No medical care for 45% of recorded deaths in 2020, highest ever: New data

THE CIVIL Registration System (CRS) data for 2020 includes a key metric that shows how difficult it was for people to access health facilities during the pandemic: over 45 per cent of all recorded deaths that year happened in the absence of medical attention, the highest percentage ever.

The data also show a sharp decline in deaths recorded in hospitals and other medical facilities in 2020.

For several months in 2020, when the pandemic first gripped the world, non-Covid medical services were suspended or operating thinly in
India, with 80 to 100 per cent of beds in several hospitals reserved for Covid patients. As a result, a large number of people were unable to receive medical care for non-Covid illnesses.

The CRS data has captured this agony for the first time.

In 2011, only 10 per cent of all recorded deaths occurred in the absence of medical care.

The proportion of people dying in the absence of medical attention increased from 34.5 per cent of all recorded deaths in 2019 to 45 per cent in 2020, the largest single-year jump.

Simultaneously, deaths under institutional care dropped from 32.1 per cent in 2019 to 28 per cent in 2020, the sharpest ever decline.

These two data points do not indicate a new or unusual phenomena. The proportion of deaths in the absence of medical attention has been steadily increasing over the past decade, and the proportion of institutional deaths coming down.

What is new, however, is the quantum of increase, and decline, this year.

In 2011, only 10 per cent of all recorded deaths occurred in the absence of medical care. But that was also the period when less than 70 per cent of all deaths in the country were being registered — only 67 per cent in 2011. Institutional deaths formed a bulk because most of them would get registered, unlike deaths at home.

As the level of death registrations increased, so did the proportion of deaths outside medical institutions.
In 2017 and 2018, the proportion of institutional deaths and those without medical attention were roughly equal, each accounting for about one-third of all registered deaths. The remaining one-third were deaths that required no medical care, or received some medical care at home or for which details were not available.

By 2019, the proportion of recorded deaths in the absence of medical care had overtaken that of institutional deaths. But due to the pandemic, an unusual acceleration of these trends took place in 2020. These trends are expected to be reinforced in the data for 2021, when a large number of Covid deaths also happened due to lack of access to hospital care.

Overall, the CRS data, released on Tuesday by the office of the Registrar General, showed that 81.16 lakh deaths were registered in the country in 2020 — about six per cent higher than the previous year’s number, which is consistent with the trend of increasing registrations of births and deaths.

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