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Titolo:
Certificate of need and the quality of cardiac surgery
Autore:
Robinson, JL; Nash, DB; Moxey, E; OConnor, JP;
Indirizzi:
Thomas Jefferson Univ, Jefferson Med Coll, Philadelphia, PA 19107 USA Thomas Jefferson Univ Philadelphia PA USA 19107 hiladelphia, PA 19107 USA Thomas Jefferson Univ, Off Hlth Policy & Clin Outcomes, Philadelphia, PA 19107 USA Thomas Jefferson Univ Philadelphia PA USA 19107 hiladelphia, PA 19107 USA
Titolo Testata:
AMERICAN JOURNAL OF MEDICAL QUALITY
fascicolo: 5, volume: 16, anno: 2001,
pagine: 155 - 160
SICI:
1062-8606(200109/10)16:5<155:CONATQ>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANGIOPLASTY PROCEDURES; PERFORMANCE DATA; SURGICAL VOLUME; PUBLIC RELEASE; HEALTH-CARE; MORTALITY; COMPLICATIONS;
Keywords:
bypass surgery; certificate-of-need; mortality; outcomes; quality;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Nash, DB 1015 Walnut St,Suite 115, Philadelphia, PA 19107 USA 1015 WalnutSt,Suite 115 Philadelphia PA USA 19107 PA 19107 USA
Citazione:
J.L. Robinson et al., "Certificate of need and the quality of cardiac surgery", AM J MED QU, 16(5), 2001, pp. 155-160

Abstract

Historically, states have used Certificate of Need (CON) programs to review proposals for new construction and expanded services in an effort to control costs and to improve the quality of and promote access to health care services. Congressional funding for CON ended in 1987. However, today, 26 states use CON to regulate cardiac surgery. There has been little evidence ofthe impact of CON on the quality of services. Pennsylvania is in a unique position to study the impact of CON on the quality and outcomes of care because the state terminated CON in 1996 and has publicly reported quality andoutcomes data on coronary bypass graft (CABG) surgeries since 1992. Using a statewide inpatient data-reporting system, the volumes and outcomes of CABG surgeries at all Pennsylvania hospitals were examined in the 3 years prior to and the 3 years after the termination of CON. In the 3 years following the elimination of CON, the number of open-heart surgery pro. grams increased 25%, yet there was no significant increase in the number of CABG surgeries performed. Quality, as measured by mortality rate, was not impacted bythe reallocation of the relatively stable CABG volume in the short term; this may be due, in part, to itinerant surgeons and statewide public performance monitoring. The long-term implications of deregulation are unclear anddeserve future study.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 15:16:44