Decision model of physician visits : theory and empirical analysis

伴随着日本老龄化社会的快速推进，对未来医疗费用增加的忧虑也沿着上升。正如许多研究者所指出的那样，这使得向患者提供健康教育作为措施之一的重要性。原因是健康教育所提供的健康知识增加，预期会导致疾病的早期发现和预防。然而，这种保护作用并不一定适用于所有的疾病，有些疾病是不可能通过人的努力来预防的。本文首先分析了健康知识对不同疾病在不同诊疗单位的咨询行为的影响是否存在差异，其次分析了这种差异的原因。本研究采用微观数据，从每个患者的健康知识水平、疾病种类、医疗费用、就诊动机、就诊医疗机构的规模差异等方面，从经济学的角度探讨健康教育最有效的疾病种类，研究结果对降低卫生费用具有重要的政策意义。

The anxiety about the future increase in health expenditure has risen along with the rapid progress of aging society in Japan. This brings the importance of health education provided to the patient as one of the measures, as pointed out by many researchers so far. The reason is that the increase in health knowledge provided by health education is expected to lead to early detection and prevention of the disease. However, this protective efficacy does not necessarily apply to all kinds of diseases.Some kinds of diseases may not be possibly prevented by man's effortIn this paper, we firstly analyzed the variation, if any, of the impact of health knowledge on the consultation behavior of different diseases at different diagnosis and treatment unit.Second, we looked at the causes of this variation. We used micro data on the level of health knowledge each patient possess, their disease's kind, their medical expense, their motivation for the consultation, and the scale difference of medical institution in with they receive the consultation.This study would find the kind of disease to which health education is applied most efficiently from the economic view point, and the result gives important policy implication for the reduction of health expenditure.