Decision model of physician visits : theory and empirical analysis

随着日本老龄化社会的快速推进，人们对未来医疗支出增加的焦虑情绪也随之上升。这就带来了向病人提供健康教育的重要性，这是迄今为止许多研究人员指出的措施之一。原因是健康教育提供的健康知识的增加有望导致疾病的早期发现和预防。然而，这种保护效果并不一定适用于所有的疾病。有些疾病可能不是人的努力可以预防的。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差异，然后分析了这种差异的原因。通过对每个患者的健康知识水平、疾病种类、医疗费用、就诊动机、就诊医疗机构规模差异等微观数据的分析，从经济学角度找出健康教育效果最好的疾病类型，为降低医疗费用提供重要的政策依据。

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.