S A Lorch1, P Maheshwari, O Even-Shoshan. 1. Department of Pediatrics, The Children's Hospital of Philadelphia and The University of Pennsylvania School of Medicine, Philadelphia, PA, USA. lorch@email.chop.edu
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. STUDY DESIGN: 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. RESULT: 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. CONCLUSION: There has been an erosion of CON programs that oversee NICUs. CON programs are associated with more efficient delivery of neonatal care.
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. STUDY DESIGN: 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. RESULT: 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. CONCLUSION: There has been an erosion of CON programs that oversee NICUs. CON programs are associated with more efficient delivery of neonatal care.
Authors: David J Wallace; Derek C Angus; Christopher W Seymour; Amber E Barnato; Jeremy M Kahn Journal: Am J Respir Crit Care Med Date: 2015-02-15 Impact factor: 21.405
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Authors: Sara C Handley; Molly Passarella; Heidi M Herrick; Julia D Interrante; Scott A Lorch; Katy B Kozhimannil; Ciaran S Phibbs; Elizabeth E Foglia Journal: JAMA Netw Open Date: 2021-10-01