An Introduction of Capitation in Medical Care for the Elderly and the Effects on the Medical Sector in a Macro System

该项目最初于1993年启动，当时的名称是“日本和美国之间医疗制度的比较分析”。“第一阶段，即头三年，是题为“日本医疗部门效率低下及其原因：经济计量分析”的项目（文部科学省：批准号：05630023）。第二个三年期扩展了前一个项目：“对老龄化人口和医疗保健的综合和卫生经济学方法：实证分析”（文部省：批准号08630035）。1999年至2001年为第三阶段，即“老年人医疗按人头付费及其对宏观医疗系统的影响“研究，（文部省：关于项目的第三阶段，本研究利用不同的微观数据，对日本老年人的医疗需求进行了实证研究。此外，还从控制成本的角度对日本的医疗健康检查制度进行了评价。结果|结果表明，日本人口在健康检查需求方面存在着相当大的差异，本研究还表明了针对职业、年龄类别和保险类型的特定群体可以采取哪些适当的政策。该项目的所有研究成果都在加拿大、英国、瑞典、台湾、日本和美国举行的各种国际会议上发表。在过去的三年里，该项目积累了丰富的成果，但时间太短，无法完成研究医疗部门按人头收费对老年人医疗费用影响的经济宏观体系的构建。我们将继续这一项目，以满足目前对政策的需求，以科普日本医疗费用的急剧增加，并改善社会福利。

This project was initially started in 1993 under the name, "A Comparative Analysis of Medical Systems between Japan and the U.S." The first phase, the first three years, was the project entitled, "Inefficiency in the Medical Sector in Japan and their Causes: An Econometric Analysis" (The Ministry of Education, Culture, Sports, Science and Technology (MEXT) : Grant No. 05630023). The second three-year phase extended the previous project : "Synthesis and Health Economics Approach to Aging Population.and Medical Care : an Empirical analysis" (MEXT : Grant No. 08630035). The third phase, from 1999 through 2001, was the study, "An Introduction of Capitation into Medical Care for the Elderly and its effects on Medical Sector in Macro System, " (MEXT : Grant No. 11630034).With respect to the third phase of the project, we obtained a number of empirical findings with regard to the Japanese elderly in terms of their demand for medidal care by using different sets of micro data. Further, the medical health check-up system in Japan was also evaluated in terms of cost-containment perspectives. The results | show that there exist quite a number of differentials among the Japanese population in their health check-up demand, and this study also shows what adequate policy targeting at specific groups in occupation, age category and insurance type may be adopted. All research results from, the project were presented at various international conferences held in Canada, England, Sweden, Taiwan, Japan and the U.S. While cultivating rich results from this project for the last three years, the period was to short to complete constructing an economic macro system to study the effects of capitation in the medical sector with regard to the costs of elderly medical care. We will continue this project to meet the current demand for policies to cope with the sharp increase in medical care costs in Japan as well as to improve social welfare.