Levels of Care
What are the three levels of healthcare, listed in order from the least to the most specialized?
Primary → Secondary → Tertiary.
What does CCSS stand for?
Caja Costarricense de Seguro Social.
Name one service commonly provided in primary healthcare.
A healthy 5-year-old comes for routine vaccines. Which level?
Primary care.
What happens if a woman gives birth at a CCSS hospital without completing the minimum of 10 prenatal care visits?
A social worker is notified to assess the situation and identify any barriers to prenatal care, as inadequate prenatal follow-up may indicate medical or social risk factors.
Which level of care is primarily responsible for coordinating a patient's journey through the healthcare system, including referrals and continuity of care?
Primary healthcare.
What is the name of Costa Rica's primary care clinics that serve local communities? Complete name and acronym.
EBAIS (Equipos Básicos de Atención Integral en Salud).
Who are the professionals commonly found in an EBAIS team?
A patient with persistent knee pain is referred to an orthopedic specialist. Which level?
Secondary care.
How long should a couple try to conceive before seeking a fertility evaluation?
1 year.
A patient with well-controlled type 2 diabetes develops diabetic retinopathy requiring evaluation by an ophthalmologist. Which level of care manages the new complication?
Secondary care (specialist consultation).
Life expectancy in Costa Rica.
80 years.
Give two examples of preventive services.
A patient needs chemotherapy at a cancer center. Which level?
Tertiary care.
How many Indigenous peoples are officially recognized in Costa Rica?
8 groups.
A patient is diagnosed with a brain aneurysm requiring endovascular intervention performed at a national referral hospital. Which level of care provides this service, and why?
Tertiary care, because it involves highly specialized technology, expertise, and complex procedures available only in specialized hospitals.
Name one major national tertiary referral hospital in Costa Rica.
Name three contraceptive methods available through the CCSS.
Condoms
Oral contraceptive pills
Injectable contraceptives
Subdermal implants
IUDs (Intrauterine Devices) — typically for adults
Emergency contraception
A pregnant woman attends regular prenatal visits. Which level?
Primary care.
Approximately how many people does a health area serve in Costa Rica?
20,000 to 60,000 people.
Why is bypassing primary healthcare and directly seeking care at tertiary hospitals considered inefficient for the health system?
Because it overloads specialized hospitals with conditions that can often be managed in primary or secondary care, increases healthcare costs, lengthens waiting times, fragments continuity of care, and reduces access for patients who truly need highly specialized services.
Why is the Costa Rican healthcare system often recognized internationally?
Because of its strong primary healthcare system, universal coverage, preventive care, and good health outcomes.
What are the four essential attributes of high-quality primary healthcare? (Video)
A patient insists on going directly to a tertiary hospital because of a sore throat, even though no emergency signs are present. Explain why this is not the most appropriate use of the healthcare system.
The condition should first be evaluated in primary care. Directly using tertiary services for minor conditions overloads specialized hospitals, increases waiting times, and uses resources intended for patients with complex medical needs.
In what year was the EBAIS model established in Costa Rica?
1995