key: cord-1016237-au2je08j
authors: Varghese, Bipin T.
title: The Kerala Model of Health Care delivery and its impact on Oral cancer care during the Covid 19 pandemic
date: 2020-05-03
journal: Oral Oncol
DOI: 10.1016/j.oraloncology.2020.104769
sha: 5e848311409f2a9347ce501a83faa7e78ba630ae
doc_id: 1016237
cord_uid: au2je08j

• Unlike the Quid cancers ( Carcinoma GingivoBucal Complex)of the Rest of India, Kerala has a higher incidence of tongue cancers akin to the Western world. • High Literacy and Social equality have been instrumental in cost-effective and equitable treatment of Oral cancers, which has become more noticeable during the current COVID 19 pandemic.

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© 2020 Published by Elsevier Ltd.

The Kerala Model of Health Care delivery and its impact on Oral cancer care during the Covid 19 pandemic.

Unlike the rest of India, among the Oral cancers, Tongue is the most common site in the Southernmost State of Kerala, as seen in the Western population. As per the hospital-based cancer registry of our institute, the leading Governmentowned tertiary cancer care centre, during the year 2010, 286 of 428 patients registered with cancer of the mobile Tongue were men, and a bare 8.1% of these patients presented in stage I. Thirty-five of 286 men had no treatment, the reason for it being advanced presentation with or without treatment elsewhere or financial constraints. Most of these patients were lost to follow up 1 . It is generally perceived that causes for treatment deprivation are low socioeconomic status, lack of insurance and poor awareness of the nature of disease 2 . It is worth appreciating that funding from the state government's health insurance scheme over the past 10 years (Karunya Scheme and the Karunya Arogya Suraksha Padhadi (KASP)) has been instrumental in combating this.

Despite its relatively low income, the state of Kerala in India has a high literacy level and social equality compared to the rest of the states of India, and in health care delivery, the public sector is neck and neck, if not ahead of its private counterparts. Regardless of this existing paradox, the universal inverse care law, which, in effect, states that care of a patient is inversely proportional to the overall resource of the region because more resources get utilized for the affluent group with less catastrophic illness 3 is minimally operational. With the growing years, this diabolic situation has been sorted out with the help of the initiatives of the state government and the healthy participation of the people. Other issues like fear and isolation and lack of family support have now taken the toll instead of actual financial constrain. The most recent example of the success of the 'Kerala Model' has been the Covid 19 pandemic, where equitable oral cancer care delivery within the state has been continuing with the support of the people and the Government Machinary 4 .

Hospital Based Cancer Registry Regional Cancer Centre

Untreated oral cavity cancer: Long-term survival and factors associated with treatment refusal

The inverse care law

Covid19 Pandemic; A practicing Head and Neck Surgeon's perspective of an Institutional Model

 High Literacy and Social equality have been instrumental in costeffective and equitable treatment of Oral cancers, which has become more noticeable during the current COVID 19 pandemic.