Certificate-of-need regulation and the diffusion of innovations: A random coefficient model

In this paper, we examine empirically the effect that certificate-of-need regulation by state health planning organizations has had on the speed of diffusion of a relatively new medical technology--haemodialysis. Specifically, we test the hypothesis that a requirement that investments be subject to certificate-of-need review has significantly slowed the rate of adoption of this particular treatment modality. In subjecting this hypothesis to empirical verification, we estimate a random coefficient model. This approach allows us to make more efficient use of the available data than the traditional two-stage approach to modelling diffusion processes wherein separate logistic functions are first estimated over the time series observations followed by hypothesis tests conducted over the cross-sectional observations. We find evidence that certificate-of-need regulation slows the spread of haemodialysis technology.