Preoperative Evaluation for Elective Surgery in Peru: Regulatory Heterogeneity, Impact on Healthcare Delivery, and a Proposal for National Standardization

Cabrera-Enriquez J.A.; Díaz Díaz R.L.; Ulco Anhumán S.F.; Huanca-Carreño L.A.; Díaz-Vélez C. · Revista del Cuerpo Medico Hospital Nacional Almanzor Aguinaga Asenjo (2026) · DOI: 10.35434/rcmhnaaa.2026.192.3192

Resumen

Preoperative evaluation for elective surgery in Peru is governed by fragmented regulations across health subsystems, without uniform national criteria for test selection, risk stratification, validity periods, repeat testing, or specialist consultation. To analyze the Peruvian regulatory framework, compare it with international recommendations, and identify components for national standardization. A systematized descriptive-comparative documentary review of regulations and technical documents in force through December 2025 was conducted and complemented with empirical evidence from EsSalud. Eleven documents were identified, mainly addressing surgical safety, anesthesiology, ambulatory surgery, and surgical timeliness, but none provided a comprehensive cross-sector evaluation matrix. The EsSalud study showed moderate agreement with NICE recommendations, low agreement for individual tests, and an estimated net cost difference of PEN 1.17 million. A national technical standard applicable across all health subsystems is proposed, incorporating risk-based testing, interoperability, audit mechanisms, and indicators of timeliness, efficiency, care quality, and patient safety.

Instituciones: Universidad Científica del Sur; Universidad Nacional Pedro Ruiz Gallo; Universidad San Ignacio de Loyola