RAND Corporation, Arlington, VA, USA.
Brown University School of Public Health, Providence, RI, USA.
Inquiry. 2024 Jan-Dec;61:469580241277444. doi: 10.1177/00469580241277444.
In over half of US states, health planning boards monitor and control the supply of health care through certificate of need (CON) laws. The COVID-19 pandemic led several states to impose moratoria on CON regulations, hoping to bolster hospital and skilled nursing facility (SNF) beds. Using a difference-in-difference research design, we leverage 2015 to 2021 cost report data from SNFs to study the association between COVID-related CON moratoria and health care supply. Counties that imposed moratoria experienced a slight decline in per-capita SNF bed count. However, once adjusted for potential differential shocks in pre-pandemic high utilization counties, we find little evidence that moratoria led to increased nursing home capacity, overall or by urbanicity. In the context of nursing homes, we conclude that CON deregulation was relatively ineffective at mitigating pandemic-era supply concerns.
在美国一半以上的州，卫生规划委员会通过需求证明（CON）法来监测和控制医疗保健的供应。COVID-19 大流行导致一些州暂停 CON 法规，希望增加医院和熟练护理设施（SNF）床位。我们使用差异中的差异研究设计，利用 2015 年至 2021 年 SNF 的成本报告数据，研究 COVID 相关 CON 暂停与医疗保健供应之间的关联。实施暂停的县人均 SNF 床位数量略有下降。然而，一旦对大流行前高使用率县的潜在差异冲击进行调整，我们几乎没有发现暂停导致疗养院容量增加的证据，无论是整体还是按城市划分。在疗养院的背景下，我们的结论是，CON 放宽管制在缓解大流行时期的供应问题方面相对无效。
