《需求证书法对全因死亡率的影响》
The Effect of Certificate of Need Laws on All-Cause Mortality.
机构信息
Department of Economics and Finance, Heider College of Business of Creighton University, Omaha, NE, USA.
出版信息
Health Serv Res. 2018 Feb;53(1):49-62. doi: 10.1111/1475-6773.12619. Epub 2016 Dec 1.
OBJECTIVE
To test how Certificate of Need laws affect all-cause mortality in the United States.
DATA SOURCES
The data of 1992-2011 all-cause mortality are from the Center for Disease Control's Compressed Mortality File; control variables are from the Current Population Survey, Behavioral Risk Factor Surveillance System, and Area Health Resources File; and data on Certificate of Need laws are from Stratmann and Russ ().
STUDY DESIGN
Using fixed- and random-effects regressions, I test how the scope of state Certificate of Need laws affects all-cause mortality within US counties.
PRINCIPAL FINDINGS
Certificate of Need laws have no statistically significant effect on all-cause mortality. Point estimates indicate that if they have any effect, they are more likely to increase mortality than decrease it.
CONCLUSIONS
Proponents of Certificate of Need laws have claimed that they reduce mortality by concentrating more care into fewer, larger facilities that engage in learning-by-doing. However, I find no evidence that these laws reduce all-cause mortality.
目的
检验需求方管制法如何影响美国的全因死亡率。
资料来源
1992-2011 年全因死亡率数据来自疾病控制中心的压缩死亡率文件；控制变量来自当前人口调查、行为风险因素监测系统和区域卫生资源文件；需求方管制法的数据来自 Stratmann 和 Russ（）。
研究设计
使用固定效应和随机效应回归，我检验了州需求方管制法的范围如何影响美国各县的全因死亡率。
主要发现
需求方管制法对全因死亡率没有统计学上的显著影响。点估计表明，如果它们有任何影响，它们更有可能增加死亡率而不是降低死亡率。
结论
需求方管制法的支持者声称，这些法律通过将更多的护理集中到少数更大的、通过实践学习的设施中，从而降低死亡率。然而，我没有发现这些法律降低全因死亡率的证据。
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