title: The impact of certificate of need programs on neonatal intensive care units.
abstract: OBJECTIVE
  To determine the impact of state certificate of need programs (CON) on the number of hospitals with neonatal intensive care units (NICU) and the number of NICU beds.
  
  
  METHODS
  The presence of a CON program was verified from each state's department of health. Multivariable regression models determined the association between the absence of a CON program and each outcome after controlling for socioeconomic and demographic differences between states.
  
  
  RESULTS
  A total of 30 states had CON programs that oversaw NICUs in 2008. Absence of such programs was associated with more hospitals with a NICU (Rate Ratio (RR) 2.06, 95% CI 1.74 to 2.45) and NICU beds (RR 1.96, 95% CI 1.89 to 2.03) compared with states with CON legislation, and increased all-infant mortality rates in states with a large metropolitan area.
  
  
  CONCLUSIONS
  There has been an erosion of CON programs that oversee NICUs. CON programs are associated with more efficient delivery of neonatal care.
authors.affiliation: Department of Pediatrics, The Children's Hospital of Philadelphia and The University of Pennsylvania School of Medicine, Philadelphia, PA, USA. lorch@email.chop.edu
authors.forename: S A
authors.initials: SA
authors.lastname: Lorch
authors.forename: P
authors.initials: P
authors.lastname: Maheshwari
authors.forename: O
authors.initials: O
authors.lastname: Even-Shoshan
mesh_terms: D002567:Certificate of Need / Q000706:statistics & numerical data*; D033161:Government Regulation; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data*; D006801:Humans; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D012044:Regression Analysis; D012959:Socioeconomic Factors; D013219:State Government; D014481:United States