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- Title
The impact of certificate of need programs on neonatal intensive care units.
- Authors
Lorch, S A; Maheshwari, P; Even-Shoshan, O
- 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.
- Subjects
UNITED States; CONFIDENCE intervals; PREMATURE infants; MAPS; MEDICAL needs assessment; MULTIVARIATE analysis; NEONATAL intensive care; POISSON distribution; STATISTICS; DATA analysis; NEONATAL intensive care units; RELATIVE medical risk
- Publication
Journal of Perinatology, 2012, Vol 32, Issue 1, p39
- ISSN
0743-8346
- Publication type
Article
- DOI
10.1038/jp.2011.47