2021 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, 商学学術院, 専任講師 (70805259)
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| Project Period (FY) |
2019-04-01 – 2023-03-31
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| Keywords | Hybrid Payment System |
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| Outline of Annual Research Achievements |
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. We also investigate the spillover effect to accompany the research project.
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| Current Status of Research Progress |
Current Status of Research Progress
3: Progress in research has been slightly delayed.
Reason
Due to the pandemic, we were not able to present our studies as much as expected. So, the current status of our reseach is slightly delayed.
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| Strategy for Future Research Activity |
We aim first to submit the manuscript of investigation II propsed 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 2022. Finally, in Q1 of 2023, we plan to summarize the overall project with comprehensive reports.
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| Causes of Carryover |
Due to the pandemic, we were not able to proceed as planned.
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Research Products
(5 results)
