2020 Fiscal Year Research-status Report
Population Aging, End-of-Life Medical Cost and Health Insurance Coverage Scheme
| Project/Area Number |
19K01670
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| Research Institution | The University of Tokyo |
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Principal Investigator |
Chen Stacey 東京大学, 大学院公共政策学連携研究部・教育部, 教授 (40785680)
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| Co-Investigator(Kenkyū-buntansha) |
Hsu Minchung 政策研究大学院大学, 政策研究科, 准教授 (20467062)
chuang hongwei 国際大学, 国際経営学研究科, 准教授(移行) (70732551)
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| Project Period (FY) |
2019-04-01 – 2023-03-31
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| Keywords | physician quality / social ties / communication / information |
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| Outline of Annual Research Achievements |
Using cancer registry and doctor certificate records, we capture physician quality by matching comparable patients with advanced cancer by doctor, hospital, and admission period. Estimates show that physician-patients are less likely to use surgery or radiation, more likely to use targeted drug therapy, spend less on checkups, and enjoy higher long-term survival while paying less on coinsurance than nonphysician-patients. Restricting data to less informed physician-patients, we find that those with stronger professional ties receive less surgical/radiation therapy and have higher survival, though only for 0.5 years. We show that relational and informational advantages appear in healthcare agency problems. This paper is the first to evaluate the relative importance of the relational and informational influences in healthcare agency problems by relaxing this restriction. Crucial to our evaluation is a wide range of individually identifiable medical specialists who have attended about 0.3 million patients with advanced cancer, of whom 611 are physician-patients. Using Taiwan’s cancer registry, doctor personnel panel records, and universal health insurance administrative data, we have rich controls for both patients' and doctors' attributes. By looking within the matched physician-patients with different specialties attended by the same doctor, we aim to disentangle the relational advantage's impact due to stronger professional ties from the informational advantage's effect driven by being more informed.
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| Current Status of Research Progress |
Current Status of Research Progress
4: Progress in research has been delayed.
Reason
The research relies on the confidential version of national health insurance data located in Taipei. The travel bans during the pandemic have caused many delays and forced us to find one extra collaborator who could implement the on-site data analysis for the project. Also, the data center had the hard disc unexpectedly damaged over the summer. It took one month to recover the data and another month to recover the data work that had done.
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| Strategy for Future Research Activity |
Since we have found a collaborator who could implement the on-site data analysis for the project last year, finally we are gradually going back the normal pace. Additionally, we should find research assistants or contractors to speed up our progress for the data work off-site.
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| Causes of Carryover |
Covid-19 has delayed several research visits and hiring. Need to pick up the research progress next fiscal year to pay for research visits and hiring.
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