Costa Rica’s healthcare system has consistently delivered high-quality medical services yet increasing emergency visits and hospital occupancy rates threaten its efficiency. In 2023, Costa Rica recorded 6,650,411 emergency visits, with three major hospitals handling 456,773 cases (6.87% of the national total). A significant portion of these cases were non-urgent, indicating inefficiencies in primary care and referral systems. This review aims to assess the key challenges in emergency service utilization and hospital bed management while comparing Costa Rica’s performance with international benchmarks.

Among the three major hospitals, the number of emergency visits and their classification were as follows:

Hospital México recorded the highest proportion of non-urgent cases (36.67%), suggesting a higher misuse of emergency services. National data indicate that 52.34% of all emergency visits in Costa Rica were non-urgent, further exacerbating the overcrowding issue.

The average hospital stay in Costa Rica in 2023 was 6.89 days, with notable variations across major hospitals:

When compared internationally, Costa Rica’s hospital stays aligned with global trends but highlights areas for improvement. In Spain, the average hospital stay in 2021 was 8.3 days (7.9 days in public hospitals, 9.3 days in private facilities) [2] . In contrast, Mexico reported an average hospital stay of 5.7 days in hospitals implementing efficiency strategies [3] . The prolonged stays observed at Hospital San Juan de Dios and, to a lesser extent, Hospital México, indicate inefficiencies in hospital workflow, suggesting that improvements in discharge protocols, bed management, and patient flow optimization could reduce unnecessary hospital occupancy and enhance overall efficiency.

Costa Rica’s bed turnover rate in 2023 was 44.3, reflecting moderate efficiency. However, certain conditions significantly impact hospital bed availability due to their extended hospital stays:

Over the past four decades, Costa Rica has experienced a significant decline in hospital bed availability.

Costa Rica’s bed occupancy rate currently stands at 80.8%, reflecting sustained high utilization of hospital resources. Over the past two decades, while hospital bed capacity has declined, emergency visits have increased, straining inpatient services and delaying the discharge process. This imbalance has led to prolonged hospital stays and inefficient use of available resources.

When compared internationally, Costa Rica’s bed occupancy rate falls within the range of other healthcare systems:

These figures underscore the need for Costa Rica to optimize bed management strategies to align with international benchmarks and ensure efficient hospital resource utilization.

Costa Rica’s emergency services face significant overcrowding, exacerbated by high rates of non-urgent visits and prolonged hospital stays due to high-burden conditions. Comparative analysis suggests that Costa Rica’s hospital efficiency can be improved by optimizing discharge processes and strengthening primary care systems. Addressing these challenges will enhance patient outcomes and ensure the sustainability of the healthcare system.