Q COSTARICA — Cancer patients at the Caja Costarricense de Seguro Social (CCSS) —Costa Rica’s Social Security System—are waiting up to 648 days for an MRI, even though their cases are considered urgent.
An Internal Audit report on the Centro Nacional de Imágenes Médicas (CNIM)—National Center for Medical Imaging, reveals this troubling delay.
On average, patients wait about 115 days for their scans, but some end up waiting more than 18 months. These long waits could delay early detection and treatment for serious illnesses.
The audit looked at 418 MRI requests and found that wait times vary depending on how patients are admitted.
Outpatients, who make up 60% of those analyzed, face an average wait of 189 days, with some waiting as long as 821 days. Hospitalized patients have it a bit better, with average waits ranging between 11.5 and 13 days.
Still, the report warns that even these delays hurt patient care by keeping beds occupied longer and slowing down the admission of new patients.
The audit also found that patients who had to take legal action to get an MRI waited around 234 days on average, showing that access to this essential diagnostic test remains a challenge.
Lack of a consolidated registry
One of the main findings is the lack of a consolidated registry.
The National Center for Medical Imaging does not have a clear list of patients awaiting an MRI, which prevents an accurate assessment of the waiting list and increases the risk of delays or omissions in diagnoses.
Currently, requests are managed through the institutional SharePoint platform, where they are stored according to the date of the follow-up appointment with the specialist. However, the Audit Office points out that this mechanism does not guarantee timely scheduling, as there is no defined average time for the studies to be performed.
This is compounded by non-compliance with internal regulations, which stipulate that MRIs must be scheduled at least 30 days before the follow-up medical appointment, a requirement that is not met in practice.
The problem is not limited to the scheduling of studies. The Audit also revealed a significant backlog in the reading and interpretation of MRI scans.
Pending Studies
As of December 2025, the CNIM had a backlog of 11,570 studies waiting to be reported. Most of these—10,933—were from outpatient consultations, with 306 related to oncology patients and 331 from hospitalized patients.
In some cases, the wait to review scans stretches as long as 570 days, particularly for brain and neck scans. This delay stalls critical clinical decisions and disrupts ongoing treatment.
The Audit highlights that this backlog poses a serious risk to timely diagnosis, especially for patients with urgent conditions like cancer, who need quick intervention to improve their chances.
In its report, the oversight body warns that CNIM’s management faces “significant risks” that threaten its ability to provide timely diagnoses and consistent treatment.
It also reminds that health services must be delivered efficiently, without interruption, and promptly—as required by regulations and constitutional law. Importantly, resource shortages don’t excuse these delays.
Because of this, the Audit Office called on the current administration to review the findings and take steps to better manage MRI scans, cut down waiting times, and enhance care quality—especially for patients with the highest clinical risks.
