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

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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.