title: Pre-hospital policies for the care of patients with acute coronary syndromes in India: A policy document analysis.
abstract: OBJECTIVE
  Ischemic heart disease is the leading cause of death in India. In high-income countries, pre-hospital systems of care have been developed to manage acute manifestations of ischemic heart disease, such as acute coronary syndrome (ACS). However, it is unknown whether guidelines, policies, regulations, or laws exist to guide pre-hospital ACS care in India. We undertook a nation-wide document analysis to address this gap in knowledge.
  
  
  RESULTS
  From November 2014 to May 2016, we searched for publicly available emergency care guidelines and legislation addressing pre-hospital ACS care in all 29 Indian states and 7 Union Territories via Internet search and direct correspondence. We found two documents addressing pre-hospital ACS care.
  
  
  CONCLUSIONS
  Though India has legislation mandating acute care for emergencies such as trauma, regulations or laws to guide pre-hospital ACS care are largely absent. Policy makers urgently need to develop comprehensive, multi-stakeholder policies for pre-hospital emergency cardiovascular care in India.
authors.affiliation: Departments of Preventive Medicine and Medicine-Cardiology, Northwestern University Feinberg School of Medicine, Chicago, USA. Electronic address: amishapa@gmail.com.
authors.forename: Amisha
authors.initials: A
authors.lastname: Patel
authors.affiliation: Centre for Chronic Disease Control, Gurgaon, India; Public Health Foundation of India, Gurgaon, India.
authors.forename: Dorairaj
authors.initials: D
authors.lastname: Prabhakaran
authors.affiliation: Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Berendsen
authors.affiliation: Westfort Hi-Tech Hospital, Thrissur, India.
authors.forename: P P
authors.initials: PP
authors.lastname: Mohanan
authors.affiliation: Departments of Preventive Medicine and Medicine-Cardiology, Northwestern University Feinberg School of Medicine, Chicago, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Huffman
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000628:therapy*; D019468:Disease Management; D004632:Emergency Medical Services / Q000592:standards; D005260:Female; D006761:Hospitals / Q000592:standards*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D057766:Policy; D011785:Quality Assurance, Health Care; D012042:Registries; D015996:Survival Rate / Q000639:trends
keywords: Acute coronary syndromes; Emergency; Guidelines; Healthcare infrastructure; Pre-hospital