary care; a degree of inter-sectoral co-ordination that serves as a model of good practice; detailed and effective dialogue between users and health service managers; and, innovation around professional roles and the use of ICT that other health systems could learn from. All this leads to health outcomes on a par with several OECD economies. Nevertheless, serious strains are evident: spending is rising steeply, fuelled by salaries, fees and facility payments based on last year’s outlay. These spending increases are not always associated with improvement in services: waiting lists are excessively long and growing. The system is perhaps too stable: institutional rigidity and vested interests have stalled vital reforms, meaning that Costa Rica still lacks systematic application of DRGs and health technology assessment, despite attempts to bring them in.

Published on November 22, 2017

In series:OECD Reviews of Health Systemsview more titles


Foreword and acknowledgements
Executive summary
Assessment and recommendations
Health care needs and the health care system in Costa Rica
Health care access and quality in Costa Rica
Health care efficiency and sustainability in Costa Rica
Annexes4 chapters available
Historical development of the Costa Rican health care system
Illustration of a CCSS service network
CCSS primary care performance framework
Screenshot of a primary care performance indicator availablefrom the EDUS information system
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