A good strategy to address health sector budget challenges is to be more efficient with resources. Meeting health needs at the primary level can avoid more costly treatment at the hospital level. Network management with integration of other social services and results-based budgeting are other key elements.
In his article, Claudio Arce discusses one of the ways to improve the efficiency of healthcare spending in Costa Rica. In the case of the Health Insurance administered by the CCSS, it is estimated that avoidable hospitalizations consume approximately 11% of total hospital admissions over a period of 45 years.
Effective and timely primary care can help reduce the risk of hospitalization by preventing the onset of illness (e.g., diseases for which there is an effective vaccine), treating an acute illness such as pneumonia, or managing a chronic disease such as diabetes.
Some proposals to facilitate patient utilization of primary services include:
- Invest in the creation of more “Equipos Básicos de Atención Integral en Salud” (EBAIS) so that the entire population in the country has access and achieves the goal of at least 1 EBAIS for every 3500 inhabitants.
- Improve the response capacity of the EBAISs, for example, by extending opening hours for evening care, coordinating preventive health actions with other local actors.
- Integrated network management and integration of health and social services, with emphasis on preventive services, reduction of hospital inefficiency, rehabilitation services and social assistance once patients are discharged.
- Results-based budgeting, aimed at migrating in the medium term from a historical allocation to an allocation based on health objectives and goals.
