QCOSTARICA — To get an appointment with a specialist or undergo surgery, patients must wait more than a year on average, according to data from the Caja Costarricense del Seguro Social (CCSS) – Costa Rican Social Security Fund.
The number of days will depend on the specialty and the saturation of the service in each hospital.
For example, a nephrology consultation at the Baltodano Briceño Hospital in Liberia requires a 350-day wait, but at Calderón Guardia Hospital in San Jose, only 164 days.
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Meanwhile, in the case of cardiovascular surgery, the waiting time is 640 days at Hospital México and 213 at Hospital San Juan de Dios, both in San José.
In the midst of all this, there are patients who suffer terrible pain or end up dying due to lack of care.
Delays in scheduling and a shortage of staff are causing complications with waiting lists, as demonstrated by the recent protest of specialist doctors who refused to work extra hours until improved resources and salary conditions are met.
Additionally, it should be noted that there is a trend of skilled individuals leaving the public sector for opportunities in the private sector.
“There are several reasons that are motivating specialists to make the decision to leave the CCSS and they are not only salary issues, which of course have an impact. However, we consider that the most important issues are those of life balance, of flexibilities that are not found in the institution and that are found at the private level, for example, to have more time for educational issues and more time for research activities,” said Massimo Manzi, executive director of the Chamber of Health.
In Costa Rica, there are more than 14,000 doctors, of which 6,400 have some specialty, according to the College of Physicians.
However, it would not be enough to serve the entire national population. When comparing Costa Rica with other countries, it is revealed that the country is slightly below the average and very far from the leading countries, according to data from the World Bank.
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On the other hand, there is poor administration of public resources, according to Otto Guevara, consultant and former legislator and former perennial presidential candidate, since at this time there are doctors who receive more money for the overtime they work and not for their regular salary. In some cases, they add up to more than ¢22 million per month.
“There is a disorder in the management of human resources at the CCSS since it is not possible that so much extra salary should be paid. This denotes a poor allocation of work hours. As I understand it, there are practically no controls over overtime, on-call and availabilities, or performance indicators. This extraordinary salary is paid almost automatically. The extraordinary salary has practically become an ordinary salary,” said Guevara.
Slightly low average
The number of doctors per 1,000 inhabitants in Costa Rica is lower in relation to other countries. It is not that the country is in the red, but a lag is noticeable.
- Costa Rica, 3
- Cuba, 8
- Spain, 5
- Germany, 5
- United States, 4
- Canada, 3
- UK, 3
- Colombia, 2
- Panama, 2
- Guatemala, 1
- Nicaragua, 1
Figures from the World Bank.
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