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Variabilidad Geográfi ca Y Factores Explicativos De Las Tasas De Hospitalización Por Problemas De Salud Susceptibles De Resolverse Ambulatoriamente: El Caso De Costa Rica/Geographic variability and explonatory factors of hospitalization rates by Ambulatory Care Sensitive Conditions: the case of Costa Rica



    (Caja Costarricense de Seguro Social)


The study estimate the infl uence of Costa Rican Sanitary Reform, characteristics of primary care and the socioeconomic factors of the population, on the hospitalization rates for Ambulatory Care Sensitive Conditions (ACSC). In addition it analyzes the geographic variability and the cost of these hospitalizations.The hospitalization data comes from the minimum set of data of the Public Health System and the population estimations are based on Census 2000. The results show that the annual cost of the hospitalizations for ACSC is 31,4 million American dollars, 82.8% of the hospitalizations are concentrated in four diagnostic groups and the health areas located in the south of the country have hospitalization rates proportionally greater than the national average. The Poisson regression analysis show an inverse relation between the hospitalization rates by ACSC and the health areas that initiated early the reform process, have continued attention or specialized ambulatory supply, are more remoter of their reference hospital and have greater percentage of population educated in their attraction zone. Este trabajo estima el impacto de la reforma sanitaria de Costa Rica, características de la atención primaria y factores sociodemográfi cos de la población, sobre las tasas de hospitalización por problemas de salud susceptibles de resolverse ambulatoriamente (PSSRA). Adicionalmente se analiza la variabilidad geográfica y el costo de estas hospitalizaciones. La información de altas hospitalarias se tomó del conjunto mínimo de datos del sistema público de salud y las estimaciones de población por área de salud se basan en el Censo 2000. Los resultados muestran que el costo anual de las hospitalizaciones por PSSRA es 31.4 millones de dólares estadounidenses, el 82% de las altas está concentrado en cuatro grupos diagnósticos y las áreas de salud ubicadas en el sur del país tienen tasas de hospitalización proporcionalmente mayores que el promedio nacional. La estimación del modelo de regresión de Poisson muestra una relación inversa entre las tasas de hospitalización por PSSRA y las áreas de salud que iniciaron tempranamente la reforma, las que poseen atención continuada u oferta especializada ambulatoria, las que están más alejadas de su hospital de referencia y las que poseen mayor porcentaje de población educada en su zona de atracción.

Suggested Citation

  • Morera Salas, Melvin, 2006. "Variabilidad Geográfi ca Y Factores Explicativos De Las Tasas De Hospitalización Por Problemas De Salud Susceptibles De Resolverse Ambulatoriamente: El Caso De Costa Rica/Geographic variability and ex," Estudios de Economía Aplicada, Estudios de Economía Aplicada, vol. 24, pages 803-820, Diciembre.
  • Handle: RePEc:lrk:eeaart:24_3_6

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    References listed on IDEAS

    1. Malmström, Marianne & Johansson, SvenErik & Sundquist, Jan, 2001. "A hierarchical analysis of long-term illness and mortality in socially deprived areas," Social Science & Medicine, Elsevier, vol. 53(3), pages 265-275, August.
    2. Coburn, David, 2004. "Beyond the income inequality hypothesis: class, neo-liberalism, and health inequalities," Social Science & Medicine, Elsevier, vol. 58(1), pages 41-56, January.
    3. David Moore & Mark Hayward, 1990. "Occupational careers and mortality of elderly men," Demography, Springer;Population Association of America (PAA), vol. 27(1), pages 31-53, February.
    4. Rachel A Morello-Frosch, 2002. "Discrimination and the political economy of environmental inequality," Environment and Planning C: Government and Policy, Pion Ltd, London, vol. 20(4), pages 477-496, August.
    5. Doorslaer, Eddy van & Jones, Andrew M., 2003. "Inequalities in self-reported health: validation of a new approach to measurement," Journal of Health Economics, Elsevier, vol. 22(1), pages 61-87, January.
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    More about this item


    Primary Care; Ambulatory Care Sensitive Conditions (ACSC)/Atención Primaria; Problemas de Salud Susceptibles de Resolverse Ambulatoriamente.;

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior


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