Econometric Analyses of Market and Organization in Health Care Service Industry

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In this study, we investigate health service industry of Japan from following three viewpoints. First we examine how hospitals or clinics compete with each other confronting on what types of market with industrial organization approach. Second we examine how physicians are supplied in what types of labor market of physicians. Third we examine how changes of health policies affect incentives of physicians or patients and thus how supply or demand for health services have changed. For the first point, namely competition in health service market, we investigate theoretically and empirically (1) entry and exit of dental clinics, (2) coalition between big hospitals and clinics, (3) selection between beds for acute diagnoses and those for long term care, and so on. For the second point, namely labor market of physicians, focusing on the career path and alumni network, we investigate (1) how female physicians decide their career paths, (2) what types of teaching hospitals can attract trainee physicians after the introduction of new post-graduation training systems (3) how concrete and stable of job networks of alumni. For the third point, namely health policies, we investigate (1) what decides allocation of the elderly patients into whether health-insurance-applied beds or long-term-care-insurance-applied bed from both aspects of demand and supply sides, (2) who bears the increase of premium, employee and employer, when contribution to the health services system for the elderly increases, (3) whether financial subsidy to municipality-based national health insurance leads to excess increase of per-capita health expense.