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Background Road traffic-related crashes in India represent a significant public health challenge, with high rates of injuries, deaths, and disabilities. In 2022, there were 461,312 reported crashes, resulting in 443,366 injuries and 168,491 deaths, particularly affecting young adults. These figures might underestimate the situation, with estimates indicating a ratio of 1:15:50 between deaths, injuries requiring hospital care and minor injuries. Road crash survivors often experience long-term health conditions, regardless of injury severity, emphasising the need for comprehensive rehabilitation services. Objective and Policy Analysis Addresses deficient rehabilitation services within India's emergency care ecosystem and proposes home healthcare as a potential mode of service delivery, drawing on existing literature and policies/programs. Policy Implications National Health Policy 2017 lacks recognition of rehabilitation within emergency care, confining it to primary healthcare and geriatric conditions. The Ministry of Social Justice & Empowerment and Health & Family Welfare oversees programs for rehabilitation and services for people with disabilities. However, these offer little guidance on post-discharge care for road crash survivors leading to discharge without comprehensive follow-up plans. Insufficient data reflect this lack of prioritisation on rehabilitation needs of road crash survivors, including data on minor injury-related disabilities and long-term care needs. For road traffic crashes, estimates show after 12 months following hospital discharge, average out of pocket expenditures tripled compared to hospitalisation costs but reasons for such high costs are not thoroughly studied. Prospective studies with long-term follow-up are required to assess the needs and cost contributors among road crash survivors, irrespective of injury severity. Home Healthcare (HHC) has emerged as a potential mode of service delivery, especially amid the COVID-19 pandemic, catering to diverse patient needs, including home-based rehabilitation of road crash survivors, but it lacks standardisation. Establishing guidelines for HHC practices, protocols and training programs is crucial for enhancing caregiver skills and ensuring service quality. Examining available providers and private organisations offering home-based rehabilitation could assist in program planning. Conclusion Standardising home-based rehabilitation practices is essential to ensure consistent and quality care delivery for crash survivors. HHC could be promising solution offering tailored services with potential to bridge existing gaps in post-crash injury rehabilitation and long-term care needs.
Randhawa et al. (Fri,) studied this question.