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
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