2004 Fiscal Year Final Research Report Summary
Study on Appropriate Sizes for Health Insurance and Long-Term Care Insurance and Their Risk Adjustment
| Project/Area Number |
15590452
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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 |
Medical sociology
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| Research Institution | University of Tokyo |
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Principal Investigator |
KOBAYASHI Yasuki University of Tokyo, Graduate School of Medicine, Professor, 大学院・医学系研究科, 教授 (70178341)
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| Project Period (FY) |
2003 – 2004
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| Keywords | health insurance / long-term care insurance / health care expenditures / population structure / demand for services / estimation of expenditures / supply-side policy |
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| Research Abstract |
Health care expenditures are related to population size and structure, prevalence of diseases and injury, and incomes of the population. In relation to the health insurance system in Japan, there was about 6 times difference among municipalities when comparing the proportion of those 65 years old and over, however, such a difference becomes double among prefectures. In the long-term care insurance system, the proportion of those 75 years old and over matters. There was about 8 times difference among municipalities ; however, such a difference becomes double among prefectures. The average income for the society-managed health insurance was about 370,000 and that for the government-managed one about 290,000. From the perspective of public health insurance systems, the Japanese system has a structural problem in terms of age structure and incomes of the population. Concerning the situations of diseases and injury, about 40% increase for inpatients and about 20% increase for outpatients are expected by 2020, if the present medical environment and demand for services are assumed. However, the medical environment may change. While the progress of separation of prescribing and dispensing would cause an increase in pharmaceutical expenditures because of physicians' preference for brand-name drugs, an excessive competition among hospitals may increase health care expenditures because of unregulated increases of high-cost diagnostic equipments. Therefore, not only restructuring of the insurance systems, but also developing of precise estimate methods for the future health expenditures and appropriate supply-side policies are necessary.
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