Almost 86 per cent of districts with high rural population in the country do not have adequate provision of the most basic diagnostic tests required for managing chronic diseases and only 34 per cent of the population in the rural areas has access to diagnostic centres, according to a study by Chronic Care Foundation.

The study titled 'non-communicable chronic diseases in India-A study of gaps, quality and cost of care' and based on the responses of the affected persons in all four regions in the country, also showed that 80.9 per cent of the PSUs in high rural areas do not have treatment facility for any of the chronic ailments

The findings reveal that only 45 per cent of total respondents find easy access to medicines and this was most difficult for stroke and chronic kidney disease patients. There is high dependence on private facilities due to inadequate services at the Government managed units.

On quality aspects, the Indian Public Health Service (IPHS) standards were the benchmark for this study and the findings revealed that very low proportion of Health Care Facilities (HCFs) adhere to the quality parameters laid down by IPHS standards, it said.

Only 60 per cent tertiary HCFs had guidelines about time taken to admit a patient. On sterilization standards and methods followed, boiling was the most common method used especially in rural areas, due to lack of other alterative equipment. Primary health care facilities were found to lack the infrastructure facilities as suggested by IPHS guidelines. It is also significant to note that blood bank facilities present in less than 50 per cent of tertiary HFCs.

On the arena of cost of care, the study found that the direct cost contributed about 45.8 per cent of the total expenses in rural areas as compared to 39.6 per cent in urban areas. Hospitalization expenses contributed the most to the total costs. In rural areas, this cost reached staggering 79.1 per cent of the total expenses due to lack of facilities locally and people having to move out for hospitalization and specialized care, the study said.

Quoting the latest data, the foundation said by 2020, chronic diseases are expected to claim 7.63 million lives in India. Cardiovascular, respiratory diseases, cancer and diabetes account for 53 per cent deaths in the country, making higher than those caused by infectious diseases. India accounts for nearly 20 per cent of the world's population suffering from heart diseases. There are over 60 million coronary heart patients and over 57.2 million diabetes patients in India and the numbers increase every year. It is estimated that less than 50 per cent of End-Stage Renal Disease (ESRD) patients get to see a doctor and about 14-15 per cent in total are on not in any form of long-term therapy. Over 70 per cent of patients, who start therapy, drop out in the first year itself, primarily due to lack of funds. Less than 10 per cent of all Indian ESRD patients get any meaningful Renal Replacement Therapy (RRT), the foundation said.