Delays in Accessing Emergency General Surgical Care in Tertiary Care Hospital during COVID-19 Pandemic in North-East India

Abstract

Introduction: Emergency general surgery (EGS) patients are those who require an emergent surgical intervention for diseases within the realm of general surgery. However, its accessibility in passable time and place is limited in several low and middle-income countries including India. Though we know that the COVID-19 pandemic bought further diversion of medical resources, there have been no studies in the region to identify these barriers. Our study aims to fill this gap by utilizing the three delays model - delay in seeking care, reaching care and in-hospital care. Materials & Methods The study analysed prospective data from 2021 (2nd COVID-19 pandemic wave), which was collected in the fixed window from 1st May to 31st July during the lockdown. Demographic profile, diagnosis, treatment, quantity and quality data for delays were collected and analysed using IBM SPSS Statistics ver. 20. Results In three months duration, 38 patients admitted with general surgery emergency having a median delay of one day were observed in all three stages of delay. Delay in seeking care showed association with diagnosis of the patients while in-hospital delay showed associated with both diagnosis and American Society of Anaesthesiologists (ASA) grade of the patients. The postoperative stay (POS) positively increases with delay in seeking care and in-hospital care. Conclusion This is the first study in the region to address delays faced by the patients in seeking emergency surgical care and highlights the influence of the pandemic. Thus, it will help in developing future public policy in global surgery in the region and worldwide.