Computed Tomographic Scanning; A Policy Statement

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: HEALTH PLANNING POLICY FOR CT SCANNING A fundamental problem with CT scanning and, indeed, with all diagnostic services is the seeming inability of the health care system to assure that only medically necessary and appropriate use occurs. The lack of control over use provides financial support for socially undesirable proliferation of facilities capable of rendering such services. In the absence of a complete restructuring of providers' economic incentives, two regulatory approaches to this dilemma are possible; control over the number and location of scanners; or control over the utilization of CT services. The first approach assumes that providers of health care can and will develop systems for appropriately rationing the use of such services. The committee believes that control over the placement of CT scanners is necessary but not sufficient; effective control over the utilization of CT services is also required. Providers of CT services cannot be expected to effectively ration access to CT scanning capability without such controls. This section discusses policy issues involving planning and regulation of CT scanner placement. The following chapter will consider policies for controlling the utilization of such services. CERTIFICATE OF NEED The major regulatory tools currently available to control the number and location of CT scanners are state certificate of need (CON) laws. CON legislation requires approval by a planning agency for major capital investments in health care resources. Twenty-nine states and the District of Columbia have CON requirements, and PL 93-641 mandates CON legislation in each state by 1980. However, laws in only three states require CON approval for capital investments made by private physicians. In the others physicians wishing to purchase...