San José, Costa Rica, since 1956
Public health

Inefficiency in Costa Rica’s public health care system tops complaints at Ombudsman’s Office

Complaints related to delays or denial of services at public agencies accounted for 24 percent of citizen complaints at the Ombudsman’s Office last year, Ombudswoman Montserrat Solano Carboni reported on Monday.

The “violation of the right to public health care” accounted for 18 percent of the total, the annual report states.

At the report’s presentation Solano noted an improvement in the quality of services at many public agencies, but she said better planning is still needed at the Social Security System, or Caja.

In 2014, the Ombudsman’s Office received a total of 30,264 complaints, with more than half — 52 percent — filed by women. The figure also represents the largest number of annual complaints received in the last two decades.

Complaints filed between 2010 and 2014 increased by 46.5 percent, with women from rural areas aged 25-45 filing the most during that period.

Most complaints were related to inefficiency, neglect or the denial of health care services at Caja facilities, including long waiting lists at public hospitals, delays in implementing digital health records, and recent cases of abuse in obstetric services, the report states.

Caja officials currently are implementing emergency protocols to reduce waiting lists that in some cases have led to patient deaths, specifically in cardiac catheterization procedures.

The agency also is searching for solutions for patient overload in emergency rooms at hospitals in the Greater Metropolitan Area (GAM), particularly in Alajuela, Cartago and San José.

The Ombudsman’s Office report also found “little progress” in solving cases of discrimination against Afro-Caribbean and indigenous people, the elderly and children.

Solano said the office has set a goal for this year of visiting at least 70 rural communities outside the GAM to provide the public with an opportunity to file complaints.

According to the report, 80 percent of complaints received last year were solved efficiently in an average of two months.

Contact L. Arias at

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My wife seriously injured her shoulder in a fall. She spent 12 days in San Juan de Dios awaiting surgery. As she continued to press for information as to when the surgery would happen, one of the doctors told her that, being a Gringo, she should go to a private hospital as she would be waiting “a month or two” for surgery at the public hospital. We immediately moved her to Metropolitano where she had a total shoulder replacement within 8 hours. The public hospitals have to do better. Too many of their doctors spend most of their time working at private service institutions leaving the public system at a loss for speedier service.

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Ken Morris

Beginning in the 7th paragraph, about halfway through, this article is wrong.

Emergency protocols have nothing to do with the problems in the Caja, and to imagine they do is to believe the bureaucratic myth the Caja likes to disseminate.

The problem with the Caja is quite simple: Arrogant, union-protected employees who don’t want to be bothered by patients.

Come on, I spent three months trying to make an approved appointment with a specialist only to have a bitch clerk at my 6th visit shrug and say she couldn’t find my file–and then go back to yakking on her cell phone. I gathered that in her opinion I needed to start over, since it was my fault she couldn’t find my file.

I also noticed that she clearly knew how to use a telephone, since she was yakking on her own, so this told me that Caja employees actually do know how to use a phone, just don’t bother to use their work phones.

And some idiots imagine that the bureaucratic solution of doing things online are the answer. Yeah right, these clowns won’t even bother with telephone technology when it involves their jobs.

I have had worse experiences than this, even life-threatening ones, with Caja employees, but this one encapsulates it. Honestly, what do you do when a bitch clerk just shrugs and says that she can’t find your file and then goes back to her personal conversation?

Not much you can do, and I’m sure she was a union member. This is the other thing. Even Caja docs have no authority over clerks or janitors for that matter either. Employees in the Caja don’t answer to anyone except their union reps, and really don’t like to be bothered by mere patients.

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