Willemain T R, Farber M E
Med Care. 1976 Oct;14(10):880-3. doi: 10.1097/00005650-197610000-00009.
The theory of certification-of-need is based in large part on the Roemer-Feldstein hypothesis, which holds that demand for services is proportional to bed supply. Athough developed solely from hospital data, this hypothesis is commonly assumed to hold for nursing homes as well. In fact, a high correlation between nursing home bed supply and bed utilization does exist. However, the rate of utilization should not be judged without reference to the appropriateness of use. Analysis of nursing home placement data revealed that overplacement of patients in skilled nursing facilities decreased as bed supply increased. These results suggest that the Roemer-Feldstein hypothesis may provide an inadequate rationale for regulation of nursing home bed supply. Further developments should be based on more sophisticated notions of bed supply, should make reference to the appropriateness of services, and should be subjected to empirical verification.
需求认证理论在很大程度上基于罗默-费尔德斯坦假说，该假说认为服务需求与床位供应成正比。尽管这一假说仅从医院数据得出，但通常认为它同样适用于疗养院。事实上，疗养院床位供应与床位利用率之间确实存在高度相关性。然而，在评判利用率时不应不考虑使用的适当性。对疗养院安置数据的分析显示，随着床位供应增加，患者在专业护理机构中的过度安置情况有所减少。这些结果表明，罗默-费尔德斯坦假说可能无法为疗养院床位供应监管提供充分的理论依据。未来的发展应基于更复杂的床位供应概念，应参考服务的适当性，并应经过实证验证。
