2002 Fiscal Year Final Research Report Summary
The Theoretical and Experimental Study on Reform of Payment System for Reimbursement to Medical Institutions
| Project/Area Number |
13630078
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
経済政策(含経済事情)
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| Research Institution | Yokkaichi University |
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Principal Investigator |
INAGAKI Hideo Yokkaichi University, Economics, Professor, 経済学部, 教授 (70159937)
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| Co-Investigator(Kenkyū-buntansha) |
AKAGI Hirobumi Meijo University, Urban Science, Associate Professor, 都市情報学部, 助教授 (30254270)
KAMATA Shigenori Meijo University, Urban Science, Associate Professor, 都市情報学部, 助教授 (70214509)
MORI Toru Nagoya City University, Economics, Professor, 経済学部, 教授 (60134160)
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| Project Period (FY) |
2001 – 2002
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| Keywords | DRG-PPS / patient's selective behavior / national medical costs / swingback of reimbursement cost / Fee-for-Service / patient benefit / hospital profit / composite payment system |
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| Research Abstract |
DRG-PPS (Dynagoses Related Group and Prospective Payment System) for medical rewards has been introduced to the United States of America and other countries reducing national medical costs, especially hospital payments.
The Japanese authority also plans to adapt DRG-PPS to the existing medical reward system. However, the Japanese market for health care is characterized by the most severe competition among hospitals since patients can freely choice and change any hospital that they visit.
Therefore, to analyze effects concerning an introduction of DRG-PPS into the Japanese health market needs a dynamic framework possible to that patient choices hospital repeatedly.
In this project, we investigate
1) whether the introduction of DRG-PPS decreases a per capita service level of health care or not,
2) whether any swingback of reimbursement cost for health care happened in the periods that follow it or not,
and 3) what kind of medical payment system fulfills any optimal supply for health care.
Summarizing the results, first, the per capita service level of health care supplied in steady state is the identical to every hospital, regardless of that each hospital has a different agent coefficient. Then the introduction of DRG-PPS happen to decrease the service level of health care relatively to under Fee-for-Service.
Next, when we investigate dynamic paths to converge on equilibrium, we can find the swingback of reimbursement cost for health care. The swingback of reimbursement cost means that reimbursement cost in steady state becomes much larger than in the morrow of introducing DRG-PPS. This phenomenon arises when some hospitals extremely respect patient benefit rather than hospital profit.
Finally, under certain condition, there is a composite payment system to maximize the net benefit for patient that deducts a medical cost from a patient benefit gained by receiving health care.
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