Prehabilitation: A Catalyst for Transforming Toward Value-Based, Personalized Perioperative Health and Care

The growing strain on global healthcare systems, driven by aging populations, rising prevalence of chronic diseases, and workforce shortages, has increased interest in strategies that enhance perioperative outcomes and healthcare sustainability. From this perspective, prehabilitation-a proactive, multimodal approach to enhance patients' functional, nutritional, and psychological status prior to surgery-has gained attention as a potential contributor to value-based, personalized care. This study aims to synthesize mechanistic rationale, clinical evidence, and system-level considerations for prehabilitation, with particular focus on allostatic capacity and the body's response to surgical stress. Current evidence shows that prehabilitation may reduce postoperative complications, shorten hospital stays, and improve functional recovery, particularly when interventions are multimodal. However, the existing literature is characterized by methodological heterogeneity and variable quality, seemingly limiting generalizability and large-scale implementation. Further research is required to standardize outcome measures, identify patient subgroups most likely to benefit, and evaluate cost-effectiveness. Integration of prehabilitation into perioperative care pathways will depend on improved mechanistic understanding, robust clinical trials, and alignment with broader health policy and system-level initiatives. Prehabilitation may represent a meaningful step toward value-based and sustainable surgical care, though its implementation must be guided by high-quality evidence and careful consideration of context-specific factors.