title: [Cardiac surgery in Quebec: Do we have too many centers? Too many surgeons? Too many patients?].
abstract: OBJECTIVE
  In restructuring the Quebec health care system with hospital budget cuts, salary ceiling of physicians and a small number of practising cardiac surgeons, the future of this specialty needs to be defined beyond individual self-interest. To evaluate the actual situation and to suggest changes that will improve surgical care delivery in cardiac surgery, surgeon and centre case loads in the province of Quebec were reviewed.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Province of Quebec, 1994.
  
  
  METHODS
  Patients who underwent coronary artery bypass grafting in 1994.
  
  
  RESULTS
  The rate of coronary bypass grafting in Quebec was similar to that in Canada as a whole. The number of patients undergoing coronary artery bypass grafting increased at a rate of 6.5%/year during the five years preceding 1994, when operations numbered 5000. Thus, 7000 procedures will be performed in the year 2000 if the actual increase remains similar. There are 12 centres performing cardiac surgery in Quebec, with one centre/600,000 population and 3.4 surgeons/centre, compared with one centre/800,000 population and 3.7 surgeons/centre in Canada. In the year 2000, to accommodate 7000 cases, 18 centres will be required for a minimal case load per centre (300 cases/centre) or nine centres for an optimal case load per centre (700 cases).
  
  
  CONCLUSIONS
  Each centre of cardiac surgery should perform an optimal volume of cases to achieve maximal use of human and physical resources devoted to the care of cardiac surgical patients in the province of Quebec.
authors.affiliation: Département de Chirurgie, Institut de Cardiologie de Montréal, Québec. carrier@icm.umontreal.ca
authors.forename: M
authors.initials: M
authors.lastname: Carrier
authors.forename: L C
authors.initials: LC
authors.lastname: Pelletier
mesh_terms: D002300:Cardiac Care Facilities / Q000706:statistics & numerical data / Q000600:supply & distribution*; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D006285:Health Planning; D016027:Heart Transplantation / Q000706:statistics & numerical data; D006801:Humans; D011792:Quebec; D000078329:Workforce
vernacular_title: La chirurgie cardiaque au Québec: Avons-nous trop de centres? Trop de chirurgiens? Trop de patients?