caa a22 4500 397577125 CHVBK 20180308164859.0 cr unu---uuuuu 161202e199612 xx s 000 0 eng 10.1093/oxfordjournals.pubmed.a024544 doi (NATIONALLICENCE)oxford-10.1093/oxfordjournals.pubmed.a024544 Setting targets for CABG surgery in the North Western region [Elektronische Daten] [C. H. Pain, F. Frankovitch, G. Cook] Background A national target for coronary artery by pass graft (CABG) operations of 300 per million population was established by the Department of Health in 1987. Regional Health Authorities were required in 1993-1994 to achieve this target. The 1990-1991 Regional all-ages CABG ratewas 239 per million population. The North Western Region planned to devolve the purchasing of certain services, including cardiac surgery, to districts in April 1993. Three districts had provider units within their boundaries. No means existed for estimating the appropriate operation rate, according to need, for district populations. A method was therefore devised for calculating guideline targets. Methods Based on the assumption that the ischaemic heart disease standardized mortality ratio (IHD SMR) is a valid proxy of the need for CABG operations and using a linear regression model, the existing district IHD SMRs and IHD hospitalization rates were used to derive guideline targets for districts, taking account of the need to raise the average operation rate for the Region to 300 per million population.Further targets using alternative Poisson regression model and weighting formulae were also derived. Results The derived operation targets based on the linear regression model were lower than the existing operation rate in the three provider districts and in the biggest provider's two neighbours. In all other districts, exceptone, targets were higher than the existing number of operations. The two further analyses produced essentially similar results. Conclusions In the North Western Region wide variations in CABG operation rates existed. Access to CABG surgery in the North Western Region appears to depend on proximity to the provider districts. Operation rates should reflect need.This paper presents a method for deriving targets which take account of need. © Oxford University Press Articles nationallicence coronary artery bypass graft surgery nationallicence target setting nationallicence health need nationallicence health services utilization nationallicence Pain C. H. Department of Epidemiology and Public Health, University of Leicester 22-28 Princess Road West, Leicester LE1 6TP aut Frankovitch F. North Western Regional Health Authority 930-932 Birchwood Boulevard, Millenium Park, Birchwood, Warrington WA3 7QN aut Cook G. North Western Regional Health Authority Gateway House, Piccadilly South, Manchester M60 7LP aut Journal of Public Health Oxford University Press 18/4(1996-12), 449-456 1741-3842 18:4<449 1996 18 pubmed https://doi.org/10.1093/oxfordjournals.pubmed.a024544 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/oxfordjournals.pubmed.a024544 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pain C. H. Department of Epidemiology and Public Health, University of Leicester 22-28 Princess Road West, Leicester LE1 6TP aut NATIONALLICENCE 700 1- Frankovitch F. North Western Regional Health Authority 930-932 Birchwood Boulevard, Millenium Park, Birchwood, Warrington WA3 7QN aut NATIONALLICENCE 700 1- Cook G. North Western Regional Health Authority Gateway House, Piccadilly South, Manchester M60 7LP aut NATIONALLICENCE 773 0- Journal of Public Health Oxford University Press 18/4(1996-12), 449-456 1741-3842 18:4<449 1996 18 pubmed Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford