Explain Healthcare Burden OF HEART DISEASES?
CAD and its complications use up a substantial portion of the scarce healthcare resource of the country. It has been reported that CAD formed 5-20 per cent of all heart disease admissions in big hospitals in Delhi, Mumbai and some other cities. In 1971-75 CAD was present in 16.5 per cent of all heart disease cases seen in AIIMS and that rose to 19.7 per cent in 1981-85. In the same years, proportion of CAD admissions rose from 20.8 per cent to 23.9 per cent respectively. Pooled data from the states of Assam, Madhya Pradesh, Punjab, Kerala and Karnataka show that proportion of all cwdi.ac admissions to various government hospitals and incidence of CAD increased from 14 per cent in 1970 to 19 per cent in 1985. Admissions to a non-government tertiary care hospital in Vellore (South India) steadily increased from 4 per cent in 1960 to 33 per cent in 1989. Again, between 1966 to 1988 there has been a more than 20-fold increase in admissions for acute myocardial infarction in a single medical college hospital in Kerala. In Orissa, CAD admissions increased from 19.9 per cent in 1981-90 to 28 percent in the next decade. There is definitely substantial regional variation in Cardio-vascular admissions and mortality in different parts of the country. However all these studies report an increasing burden from CAD on the healthcare system, especially on the urban hospitals.
The situation in the rural areas is also not much different. Though serial studies in rural areas alee not available, in one report from Rajasthan, CAD contributed to 8 per cent of patients attending a general medical clinic. Another report has shown that of a total of 1362 medical cases seen in a referral medical clinic, there were 110 CAD cases (roughly 9 per cent). If converted into absolute numbers, there are millions of patients with CAD seen all over India in hospitals, urban clinics and rural centres. No doubt burden on population and healthcare from CAD is very high.