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The impact of certificate of need programs on neonatal intensive care units

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.

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Correspondence to S A Lorch.

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Lorch, S., Maheshwari, P. & Even-Shoshan, O. The impact of certificate of need programs on neonatal intensive care units. J Perinatol 32, 39–44 (2012). https://doi.org/10.1038/jp.2011.47

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