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

BackgroundTo understand the burden of emergency medical conditions (EMCs) and healthcare service utilization, we assessed Emergency Medicine Department (EMD) data from the Health Management and Information System (HMIS) of India and EMCs from the Global Burden of Disease (GBD). MethodsThis was a retrospective cross-sectional analysis of HMIS and GBD data for 2019. We extracted EMD registrations, hospital admissions, and deaths from HMIS and incidence and deaths 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. ResultsIn 2019, 119,103,358 patients (8935.66 per 100,000 people) were registered at EMDs per HMIS. The national EMD registration rate was 6744.21 per 100,000 hospital admissions, and the EMD death rate was 36002.6 per 100,000 hospital deaths. Only 12.14% of all HMIS registrations had cause-specific data. GBD estimated that EMCs accounted for 27.22% of all-cause incidence. 51.71% of all-cause mortality, and 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. ConclusionThe study reveals gaps in EMD utilization compared to EMC disease burden estimates. Improved data integration and reporting can address regional disparities.