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Medical Tourism - Destination - Costa Rica

General Informations

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Costa Rica attracts 150,000 medical tourists annually, thanks to being a safe, established holiday destination and its proximity to the US. The majority of these (95%) are from the US and come to take advantage of the 25% cost savings. Currently, Costa Rica specialises in dental and plastic surgery yet it is a relatively unknown destination within the industry. Promotion has recently started in order to increase the number of medical tourists by 8-9% during 2010.

Costa Rica
Localisation Central America, bordering Nicaragua and Panama
Capital San José
Biggest cities (population) San José (335,007), Puerto Limón (63,081), San Francisco (55,923)
Inhabitants 4,509,290
Politics presidential representative democratic republic
Religion Catholicism (70.5%), Protestantism (13.8%), atheism (11.3%), other (4.4%)
Currency Costa Rican Colón (CRC) = € 0.001188
GDP € 19,926 million, 0.05% of the world’s GDP
Official language(s) Spanish
Climate tropical, average temperature between 14°C - 27°C with variation between the seasons
Time zone GMT -6
Happy Planet Index (HPI) 1

Cultural Aspects

General Culture

Costa Rica was a Spanish colony until 1812 when it became independent, however, the Spanish influence in Costa Rica is not as strong as in many other Latin American countries. Rice and beans are the base of all meals and different meats are eaten. English is widely spoken in tourist destinations and signs are usually bilingual. It is interesting to note that Costa Rica has no military force, since it was made illegal in 1948. Even though Catholicism is recognised as the official religion in the country, the devotion varies.

Safety

Costa Rica ranks 29 on the GPI. The crime rate is low throughout the country, but petty crime does occur and normal precautions should be taken.

Tourists Attractions and Sights

  • Arenal Volcano National Park: excellent views of the volcano and Arenal Lake
  • Our Lady of Los Angeles: a church built in the Byzantine style in 1639 located in Cartago
  • Rainmaker: the area featuring suspension bridges running through the rainforest canopy
  • Pre-Columbian Gold Museum: in San José houses one of the largest collections of pre-Columbian gold pieces in the Americas
  • Guayabo National Monument: Costa Rica’s most important archaeological site. Excavations have uncovered stone aqueaducts, cobbled roads, mounds, walls and petroglyph

Visa Requirements

In general, one is required to have a visa to enter Costa Rica, however, there is an extensive list of countries that are permitted to enter without a visa for stays up to 90 days. These countries are included:

Andorra, Argentina, Australia, Austria, Bahamas, Barbados, Belgium, Brazil, Bulgaria, Canada, Croatia, Chile, Cyprus, Denmark, Slovak Republic, Slovenia, Spain, United States, Estonia, Finland, France, Germany, Hungary, Ireland, Iceland, Israel, Italy, Japan, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Mexico, Montenegro, Norway, New Zealand, Netherlands, Panama, Paraguay, Poland, Portugal, Principality Of Monaco, San Marino, Puerto Rico, Serbia, South Africa, United Kingdom, Czech Republic, Republic Of South Korea, Greece, Romania, United States, Vatican City, Singapore, Sweden, Switzerland, Republic Of China (Taiwan), Trinidad And Tobago and Uruguay.

Infrastructure

Transportation

Costa Rica has an extensive road infrastructure, but due to poor maintenance and lack of investments, many areas have fallen into disrepair. The only international airport is located in San José. Taxis are the most common and reliable transportation method for tourists within the city limits, although, buses are also available and have an extensive network both in and outside the urban areas. The only train connection available is between San José and Heredia.

Accommodation

There are a few international hotel chains present on the Costa Rican hospitality market such as Marriott Hotels and Resorts, Starwood Hotels and Resorts Worldwide and the InterContinental Hotels Group. Accommodation can be found in all price categories. There are a few hospitals cooperating or running their own hotels in the proximity of the hospital. The Hotel “Hospital La Católica”, mentioned under point 4 in the Top Facility Chart, is one of the forerunners.

Health Care System

WHO ranking 36
Physicians per 10,000 population 13.0 (2003)
Nurses per 10,000 population 9.0 (2000)
GDP spent on health care 7.0% (2006)
Education period of doctors 6 plus 1 year social service in a state funded hospital
Education period of specialists additional 2 to 8 years

Health Care Providers

Costa Rica’s health care system has existed for over 60 years and the government runs 30 hospitals and 250 clinics around the country. There are also five private hospitals in the country, which are more focussed on medical tourists than the government operated ones.

Insurance

Until the end of 2008, Costa Rica was under a government-owned monopoly insurance system called Caja Costarricense de Seguro Social (CCSS), but after joining the Central American Free Trade Agreement (CAFTA), private insurance is now also available. CCSS is not mandatory and if the decision is made to join, one will pay approximately 13% of one’s income. Before the CAFTA, in 2005, 90% of the population was insured by the public insurance.

