Health care efficiency and sustainability in Costa Rica

This chapter assesses the efficiency and financial sustainability of health care in Costa Rica. Health spending now surpasses the OECD average, as a share of GDP. Upward trajectories of spending mean that the health system’s, at best, fragile efficiency is likely to deteriorate.. Spending increases have been almost entirely consumed by increases in the number and salary of CCSS employees, without convincing evidence of benefit to patients. In the shorter term, Costa Rica will need to apply more effective expenditure ceilings and spending reviews to the health sector. In the longer term, better use of performance data as well as innovative payments systems will be needed. A shift away from employment-linked contributions as a basis for health system revenue will also contribute to longer-term sustainability.