Peru

Original Editor - Boyd Eastman.

Top Contributors - Boyd Eastman, Didzis Rozenbergs, Elaine Lonnemann and Evan Thomas

Patient Access to Physiotherapy or Physical Therapy Services / Entry Point

Citizens of Peru typically access physical therapy services via consultation with a medical doctor, obtaining a prescription for physical therapy services and then recurring to a physical therapy clinic that is either public or private. If the individual’s insurance does not cover physical therapy services or the individual does not possess health insurance then he/she must obtain services in a private clinic.

Do PT's have direct access or are they part of a primary care team?

Citizens of Peru may access physical therapy services directly in private clinics via private pay. When treating patients that are referred from a primary caregiver the physical therapist defers treatment decisions to the referring provider. Physical therapy services are also offered in hospitals at the discretion of the patient's physicians.

Therapist Preparation

Degree/Credentialing

Typical education of Physical Therapists in Peru involves obtaining a bachelors degree in Physical Therapy or Physical Therapy and Rehabilitation through a School of Medical Technology.  A School of Medical Technology is one of the many schools that one will typically find on a university campus in Peru. The program consists of 5 years, 10 semesters, of post secondary education including 2 semesters of internships. [1][2][3][4]

Specialization

Physical Therapists in Peru specialize in different aspects of physical therapy via experience in that setting. They may also specialize via additional degrees or university education. The Universidad Federico Villareal, located in Lima, offers specializations in Cardiopulmonary and Geriatric rehabilitation.

Professional Associations

Asociacion Peruana De Terapistas Fisicos (Peruvian Physical Therapist Association) was established on February 8, 1996.

Peruvian Physical Therapist Association is a member of The Latin American Confederation for Physical Therapy and Kinesiology (La Confederación Latinoamericana de Fisioterapia y Kinesiología)

Asociacion Peruana de Terapistas Fisicos is a member of the World Confederation of Physical Therapy (WCPT). [5]

Information about the Patient Community

The population of Peru as of 2010 is 29,000,000.  Life expectancy as of 2009 is 74 years of age for males and 77 years of age for females. The top ten causes of death in Peru follow in order of greatest to least: lower respiratory infections, ischemic heart disease, cerebrovascular disease, stomach cancer, perinatal conditions, tuberculosis, cirrhosis of the liver, nephritis and nephrosis, HIV/AIDS, and Diarrheal diseases. [6]
 

Social/Cultural Influences

A good starting place for any discussion of Hispanic culture is with la familia, the family. Family involvement often is critical in the health care of the patient. Traditionally, Hispanics include many people in their extended families, not only parents and siblings, but grandparents, aunts, uncles, cousins and compadres, close friends, and godparents (padrinos) of the family's children. When ill or injured, Hispanic people frequently consult with other family members and often ask them to come along to medical visits. [7]

What are the typical patient's living conditions, family dynamics, and cultural back ground?

In a speech given to the United Nations general assembly in September of 2010 President Alan Garcia stated that the country would reach its goal of cutting the poverty rate to 30 percent in 2011. It is expected that the poverty rate will fall below 10% by 2021. [8] Literacy rates for adult males and females age 15 and above are 95% and 85% respectively. 77% of the population lives in urban areas. Probability of dying under five is 18 per 1 000 live births. [6] 

Delivery of Care

The Government of Peru published on April 9, 2009 the Law on Health Insurance to enable all Peruvians to access quality health services, and contribute to regulate the financing and supervision of these services. President Alan Garcia enacted the law that its implementation marks a major reform that will enable all Peruvians to "timely access quality health services" regardless of their economic status. [9]  

