| Budget Amount *help |
¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 2001: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 2000: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 1999: ¥1,200,000 (Direct Cost: ¥1,200,000)
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| Research Abstract |
We examine the effects of additional patient co-payments on the insured in Japan. This provision, involving an increase in co-payments to 20%, was introduced when the Employee Health Insurance in Japan was revised in September 1997. Co-payments for the insured had been 10% since October 1984, and nearly zero before that. Here, we examine the effect of the additional 10% co-payments introduced in 1997. This study includes all employees insured by the 1,797 health insurance societies belonging to the National Federation of Health Insurance Societies in 1996 and 1998. We again evaluate indicators of inpatient, outpatient, and dental service demand, including not only case rates and the number of service days per case, as in the previous study, but also the medical cost per day and the medical cost per insured. We estimate the effects of the additional 10% co-payments, controlling for average age, average monthly salary, and total number of the insured, gender (male-to-female) ratio, and dependent ratio (the number of dependents/ the number of insured). Insurers saved substantial medical costs in 1997 from the additional cost shifting to the insured. We also observed an income effect from the additional 10% co-payments, where we had not in the earlier study of the initial 10% co-payments. The impact of co-payments on quality of care remains unknown.
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