Year : 2016 | Volume
: 9 | Issue : 4 | Page : 129--130
What's new in Emergencies Trauma and Shock? Calculating Costs for Disaster Preparedness!
Department of Operations Management, Indian Institute of Management, Lucknow, Uttar Pradesh, India
Department of Operations Management, Indian Institute of Management, Lucknow, Uttar Pradesh
|How to cite this article:|
Saddikuti V. What's new in Emergencies Trauma and Shock? Calculating Costs for Disaster Preparedness!.J Emerg Trauma Shock 2016;9:129-130
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Saddikuti V. What's new in Emergencies Trauma and Shock? Calculating Costs for Disaster Preparedness!. J Emerg Trauma Shock [serial online] 2016 [cited 2021 May 11 ];9:129-130
Available from: https://www.onlinejets.org/text.asp?2016/9/4/129/193345
Demand for affordable and quality care is increasing across the globe on one side and on the other hand on supply side the cost of care is increasing particularly human resource cost, infrastructure cost, etc. In case of trauma care, the demand is increasing several fold. One of the main reasons is road accidents, particularly in developing countries. Road accidents cost India $20 billion annually with 1% of world's vehicles and 10% of road accident deaths.  According to data released by the Central Statistical Organisation of India on Gross Domestic Product (GDP), the cost of road accidents is estimated as INR 3.8 lakh crore which is about 3% of the GDP. The magnitude of road accidents can be understood from the following: ,
"According to report on road accidents in India 2015, on an average 400 persons (1374 accidents in a day, 17 deaths in 57 crashes per hour) die every day in road accidents in India. Over 54% of those getting killed are in the age group of 15-34 years. Delhi recorded highest number of deaths (1622) in the country during 2015. This magnitude was not killed in wars, epidemics and militancy."
Shri Nitin Gadkari, Minister for Road Transport and Highways, Government of India
India is a signatory to the Brasilia Declaration and is committed to reduce the number of road accidents and fatalities by 50% by 2020. Some of the solutions suggested include better roads and highways, enforcement of proper licensing and road safety laws and establishment of more trauma centers within cities and along highways. An Expert Committee  by National Human Rights Commission has studied the existing system for emergency medical care in India and suggested methods for emergency medical care at the country level. The committee reviewed the accidents from Centralised Accident and Trauma Services and found that annually about 4 lakh persons lose their lives due to injuries, 75 lakh are hospitalized and 3.5 lakh persons with minor injuries in India. The committee found that the present Emergency Medical Support in the country is functioning suboptimally and requires upgradation. 
Shri. A.P.J. Abdul Kalam, former President of India, in his address to Indian Red Cross Society in 2004 strongly suggested for an integrated and institutionalized approach for emergency response. He suggested a scheme using mobile technologies, in which whenever an accident occurs, a message could be sent to the nearest ambulance team and immediate medical help is arranged for. He also recommended for formulating a legal mechanism for providing such emergency support in critical situations.
The government of India has accorded permission for the establishment of 100 Emergency Accident Relief Centres along the National Highways (for a distance of 50 km) to give timely first aid and to arrange for further medical treatment in hospitals.  This program was implemented by the government jointly with private hospitals, sponsors, etc. Out of the 100 centers targeted, 77 are functioning. Among the centers functioning, 41 are fully financed by private hospitals and institutions while the remaining 36 are partly supported by the government and provide a monthly support limited to INR 40,000. It is noted that during the year 2004, these centers have saved 19,595 lives, treated 6400 serious injured cases and 13,195 persons with minor injuries.
Singh et al,  in their study "Cost Analysis of a disaster facility at an Apex Tertiary Care Trauma Centre of India" have addressed various cost elements of establishing and operating a trauma care center in India during common wealth games period for providing emergency medical services for the players and other VIPs, etc. Singh et al,  have clearly highlighted both capital cost (26%) and operating costs (74%) in establishing and operating the trauma care facilities. Major cost (47%) is due to human resource followed by capital cost (26%), support services (19%). These details will act as a reference for establishing similar facilities across the country and helps in better resource allocation. This study can help Ministry of Road Transport and Highways for setting up of trauma care centers along national highways under public-private-partnership (PPP) model. This study further enhances the public opinion and transparency, particularly in large size public hospitals. This will also help in establishing trauma care facilities in the newly coming up All India Institutes of Medical Sciences (AIIMS) across the country and helps in establishing standards. This can also help insurance companies for design of suitable public health-care insurance schemes launched by Government of India and other state governments.
Findings of this study will certainly act as a reference point for policy makers and other stakeholders in resource allocation, workforce capacity building for emergency care delivery. Due to resource constraints and operational difficulties, government organizations are adopting PPP models in public services delivery including healthcare services. One of the most important aspects of PPP in service delivery is clarity on capital and operating costs which are very critical for collaboration/partnership in healthcare delivery. It also demonstrates the need for further studies using KTI framework (knowledge [K] [highly qualified doctors and support staff], technology [T], and institutionalization [I]) for care delivery. KTI framework has been adopted by world class health-care organizations like Aravind Eye Care System, e-hospital of AIIMS, etc.
The current study used standard or traditional costing method. Future studies can focus on advanced models of costing like activity-based costing, willingness to pay models  for trauma care delivery in public setting. Finally, this kind of studies can help policy makers as well as private organizations to understand the role of technology and infrastructure, workforce capacity building, institutionalization of processes particularly in trauma care in India.
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