Measurement of income-related inequalities in health care and factor decomposition under universal coverage in Korea

• Project/Area Number: 18K17341
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: Institute of Developing Economies, Japan External Trade Organization
• Principal Investigator: 渡邉 雄一 独立行政法人日本貿易振興機構アジア経済研究所, 地域研究センター東アジア研究グループ, 研究員 (20450538)
• Project Period (FY): 2018-04-01 – 2024-03-31
• Project Status: Completed (Fiscal Year 2023)
• Budget Amount: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2020: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2019: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2018: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
• Keywords: 医療格差 / 要因分解 / 韓国

Outline of Annual Research Achievements

本研究の目的は、韓国における個人・家計の医療費支出や医療アクセス頻度の不平等度を所得水準や年齢階級別に測定し、その格差を構成する要因分解を行って韓国の医療格差の実態やメカニズム、経年変化を定量的に解明することである。医療保険に関する日韓での異なる制度設計が、経済力の差によって同じ医療ニードでもアクセスできる医療サービスに格差をもたらしているのではないかという問いに答えるべく、本研究では「韓国医療パネル調査」の個票データを用い、経済学的な分析手法を応用して韓国における医療格差を実証的に明らかにする。分析手法には、格差の構成要素となる要因分解から寄与度を算出できる平均対数偏差（Mean Log Deviation: MLD）と呼ばれる手法を応用して、韓国の医療格差を実証的に明らかにする。

研究期間の前半では、データ分析に必要なコンピュータやStata等のソフトウェアの購入、韓国保健社会研究院（KIHASA）が提供する「韓国医療パネル調査」の個票データの入手および分析用データセットの構築、医療経済学や韓国の医療制度・政策に関する関連文献・資料等を通じた先行研究や分析手法の整理などを行った。中盤からは、適宜「韓国医療パネル調査」の個票データを更新しながら、回帰分析による手法を用いて韓国の医療格差を測定し、その分析結果をまとめて、国内外の学術大会やセミナー等で研究報告を行った。終盤には、学術論文を執筆して、国際学術雑誌への投稿を行った。最終年度には、投稿論文の改稿を行いながら、アジア経済研究所内のワーキングペーパーにて公開した。

