title: [The health system of Costa Rica].
abstract: This paper describes the Costa Rican health system which provides health, water and sanitation services. The health component of the system includes a public and a private sector. The public sector is dominated by the Caja Costarricense de Seguro Social (CCSS), an autonomous institution in charge of financing, purchasing and delivering most of the personal health services in Costa Rica. CCSS is financed with contributions of the affiliates, employers and the state, and manages three regimes: maternity and illness insurance, disability, old age and death insurance, and a non-contributive regime. CCSS provides services in its own facilities but also contracts with private providers. The private sector includes a broad set of services offering ambulatory and hospital care. These services are financed mostly out-of-pocket, but also with private insurance premiums. The Ministry of Health is the steward of the system, in charge of strategic planning, sanitary regulation, and research and technology development. Among the recent policy innovations we can mention the establishment of the basic teams for comprehensive health care (EBAIS), the de-concentration of hospitals and public clinics, the introduction of management agreements and the creation of the Health Boards.
authors.affiliation: Consultores en Desarrollo, Sociedad y Administración, Costa Rica. saenz.rocio@gmail.com
authors.forename: María del Rocío
authors.initials: Mdel R
authors.lastname: Sáenz
authors.forename: Mónica
authors.initials: M
authors.lastname: Acosta
authors.forename: Jorine
authors.initials: J
authors.lastname: Muiser
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Bermúdez
mesh_terms: D003256:Community Participation / Q000706:statistics & numerical data; D003364:Costa Rica; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D003710:Demography; D005381:Financing, Organized / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D006078:Government Programs / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data; D006295:Health Resources / Q000458:organization & administration / Q000706:statistics & numerical data / Q000600:supply & distribution; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006298:Health Services Administration / Q000191:economics / Q000706:statistics & numerical data; D006305:Health Status Indicators; D006801:Humans; D007342:Insurance Benefits / Q000191:economics / Q000706:statistics & numerical data; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D009936:Organizational Innovation; D017149:Private Sector / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012499:Sanitation / Q000191:economics / Q000706:statistics & numerical data; D012943:Social Security / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D014798:Vital Statistics