he effect of 2006 Long-term Care Insurance Amendment on Cost Containment: an empirical evidence from nationally representative claims data

2018 Fiscal Year Annual Research Report

• Project/Area Number: 17H07182
• Research Institution: Waseda University
• Principal Investigator: 富 蓉 早稲田大学, 政治経済学術院, 助教 (70805259)
• Project Period (FY): 2017-08-25 – 2019-03-31
• Keywords: Long-term Care Insurance / Moral Hazard

Outline of Annual Research Achievements

We evaluate the presence and magnitude of moral hazard in Japan’s public long-term care insurance (LTCI) market. Using monthly LTCI claim records from January 2006 to December 2015 linked to concurrent death records, we construct a sample by propensity score matching insured individuals who copay 10% of their fees to those with no required copayments, and we implement fixed-effect estimations. We find that a ten-percentage-point reduction in the copayment rate increases monthly costs by 10.2 thousand yen, corresponding to a price elasticity of about -0.1. Insured individuals with no copayments tend to use more services and have more utilization days than those with copayments do. Furthermore, we find that insured individuals who die from cerebral (myocardial) infarction increase their service use more in response to a reduction in the copayment rate than those who die from senility do, indicating a positive association between ex-ante health risks and ex-post service use. We verify that a cost-sharing adjustment is a valid solution for soaring LTCI expenditures. These findings could provide broad implications for the rapidly aging world.

Research Progress Status

平成30年度が最終年度であるため、記入しない。

Strategy for Future Research Activity

平成30年度が最終年度であるため、記入しない。

Research Products

• [Journal Article] Moral hazard under zero price policy: evidence from Japanese long-term care claims data (2019)
  • Author(s): Fu Rong、Noguchi Haruko
  • Journal Title: The European Journal of Health Economics Volume: forthcoming Pages: forthcoming
  • DOI: https://doi.org/10.1007/s10198-019-01041-6
  • Peer Reviewed
• [Presentation] Hospital Responses to Prospective Payment under the Japanese Universal Healthcare System (2018)
  • Author(s): Rong Fu
  • Organizer: The 1st meeting of Asian Workshop on Econometrics and Health Economics
  • Int'l Joint Research
• [Presentation] Moral Hazard under Zero Price Policy: Evidence from Japanese Long-term Care Claims Data (2018)
  • Author(s): Rong Fu
  • Organizer: The 12th European Conference on Health Economics
  • Int'l Joint Research
• [Presentation] Health and Health care disparities among elderly in Sweden and Japan (2018)
  • Author(s): Rong Fu
  • Organizer: Sweden-Japan MIRAI Project 2018 Aging workshop
  • Int'l Joint Research / Invited
• [Presentation] Moral Hazard under Zero Price Policy: Evidence from Japanese Long-term Care Claims Data (2018)
  • Author(s): Rong Fu
  • Organizer: 日本経済学会2018年度春季大会
• [Remarks] https://www.researchgate.net/profile/Rong_Fu4
• [Remarks] https://sites.google.com/view/nataliefu-homepage
• [Remarks] https://researchmap.jp/nataliefu/