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Strategy for determining local area need for cardiovascular surgical services
Insights
Expansion of cardiovascular surgery services in Hartford is not recommended. A study found that focusing on probable service use, rather than unknown disease needs, is a more practical approach for facility planning.
Area of Science:
- Health Services Research
- Cardiovascular Surgery Planning
Background:
- A study was commissioned by the Connecticut State Council on Hospitals to assess cardiovascular surgery facilities in Hartford.
- Data on cardiovascular disease incidence/prevalence and surgical candidate criteria were insufficient for needs assessment.
- Existing methods for determining facility needs were inadequate due to data limitations.
Purpose of the Study:
- To evaluate the appropriateness of expanding cardiovascular surgery services in the Hartford area.
- To develop a practical mechanism for assessing healthcare facility needs based on probable service utilization.
Main Methods:
- Estimated potential caseloads using national and local cardiac surgery rate trends (1961-1969 and 1972).
- Assessed existing surgical unit capacity through onsite surveys of facilities, diagnostics, and personnel.
- Compared estimated caseloads with existing service capacities.
Main Results:
- Evidence suggested that expanding cardiac surgical services in Hartford would be inappropriate.
- The study identified a lack of data for traditional needs-based assessments.
- A comparison of projected caseloads with existing capacity indicated no immediate need for expansion.
Conclusions:
- The proposed methodology offers a practical approach to healthcare facility planning by focusing on probable service use.
- This method provides a more concrete basis for discussion than relying on immeasurable disease prevalence.
- Expansion of cardiovascular surgery services in the Hartford area was deemed inappropriate based on the study's findings.
Abstract:
At the request of the Connecticut State Council on Hospitals, a study was made of existing and needed facilities for cardiovascular surgery in the Hartford area. Adequate data on incidence or prevalence of cardiovascular disease were unavailable, and agreed-upon criteria for selecting suitable candidates for surgical intervention were lacking. It was therefore impossible to estimate need for cardiovascular surgery as a basis for determining the need for additional facilities. Instead, estimates were made of potential caseloads, based on trends in rates of cardiac surgery nationwide for 1961-69 and on actual rates in the Hartford area hospitals in 1972. These estimates of potential caseloads were compared with the capacity of existing surgical units as determined by onsite surveys of surgical units, diagnostic facilities, and supportive services and personnel. The methods described provided evidence to suggest that expansion of cardiac surgical services in the Hartford area would be inappropriate. Of more practical import, the approach, although not unassailable, affords one mechanism for focusing discussion of need for facilities on questions of "probable use" of services, rather than on vague generalities based on unknown and immeasurable "needs" for cardiac surgery.