Certificate of Need Legislation and the Dissemination of Robotic Surgery for Prostate Cancer

Abstract

State based certificate of need regulations were ineffective in constraining robotic surgery adoption. Despite decreased use in high stringency markets, similar adoption rates suggest that other factors impact the diffusion of robotic prostatectomy.

Association Between Certificate of Need Legislation and Radiation Therapy Use Among Elderly Patients With Early Cancers

“…Our study adds to the body of literature demonstrating that health care utilization may not be curbed by CON programs (5)(6)(7)(8)(9). This study is unique in examining the use versus non-use of radiation therapy by CON status, which had not been examined previously.…”

Understanding the Diffusion of Ambulatory Surgery Centers

“…Previous work by our group and by others has questioned the value of certificate of need laws to curtail the unfettered addition of capacity in a variety of contexts. 12,40,41 Collectively, these data suggest that opportunity for a return on investment, as typified by advantageous socioeconomic and noncompetitive climates, trump the regulatory milieu in terms of determining where these facilities open. This study should be interpreted with 2 limitations in mind.…”

Economics of Robotic Surgery

“…Some been suggested that state-based certificates of need should be implemented to control RALS utilization and limit costs as they pertain to prostate cancer. 25 However, state-based regulations were ineffective in constraining robotic surgery adoption and intensity-modulated radiation therapy, another controversial, high-cost prostate cancer treatment modality. 26 As health care reform gets underway, one may expect similar constructs to be implemented in order to control RALS and health care costs while striving to improve patient outcomes.…”