Effects of reduced cost-sharing on children's health: Evidence from Japan

Takaku, Reo

doi:10.1016/j.socscimed.2015.12.038

Cited by 19 publications

(15 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We believe our study complements Takaku’s [ 15 ] in two aspects. First, we use administrative admission data which cover large areas of Japan.…”

Section: Introductionsupporting

confidence: 69%

“…In Japan, Takaku [ 15 ] conducted a study on the impact of medical subsidies for children, specifically the effect of expanded outpatient care subsidy, using data from a nationally representative questionnaire survey conducted by the Ministry of Health, Labour and Welfare (MHLW). He found that the subsidy improved subjective health measures but did not reduce hospitalization for pre-school children, whereas it had no effect on the subjective health measures or hospitalization for school-aged children.…”

Section: Introductionmentioning

confidence: 99%

“…First, we use administrative admission data which cover large areas of Japan. Since Takaku [ 15 ] referenced the questionnaire survey, there is a possibility of measurement errors, such as those due to a recall bias. He focused on whether a respondent was hospitalized on the date of the survey to identify hospitalization status.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the actual grant of the subsidy is determined by the latter. Children living in the municipality and within the age limit are granted the subsidy by their respective municipalities, although many municipalities have recently increased the eligible age [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of reducing cost sharing for outpatient care on children’s inpatient services in Japan

Kato

Goto

2017

Health Econ Rev

View full text Add to dashboard Cite

BackgroundAssessing the impact of cost sharing on healthcare utilization is a critical issue in health economics and health policy. It may affect the utilization of different services, but is yet to be well understood.ObjectiveThis paper investigates the effects of reducing cost sharing for outpatient services on hospital admissions by exploring a subsidy policy for children’s outpatient services in Japan.MethodsData were extracted from the Japanese Diagnosis Procedure Combination database for 2012 and 2013. A total of 366,566 inpatients from 1390 municipalities were identified. The impact of expanding outpatient care subsidy on the volume of inpatient care for 1390 Japanese municipalities was investigated using the generalized linear model with fixed effects.ResultsA decrease in cost sharing for outpatient care has no significant effect on overall hospital admissions, although this effect varies by region. The subsidy reduces the number of overall admissions in low-income areas, but increases it in high-income areas. In addition, the results for admissions by type show that admissions for diagnosis increase particularly in high-income areas, but emergency admissions and ambulatory-care-sensitive-condition admissions decrease in low-income areas.ConclusionsThese results suggest that outpatient and inpatient services are substitutes in low-income areas but complements in high-income ones. Although the subsidy for children’s healthcare would increase medical costs, it would not improve the health status in high-income areas. Nevertheless, it could lead to some health improvements in low-income areas and, to some extent, offset costs by reducing admissions in these regions.

show abstract

“…We believe our study complements Takaku’s [ 15 ] in two aspects. First, we use administrative admission data which cover large areas of Japan.…”

Section: Introductionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of reducing cost sharing for outpatient care on children’s inpatient services in Japan

Kato

Goto

2017

Health Econ Rev

View full text Add to dashboard Cite

show abstract

“…Unfortunately, health status is also unavailable in the data, and it is highly likely that a potential bias in the estimates remains. If health at admission is the same for MA and PHI patients, one good way to separate these effects is to employ the subsample of patients aged 3 and under, because the copayment for PHI patients aged 3 and under has been fully covered by prefectural public subsidy since 1994 [ 52 , 53 ]. This means the major difference between MA and PHI patients is the health capital stock based on family income level because the actual copayment of any patient aged 3 and under is zero.…”

Section: Discussionmentioning

confidence: 99%

The medical assistance system and inpatient health care provision: Empirical evidence from short-term hospitalizations in Japan

Yuda

2018

PLoS ONE

View full text Add to dashboard Cite

This paper uses two nationally representative sets of medical claims data from medical assistance and universal public health insurance systems to examine how medical assistance system assignment affects short-term inpatient health care provision. In Japan, the medical assistance system, which is part of a public assistance system, provides medical care services for its beneficiaries without imposing any financial burdens, such as copayments or advance premium payments. These circumstances can lead to inpatient costs, as physicians may provide more treatments because there is a financial incentive. Because the assignment of public assistance in Japan is not random but is subject to means testing by the local government, I employ the instrumental variable model to control the potential correlation. I find that medical expenditure is significantly higher for medical assistance patients than for universal public health insurance patients, with an arc elasticity of approximately 0.20. This elasticity is slightly greater than that found for inpatient care in the randomized RAND Health Insurance Experiment and recent empirical studies on low-income populations. In addition, the elasticities for patients who receive medication, treatment and surgery are greater.

show abstract

Effects of establishing a financing scheme for outpatient care on inpatient services: empirical evidence from a quasi-experiment in China

2021

Eur J Health Econ

View full text Add to dashboard Cite

Effects of reduced cost-sharing on children's health: Evidence from Japan

Cited by 19 publications

References 21 publications

Effect of reducing cost sharing for outpatient care on children’s inpatient services in Japan

Effect of reducing cost sharing for outpatient care on children’s inpatient services in Japan

The medical assistance system and inpatient health care provision: Empirical evidence from short-term hospitalizations in Japan

Effects of establishing a financing scheme for outpatient care on inpatient services: empirical evidence from a quasi-experiment in China

Contact Info

Product

Resources

About