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Observational Study
. 2023 Mar:283:127-136.
doi: 10.1016/j.jss.2022.10.024. Epub 2022 Nov 17.

Monitoring Indicators of Universal Access to Accessible and Safe Anesthetic and Surgical Care in a Peruvian Region: An Ambispective Study

Carlos Shiraishi-Zapata  1 , Yovanky More-Vilela  2 , Aldo Villarreal-Álamo  3 , Víctor Morales-Cuervo  4 , Dante Gil-Chiroque  5 , Jaime Castillo-Tovar  6 , Dante Ramírez-Ríos  7 , Salomón Aguirre-Uribe  8 , Joselyne Lecca-Castillo  9 , Roxanna Garcia  10 , Mario Oyanguren-Maldonado  5 , Juan Paico-Palacios  11 , Arnaldo Vite-Quiroga  11 , Milagros Niquen-Jimenez  12
Affiliations
Observational Study

Monitoring Indicators of Universal Access to Accessible and Safe Anesthetic and Surgical Care in a Peruvian Region: An Ambispective Study

Carlos Shiraishi-Zapata et al. J Surg Res. 2023 Mar.

Abstract

Introduction: The Lancet Commission on Global Surgery indicators for monitoring anesthetic and surgical care allow the identification of access barriers, evaluate the safety of surgeries, facilitate planning, and assess changes over time. The primary objective was to measure these indicators in all health facilities of a Peruvian region in 2020.

Methods: This was an ambispective observational study to measure the anesthetic and surgical care indicators in Piura, a region in Peru, between January 2020 and June 2021. Public and private health facilities in the Piura region that performed surgical care or had specialists from any surgical specialty participated in the study. Data were collected from all regional health facilities that provided surgical care to estimate the density of surgical workforce. Likewise, the percentage of the population with access to an operating room within 2 h was estimated using georeferenced tools. Finally, a public database was accessed to determine the surgical volume, the percentage of the regional population protected with health insurance.

Results: In 2020, 88.4% of the inhabitants of this Peruvian region had access to timely essential surgery. There were 18.4 surgical specialists and 1174 surgeries per 100,000 populations, and 91% of the population had health insurance. In addition, there was a rate of 2.1 working operating rooms per 100,000 inhabitants in 2021.

Conclusions: This Peruvian region presented an increasing trend with respect to the population's access to essential and timely surgical care, and health insurance coverage. However, the workforce distribution was inequitable among the provinces of the region, the surgical volume was reduced, and timely access was hindered because of the SARS-CoV-2 pandemic.

Keywords: Anesthesia; Health services accessibility; Health workforce; Peru; Surgery; Universal health insurance.

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Conflict of interest statement

Disclosure

The authors have no conflicts of interest. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Health Ministry of Peru and Social Security of Health of Peru-EsSalud.

Figures

Fig. –
Fig. –
Results map of the Piura region showing measured indicators in each province. Note: SAO density is shown in yellow color. Percentage of the region population with health insurance (surrogate indicator) is shown in purple color. The percentage of people with access within 2 h to a working operating room for emergency surgery is represented in red color within circles. The surgical rate for 100,000 inhabitants is displayed in green color. Source: built by the authors.
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