Type of Health System

The Government of Peru published on April 9, 2009 the Law on Health Insurance to enable all Peruvians to access quality health services, and contribute to regulate the financing and supervision of these services. President Alan Garcia enacted the law that its implementation marks a major reform that will enable all Peruvians to "timely access quality health services" regardless of their economic status. The law enables all population to access diverse health services to prevent illnesses, and promote and rehabilitate people, under a Health Basic Plan (PEAS). [9] On April 2, 2010 President Alan Garcia signed legislation that Peru’s Universal Health Insurance law aims to increase access to timely and quality health care services, emphasizes maternal and child health promotion, and provides the poor with protection from financial ruin due to illness. In this regard, it meets the objectives of promoting and expanding the coverage of the covered population, avoiding duplication in the use of resources and expanding benefit coverage according to demographic and epidemiological profile. The regulation states that membership of the Universal Health Insurance is compulsory for the entire population living in the country. It establishes that public, private or mixed institutions are responsible for ensuring that all people who are in the scope of their activities, under any form of contracting, are affiliated to the Universal Health Insurance regime. [10]

Beginning in April of 2009 Universal Health Insurance was initiated in three regions: Apurímac, Ayacucho y Huancavelica. [11] The Universal Health Insurance is to be progressively implemented throughout the country. [12]

Payment System

The Universal Health Insurance is comprised of three types of coverage: a contributive plan, a semi-contributive plan and a subsidized plan. [11] Each plan requires a regular payment, which is income dependent, or no payment depending on the individual’s or family’s economic circumstances. [11] [13]  At this time 32.9% of Peruvians are insured through SIS; 20.1% are insured through EsSalud; .3% are insured through EsSalud SIS and 3.6% are insured through other companies. [11] SIS does not cover rehabilitation services and therefore it does not cover physical therapy services. [13] EsSalud regular insurance does cover physical therapy services. [14]

References

  1. http://www.upch.edu.pe/famed/portal/pregrado/pregrado-tecnologia-medica/carreras/
  2. http://www.uigv.edu.pe/facultades/estomatologia/#
  3. http://www.unfv.edu.pe/site/
  4. http://www.uwiener.edu.pe/portales/TerapiaFisica/presentacion.aspx
  5. http://www.wcpt.org/node/26478
  6. 6.0 6.1 World Health Organization. [Online] http://www.who.int/countries/per/en/.[accessed July 9, 2011.]
  7. http://erc.msh.org/mainpage.cfm?file=5.4.5.htm&module=provider&language=English
  8. http://www.un.org/en/ga/65/meetings/generaldebate/View/SpeechView/tabid/85/smid/411/ArticleID/90/reftab/224/t/Peru/Default.html
  9. 9.0 9.1 Law on Health Insurance published today. Andina: agencia peruana de noticias. [Online] April 9, 2009. http://www.andina.com.pe/Ingles/Noticia.aspx?id=mSOVQJu0hxY=.[accessed 16 2011, July.]
  10. President Garcia signs regulations for Universal Health Insurance law. Andina: agencia peruana de noticias. [Online] April 2, 2010. http://www.andina.com.pe/Ingles/Noticia.aspx?Id=GWzJKZKIRnY=.[accessed July 16, 2011.]
  11. 11.0 11.1 11.2 11.3 Preguntas Frequentes. Peru: Ministerio de Salud. [Online] http://www.minsa.gob.pe/portada/aseguramiento/default.html.[accessed July 16, 2011.]
  12. A UN AÑO DE IMPLEMENTACION DEL ASEGURAMIENTO UNIVERSAL EN SALUD. ABRIL 2009- ABRIL 2010. Peru:Ministerio de Salud. [Online] April 2009. http://www.minsa.gob.pe/portada/aseguramiento/Archivos/Informe_Primer_Anio_AUS.pdf.[accessed July 17, 2011.]
  13. 13.0 13.1 Seguro Intergral de Salud. Peru: Ministerio de Salud. [Online] 2011. http://www.sis.gob.pe/Portal/index.html#. [accessed: July 17, 2011.]
  14. EsSalud. [Online] http://www.essalud.gob.pe/contenido.php?id=3.[accessed July 17, 2011.]