Sahu Dinesh Prasad, Singh Arvind Kumar, Mishra Baijayantimala, Behera Bijayini, Patro Binod Kumar, Kunjanpillai Jawahar Sreevihar, Nair Jyolsna, Panigrahi Manoj Kumar, Mohanty Manoj Kumar, Behera Priyamadhaba, Mohapatra Prasanta Raghav, Barik Sadananda, Mohanty Sachidanand, Sahu Subhakanta, Singh Sudipta Ranjan, Tripathy Swagata
Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
J Family Med Prim Care. 2023 Jul;12(7):1331-1335. doi: 10.4103/jfmpc.jfmpc_1956_22. Epub 2023 Jul 14.
Mortality from coronavirus disease 2019 (COVID-19) pandemic has left footprints across all ages and socio-economic strata. The deaths because of COVID-19 are usually multi-factorial. The study aimed to assess the health system factors related to COVID-19-related deaths.
A hospital-based retrospective study was conducted at a tertiary care hospital of eastern India. A total of 272 COVID-19 deaths that occurred between April and November 2020 were investigated. Data were extracted from Medical Record Department, and telephonic interviews were conducted to assess the different delays related to death. Data were analysed using Statistical Package for Social Sciences. Travel time, travel distance, delay in testing, and delay in receiving quality care were presented as median with inter-quartile range.
Complete information could be collected from 243 COVID deaths of the 272 deaths (89.3%). The duration of hospital stay was 1-7 days for 42% of the deceased. The median travel time was 120 min, and the median distance travelled was 60 km. The median time to receive first attention of health care workers was 10 minutes. There was hardly any delay in reporting of test results, whereas the median time from symptoms to test and the median time from symptoms to admission were 4 days each.
Health system factors related to death of COVID-19 need to be addressed to avoid the avoidable deaths during the pandemic situation. The resilience of the health system can be helpful in reducing death toll in a low-resource country like India.
2019年冠状病毒病（COVID-19）大流行造成的死亡波及所有年龄层和社会经济阶层。COVID-19导致的死亡通常是多因素造成的。本研究旨在评估与COVID-19相关死亡有关的卫生系统因素。
在印度东部一家三级护理医院开展了一项基于医院的回顾性研究。对2020年4月至11月期间发生的272例COVID-19死亡病例进行了调查。从病历科提取数据，并通过电话访谈评估与死亡相关的不同延误情况。使用社会科学统计软件包对数据进行分析。出行时间、出行距离、检测延误和获得优质护理的延误情况以中位数和四分位间距表示。
在272例死亡病例中，有243例（89.3%）的完整信息得以收集。42%的死者住院时间为1至7天。出行时间中位数为120分钟，出行距离中位数为60公里。获得医护人员首次关注的时间中位数为10分钟。检测结果报告几乎没有延误，而从出现症状到检测的时间中位数以及从出现症状到入院的时间中位数均为4天。
需要解决与COVID-19死亡相关的卫生系统因素，以避免在大流行期间出现可避免的死亡。在印度这样资源匮乏的国家，卫生系统的韧性有助于降低死亡人数。
