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Identifier to cite or link to this item: https://hdl.handle.net/10086/14653

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Title
Regional Variations in Medical Expenditure and Hospitalization Days for Heart Attack Patients in Japan: Evidence from the Tokai Acute Myocardial Study (TAMIS)
Creator
Creator Name
Noguchi, Haruko Noguchi, Haruko
野口, 晴子 野口, 晴子
ノグチ, ハルコ ノグチ, ハルコ
Affiliation
Affiliation Name
National Institute of Population and Social Security Research
Creator Name
Shimizutani, Satoshi Shimizutani, Satoshi
清水谷, 諭 清水谷, 諭
シミズタニ, サトシ シミズタニ, サトシ
Affiliation
Affiliation Name
Institute for International Policy Studies
Creator Name
Masuda, Yuichiro Masuda, Yuichiro
益田, 雄一郎 益田, 雄一郎
Affiliation
Affiliation Name
Nagoya University
Editor
Contributor Name
世代間問題研究プロジェクト（世代間問題の経済分析） = Economic Analysis of Intergenerational Issues, Project on Intergenerational Equity
Contributor Name
一橋大学経済研究所世代間問題研究機構 = Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University
Key Word
health care in Japan
physician-induced demand
two-part model
acute myocardial infarction (AMI)
Tokai Acute Myocardial Infarction Study (TAMIS)
JEL
I11
Abstract
The use of percutaneous transluminal coronary angioplasty (PTCA), a costly high-tech treatment for patients with acute myocardial infarction (AMI), is much more frequent in Japan than in other developed countries, resulting in large medical expenditure. Using chart-based data from the Tokai Acute Myocardial Infarction Study (TAMIS) and exploiting regional variations, we explore what factors explain the intensive use of PTCA in Japan, employing propensity score matching to estimate the average treatment effects on hospital expenditure and hospital days. We find that the probability of receiving high-tech treatment is affected by a patient's characteristics as well as the density of medical resources in a region. Moreover, once heterogeneity between treated and non-treated patients is adjusted for, medical expenditure is higher for treated patients while there are no significant differences in hospitalization days. Our findings imply that the higher medical costs resulting from high-tech treatments are not associated with better outcomes and that the frequent use of high-tech treatments is economically motivated.
Abstract (104 words): In Japan, the use of percutaneous transluminal coronary angioplasty (PTCA) for the treatment of acute myocardial infarction (AMI) is extraordinarily frequent, resulting in large medical expenditure. Using chart-based data and exploiting regional variations, we explore what factors explain the frequent use of PTCA, employing propensity score matching to estimate the average treatment effects on hospital expenditure and hospital days. We find that the probability of receiving PTCA is affected by the density of medical resources in a region. Moreover, expenditure is higher for treated patients while there are no significant differences in hospitalization days, implying that the frequent use of PTCA is economically motivated.
Publisher
Institute of Economic Research, Hitotsubashi University
Issued Date
2007-11
Language
English(eng)
Resource Type
technical report
Version Type
VoR
Is Part OfRelation -
Related Title
PIE/CIS Discussion Paper ; No. 341
Relation
Related Identifier
URI
  http://cis.ier.hit-u.ac.jp/English/
Related Identifier
URI
  http://www.ier.hit-u.ac.jp/pie/stage2/Japanese/
Number of Pages
32
Sponsorship
科学研究費補助金（特別推進研究） = Grant-in-Aid for Specially Promoted Research
Appears in Collections
PIE/CIS Discussion paper
URL
https://hdl.handle.net/10086/14653