General Medical Tourism Information

Costa Rica was visited by 2.09 million tourists in 2008 generating USD 2.14 billion (€1.43 billion) revenue. During 2006, 150,000 medical tourists, mainly for dental and plastic surgery, visited Costa Rica. The revenue received from medical tourism is not known.

The Council for International Promotion of Costa Rica Medicine (Promed) is a non-profit organisation starting to promote Costa Rican medical tourism and to ensure uniform quality in hospitals.

Flows

The most important medical tourism flows come from the US, namely 95% of all visitors . Regions that account for the other 5% are Latin America and Europe.

Reasons

  • Proximity: American medical tourists choose Costa Rica due to proximity.
  • Cost saving: cost savings are 25% compared to the US.
  • Holiday destination: many medical tourists combine their treatments with a holiday.
  • Safety: Costa Rica is a safe country with a stable democratic environment.

Specialisation

The main areas of medical specialisation in Costa Rica include:

  • Dentistry (Veneers)
  • Ophthalmology
  • Orthopaedics
  • Bariatric surgery
  • Cosmetic and plastic treatments (Botox, breast augmentation)

Top Facilities

The top facilities have been selected using the following criteria’s, listed in order of importance: JCI Accreditation, ISQua accreditation, international orientation. In general national accreditation systems have not been taken into consideration, due to the fact that there are too many and judging them is out of scope of this study. There are three JCI accredited hospitals in Costa Rica, all included in the list below:

  • Hospital CIMA, San José
  • Hospital Clinica Biblica, San José
  • Hospital La Católica, San José

SWOT

Strengths Weaknesses
  • Proximity to the US
  • Cost savings of 25% compared to the US
  • Established holiday destination
  • Safe country as it ranks 29 on the GPI
  • Famous for dental and plastic surgery
  • Road infrastructure is not satisfactory
  • Relatively unknown medical tourism destination. Promotion only started recently

Conclusion

Thanks to being a safe, established holiday destination and its proximity to the US, Costa Rica attracts 150,000 medical tourists annually. The majority of these (95%) are from the US and come to take advantage of the 25% cost savings. Currently, Costa Rica specialises in dental and plastic surgery yet it is a relatively unknown destination within the industry. Promotion has recently started in order to increase the number of medical tourists by 8-9% during 2010.

Top Facility Chart

Costa Rica Hospital CIMA San Jose Hospital Clinica Biblica Hospital La Catolica
Location and website San Jose www.hospitalcima.com San Jose www.clinicabiblica.com San Jose www.hospitallacatolica.com
Accreditations or certifications JCI JCI JCI
Capacity of hospital beds 100 beds 130 beds 104 beds
Possible for accompanying person to stay in room No, but assistance with accommodation Yes, in the private rooms Yes, in the Hospital-Hotel La Posada El Convento (34 rooms)
Medical tourists 25% of all patients 20% of all patients 70% of patients, mainly from US, Latin America and Europe
Number of medical staff doctors/nurses 230 physicians 200 physicians 110 physicians
Type of rooms available (prices) Private single rooms and suites Private single rooms Private single rooms
International patient department Yes, they organise all the arrangements Yes, they organise all the arrangements Yes, they organise all arrangements
Adaptations to cultures and nations Yes, in food Yes, in food and religious habits Yes, in food and religious habits
Languages spoken by staff Spanish and English Spanish and English Spanish and English
Marketing of the facility/USP Affiliation with Baylor University Medical Centre in Dallas, Texas gives access to academic support and specialised trainings Works with 3 large hospitals in US and many international insurance companies Unique concept of having the hospital and the hotel integrated, as well as member of PROMED
Specialisations Diagnostics, radiology and general surgery Cardiology, dermatology, ophthalmology, radiology, orthopaedics and cosmetic surgery Cosmetic surgery, bariatric surgery, laparoscopic surgery and orthopaedics

Price Chart (in €uro)

Treatment Average Price Hospital CIMA San Jose Hospital Clínica Bíblica
Cardiac bypass 16,033 25,052 18,371
Gastric bypass 9,390 N/A 8,351
Knee replacement 7,349 7,015 7,683
Hip replacement 8,017 N/A 8,351
Hip resurfacing 8,685 N/A 8,017
Botox treatment 251 N/A N/A
Breast augmentation 4,342 N/A 2,472
Facelift 5,344 N/A 2,605
Liposuction 2,605 N/A 2,605
Dental implants 2,338 N/A 668
Rhinoplasty 6,680 N/A 2,939
Lasik eye surgery 1,202 N/A 1,202

Note: All prices are estimates, and may vary widely from source to source depending on services included in the estimate (i.e. doctor’s fees, hospitalisation, administration costs or the patient’s age and medical history). Due to non-disclosure strategies of the various locations, it was not possible to make a clear separation between those factors. All prices given for the specific facilities have been provided by the hospitals/clinics themselves via email or telephone contact. The prices are given in Euros (€).

N/A means either that treatment are not available in the specific hospital, that a price estimation cannot be found or that the medical facility did not disclose the information. For the average prices, printed literature has been used before researching sources on the internet.