Theoretical and Empirical Analysis of Reforms in the Fields of Medicine, Home Care, Health, and Pension by Utilizing Information Technology and the Market Mechanism.

本研究在理论研究和实证研究的基础上，重点探讨了构建面向老龄化社会的医疗、家庭护理、健康、养老等领域的有效制度。其中一项研究分析了电子健康(远程家庭医疗)的经济效益，并在岩手县龟石市和岩泽镇、福岛县西爱津镇和片尾村等不同地区进行了实地调查。我们通过应用CVM方法，以WTP(WTA)的形式估计了系统的收益。例如，Kamaishi和Katsurao分别为\4,519和\1,640。然后进行了成本效益分析。这些系统的成本也被扼杀了，我们在这两个方面进行了比较。效益/成本(B/C)比率。龟石和胜老的这两个数字分别为1.07和0.54。与其他地区的所有比率都约为0.5。这意味着除了Kamaishi以外的所有地区都在亏损。此外，我们还对如何在居民和医疗(长期护理)保险之间分担制度费用进行了回归分析，即我们估计了确切的报销金额。在Kamaishi的情况下，我们得到了居民应该承担3961和保险(或税收)558。由此得出以下结论：电子健康系统被证明有助于降低医疗成本，不平衡收入和成本，当前的系统不可能转变为市场系统。除了创建所谓的商业模式外，还需要建立由当地政府、非营利组织和志愿者等居民和代理人合作的制度。

This research focuses on the construction of efficient systems in the fields of medicine, home care, health, and pension towards an aging society based on theoretical as well as empirical studies. One research analyzed the economic efficiency of e-health (tele-homecare), and we conducted field surveys in different regions such as Kamaishi City and Izawa Town, Iwate Prefecture, Nishi-Aizu Town and Katurao Village, Fukushima Prefecture. We estimated benefits of the system in terms of WTP (WTA) by applying the CVM method. Those are, for example, \4,519 and \1,640 for Kamaishi and Katsurao, respectively. Then we applied the cost-benefit analysis. Costs of the systems were also ;stimated, and we compared with these two in terms. of benefit/cost (B/C) ratio. These are 1.07 and 0.54 for Kamaishi and Katsurao, respectively. All of ratios pf other regions were approximately 0.5. This implies that all regions except Kamaishi were making losses. In addition, we applied the regression analysis regarding how to share the costs of the system among residents and medical (long-term care) insurance, that is, we estimated the exact amount of reimbursement. In case of Kamaishi, we obtained that residents should bear \3,961 and the insurance (or tax) \558. Thus, the following conclusion was obtained: the e-health system, which is proved to contribute to lower the medical costs, does not balance revenues and costs, and it is impossible for the current system to be transformed into the market system. In addition to creating a so-called business model, it is required to establish the system of collaborating residents and agents such as local governments, NPO, and volunteers in the region.