F. Lema1, C. Flores1, V. Padmanaban2, P. F. Johnston2, F. R. Muñoz Córdova3, Z. C. Sifri2 1New Jersey Medical School,Newark, NJ, USA 2University Of Medicine And Dentistry Of New Jersey,Surgery,Newark, NJ, USA 3Universidad Privada Antenor Orrego (UPAO),Trujillo, Peru
Introduction:
The Peruvian government offers Seguro Integral de Salud (SIS), a free health insurance program, to any citizen below a defined poverty level. Despite the ostensible availability of this coverage, many patients lack access to surgical care. Local healthcare workers involved in surgical care may provide additional insight into this problem. We conducted a survey to investigate the perceptions of local healthcare workers on access and barriers to surgical care in Trujillo, Peru.
Methods:
A qualitative survey was issued on paper in Spanish to healthcare workers (HCWs) in the urban center of Trujillo, Peru at three main hospitals. The survey asked providers questions regarding health services in Peru with emphasis on access, barriers and potential solutions to surgical care delivery. Data on basic demographics, medical role and specialty, and years of clinical experience was collected.
Results:
Forty-seven HCWs who completed surveys averaged 35 ± 15 years of age and 9.5 ± 13 years employed in the Peruvian healthcare system. Fifty-five percent of participants included 26 physicians: 7 general surgeons, 1 trauma surgeon, 1 anesthesiologist, 12 interns, 1 pediatrician, 1 gynecologist, and 3 in rural medicine.
The majority of study participants either disagreed (45%) or strongly disagreed (6%) when asked if they believe health services are accessible to every Peruvian regardless of their economic situation. Seventy-four percent of HCWs agreed that there is a problem with access to surgical care in Trujillo and furthermore, this perception by HCW was the same regardless of medical role, gender, years of clinical service, and hospital sites.
Factors that HCWs cited as barriers to surgical care included inadequate funding, deficits in surgical infrastructure, long wait times, lack of qualified surgeons and a lack of surgical resources. Participants elaborated that the lack of surgical resources is a stimulus for patients’ out-of-pocket expenditures, precluding the most impoverished Peruvian patients. Additionally, HCWs agree (47%) and strongly agree (53%) that surgical international humanitarian organizations are an important part of the care for Peru’s poorest patients.
Conclusion:
Notably, the majority of healthcare workers surveyed believe there exists a problem with access to both health services in Peru and surgical care in Trujillo. Furthermore, all participants consider that international surgical teams are a necessary part of the local healthcare system, especially for the care of the poorest citizens. Given that participants were able to name several of these organizations, indicated that their belief is supported by experience. Further study to identify long-term sustainable solutions is warranted.