---

Density of medical doctors (per 10,000 population) (2012-2020): 33.0
Density of nursing and midwifery personnel (per 10,000 population) (2012-2020): 38.0
Density of dentists (per 10,000 population) (2012-2020): 11.5
Density of pharmacists (per 10,000 population) (2012-2020): 11.9

Source: World health statistics 2022: monitoring health for the SDGs, sustainable development
goals. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.

---

“A key determinant of access and quality is the availability and distribution of appropriate human resources for health. Issues of geographical distribution as well as number and speciality of physicians have been persistent challenges in Costa Rica, and despite several work force planning initiatives, ensuring adequate supply of workforce remains challenging.

“CCSS [Costa Rican Social Security Institute] provides incentives for health care workers to serve in rural areas. However, the incentive has been insufficient to attract doctors to more distant localities, and is particularly problematic for specialists such as anaesthesiologists and ophthalmologists. In addition, specialisation in primary care is not well developed. As earlier mentioned, most doctors working in EBAIS do not have specialist post-graduate training in primary care.

“The CCSS plays a key role in determining the number and speciality of physicians, as all clinical training must occur within CCSS facilities. Practically, this means that CCSS and its physical and human resource restrictions/requirements determines the number and specialities of students that can be trained in a given year. The number of new trainees has remained flat over time at about 500 graduates per year since 2011 (see Figure 2.5). As a consequence, Costa Rica has a density of 2.1 physicians per 1 000 inhabitants, below the OECD average of 3.3 per 1 000 inhabitants (OECD, 2016d; see also Section 4 in Chapter 1).

“The College of Physicians and Surgeons of Costa Rica will only license foreign doctors following a lengthy accreditation procedure. In a closed market in a country with limited supply of home-trained doctors, simplified recognition of qualifications and training obtained elsewhere may be sensible in some cases. More promisingly, there is some discussion of task shifting (e.g., training general medics in ultrasound rather than relying on a radiologist). Some OECD countries, however, have gone much further in this direction, and allow non-medics or technologists to provide these services. It seems unlikely, however, that the College of Physicians and Surgeons would be ready to embrace this degree of task shifting.

“In contrast, there is an oversupply of trained nurses. More nurses graduate than there are jobs available in the public or private sector. Nevertheless, Costa Rica reports well below the OECD average of nurses for every doctor; there are 3.1 nurses per 1 000 population, compared to 9.1 per 1 000 on average among OECD countries (OECD, 2016d; see also Section 4 in Chapter 1). Nursing professionals themselves note that nurses could play a larger role in EBAIS, particularly given that the University of Costa Rica’s programmes feature several nursing specialities (hemofiltration, ITU, paediatrics, anaesthetics, mental health, for example) and a home-grown Master’s programme. Given that many nurses are highly trained, CCSS could open additional spots for nurses to address the shortage of specialist physicians.”

Source: OECD (2017), OECD Reviews of Health Systems: Costa Rica 2017, OECD Publishing, Paris. http://dx.doi.org/10.1787/9789264281653-en.

---

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

---

Page last updated Nov. 11, 2022 by Doug McVay, Editor.