Costa Rica Case Study : Primary Health Care Achievements and Challenges within the Framework of the Social Health Insurance

The objective of this paper is to assess the key interventions Costa Rica has developed to expand health coverage for the poor and other vulnerable groups, with an emphasis on its approach to primary health care. Universal health coverage in Costa Rica is provided through a single national health in...

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Bibliographic Details
Main Author:	Montenegro Torres, Fernando
Format:	Working Paper
Language:	en_US
Published:	World Bank, Washington, DC 2013
Subjects:	abuse access to health services access to services Adult mortality Adult mortality rate age groups aged aging allocation of resources ambulatory care ambulatory services basic health care breast cancer burden of disease causes of death Child Survival clinical guidelines Clinics communicable diseases contraception Contraceptive prevalence cost structure cost-effectiveness deaths debt Delivery of Health Care demographic transition Demographic Trends Dental care dependency ratio developing countries disabilities Disability Economic Analysis economies of scale elderly elderly population emergencies employment epidemiological changes epidemiology families family health Fertility Fertility Rate financial management financial protection financial risks financial situation Health Care Coverage health care facilities health care management health care networks health care providers health care system Health Centers Health Coverage Health Data health expenditure health expenditure per capita Health Expenditures health facilities health financing health for all health information health institutions Health Insurance Health Insurance System health interventions health needs Health Organization Health Outcome Indicators health outcomes health promotion health sector Health Services Health System health systems health technology evaluation health workers health-care healthcare services HIV hospital hospital beds hospitalization Hospitals household income household surveys Human Resources human resources management hypertension ill health immunization incentives for efficiency income income countries income groups indigenous people indigenous peoples indigenous populations individual health infant infant mortality infant mortality rate infant mortality rates informal sector information systems inpatient care institutional capacity integration International comparisons investments in education laws life expectancies life expectancy Life expectancy at birth live births mandates maternal deaths Maternal mortality Maternal mortality rate medical services medical staff Medicines midwives Ministry of Health morbidity mortality national Health National Health Expenditures national Health Insurance national level nationals Neonatal mortality Number of births number of children Number of deaths nurse nurses older adults older age groups patient patients physician physicians Pocket Payments Policy Decisions policy dialogue policy makers political parties Population growth pregnant women prenatal care primary care Primary Health Care primary health care services primary health care system private sector provision of care provision of health services provision of services psychiatric hospitals psychiatry Public expenditure Public expenditure on health public health Public health expenditure public health insurance public health interventions public information Public opinion public policies public sector purchasing power purchasing power parity quality of care quality of services regional networks rehabilitation resource allocation respect risk factors rural areas Rural population safe water safety net sanitation sanitation facilities set of recommendations Share of Public Spending Skilled birth attendance Social Health Insurance social insurance social policy social sector Social Security socioeconomic status tertiary level tertiary levels trade unions Tuberculosis universal access universal health insurance coverage urban areas urban development use of resources vulnerable groups vulnerable populations woman workers World Health Organization
Online Access:	http://hdl.handle.net/10986/13279

Description
Summary:	The objective of this paper is to assess the key interventions Costa Rica has developed to expand health coverage for the poor and other vulnerable groups, with an emphasis on its approach to primary health care. Universal health coverage in Costa Rica is provided through a single national health insurance program. This program, which protects the poor without the pitfalls of a fragmented system, and the sustained policies that have enabled the building of a solid primary health care system, is broadly recognized as a success story. At the same, time new challenges are emerging to sustaining the success of Costa Rica's universal health coverage. Social Security of Costa Rica (Caja Costarricense de Seguridad Social, CCSS) faces increased production costs and demographic and epidemiological changes in a rapidly aging population. This report is divided into three broad sections: (1) objective of the case study and health system overview; (2) primary health care and the organization of health services within CCSS; and (3) agenda of key policy decisions for a renewed primary health care approach as part of a more responsive and sustainable health insurance system.

Costa Rica Case Study : Primary Health Care Achievements and Challenges within the Framework of the Social Health Insurance

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