Strategy for determining local area need for cardiovascular surgical services.

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.