Does certificate of need affect cardiac outcomes and costs?
Several U.S. states enforce Certificate of Need (CON) regulations, which limit the number of hospitals performing open heart surgery or coronary angioplasty. CON regulations were intended to restrain cost growth and improve quality of care. This study compares mortality rates and costs for cardiac care in states with and without CON. CON appears to raise hospital procedure volume and lower the average cost of care. However, CON is associated with little reduction in inpatient mortality, and it may lead hospitals to operate on more patients than they would otherwise. The claimed welfare benefits of CON regulations require careful reconsideration.
Ho
Vivian
V
Baker Institute for public policy-HS 40, Rice University, 6100, Main St., Houston, TX 77005, USA. vho@rice.edu
D015906:Angioplasty, Balloon, Coronary / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data*; D002567:Certificate of Need / Q000331:legislation & jurisprudence*; D001026:Coronary Artery Bypass / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data*; D003363:Cost Control / Q000379:methods; D017281:Cost of Illness; D017048:Health Care Costs / Q000639:trends*; D019981:Health Care Sector; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000639:trends*; D010414:Pennsylvania; D014481:United States; D016270:United States Agency for Healthcare Research and Quality