Patient Needs and Medical-Care Planning

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Abstract
To illustrate how plans can be developed to meet medical needs, Massachusetts demographic data and myocardial-infarction incidence rates were used to propose a regional system of coronary-care units. Using Framingham Heart Study incidence data for acute and serious heart disease, we suggest that 5.6 million people can be served by 39 coronary-care units with 336 beds, as contrasted with the 94 units with 446 beds currently in Massachusetts. The proposed 39 units would be so distributed that every patient would be no more than 30 minutes from a unit and would have a 95 per cent chance of obtaining a bed in the closest unit. By adherence to admission criteria and by realizing economies of scale, the estimated annual operating cost of the proposed units plus other substituted hospital services would be $14.5 million dollars — $3 million less than current costs. (N Engl J Med 290:1171–1177, 1974)