[Determinants of health care utilization in Costa Rica]

To analyze the determinants of health care utilization (visits to the doctor) in Costa Rica using an econometric approach.

Data were drawn from the National Survey of Health for Costa Rica 2006. We modeled the Grossman approach to the demand for health services by using a standard negative binomial regression, and used a hurdle model for the principal-agent specification.

The factors determining healthcare utilization were level of education, self-assessed health, number of declared chronic diseases and geographic region of residence.

The number of outpatient visits to the doctor depends on the proxies for medical need, but we found no multivariate association between the use of outpatient visits and income or insurance status. This result suggests that there is no problem with access in the public - almost universal - Costa Rican health system. No conclusive results were obtained on the influence of the physician on the frequency of use of health care services, as postulated by the principal-agent model.