Regionalization of Cardiac Services and the Responsiveness of Treatment Choices

Efforts to regionalize cardiac services can increase access costs for patients. This study is the first to quantify this trade off by estimating a demand model for surgery services that is used simulate the effect of centralization of cardiac services on hospital and treatment choices. The model is estimated using a sample of Medicare beneficiaries from the Cooperative Cardiovascular Project. Regulation policies that alter both the quality of providers and access to the providers, such as minimum volume thresholds, need to consider that patients will respond to changes in both dimensions.