An Introduction of Capitation in Medical Care for the Elderly and the Effects on the Medical Sector in a Macro System

老年人医疗按人头付费简介及对宏观系统医疗行业的影响

• 批准号: 11630034
• 负责人: YAMADA Tadashi
• 金额: $ 1.86万
• 依托单位: University of Tsukuba
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11630034/
• 关键词: Health Economics; Health Check-up; Medical Expenditures for the Elderly; Home Care; Efficiency of Medical Service Supply; 出来高制診療報酬制; 定額診療報酬制; 高齢者医療; 国民生活基礎調査; 就業者; 医療保険; 機会費用; 入院確率; 入院期間; 医療費削減; 病院の効率性; 健康診断の需要

This project was initially started in 1993 under the name, "A Comparative Analysis of Medical Systems between Japan and the U.S." The first phase, the first three years, was the project entitled, "Inefficiency in the Medical Sector in Japan and their Causes: An Econometric Analysis" (The Ministry of Education, Culture, Sports, Science and Technology (MEXT) : Grant No. 05630023). The second three-year phase extended the previous project : "Synthesis and Health Economics Approach to Aging Population.and Medical Care : an Empirical analysis" (MEXT : Grant No. 08630035). The third phase, from 1999 through 2001, was the study, "An Introduction of Capitation into Medical Care for the Elderly and its effects on Medical Sector in Macro System, " (MEXT : Grant No. 11630034).With respect to the third phase of the project, we obtained a number of empirical findings with regard to the Japanese elderly in terms of their demand for medidal care by using different sets of micro data. Further, the medical health check-up system in Japan was also evaluated in terms of cost-containment perspectives. The results | show that there exist quite a number of differentials among the Japanese population in their health check-up demand, and this study also shows what adequate policy targeting at specific groups in occupation, age category and insurance type may be adopted. All research results from, the project were presented at various international conferences held in Canada, England, Sweden, Taiwan, Japan and the U.S. While cultivating rich results from this project for the last three years, the period was to short to complete constructing an economic macro system to study the effects of capitation in the medical sector with regard to the costs of elderly medical care. We will continue this project to meet the current demand for policies to cope with the sharp increase in medical care costs in Japan as well as to improve social welfare.

这个项目最初开始于1993年，当时的名称是“日本和美国医疗系统的比较分析”。第一阶段，即前三年，是题为“日本医疗部门效率低下及其原因：计量经济学分析”的项目（教育、文化、体育、科学和技术部（文部科学省）：批准号05630023）。第二个三年阶段扩展了前一个项目：“人口老龄化综合和卫生经济学方法”。和医疗保健：实证分析" （MEXT：批准号08630035）。第三阶段，从1999年到2001年，是关于“引进人均制老年医疗及其对宏观医疗部门的影响”的研究（MEXT：批准号11630034）。在项目的第三阶段，我们通过使用不同的微观数据集，获得了一些关于日本老年人对医疗保健需求的实证研究结果。此外，还从成本控制的角度对日本的医疗健康检查制度进行了评估。结果|表明，日本人口在健康检查需求方面存在相当大的差异，本研究也表明可以采取针对职业、年龄类别和保险类型的特定群体的适当政策。该项目的所有研究成果均在加拿大、英国、瑞典、台湾、日本和美国等多个国际会议上发表。虽然近三年的项目成果丰富，但时间较短，无法完成构建一个经济宏观体系来研究医疗部门的资本化对老年人医疗成本的影响。我们将继续这个项目，以满足目前对政策的需求，以应对日本医疗费用的急剧增加，并改善社会福利。

项目成果

Yamada, Tetsuji, Tadashi Yamada, Chang Gun Kim, Haruko Noguchi: "Medical Services and Imperfect Information in Japan"Institute of Policy and Planning Sciences, Discussion Paper, University of Tsukuba. 839. 1-32 (1999)

Yamada、Tetsuji、Tadashi Yamada、Chang Gun Kim、Haruko Noguchi：“日本的医疗服务和不完全信息”政策与规划科学研究所，讨论论文，筑波大学。

Yamada, Tetsuji, Tadashi Yamada, Chang Gun Kim, Haruko Noguchi, I-Ming Chiu: "Medical Services and Imperfect Information in Japan"International Political Economy. Vol. 8. 1-19 (2001)

Yamada、Tetsuji、Tadashi Yamada、Chang Gun Kim、Haruko Noguchi、I-Ming Chiu：“日本的医疗服务与不完全信息”国际政治经济学。

Yamada, Tadashi: ""Hospital Services under the National Health Insurance System : A Transition from Fee-for-service to Capitation System," in The Economics of Health Care in Asian-Pacific Countries. Eds.Teh-Wei Hu and Chee-Ruey Hsieh"University of Chicago

Yamada, Tadashi：“《国民健康保险体系下的医院服务：从按服务收费到按人头付费制度的转变》”，《亚太国家医疗保健经济学》。Teh-Wei Hu 和 Chee-Ruey 编着

Tadashi Yamada,et al.: ""Technical Efficiency of Production in Hospitals in Japan""IPPS Discussion Paper Series. No.826. 1-44 (1999)

Tadashi Yamada 等人：“日本医院生产的技术效率”IPPS 讨论论文系列。

Yamada, Tetsuji, Tadashi Yamada: "Transition from Fee-for-service to Prospective PaymentSystem : Hospital Services under National Health Insurance System"Institute of Policy and Planning Sciences, Discussion Paper, No.817, University of Tsukuba, April. 1-

Yamada、Tetsuji、Tadashi Yamada：“从收费服务到预期支付系统的转变：国民健康保险系统下的医院服务”政策与计划科学研究所，讨论文件，第 817 号，筑波大学，4 月。