需求证明法对全因死亡率的影响

The Effect of Certificate of Need Laws on All‐Cause Mortality

Health Services Research · 2016
被引 31
ABS 3

中文导读

研究美国各州需求证明法的覆盖范围对县级全因死亡率的影响,发现该法律无显著统计效应,点估计显示其更可能增加而非降低死亡率。

Abstract

OBJECTIVE: To test how Certificate of Need laws affect all-cause mortality in the United States. DATA SOURCES: The data of 1992-2011 all-cause mortality are from the Center for Disease Control's Compressed Mortality File; control variables are from the Current Population Survey, Behavioral Risk Factor Surveillance System, and Area Health Resources File; and data on Certificate of Need laws are from Stratmann and Russ (). STUDY DESIGN: Using fixed- and random-effects regressions, I test how the scope of state Certificate of Need laws affects all-cause mortality within US counties. PRINCIPAL FINDINGS: Certificate of Need laws have no statistically significant effect on all-cause mortality. Point estimates indicate that if they have any effect, they are more likely to increase mortality than decrease it. CONCLUSIONS: Proponents of Certificate of Need laws have claimed that they reduce mortality by concentrating more care into fewer, larger facilities that engage in learning-by-doing. However, I find no evidence that these laws reduce all-cause mortality.

卫生经济学公共政策流行病学卫生服务研究