The Effect of Primary Health Care on Mortality : Evidence from Costa Rica

This paper uses the gradual implementation of a primary health care intervention in Costa Rica to examine the long-term effect of primary health care on mortality. Nine years after opening a primary health 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 for those aged 65 years and older and for those with non-communicable diseases, such as cardiovascular-related causes of death. We also show that as Health Areas opened, more individuals sought care at primary care clinics and fewer at emergency rooms, which may have partially mediated the effect of the intervention on mortality