BURDEN OF EMERGENCY AND OPERATIVE CONDITIONS IN INDIA: A STATE-LEVEL RETROSPECTIVE ANALYSIS FROM 1981 TO 2021 jnv4@duke.edu

 

BURDEN OF EMERGENCY AND OPERATIVE CONDITIONS IN INDIA: A STATE-LEVEL RETROSPECTIVE ANALYSIS FROM 1981 TO 2021

6

United States

Oral or Poster

Disease burden is an important factor determining healthcare policy and resource allocation. We analyzed the burden of emergency and operative conditions subnationally in India from 1981 to 2021.

We extracted mortality and disability-adjusted life-year (DALY) estimates for 31 Indian states and Union Territories from 1981-2021 from the Global Burden of Disease (GBD) 2021 Study. We used existing expert-consensus-based classifications for defining emergency (30 conditions), operative (57 conditions), and emergency-operative conditions (7 conditions). We investigated the rates per 100,000 people and proportion attributed to the above conditions out of total mortality/DALY. For brevity, we report only mortality numbers here.

In 2021, emergency (rate: 345.82 per 100,000), operative (rate: 143.07 per 100,000), and emergency-operative conditions (rate: 70.69 per 100,000) accounted for 41.65%, 17.23%, and 8.51% of all-cause mortality, respectively. Tamil Nadu, Chhattisgarh, and Uttarakhand had higher mortality rates for the three condition groups. From 1981 to 2021, mortality rates generally decreased for all conditions with the largest decrease for emergency conditions. Rates for Nagaland, Himachal Pradesh, and Punjab either decreased minimally or increased since 2001.

Despite significant improvements in healthcare nationally, the time trend of several states in India showed a consistent trend over time, reporting a persistently high burden of emergency and operative conditions. Given the relatively large share of emergency and operative conditions toward all-cause mortality, surgical care should be a high priority on national and state-level cross-sectoral policymaking.