According to a survey that examined the current situation of 100 emergency and injury treatment centres in government and private hospital settings, emergency departments only account for 3-5 percent of total hospital beds in the country.
The Department of Emergency Medicine, AIIMS, submitted a study to Niti Aayog titled “Emergency and Injury Care at Secondary and Tertiary Level Centres in India.”
According to the survey, while having sufficient overall numbers of essential human resource, most hospitals lacked general doctors, specialists, and nursing staff dedicated to emergency departments in comparison to the average footfall of patients.
The paper evaluated the current state of 100 emergency and injury treatment centres in government and private hospital settings, as well as 34 district hospitals, across 28 Indian states and two union territories.
The absence of a point-of-care lab (73 percent), a demarcated triage area (65 percent), a police control room (56 percent), separate ambulance access (55 percent), and adequate emergency department spacing were among the critical infra-related quality parameters assessed in emergency departments (EDs) (52 per cent).
Emergency and injury cases accounted for 9-13 percent of all patients presenting to a health facility each year, 19-24 percent of admissions in government hospitals, and 31-39 percent of admissions in private hospitals, according to the research.
Emergency care is described as the provision of time-sensitive measures that are required to avoid death or impairment, and for which delays of hours might worsen prognosis or make care less effective.
While compliance with overall recommended biomedical equipment and vital equipment was determined to be mostly satisfactory at all private hospitals (86-93%) and government medical college hospitals (68%) in the report, inadequacies were mostly detected in smaller government hospitals (45-60 per cent).
Because it is critical to have a complete list of all prescribed emergency drugs available 24 hours a day, 7 days a week in emergency departments, the research stated that just 9% of all hospitals met this condition.
Many government medical colleges, according to the survey, lacked common HDU (55%), Cardiac ICU (55%), and Neuro ICU (55%). (55 per cent).
They also lacked facilities for Coronary Artery By-pass Graft (55%) and Cardiac Cath Labs (30%), as well as interventional radiology (40%) according to the report.
According to the survey, most hospitals lacked a specialised blood bank in the emergency room as well as an uniform process for big blood transfusions.
It also said that in government medical colleges (90 minutes), the patient disposition time for the sickest group (red zone) was longer than at private hospitals (15 minutes).
The causes for the delay included a high patient load, a lack of in-house specialists in the ED, the necessity for several cross referrals, and an overarching lack of a specialised emergency services department, according to the report.
Although 91% of hospitals had in-house ambulances, just 34% had trained paramedics to support ambulance services, according to the survey.
Only 19% of hospitals have a mobile stroke/STEMI (heart attack) programme, with only 4% having a mobile stroke unit, according to the survey.
Equipment deficits were mostly found in the pediatric-care category (75%) and a few sets of specific equipment in the Airway, breathing, circulation, and general categories (10-72%), according to the report.
Violence between families of care-seekers and health-care personnel was reported by 22-47 percent of hospitals, with government hospitals having the highest prevalence, according to the survey.
In the report’s Foreword, Niti Aayog member V K Paul emphasised the significance of India developing a world-class, efficient, professional, integrated emergency-care system that is enabled by technology for the care of any accident, emergency, or trauma victim in any region of the country.
He has stated that the assessment completed as part of this pan-India study will serve as a critical beginning point for these discussions.