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Does certificate of need affect cardiac outcomes and costs?

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  • Vivian Ho

Abstract

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. Copyright Springer Science+Business Media, LLC 2006

Suggested Citation

  • Vivian Ho, 2006. "Does certificate of need affect cardiac outcomes and costs?," International Journal of Health Economics and Management, Springer, vol. 6(4), pages 300-324, December.
    • Handle: RePEc:kap:ijhcfe:v:6:y:2006:i:4:p:300-324
    DOI: 10.1007/s10754-007-9008-9
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    References listed on IDEAS

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    Cited by:

    1. David M. Cutler & Robert S. Huckman & Jonathan T. Kolstad, 2010. "Input Constraints and the Efficiency of Entry: Lessons from Cardiac Surgery," American Economic Journal: Economic Policy, American Economic Association, vol. 2(1), pages 51-76, February.
    2. Wang, Justin & Hockenberry, Jason & Chou, Shin-Yi & Yang, Muzhe, 2011. "Do bad report cards have consequences? Impacts of publicly reported provider quality information on the CABG market in Pennsylvania," Journal of Health Economics, Elsevier, vol. 30(2), pages 392-407, March.
    3. Polsky, Daniel & David, Guy & Yang, Jianing & Kinosian, Bruce & Werner, Rachel M., 2014. "The effect of entry regulation in the health care sector: The case of home health," Journal of Public Economics, Elsevier, vol. 110(C), pages 1-14.
    4. James Bailey, 2018. "Does “Excess Supply” Drive Excessive Health Spending? The Case of Certificate-of-Need Laws," Journal of Private Enterprise, The Association of Private Enterprise Education, vol. 33(Winter 20), pages 91-109.
    5. Stratmann, Thomas & Baker, Matthew, 2016. "Are Certificate-of-Need Laws Barriers to Entry? How They Affect Access to MRI, CT, and PET Scans," Working Papers 06892, George Mason University, Mercatus Center.
    6. Agnitra Roy Choudhury & Sriparna Ghosh & Alicia Plemmons, 2022. "Certificate of Need Laws and Health Care Use during the COVID-19 Pandemic," JRFM, MDPI, vol. 15(2), pages 1-11, February.
    7. Guy David & Lorens A. Helmchen & Robert A. Henderson, 2009. "Does advanced medical technology encourage hospitalist use and their direct employment by hospitals?," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 237-247, February.
    8. Baker, Matthew C. & Stratmann, Thomas, 2021. "Barriers to entry in the healthcare markets: Winners and Losers from certificate-of-need laws," Socio-Economic Planning Sciences, Elsevier, vol. 77(C).
    9. David M. Cutler & Robert S. Huckman & Jonathan T. Kolstad, 2009. "Input Constraints and the Efficiency of Entry: Lessons from Cardiac Surgery," NBER Working Papers 15214, National Bureau of Economic Research, Inc.
    10. Chiu, Kevin, 2021. "The impact of certificate of need laws on heart attack mortality: Evidence from county borders," Journal of Health Economics, Elsevier, vol. 79(C).
    11. Bailey, James, 2016. "Can Health Spending Be Reined In through Supply Constraints? An Evaluation of Certificate-of-Need Laws," Working Papers 05192, George Mason University, Mercatus Center.
    12. Suhui Li & Avi Dor, 2013. "How Do Hospitals Respond to Market Entry? Evidence from A Deregulated Market for Cardiac Revascularization," NBER Working Papers 18926, National Bureau of Economic Research, Inc.
    13. Averett, Susan L. & Terrizzi, Sabrina & Wang, Yang, 2017. "Taking the CON out of Pennsylvania: Did Hip and Knee Replacement Patients Benefit?," IZA Discussion Papers 10917, Institute of Labor Economics (IZA).

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