Certificate of need and the cost of competition in home healthcare markets.
Certificate of need and the cost of competition in home healthcare markets.
复制标题
家庭医疗保健市场的需求证明和竞争成本。
DOI：
10.1080/01621424.2020.1728464
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发表时间：
2020
影响因子：
1.4
通讯作者：
Mukamel,DanaB
中科院分区：
文献类型：
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作者：
Ettner,SusanL;Zinn,JacquelineS;Xu,Haiyong;Ladd,Heather;Nuccio,Eugene;Sorkin,DaraH;Mukamel,DanaB
我们使用2010-16年10，737个独立家庭健康机构（HHA）的医疗保险成本报告，以检查家庭健康（HH）和护理之家（NH）需要证书（CON）法律对HHA病例量，总成本和每位患者可变成本的影响。在调整其他HHA特征后，只有HH CON法律（2，975，698美元），只有NH CON法律（1，768，097美元）和两种类型的法律（3，511，277美元）的州的总成本高于没有CON法律（1，538，536美元）。由于CON降低了每位患者的成本，因此病例量导致成本上升。需要进行更多的研究，以区分这是否是由于对质量和规模经济的吝啬。
We used 2010–16 Medicare Cost Reports for 10,737 freestanding home health agencies (HHAs) to examine the impact of home health (HH) and nursing home (NH) certificate-of-need (CON) laws on HHA caseload, total and per-patient variable costs. After adjusting for other HHA characteristics, total costs were higher in states with only HH CON laws ($2,975,698), only NH CON laws ($1,768,097), and both types of laws ($3,511,277), compared with no CON laws ($1,538,536). Higher costs were driven by caseloads, as CON reduced per-patient costs. Additional research is needed to distinguish whether this is due to skimping on quality vs. economies of scale.