Emergency Care in India: A Retrospective Cross-sectional Analysis of Health Management and Information System and Global Burden of Disease

Abstract

Background: To understand the utilization and burden of emergency medical conditions (EMCs), we assessed EM Department (EMD) data from the Health Management and Information System (HMIS) of India and EMC from the Global Burden of Diseases (GBD). Methods: This was a retrospective cross-sectional analysis of HMIS and GBD data for 2019. We extracted EMD registrations, admissions, and deaths from HMIS and incidence, deaths, and DALYs from GBD for 31 EMCs at the national and state levels. We analyzed HMIS and GBD data for proportions and rates of registrations, deaths, and incident cases relative to population counts and hospital admission numbers. Results: In 2019, 119,103,358 patients (8,935.66 per 100,000 people) were registered at EMDs. The national EMD registration rate was 6,744.21 per 100,000 hospital admissions and the EMD death rate was 43,939.49 per 100,000 inpatient deaths. Only 12.14% of all HMIS registrations had cause-specific data. GBD estimated 2,047,175,737 EMC incident cases nationally, accounting for 27.22% of all-cause incidence, 51.71% of all-cause mortality, and 42.30% of all-cause DALYs. Trauma-related registrations were 9.27% in HMIS while injuries in GBD accounted for 7% of EMCs. Overall, HMIS EMD registrations were lower than GBD EMC incidence numbers, with regional variations. Conclusions: The study reveals gaps in the EMD utilization as per HMIS data compared to the EMC burden estimates from GBD. Improved data integration and reporting can address regional disparities.