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

这个项目最初是在1993年开始的，当时的名称是“日美医疗制度比较”。第一阶段，即头三年，是题为“日本医疗部门效率低下及其原因：计量分析”的项目(文部科学省：05630023号补助金)。第二个为期三年的阶段是前一个项目的延伸：“老龄人口和医疗保健的综合和健康经济学方法：实证分析”(经济和社会事务部：08630035号补助金)。第三阶段，从1999年到2001年，是一项研究，名为《在宏观系统中引入老年医疗服务及其对医疗部门的影响》(MEXT：批准号：11630034)。在该项目的第三阶段，我们通过使用不同的微观数据，获得了关于日本老年人对医疗服务需求的一些实证结果。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。结果显示，日本民众的健康体检需求存在较大差异，本研究还提出了针对特定群体在职业、年龄类别和保险类型方面可以采取的适当政策。该项目的所有研究成果都在加拿大、英国、瑞典、台湾、日本和美国举行的各种国际会议上公布。在过去三年培育该项目丰富成果的同时，该项目的时间太短，无法完成经济宏观体系的构建，以研究医疗部门人口统计对老年医疗保健成本的影响。我们将继续这一项目，以满足目前对政策的需求，以应对日本医疗成本的急剧增长以及改善社会福利。

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.