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

Background: To understand the burden of emergency medical conditions (EMCs) and healthcare service utilization, we assessed Emergency Medicine Department (EMD) data from India's Health Management Information System (HMIS) and EMCs from the Global Burden of Disease (GBD). Methods: This 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 29 EMCs at the national and state levels. We analyzed HMIS and GBD data to estimate proportions and rates of registrations, deaths, and incident cases relative to population counts and hospital admissions. Results: In 2019, 119,103,358 patients (8,935.66 per 100,000 people) were registered at EMDs per HMIS. The national EMD registration rate was 6,744.22 per 100,000 hospital admissions, and the EMD death rate was 30,526.36 per 100,000 hospital deaths. Only 12.14% of all HMIS registrations had cause-specific data. GBD estimates that EMCs accounted for 27.22% of all-cause incidence and 51.72% of all-cause mortality. Trauma-related registrations were 8.22% 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. Conclusion: The study reveals gaps between EMD utilization and EMC disease burden estimates. Improved data integration and reporting can address regional disparities.