Econometric Analyses of Market and Organization in Health Care Service Industry

医疗保健服务业市场与组织的计量分析

• 批准号: 17330045
• 负责人: YOSHIDA Atsushi
• 金额: $ 8.36万
• 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 (B)
• 财政年份: 2005
• 资助国家: 日本
• 起止时间: 2005 至 2007
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17330045/
• 关键词: industrial organization of health care; entry and exit; alumni job network; labor market of physicians; premium of health insurance; health services system for the elderly; moral hazard; municipality-based national health insurance; 学閥ネットワーク; 医療施

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.

在本研究中，我们从以下三个角度来研究日本的健康服务业。首先，我们用产业组织的方法来研究医院或诊所在什么样的市场上如何相互竞争。第二，我们研究医生是如何在什么类型的医生劳动力市场提供。第三，我们研究了卫生政策的变化如何影响医生或患者的激励，从而如何供给或需求的卫生服务发生了变化。对于第一点，即医疗服务市场的竞争，我们从理论和实证两方面研究了（1）牙科诊所的进入和退出，（2）大医院和诊所的联盟，（3）急性诊断床和长期护理床的选择等。对于第二点，即医生的劳动力市场，关注职业道路和校友网络，本研究探讨（1）女性医师如何决定其职业道路;（2）在新的毕业后培训制度实施后，何种类型的教学医院能够吸引实习医师;（3）校友的工作网络是否具体和稳定。对于第三点，即卫生政策，我们从需求和供给两个方面调查了（1）是什么决定了老年患者分配到健康保险适用床位还是长期护理保险适用床位，（2）当对老年人卫生服务体系的贡献增加时，谁承担了保费的增加，员工和雇主，（3）财政补助全民健保是否会导致人均健康费用过度增加。

项目成果

How does a Physician Change the Quantity of Medical Services Associated with the Different Copayment Schemes?

医生如何更改与不同自付额计划相关的医疗服务数量？

• 发表时间: 2006
• 作者: YOSHIDA Atsushi;TAKAGI Shingo
• 通讯作者: TAKAGI Shingo

歯科医院の参入が医療費及び経済厚生に与える効果

牙科诊所进入对医疗费用和经济福利的影响

• 发表时间: 2005
• 作者: 川村顕;吉田あつし
• 通讯作者: 吉田あつし

「高齢者をめぐる医療システムのこれから」, 高齢社会を生きる(第7章, 清水哲朗編)

《高龄者医疗制度的未来》，老龄化社会的生活（第7章，清水哲朗主编）

• 发表时间: 2007
• 作者: 佐藤 伸彦;吉田 あつし;吉田あつし
• 通讯作者: 吉田あつし

Who has benefited from the health services system for the elderly in Japan?

谁受益于日本老年人保健服务体系？

• 发表时间: 2009
• 期刊: Japan and the World Economy (Elsevier)
• 作者: YOSHIDA Atsushi;KAWAMURA Akira
• 通讯作者: KAWAMURA Akira

後期高齢者医療制度をどう見るか

我们如何看待老年人的医疗保障制度？

• 发表时间: 2008
• 期刊: 経済セミナー
• 作者: YOSHIDA Atsushi;KAWAMURA Akira;Se-il Mun;吉田 あつし
• 通讯作者: 吉田 あつし