2020 Fiscal Year Research-status Report
Cost, Length of Stay, and Health Outcome: A Comprehensive Evaluation of Prospective Payment System in Japan
| Project/Area Number |
19K13729
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| Research Institution | Waseda University |
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Principal Investigator |
富 蓉 早稲田大学, 政治経済学術院, 講師(任期付) (70805259)
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| Project Period (FY) |
2019-04-01 – 2022-03-31
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| Keywords | Hybrid Payment System |
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| Outline of Annual Research Achievements |
In academic year 2020, we published two research articles. The first is about the effect of reforms on health payment system in Japan, namely, the prospective payment system. Countries seeking to move away from a purely fee‐for‐service (FFS) system may consider a hybrid approach whereby only some procedures are paid by FFS while others are paid prospectively. Yet little evidence exists whether such a hybrid payment system contains overall costs without adverse influences on health outcomes. In 2003, Japan experienced a reform from FFS to a hybrid payment system in which only some inpatient procedures were paid prospectively. We exploit this reform to test how such a hybrid system affects overall costs and health outcomes. Briefly, we find that healthcare providers responded opportunistically to the reform, moving some procedures out of the bundled inpatient setting to FFS services, leading to no reduction in cost. There was some evidence of a moderate deterioration in health outcomes, in terms of a decline in the probability of symptoms being cured at discharge. In sum, our results suggest that in some cases, a hybrid payment system can be non‐superior to either FFS or prospective payment system. Taking the situation of COVID-19 into account, we also conducted a research on the relationship between the pandemic and crime Victimizations in Japan.
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| Current Status of Research Progress |
Current Status of Research Progress
2: Research has progressed on the whole more than it was originally planned.
Reason
The research is progressed smoothly.
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| Strategy for Future Research Activity |
In 2021, we aim first to submit the manuscript of investigation II to target journal (social science & medicine, no later than Q1. We then seek to finalize the investigation III in Q2 and present the findings at workshops or international conferences. After refining the results based on comments, we expect to submit the manuscript of investigation III to target journals by the end of Q4 in 2021. Finally, in Q1 of 2022, we plan to summarize the overall project with comprehensive reports.
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| Causes of Carryover |
In 2020, almost all international conferences were cancelled or moved to online. Therefore, we could not spend the travel fee as expected.
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