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

• DOI: 10.1016/j.jss.2022.10.024
• Publication Date: 2022-11-17T22:50:42Z
• Authors: Carlos Shiraishi-...; Yovanky More-Vilela; Aldo Villarreal-Á...; Víctor Morales-Cu...; Dante Gil-Chiroque; Jaime Castillo-Tovar; Dante Ramírez-Ríos; Salomón Aguirre-U...; Joselyne Lecca-Ca...; Roxanna Garcia; Mario Oyanguren-M...; Juan Paico-Palacios; Arnaldo Vite-Quiroga; Milagros Niquen-J...
• Keywords: SARS-CoV-2; Health services accessibility; COVID-19; Health workforce; Health Services Accessibility; Specialties, Surgical; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Universal Health Insurance; General Surgery; Peru; Humans; Anesthesia; Surgery; Health Workforce; Universal health insurance; Anesthetics

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.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.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.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.