Strong coordination of care including through proactive outreach and informational continuity can facilitate more appropriate treatment across the continuum of care.123 Costa Rica has made great strides to promote coordination across levels of care with primary care systems as the first point of contact. The Costa Rican EBAIS model (Equipos Basicos de Atencion Integral de Salud) created health networks throughout the country, organized into Health Areas - the major unit of primary care.45 Each Health Area has between five and fifteen EBAIS multidisciplinary teams, or Integrated Primary Health Care Teams, providing comprehensive preventive, promotive, and curative care to empaneled populations of 30,000 to 110,000 citizens.6 The EBAIS has two policies that promote primary care as the main system for service provision, gatekeeping and dual referrals. Small groups of Health Areas generally serve as the gatekeeper to secondary and tertiary clinics through standardized regional referral networks.5 The dual referral system refers patients back to primary care for management to minimize demand on secondary and tertiary services. These gatekeeping and dual referral systems promote coordination across levels of care with primary care facilities as the primary source of care.

References:

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