Surgical care and trauma patients capacity in Perú - Cross-sectional study

Roxanna M. Garcia; Carlos Javier Shiraishi-Zapata; Ricardo César Zúñiga Vallejos; Dante Pool Gil Chiroque; Mario Alejandro Oyanguren Maldonado; Juan Carlos Paico Palacios; Ebella Estela Romero; Aldo Humberto Villarreal Álamo; Jaime Sergio Castillo Tovar; Salomón Jesús Aguirre Uribe; Renato Díaz Ruiz; Yovanky Miluska More Vilela

doi:10.5554/22562087.e1058

Roxanna M. Garcia Department of Neurosurgery, Northwestern University. https://orcid.org/0000-0002-4083-9893
Carlos Javier Shiraishi-Zapata Surgery and Anesthesiology Service, Hospital II Integrado Talara EsSalud. Talara, Perú. Second Specialization Unit, School of Health Sciences, Universidad Nacional de Piura, Perú. https://orcid.org/0000-0003-4020-7172
Ricardo César Zúñiga Vallejos Surgery Service, Hospital II Integrado Talara EsSalud. Talara, Perú.
Dante Pool Gil Chiroque Surgery Service, Hospital de Apoyo II-2 Sullana. Sullana, Perú.
Mario Alejandro Oyanguren Maldonado Surgery Service, Hospital de Apoyo II-2 Sullana. Sullana, Perú. https://orcid.org/0000-0003-3841-5773
Juan Carlos Paico Palacios Surgery and Anesthesiology Service, Hospital II-1 “Manuel Javier Nomberto”. Chulucanas, Perú.
Ebella Estela Romero Nursing Service, Hospital II-1 “Manuel Javier Nomberto”. Chulucanas, Perú.
Aldo Humberto Villarreal Álamo Surgery and Anesthesiology Service, Hospital II “Jorge Reátegui Delgado” EsSalud. Piura, Perú.
Jaime Sergio Castillo Tovar Surgery and Anesthesiology Service, Hospital II Integrado Talara EsSalud. Talara, Perú. Second Specialization Unit, School of Health Sciences, Universidad Nacional de Piura, Perú.
Salomón Jesús Aguirre Uribe Surgery and Anesthesiology Service, Hospital II-1 “Nuestra Señora de las Mercedes”. Paita, Perú.
Renato Díaz Ruiz Pediatrics Service, Hospital III “José Cayetano Heredia” EsSalud. Piura, Perú. https://orcid.org/0000-0002-3369-3881
Yovanky Miluska More Vilela Anesthesiology Service and Surgical Center “Telésforo León Velasco”, Hospital III “José Cayetano Heredia” EsSalud. Piura, Perú.

DOI: https://doi.org/10.5554/22562087.e1058

Keywords: Surgery, Anesthesia, Health Status Disparities, Public Health Systems Research, Perú

Abstract References How to Cite Downloads

Abstract

Introduction: Low and medium income countries face challenges in access to, and delivery of, surgical care, resulting in a high number of deaths and disabled individuals.

Objective: To estimate the capacity to provide surgical and trauma patients care in public hospitals in the Piura region, Perú, a middle income country.

Methods: A survey was administered in public hospitals in the Peruvian region of Piura, which combined the Spanish versions of the PIPES and INTACT surveys, and the WHO situational analysis tool. The extent of the event was assessed based in the absolute differences between the medians of the scores estimated, and the Mann-Whitney bilateral tests, according to the geographical location and the level of hospital complexity.

Results: Seven public hospitals that perform surgeries in the Piura region were assessed. Three provinces (3/8) did not have any complexity healthcare institutions. The average hospital in the peripheral provinces tended to be smaller than in the capital province in INTACT (8.25 vs. 9.5, p = 0.04). Additionally, water supply issues were identified (2/7), lack of incinerator (3/7), lack of uninterrupted availability of a CT-scanner (5/7) and blood bank working hours (2/7); in other words, the blood banks in two hospitals were not open 24 hours.

Conclusions: There is a significant inequality among the provinces in the region in terms of their trauma care capacities and several shortfalls in the public sector healthcare infrastructure. This information is required to conduct future research on capacity measurements in every public and private institution in Perú.

References

Banco Mundial. Los datos relativos a Ingreso mediano alto, Perú | Data [Internet]. 2020 [cited: 2021 Jan 7]. Available at: https://datos.bancomundial.org/?locations = XT-PE

Instituto Nacional de Estadística e Informática. Perú en cifras [Internet]. 2021 [cited: 2021 Jan 7]. Available at: https://www.inei.gob.pe/

Meara JG, Hagander L, Leather AJM. Surgery and global health: a Lancet Commission. Lancet. 2014;383(9911):12-3. doi: http://www.doi.org/10.1016/S0140-6736(13)62345-4.

Funk LM, Weiser TG, Berry WR, Lipsitz SR, Merry AF, Enright AC, et al. Global operating theatre distribution and pulse oximetry supply: an estimation from reported data. Lancet. 2010;376(9746):1055-61. doi: http://www.doi.org/10.1016/S0140-6736(10)60392-3.

Groen RS, Kamara TB, Dixon-Cole R, Kwon S, Kingham TP, Kushner AL. A tool and index to assess surgical capacity in low-income countries: an initial implementation in Sierra Leone. World J Surg. 2012;36(8):1970-7. doi: http://www.doi.org/10.1007/s00268-012-1591-3.

