The impact of certificate of need laws on heart attack mortality: Evidence from county borders

Kevin Chiu

Journal of Health Economics, 2021, vol. 79, issue C

Abstract: Certificate of need (CON) regulations requires that health care providers obtain state approval before offering a new service or expanding existing facilities. The purported goal of CON regulations is to reduce health care costs by generating regional economies of scale and reducing redundant investments resulting from excessive competition. Critics of CON regulations note that the regulatory environment increases the costs of expansion and may incentivize health care providers to forgo capital investment, which can have a negative effect on health outcomes. To estimate the net effect of CON regulations, I use a border discontinuity design to measure within-regional heart attack mortality spanning 1968 to 1982. I estimate that CON regulations led to an increase in heart attack deaths, by 6%-10%, three years after the policy was enacted.

Keywords: Certificate of need; CON; Acute myocardial infarction; Mortality; Heart attack; Health policy; Border discontinuity (search for similar items in EconPapers)
JEL-codes: H75 I11 I18 R58 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (6)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:jhecon:v:79:y:2021:i:c:s016762962100103x

DOI: 10.1016/j.jhealeco.2021.102518

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