ABSTRACT
Non-communicable diseases now account for two-thirds of the total mortality in India and are projected to account for an estimated 75% of the total mortality by 2030. Cardiovascular diseases, cancer, respiratory diseases, and diabetes are the country's leading causes of death. Taken as a whole, NCDs have a sizeable economic effect at the household, local, and national levels. Using a macroeconomic model, this study estimates that in the years between 2015 and 2030, NCDs will result in macroeconomic costs that total $3,158 per capita, equivalent to a 7% annual tax on the country's gross domestic product. It also discusses the expected effects of the COVID-19 pandemic on the NCD burden and its macroeconomic impact. © 2021 Economic and Political Weekly. All rights reserved.
ABSTRACT
BACKGROUND: Surgery for hip fractures within 48 hours of admission is considered standard. During the lockdown period due to the coronavirus disease-2019 (COVID-19) epidemic, our medical staff was reduced. OBJECTIVES: To compare the demographics, treatment pathways, and outcomes of patients with hip fractures during the COVID-19 epidemic and lockdown with the standard at routine times. METHODS: A retrospective study was conducted of all patients who were treated surgically for hip fracture in a tertiary center during the COVID-19 lockdown period between 01 March and 01 June 2020 and the equivalent period in 2019. Demographic characteristics, time to surgery, surgery type, hospitalization time, discharge destination, postoperative complications, and 30- and 90-day mortality rates were collected for all patients. RESULTS: During the COVID-19 period, 105 patients were operated due to hip fractures compared to 136 in the equivalent period with no statistical difference in demographics. The rate of surgeries within 48 hours of admission was significantly higher in the COVID-19 period (92% vs. 76%, respectively;P = 0.0006). Mean hospitalization time was significantly shorter (10 vs. 12 days, P = 0.037) with diversion of patient discharge destinations from institutional to home rehabilitation (P < 0.001). There was a significant correlation between the COVID-19 period and lower 90-day mortality rates (P = 0.034). No statistically significant differences in postoperative complications or 30-day mortality rates were noted. CONCLUSIONS: During the COVID-19 epidemic, despite the limited staff and the lack of therapeutic sequence, there was no impairment in the quality of treatment and a decrease in 90-day mortality was noted.