Superintendencia Nacional de Salud. Producción Asistencial en Intervenciones Quirúrgicas de las IPRESS | SUSALUD Datos Abiertos [Internet]. 2020 [cited: 2021 Jan 8]. Available at: http://datos.susalud.gob.pe/dataset/consulta-h-produccion-asistencial-en-intervenciones-quirurgicas-de-las-ipress

Instituto Nacional de Estadística e Informática. Estadísticas de Población y Vivienda [Internet]. 2020 [cited: 2021 Jan 8]. Available at: https://www.inei.gob.pe/estadisticas/indice-tematico/poblacion-y-vivienda/

Shiraishi-Zapata CJ. Monitoring of surgical care national indicators in the Peruvian health system. Colombian Journal of Anestesiology. 2017;45(3):210-5. doi: https://doi.org/10.1016/j.rca.2017.04.002

World Health Organization. Injuries and violence: the facts [Internet]. World Health Organization; 2021 [cited: 2021 Jan 8]. Available at: https://www.who.int/news-room/fact-sheets/detail/injuries-and-violence

Higashi H, Barendregt JJ, Kassebaum NJ, Weiser TG, Bickler SW, Vos T. Burden of injuries avertable by a basic surgical package in low- and middle-income regions: a systematic analysis from the Global Burden of Disease 2010 Study. World J Surg. 2015;39(1):1-9. doi: http://www.doi.org/10.1007/s00268-014-2685-x.

Shiraishi-Zapata CJ, Lozada-Zapata A del RL. Epidemiological analysis of lower limbs open fractures in adults treated in a Peruvian hospital. An Fac Med. 2019;80(4):539-40. doi: https://doi.org/10.15381/anales.v80i4.16727.

Instituto Nacional de Estadística e Informática. Estadísticas de Seguridad Ciudadana [Internet]. 2019 [cited: 2021 Jan 8]. Available at: https://www.inei.gob.pe/estadisticas/indice-tematico/seguridad-ciudadana/

Estadística e Informática. Resultados Definitivos de los Censos Nacionales 2017 – Censos Nacionales 2017 [Internet]. 2017 [cited: 2021 Jan 8]. Available at: http://censo2017.inei.gob.pe/resultados-definitivos-de-los-censos-nacionales-2017/

Wong EG, Gupta S, Deckelbaum DL, Razek T, Kamara TB, Nwomeh BC, et al. The International Assessment of Capacity for Trauma (INTACT): an index for trauma capacity in low-income countries. J Surg Res. 2014;190(2):522-7. doi: http://www.doi.org/10.1016/j.jss.2014.01.060.

Osen H, Chang D, Choo S, Perry H, Hesse A, Abantanga F, et al. Validation of the World Health Organization tool for situational analysis to assess emergency and essential surgical care at district hospitals in Ghana. World J Surg. 2011;35(3):500-4. doi: http://www.doi.org/10.1007/s00268-010-0918-1.

Ministerio de Salud. Resolución Ministerial N ° 546-2011-MINSA [Internet]. 2011 [cited: 2021 Jan 8]. Available at: https://www.gob.pe/institucion/minsa/normas-legales/243402-546-2011-minsa

Remy MI. Desigualdad territorial en el Perú. Reflexiones preliminares [Internet]. Instituto de Estudios Peruanos. Estudios sobre desigualdad. Lima; 2015 [cited: 2021 Jan 8]. Available at: https://repositorio.iep.org.pe/handle/IEP/952

Instituto Nacional de Estadística e Informática (INEI), Directorio Nacional de Centros Poblados. Censos Nacionales 2017 [Internet]. 2017 [cited: 2021 Jan 8]. Available at: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1541/index.htm

Gobierno del Perú. GORE invierte más de 269 millones para construcción de tres hospitales para la sierra [Internet]. 2021 [cited: 2021 Apr 2]. Available at: https://www.gob.pe/institucion/regionpiura/noticias/342564-gore-invierte-mas-de-269-millones-para-construccion-de-tres-hospitales-para-la-sierra

Blair KJ, Boeck MA, Gallardo Barrientos JL, Hidalgo López JL, Helenowski IB, Nwomeh BC, et al. Assessment of surgical and trauma capacity in Potosí, Bolivia. Ann Glob Health. 2017;83(2):262-73. doi: http://www.doi.org/10.1016/j.aogh.2017.04.002.

Markin A, Barbero R, Leow JJ, Groen RS, Skow EJ, Apelgren KN, et al. A quantitative analysis of surgical capacity in Santa Cruz, Bolivia. J Surg Res. 2013;185(1):190-7. doi: http://www.doi.org/10.1016/j.jss.2013.05.051.

How to Cite

1.

Garcia RM, Shiraishi-Zapata CJ, Zúñiga Vallejos RC, Gil Chiroque DP, Oyanguren Maldonado MA, Paico Palacios JC, Romero EE, Villarreal Álamo AH, Castillo Tovar JS, Aguirre Uribe SJ, Díaz Ruiz R, More Vilela YM. Surgical care and trauma patients capacity in Perú - Cross-sectional study. Colomb. J. Anesthesiol. [Internet]. 2022 Dec. 16 [cited 2023 Mar. 23];51(1). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1058