Summary What are the ATAPs( Community Health Workers “Plus”)？teams were sent to some of the country’s most underserved rural areas before expanding into urban centers. It is said to have allowed the country to develop a very robust information system on the determinants of health - people’s living conditions. This system, built on decades of experience with rural community health programs, is said to have changed the culture of healthcare delivery in Costa Rica. A closer look reveals some interesting mechanisms.is called a family file. This helps to maintain patient histories, such as immunization records, and enables post-discharge visits and tracking of health determinants in the community. Since the system was introduced, deaths from communicable diseases have fallen from 65 per 100,000 population in 1990 to 4.2 per 100,000 in 2010. In addition, maternal and child mortality rates have continued to decline since 1995. Furthermore, within a decade, household expenditure on health services fell more dramatically than in other Latin American countries, with Costa Rica recording just 25% of private health expenditure, compared to an average rate of around 58% in other countries in the region.opportunities to receive adequate and satisfactory treatment due to labor shortages. I was thinking about how can rural healthcare problems be solved in Japan and thought this example in Costa Rica may lead to something good for the solution.years. Introduced in the 1990s, it assigns all citizens to a regional primary healthcare team known as EBAIS (Equipo Básico de Atención Integral en Salud). These teams are made up of doctors, nurses, and health professionals working for the community, who visit each household in the area they are responsible for every year to assess the demand in that area. The data they collect is then combined with electronic health records and appears to be used to set future targets, track progress, and focus resources on areas of high medical risk. When the system was first introduced, EBAIS ATAPs (Community Health Workers “Plus”) are members of the EBAIS team who have additional responsibilities beyond the role of community health workers. They provide services at regular consultation centers and in patients’ homes, with priority given to high-risk patients. Homes with the highest priority (homes inhabited by elderly people living alone, people with uncontrolled chronic diseases, people at high risk of pregnancy, and other high-risk individuals) are visited three times a year. Homes at moderate risk receive two ATAP visits per year, while families considered to be at low risk receive one preventive ATAP visit per year. ATAPs also collect health information from each family, which Costa Rica’s healthcare system is well structured through local, community-based healthcare. I felt deeply relieved that people could get good guidance and treatment in homes, churches, and clinics. In Japan, many rural areas, do not have many
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