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  1. Article: Maintaining essential health services during a pandemic: lessons from Costa Rica's COVID-19 response.

    Mora-García, Claudio A / Pearson, Andy A / Prado, Andrea M

    BMJ global health

    2024  Volume 8, Issue Suppl 6

    Abstract: Studies on COVID-19 usually focus on health system responses to decrease the rate of COVID-19 infection and death, but patients with other diseases also require access to health services during the pandemic. This paper describes the structures and ... ...

    Abstract Studies on COVID-19 usually focus on health system responses to decrease the rate of COVID-19 infection and death, but patients with other diseases also require access to health services during the pandemic. This paper describes the structures and processes by which the Costa Rican Social Security Fund (CCSS) changed in response to the COVID-19 pandemic, which helped to sustain essential health services (EHSs). We conducted a desk review of the local literature and semistructured qualitative interviews with key informants from the CCSS. We found that the CCSS implemented changes in structure, such as creating a specialised COVID-19 centre and hiring additional interim health workers. The CCSS also implemented changes in processes, including leveraging its integrated network to optimise its resources and support alternative care modalities. These changes generated changes in outputs and outcomes that helped sustain EHSs for non-COVID-19 patients. These interventions were possible primarily due to Costa Rica's underlying health system, particularly its integrated nature with a single institution in charge of healthcare provision financed through mandatory health insurance, a unique digital medical record system and a contingency fund.
    MeSH term(s) Humans ; Costa Rica ; COVID-19 ; SARS-CoV-2 ; Pandemics ; Delivery of Health Care/organization & administration ; Health Services Accessibility ; Social Security
    Language English
    Publishing date 2024-04-24
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2059-7908
    ISSN 2059-7908
    DOI 10.1136/bmjgh-2023-014143
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The effect of primary healthcare on mortality: Evidence from Costa Rica.

    Mora-García, Claudio A / Pesec, Madeline / Prado, Andrea M

    Journal of health economics

    2023  Volume 93, Page(s) 102833

    Abstract: This paper uses the gradual implementation of a primary healthcare (PHC) intervention in Costa Rica to examine the long-term effect of PHC on mortality. Nine years after opening a primary care center, known as a Health Area, there was an associated 13% ... ...

    Abstract This paper uses the gradual implementation of a primary healthcare (PHC) intervention in Costa Rica to examine the long-term effect of PHC on mortality. Nine years after opening a primary care center, known as a Health Area, there was an associated 13% reduction in age-adjusted mortality rate in the assigned patient population. The effect was highest among adults over 65 years of age and for those with noncommunicable diseases, such as cardiovascular-related causes of death. We also show that as Health Areas opened, more individuals sought care at primary care clinics, while fewer sought care at emergency rooms; these changes may have partially mediated the effect of the intervention on mortality.
    MeSH term(s) Adult ; Humans ; Costa Rica/epidemiology ; Population Dynamics ; Delivery of Health Care ; Primary Health Care ; Mortality
    Language English
    Publishing date 2023-11-08
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 625797-5
    ISSN 1879-1646 ; 0167-6296
    ISSN (online) 1879-1646
    ISSN 0167-6296
    DOI 10.1016/j.jhealeco.2023.102833
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The Effect of Randomly Providing Nutri-Score Information on Actual Purchases in Colombia.

    Mora-García, Claudio A / Tobar, Luisa Fernanda / Young, Jeremy C

    Nutrients

    2019  Volume 11, Issue 3

    Abstract: Recently, front-of-package (FOP) food labeling systems have captured the attention of researchers and policy makers. Several Latin American governments are currently considering employing different FOP labeling systems. However, there is much need for ... ...

    Abstract Recently, front-of-package (FOP) food labeling systems have captured the attention of researchers and policy makers. Several Latin American governments are currently considering employing different FOP labeling systems. However, there is much need for more research-based evidence in these countries. In this paper, we study whether food-purchasing decisions and the nutritional qualities of those purchases are influenced by randomly informing some customers and not others about an FOP label known as Nutri-Score. We also separate the information effect from the effect of being aware of the system. We combined a randomized field intervention in a university cafeteria in Bogotá, Colombia with data from an after-purchase survey and receipts. We found that randomly providing information on Nutri-Score increased total expenditure by $0.18. Additional spending on healthier items was 21% or $0.26 higher, with no change for less healthy items. Expenditure estimates were higher among customers who were aware of the system's existence. Customers in the study were also 10% more likely to buy a healthier item than control customers were, and the concentration of protein in their purchases was greater. Information on the Nutri-Score system increased the store's sales. This potential financial incentive may facilitate the implementation of Nutri-Score.
    MeSH term(s) Choice Behavior ; Colombia ; Consumer Behavior ; Food Labeling ; Food Preferences ; Food Services ; Health Promotion ; Humans ; Nutritive Value ; Universities
    Language English
    Publishing date 2019-02-26
    Publishing country Switzerland
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu11030491
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: The Effect of Randomly Providing Nutri-Score Information on Actual Purchases in Colombia

    Mora-García, Claudio A / Tobar, Luisa Fernanda / Young, Jeremy C

    Nutrients. 2019 Feb. 26, v. 11, no. 3

    2019  

    Abstract: Recently, front-of-package (FOP) food labeling systems have captured the attention of researchers and policy makers. Several Latin American governments are currently considering employing different FOP labeling systems. However, there is much need for ... ...

    Abstract Recently, front-of-package (FOP) food labeling systems have captured the attention of researchers and policy makers. Several Latin American governments are currently considering employing different FOP labeling systems. However, there is much need for more research-based evidence in these countries. In this paper, we study whether food-purchasing decisions and the nutritional qualities of those purchases are influenced by randomly informing some customers and not others about an FOP label known as Nutri-Score. We also separate the information effect from the effect of being aware of the system. We combined a randomized field intervention in a university cafeteria in Bogotá, Colombia with data from an after-purchase survey and receipts. We found that randomly providing information on Nutri-Score increased total expenditure by $0.18. Additional spending on healthier items was 21% or $0.26 higher, with no change for less healthy items. Expenditure estimates were higher among customers who were aware of the system’s existence. Customers in the study were also 10% more likely to buy a healthier item than control customers were, and the concentration of protein in their purchases was greater. Information on the Nutri-Score system increased the store’s sales. This potential financial incentive may facilitate the implementation of Nutri-Score.
    Keywords cafeterias ; consumers (people) ; economic incentives ; food labeling ; food purchasing ; issues and policy ; nutritive value ; sales ; surveys ; Colombia
    Language English
    Dates of publication 2019-0226
    Publishing place Multidisciplinary Digital Publishing Institute
    Document type Article
    ZDB-ID 2518386-2
    ISSN 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu11030491
    Database NAL-Catalogue (AGRICOLA)

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