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Table 3

From: Certificate of need laws: a systematic review and cost-effectiveness analysis

Parameters:

DISTRIBUTION

@RISK FORMULA

EXPECTED

LOWER BOUND (5%)

UPPER BOUND (5%)

NOTES

 

Government Regulatory Costs

[P1]

Total states with CON, 2008

Constant

37

37

37

37

[a]

 

[P2]

Average FTE CON employees in states with CON

Truncated Normal

10.2

10.2

5.1

15.3

[b]

 

[P3]

Annual total compensation, state employees, 2008

Normal

52,058

52,058

39,044

65,073

[c]

 

Compliance Costs

[P4]

Average spending per CON application, WA, 2013

Constant

124,936

124,936

124,936

124,936

[d]

 

[P5]

Average annual number of CON applications, WA

Constant

52

52

52

52

[e]

 

[P6]

Personal health care expenditures (PHCE), WA, 2008 (millions)

Constant

$ 42,411

$ 42,411

$ 42,411

$ 42,411

[f]

 

[P7]

Percentage change in PHCE, U.S., 2008–2013

Constant

17.9%

17.9%

17.9%

17.9%

[g]

 

[P8]

CON compliance spending per $10,000 PHCE

Normal

$ 1.29

$ 1.29

$ 0.97

$ 1.61

[h]

 

[P9]

Personal health care expenditures (PHCE), 2008 (000’s)

Normal

$ 1,997,199

$ 1,997,199

$ 1,964,445

$ 2,029,953

[i]

 

[P10]

Share of PHCE in states with CON, 2008

Constant

56.6%

56.6%

56.6%

56.6%

[j]

 

[P11]

PHCE spending in CON states, 2008 (millions)

Calculated

$ 1,130,663

$ 1,130,663

$ 1,112,100

$ 1,149,200

[k]

 

Key Impacts

Health expenditures

[P12]

Medicare expenditures, 2008 (millions)

Normal

$ 440,758

440,758

$ 433,530

$ 447,987

[l]

 

[P13]

Share of Medicare spending in states with stringent CON, 2008

Constant

19.2%

19.2%

19.2%

19.2%

[m]

 

[P14]

Reduction in Medicare/eligible spending due to CON

Normal

1.8%

1.8%

0.5%

3.2%

[n]

 

[P15]

All other PHCE spending in CON states, 2008 (millions)

Calculated

$ 1,045,988

$ 1,045,988

$ 1027,402

$ 1,064,578

[o]

 

[P16]

Increase in per capita health spending due to CON

Exponential

0.19%

0.14%

0.01%

0.58%

[p]

 

[P17]

New CABG programs averted per 1000 CABG patients

Normal

0.97

0.97

0.75

1.19

[q]

 

[P18]

Capital cost per CABG program (millions)

Normal

$ 20.5

$ 20.5

$ 17.8

$ 23.2

[r]

 

[P19]

Amortized annual capital cost per CABG program (millions)

Normal

$ 2.0

$ 2.0

$ 1.7

$ 2.2

[s]

 

Patient time losses

[P20]

Time losses per CABG patient due to restricted supply

Normal

$ 7.50

$ 7.50

$ 3.75

$ 11.25

[t]

 

[P21]

Total CABGs in states with CON, 2008

Normal

238,586

238,586

131,404

267,020

[u]

 

General elderly hospital mortality

[P22]

Elderly hospital patients, 2008 (thousands)

Normal

13,902

13,902

11,504

16,300

[v]

 

[P23]

Elderly in-hospital mortality risk, 2008

Normal

4.1%

4.1%

4.0%

4.2%

[w]

 

[P24]

Increase in Medicare mortality rates due to stringent CON

Exponential

0.3%

7.9%

6.1%

9.7%

[x]

 

[P25]

VOSL, elderly, 2008 (millions of dollars)

Triangle

$ 2.9

$ 2.9

$ 0.6

$ 5.9

[y]

 

CABG mortality, all patients

[P26]

Change in CABG mortality rate/1000 patients due to CON

Calculated

−1.1

−1.1

−2.8

0.6

[z]

 

[P27]

Added life expectancy per CABG patient

Normal

8.0

8.0

6.0

10.0

[aa]

 

[P28]

Quality of life, CABG patients after 10 years

Normal

0.9

0.9

0.7

1.1

[ab]

 

[P29]

Value of a quality-adjusted life year (QALY), 2008 (thousands)

Triangle

$ 239.1

$ 239.1

$ 120.7

$ 407.0

[ac]

 

CABG mortality, Medicare patients, stringent CON states

[P30]

Elderly CABGs in states with stringent CON, 2008

Normal

43,840

43,840

24,145

49,065

[ad]

 

[P31]

Change in elderly CABG mortality rate/1000 due to stringent CON

Calculated

−7.3

−7.3

−14.76

0.13

[ae]

 

[P32]

Ratio of elderly CABG life expectancy to average CABG LE

Constant

0.54

0.54

0.54

0.54

[af]

 

CABG mortality rates, Medicare patients non-stringent CON states

[P33]

Elderly CABGs in states with CON, 2008

Normal

91,540

91,540

50,417

102,450

[ag]

 

[P34]

Change in elderly CABG mortality rate/1000 in all CON states

Calculated

−0.9

−0.9

−2.0

0.1

[ah]

 

[P35]

Change in elderly CABG mortality rate/1000, non-stringent CON

Calculated

4.9

4.9

−5.8

32.9

[ai]

 

Social Welfare Losses

[P36]

Marginal tax overhead costs, federal taxes

Normal

48.2%

48.2%

38.1%

64.3%

[aj]

 

[P37]

Marginal tax overhead costs, state taxes

Normal

40.5%

48.2%

32.4%

53.9%

[ak]

 

[P38]

Marginal excess burden, sales taxes

Normal

23.3%

48.2%

20.4%

26.1%

[al]

Â