Research Products

• [Int'l Joint Research] 韓国保健社会研究院（KIHASA）(韓国)
• [Journal Article] Surgical productivity recovery after the COVID-19 pandemic in Japan (2024)
  • Author(s): Nakata Yoshinori、Watanabe Yuichi、Ozaki Akihiko
  • Journal Title: Frontiers in Public Health Volume: 12
  • DOI: 10.3389/fpubh.2024.1302732
  • Peer Reviewed / Open Access
• [Journal Article] Association between surgical productivity and start time (2024)
  • Author(s): Yoshinori Nakata, Yuichi Watanabe, Akihiko Ozaki
  • Journal Title: Perioperative Care and Operating Room Management Volume: 34 Pages: 100371-100371
  • DOI: 10.1016/j.pcorm.2024.100371
  • Peer Reviewed / Open Access
• [Journal Article] Longitudinal analysis of income-related inequalities in health care under universal coverage in Korea (2023)
  • Author(s): Yuichi Watanabe
  • Journal Title: IDE Discussion Papers Volume: 909
  • Open Access
• [Journal Article] Effect of surgeon experience on technical efficiency (2023)
  • Author(s): Nakata Yoshinori, Watanabe Yuichi, Otake Hiroshi
  • Journal Title: Health Services Management Research Volume: 36: 1 Issue: 1 Pages: 34-41
  • DOI: 10.1177/09514848221080688
  • Peer Reviewed
• [Journal Article] Productivity Change of Surgeons During the Coronavirus Disease 2019 Pandemic in Japan (2022)
  • Author(s): Nakata Yoshinori, Watanabe Yuichi, Ozaki Akihiko
  • Journal Title: INQUIRY: The Journal of Health Care Organization, Provision, and Financing Volume: 59
  • DOI: 10.1177/00469580221128737
  • Peer Reviewed / Open Access
• [Journal Article] Surgical productivity did not suffer despite the states of emergency against the COVID-19 pandemic in Japan: a retrospective observational study (2022)
  • Author(s): Nakata Yoshinori、Watanabe Yuichi、Ozaki Akihiko
  • Journal Title: BMC Health Services Research Volume: 22 Issue: 1
  • DOI: 10.1186/s12913-022-08669-w
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Do technically efficient surgeons continue to provide active clinical services in a university hospital? (2021)
  • Author(s): Nakata Yoshinori, Watanabe Yuichi, Otake Hiroshi, Ozaki Akihiko
  • Journal Title: PLOS ONE Volume: 16 Issue: 7 Pages: e0254515-e0254515
  • DOI: 10.1371/journal.pone.0254515
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Equality of Surgical Fee Schedule in Japan: A Retrospective Observational Study (2021)
  • Author(s): Nakata Yoshinori, Watanabe Yuichi, Otake Hiroshi
  • Journal Title: Health Services Insights Volume: 14
  • DOI: 10.1177/11786329211048130
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] How efficient are surgical treatments in Japan? The case of a high-volume Japanese hospital (2020)
  • Author(s): Yuichi Watanabe, Haruko Noguchi, Yoshinori Nakata
  • Journal Title: Health Care Management Science Volume: 23 Issue: 3 Pages: 401-413
  • DOI: 10.1007/s10729-020-09507-3
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] 大学進学は本当にメリットがあるのか？－韓国の学歴社会を学歴収益率の変化から問い直す (2020)
  • Author(s): 渡邉雄一
  • Journal Title: 韓国経済研究 Volume: 17 Pages: 65-80
  • NAID: 120007187883
• [Journal Article] Association Between Surgeons' Technical Efficiency and Hospital Revenue (2019)
  • Author(s): Yoshinori Nakata, Yuichi Watanabe, Hiroshi Otake
  • Journal Title: INQUIRY: The Journal of Health Care Organization, Provision, and Financing Volume: 56
  • DOI: 10.1177/0046958019889443
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Japanese surgical resource utilization in 2016 (2019)
  • Author(s): Yoshinori Nakata, Yuichi Watanabe, Hiroto Narimatsu, Tatsuya Yoshimura, Hiroshi Otake, Tomohiro Sawa
  • Journal Title: International Journal of Health Care Quality Assurance Volume: 32 (6) Issue: 6 Pages: 1013-1021
  • DOI: 10.1108/ijhcqa-07-2018-0170
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Association between outpatient orthopedic surgery costs and healthcare facility characteristics (2018)
  • Author(s): Yuichi Watanabe, Yoshinori Nakata
  • Journal Title: International Journal of Health Care Quality Assurance Volume: 31(3) Issue: 3 Pages: 265-272
  • DOI: 10.1108/ijhcqa-03-2017-0043
  • Peer Reviewed / Int'l Joint Research
• [Presentation] Long-Run Measurement of Income-Related Inequalities in Health Care under Universal Coverage: Evidence from Longitudinal Analysis in Korea (2023)
  • Author(s): Yuichi Watanabe
  • Organizer: 15th IHEA (International Health Economics Association) World Congress on Health Economics
  • Int'l Joint Research
• [Presentation] Long-Run Measurement of Income-Related Inequalities in Health Care Under Universal Coverage: Evidence from Longitudinal Analysis in Korea (2023)
  • Author(s): Yuichi Watanabe
  • Organizer: 15th World Congress of the International Health Economics Association
  • Int'l Joint Research
• [Presentation] Longitudinal analysis of income-related inequalities in health care utilization and spending under the universal coverage in Korea (2022)
  • Author(s): 渡邉雄一
  • Organizer: 医療経済学会第17回研究大会
• [Presentation] 内需と人口変動のマクロ計量モデル分析：韓国・台湾の比較 (2019)
  • Author(s): 渡邉雄一
  • Organizer: 日本人口学会第71回大会
• [Presentation] Do Health Checkups Reduce Costs and Utilization of Healthcare? Evidence from a Local Municipality in Japan (2019)
  • Author(s): Yuichi Watanabe, Haruko Noguchi, Nobuyuki Izumida
  • Organizer: International Health Economics Association, Basel 2019 Congress
  • Int'l Joint Research
• [Presentation] 日韓若年層の経済的自立と家族形成の状況 (2018)
  • Author(s): 渡邉雄一・曺成虎
  • Organizer: 日本人口学会第70回大会
• [Presentation] Estimating surgical efficiency of a Japanese large-scale hospital: a stochastic production frontier approach (2018)
  • Author(s): 渡邉雄一
  • Organizer: 医療経済学会第13回研究大会
• [Presentation] Estimating surgical efficiency of a Japanese large-scale hospital: a stochastic production frontier approach (2018)
  • Author(s): Yuichi Watanabe
  • Organizer: 5th EuHEA (European Health Economics Association) PhD Student-Supervisor and Early Career Researcher Conference
  • Int'l Joint Research
• [Book] 日韓経済関係の新たな展開 (2021)
  • Author(s): 安倍誠
  • Total Pages: 212
  • Publisher: 日本貿易振興機構アジア経済研究所
  • ISBN: 9784258046447
• [Book] マクロ計量モデル―その利用と応用― (2020)
  • Author(s): 植村仁一
  • Total Pages: 184
  • Publisher: 日本貿易振興機構（ジェトロ）アジア経済研究所
  • ISBN: 9784258290543