Regulating Hospital Capital Investment: The Experience in Massachusetts (NCHSR Research Summary Series)

摘要

This study examines hospital capital investment among Massachusetts short-term general voluntary hospitals between 1967 and 1976, and assesses the impact of Certificate of Need (CON) regulation. A profile of capital expenditures for fiscal years 1967-1976 was developed from Massachusetts Rate Setting Commission data for 26 sample hospitals, stratified by teaching status and Boston versus non-Boston location. Case studies were conducted in nine sample hospitals to explore the determinants and consequences of major capital projects undertaken by the institution. Enormous capital expansion took place from 1967-76. Hospitals in areas of rapid population growth significantly increased their bed size; other hospitals replaced or modernized inpatient facilities, and expanded ambulatory care capacity. All hospitals significantly expanded their ancillary service capacity. With respect to the impact of CON regulation, the evidence revealed that by 1976 and beyond, CON review had reduced all dimensions of project scale and cost by as much as two-thirds of that originally proposed.