Demands on tertiary care for cardiovascular diseases in India: analysis of data for 1960-89.

Data on 43,544 consecutive patients with cardiac disorders admitted to one hospital were analysed under four etiological groups to study the changing trend in the demand for tertiary care between 1960 and 1989. While rheumatic fever went down in frequency, rheumatic valvular disease remained at an average of 40% of total cardiac admissions, coronary heart disease steadily increased from 4% in 1960 to about 33% in 1989, and congenital heart cases accounted for 24% of cardiac admissions. While other etiological groups have varied, coronary heart disease has shown an almost linear increase. The demand for cardiac surgery also has risen almost linearly. The implications of these findings on the health needs and health planning in the whole country pose a great challenge to planners.