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.


Regulation Certificate of need Outcomes assessment Cardiac surgery Costs 

JEL Classifications

I110 Analysis of Health Care Markets I180 Health: Government Policy Regulation Public Health 


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Baker Institute for public policy-HS 40, Rice UniversityHoustonUSA
  2. 2.Baylor College of MedicineHoustonUSA

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