Study on theory establishment of National Health Insurance Listing in which willingness to pay is adjusted to budget

本研究在674个样本（答题率24.2%）中，对医疗保险制度的支付意愿（WTP；他人在合作精神、随机效应模型和联合分析上的救生行为）的研究结果为3272（千日元/质量）。对于“治疗负荷”属性对预期效用值的影响，各要求在统计上均显著。例如，“持续时间”的标准化系数为0.570(p<0.001)；短,负担;低”。根据对ESRD维持血液滤过（HD）的调查结果，成本效益被认为为40,000 - 60,000（美元/质量）。通过蒙特卡罗模拟方法建立模型，根据患者数量、增益效用和每个QALY的WTP计算出HD的总收益。因此，当将其限制在工作世代的支付意向时，分析的平均值为1520,300（2011年估计为百万日元/年）。这一结果比全年实际公共医疗费用多出611亿日元。

The result of this research of willingness to pay (WTP; lifesaving of the others on spirit of cooperation, random effect model and conjoint analysis) about the medical insurance system became 3,272 (thousand JPY/Qaly) in 674 sample (answer rate 24.2%). As for the influence that the attribute of "therapy load" exerted on the expected utility value, all requirements were significant in statistics. For instance, the standardization coefficient is 0.570(p<0.001) in "duration; short, burden; low". As a result of the survey of the maintenance hemodiafiltration (HD) of ESRD, the cost-effectiveness was thought to be 40,000 - 60,000 (US$/Qaly). We calculated the total of HD benefit according to patient number and gain utility and WTP per QALY with the modeling by the Monte Carlo simulation method. As a result, the average of analysis is 1,520,300 (million JPY/year, estimate in 2011) when limiting it to the working generation of the payment intention of the working generation. This result is 61.1 (billion JPY) more than actual public medical expense during year.