The Theoretical and Experimental Study on Selection by Patients and Medical Physicians under The Payment System for Reimbursement to Medical Institutions
| Project/Area Number |
15530198
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Economic policy
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| Research Institution | Yokkaichi University |
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Principal Investigator |
INAGAKI Hideo Yokkaichi University, Economics, Professor, 経済学部, 教授 (70159937)
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| Co-Investigator(Kenkyū-buntansha) |
MORI Toru Nagoya City University, Graduate School of Economics, Professor, 大学院・経済学研究科, 教授 (60134160)
KAMATA Shigenori Meijo University, Urban Science, Professor, 都市情報学部, 教授 (70214509)
AKAGI Hirobumi Meijo University, Urban Science, Associate Professor, 都市情報学部, 助教授 (30254270)
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| Project Period (FY) |
2003 – 2005
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| Project Status |
Completed (Fiscal Year 2005)
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| Budget Amount *help |
¥3,400,000 (Direct Cost: ¥3,400,000)
Fiscal Year 2005: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 2004: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 2003: ¥1,700,000 (Direct Cost: ¥1,700,000)
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| Keywords | the total medical expenses / reimbursement / fee-for-service payment / prospective payment / face-to-face service / experimental economics / profit / patient's benefit / 診療報酬総枠 / 診療報酬単価 / 医療機関の競争 / 医療サービス / 社会全体の総治療量 / 規制緩和 / 包括支払制度下 / 必要最小限の利潤 / PC実験 / FTF実験 / 過少診療 / 医療機関紹介 / 対面サービス / もの / 過剰診療 |
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| Research Abstract |
The purpose of the research is to inspect how the reduction of the total medical expenses with securing a fixed treatment level influence on the Payment System for reimbursement to medical institutions which fee-for-service payment (FFS) and prospective payment (PPS) coexist. In this research, the theory model which patients can choose medical institutions freely is built first, and then those theory suppositions are investigated by the experimental economics method. Three points to mention in the following can be shown as the research result.
1.In the case that medical service was divided into the medical service concerned with the "face-to-face service" such as treatment by the doctor and the "stereotyped service" such as inspection, the difference in the reimbursement has impact on two medical services regardless of the profit or the patient's benefit maximization. The stereotyped service was supplied more than the face-to-face service, and was the main factor in the over- and under- supply of medical service.
2.In the treatment level choice of the medical institution which tries to secure the necessary minimum profit under PPS, the level of the face-to-face service treatment was higher than patient's disease level. Moreover, the patient introduction behavior to other medical institutions was observed the possibility to introduce the disease patient of the middle degree. For the serious disease patient it became clear that the introduction behavior was done frequently.
3.If a unit reward of one disease was decided by dividing total amount of reimbursement by the total request score and medical institution behaved Cournot-Nash competition. The social total treatment level of this disease rose as the number of medical institutions increased and competition was promoted.
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Report
(4 results)
Research Products
(6 results)
