The medical assistance system and inpatient health care provision: Empirical evidence from short-term hospitalizations in Japan

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

This paper uses two nationally representative sets of medical claims data from medical assistance and universal public health insurance systems to examine how medical assistance system assignment affects short-term inpatient health care provision. In Japan, the medical assistance system, which is part of a public assistance system, provides medical care services for its beneficiaries without imposing any financial burdens, such as copayments or advance premium payments. These circumstances can lead to inpatient costs, as physicians may provide more treatments because there is a financial incentive. Because the assignment of public assistance in Japan is not random but is subject to means testing by the local government, I employ the instrumental variable model to control the potential correlation. I find that medical expenditure is significantly higher for medical assistance patients than for universal public health insurance patients, with an arc elasticity of approximately 0.20. This elasticity is slightly greater than that found for inpatient care in the randomized RAND Health Insurance Experiment and recent empirical studies on low-income populations. In addition, the elasticities for patients who receive medication, treatment and surgery are greater.

Original languageEnglish
Article numbere0204798
JournalPloS one
Volume13
Issue number10
DOIs
Publication statusPublished - 2018 Oct

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Fingerprint Dive into the research topics of 'The medical assistance system and inpatient health care provision: Empirical evidence from short-term hospitalizations in Japan'. Together they form a unique fingerprint.

Cite this