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Table 4 Summary of Studies on the Effect of CON on Quality for Procedures Other than Cardiac Surgery

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

STUDY

DESIGN

STATES

YEARS

CONTROLS

KEY FINDINGS

NOTES

Zinn [29]

Cross-sectional

50

1987

Facility characteristics

Moratorium on building makes nursing home patients 7% more likely to be physically restrained, reduced RNs per patient 32%

Physical restraint increases 2.5 pp. from a 36% base; RNs per patient falls 1.3 pp. from a .04 base

Ford and Kasserman [17]

Time series of cross sections

50

1982–1989

State characteristics

Both presence of CON and CON stringency have a significant negative impact on both entry of new firms and expansion of capacity in dialysis industry

No direct evidence on quality; authors show CON increases market concentration, then cite other work saying that concentration reduces quality