Atención de salud en Costa Rica: Auge y crisis

Abstract

In 1960-1980 Costa Rica experienced a health boom, achieving significant improvements which moved that country into the number two position in Latin America and the Caribbean for indicators such as population coverage, infant mortality, life expectancy and health services. In addition, there was a gradual process of integration of health services. But in the same period, the cost of health care as a percentage of GNP increased almost 5-fold and in 1980 was the fourth highest in the subregion. The economic crisis of the 1980s aggravated the financial difficulties; to cope with them, the government introduced an austere program to reduce costs and plans to transform the current model of health care into a more efficient one capable of maintaining Costa Rica's high health standards in the future. The paper is divided into five sections: (1) summary of the historical development of health care, and description of its current organization and of its gradual process of integration; (2) estimation of population coverage and its trends, evaluation of inequalities in coverage, and identification of the non-covered group; (3) analysis of health-care financing and its sources as well as that of the recent financial desequilibrium, its causes and measures to restore the equilibrium; (4) description of health care benefits and their differences among groups and regions, analysis of the country's advances