Financial burden of coronary artery bypass grafting in India: implications for catastrophic health expenditure and healthcare access.

Cardiovascular diseases (CVD) have become a leading cause of mortality in India. High costs of coronary artery bypass grafting (CABG) impose a financial burden in patients often resulting in catastrophic health expenditure (CHE). CHE and distressed financing have significant microeconomic and macroeconomic implications. CHE depletes savings, forces asset disposal, and perpetuates poverty. At a macroeconomic level, the burden of CVD impacts gross domestic product, economic productivity, healthcare budgets, and social welfare. Addressing these challenges requires a multifaceted approach. Prioritizing accessible and affordable healthcare systems with robust financial risk protection is essential. Widespread adoption of health insurance, including government-sponsored schemes, can provide financial protection. Expanding public healthcare infrastructure, implementing price regulations, promoting generic medicines, and encouraging preventive measures for coronary artery disease (CAD) are crucial steps to reduce the burden of CABG costs and improve healthcare access.

Stereotactic breast biopsy: A review & applicability in the Indian context.

Stereotactic biopsy is used for sampling of suspicious non-palpable lesions identified on mammography or digital breast tomosynthesis which are not visible on ultrasound. Stereotactic biopsy is preferable to surgical excision biopsy and helps avoid surgery for benign lesions. Providing tissue diagnosis in patients with early breast cancer may help in formulating a management strategy. Stereotactic biopsy can be carried out using either a dedicated prone table with the patient lying prone or an upright mammographic add-on system with the patient in a sitting or lateral decubitus position. This review focuses on the advantages and disadvantages of both these systems, the indications, contraindications and the complications inherent with this technique. The important pitfalls and their management as well as ways to ensure quality assurance have also been elaborated upon. Data regarding uptake of stereotactic biopsy in other parts of the world have been discussed using evidence from existing registries and databases and attempts made to quantify the need of the technique in the Indian set-up. In the absence of a national breast screening programme and limited resources in India, a hub and spoke model has been proposed as a viable model for healthcare providers for providing stereotactic biopsy.