Econometric Analyses of Market and Organization in Health Care Service Industry

医疗保健服务业市场与组织的计量分析

基本信息

批准号：
17330045
负责人：
YOSHIDA Atsushi
金额：
$ 8.36万
依托单位：
University of Tsukuba
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2007
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17330045/
关键词：
industrial organization of health care entry and exit alumni job network labor market of physicians premium of health insurance health services system for the elderly moral hazard municipality-based national health insurance 学閥ネットワーク医療施

项目摘要

In this study, we investigate health service industry of Japan from following three viewpoints. First we examine how hospitals or clinics compete with each other confronting on what types of market with industrial organization approach. Second we examine how physicians are supplied in what types of labor market of physicians. Third we examine how changes of health policies affect incentives of physicians or patients and thus how supply or demand for health services have changed. For the first point, namely competition in health service market, we investigate theoretically and empirically (1) entry and exit of dental clinics, (2) coalition between big hospitals and clinics, (3) selection between beds for acute diagnoses and those for long term care, and so on. For the second point, namely labor market of physicians, focusing on the career path and alumni network, we investigate (1) how female physicians decide their career paths, (2) what types of teaching hospitals can attract trainee physicians after the introduction of new post-graduation training systems (3) how concrete and stable of job networks of alumni. For the third point, namely health policies, we investigate (1) what decides allocation of the elderly patients into whether health-insurance-applied beds or long-term-care-insurance-applied bed from both aspects of demand and supply sides, (2) who bears the increase of premium, employee and employer, when contribution to the health services system for the elderly increases, (3) whether financial subsidy to municipality-based national health insurance leads to excess increase of per-capita health expense.

在本研究中，我们从以下三个角度来调查日本的健康服务业。首先，我们研究医院或诊所如何通过产业组织方式在面对什么类型的市场时相互竞争。其次，我们研究了哪些类型的医生劳动力市场如何提供医生。第三，我们研究卫生政策的变化如何影响医生或患者的激励，从而影响卫生服务的供给或需求如何变化。针对第一点，即医疗服务市场的竞争，我们从理论上和实证上考察了（1）牙科诊所的进入和退出，（2）大医院与诊所的联盟，（3）急症和长期病床的选择。定期护理等。对于第二点，即医生的劳动力市场，重点关注职业路径和校友网络，我们调查（1）女医生如何决定自己的职业路径，（2）引进新制度后，什么类型的教学医院可以吸引实习医生毕业后培养体系（三）校友就业网络如何具体、稳定。对于第三点，即卫生政策，我们从需求侧和供给侧两个方面考察（1）是什么决定了老年患者是医保适用床位还是长期护理保险适用床位的分配，（ 2）当老年人卫生服务体系缴费增加时，保费的增加由雇员和雇主谁来承担；（3）对市级国民健康保险的财政补贴是否会导致人均医疗费用的过度增加。