However, these patients are no more likely to experience adverse events, such as death, than patients who had heart attacks but were treated within the first days in states without CON. These findings appear in a University of Iowa and Department of Veterans Affairs (VA) study. CON programs involve state-enacted regulations that seek to limit unnecessary expansion of medical services. The study also showed that increased CON stringency is associated with lower use of the two procedures but without a negative impact on survival.
"The study implies that certificate of need programs, which require hospitals to obtain prior approval for establishing high-cost services, limit the growth of these services. In spite of limiting the diffusion of these services, CON regulations did not adversely affect patients," said Gary Rosenthal, M.D., the study's senior investigator and professor of internal medicine in the University of Iowa College of Medicine.
The study involved a review of the administrative records of 1,139,792 Medicare beneficiaries age 68 and older who had heart attacks and had been admitted to 4,587 hospitals in the United States between 2000 and 2003. "The findings indicate that the more stringent the CON program, the lower the use of bypass surgery and angioplasty for these patients, yet death rates remained the same as in states with less stringent CON or states without CON," explained the study's lead author Ioana Popescu, M.D., a Quality Scholar with the VA Iowa City Health Care System.
"A problem for policy makers is there haven't been enough studies on the impact of certificate of need programs on quality of care and how well patients do," Rosenthal said. "There may still be an important role for regulatory policy at the state level to ensure services are not unnecessarily duplicated and to control quality of care."
MEDICA.de; Source: University of Iowa