Spatial analysis of the impact on competition among health care providers across the alternative health care delivery systems

2015 Fiscal Year Final Research Report

• Project/Area Number: 26780183
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Public finance/Public economy
• Research Institution: Hyogo University of Health Sciences
• Principal Investigator: NISHIDA Kiheiji 兵庫医療大学, 共通教育センター, 講師 (50631652)
• Research Collaborator: MATSUURA Nariaki 大阪大学大学院医学系研究科, 医療経済経営学寄付講座, 特任教授 (70190402) ; HAMADA Yoshinosuke 大阪大学大学院医学系研究科, 医療経済経営学寄付講座, 特任准教授 (10362683) ; KAWAKAMI Tetsu 近畿大学, 経済学部, 教授 (60402674) ; YAMADA Eri 近畿大学, 総合社会学部, 講師 (30706742)
• Project Period (FY): 2014-04-01 – 2016-03-31
• Keywords: 出来高払い制度 / 包括払い制度 / 医師誘発需要 / 医療施設の空間競争

Outline of Final Research Achievements

Regional mal-distribution of healthcare providers such as hospitals and clinics is conspicuous in Japan. This study analyzes whether Japan's fee-for-service reimbursement system (FFSRS) or its diagnosis procedure combination/per-diem payment system (DPC/PDPS) is the better solution for the problem, with reference to the Hotelling-style spatial competition model. Under FFSRS, we also consider two modes of competition: the Stackelberg case, in which providers can control the number of hospital visits, and the Nash case, in which providers cannot do so. Results indicate that competition under DPC/PDPS is the most intensive of the three modes of competition. To relieve the locational concentration of providers, we also find that DPC/PDPS has a better mechanism than FFSRS.

Free Research Field

医療経済学