Q COSTA RICA — Costa Rica’s public health system performed 85,046 surgeries from January through September 2026, as the Caja Costarricense de Seguro Social (CCSS) stepped up efforts to reduce a long-running backlog.
The Caja said the average wait for surgery fell by 86 days from its April 2023 level—but patients still waited an average of 449 days for an operation in September, nearly 15 months.
The agency reported that 114,444 cases were removed from surgical waiting lists over the nine-month period. Of those, 85,046 patients underwent surgery; another 29,398 records were removed after administrative review. The distinction matters: the total number of cases cleared from the list is larger than the number of people who received an operation.
The CCSS also reported a 27% increase in surgeries performed during extraordinary sessions—procedures scheduled outside regular hours. These sessions accounted for almost one in three operations for patients on waiting lists, compared with fewer than one in ten in 2021, according to the agency.
Some measures showed marked improvement. The number of patients who had been waiting since 2021 or earlier fell from 50,351 to 816, the CCSS said. Surgical waits declined by 87 days in neurosurgery and 26 days in ophthalmology during 2026. In outpatient orthopedics, the average wait dropped from 1,418 days to 769, though that still leaves patients waiting more than two years for an appointment.
The CCSS plans to continue its efforts under a 2026–2030 waiting-list plan approved in May. The strategy includes expanding performance-based extra sessions, digital appointment confirmations, greater use of electronic health records and prioritizing patients according to clinical need.
Progress, but not yet timely care
The figures point to real movement: more operations, fewer people stuck in the oldest part of the backlog and a lower average surgical wait than in 2023. Yet the 449-day average is the clearest measure of the distance still to go. An 86-day reduction is meaningful, but it does not make a wait of nearly 15 months acceptable or timely for every patient.
The figures also need to be read carefully. Removing a record after administrative review can improve the accuracy of a waiting list, but it is not the same as treating a patient. And a national average can conceal sharp differences between specialties; the orthopedics figures show how prolonged delays may persist even as the overall picture improves.
The expansion of after-hours sessions appears to be a major contributor to the rise in surgical output. Whether that pace can be maintained—and whether it translates into shorter waits across specialties—will be crucial. For now, Costa Rica’s results show progress against the backlog, not its resolution.