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Journal of Public Health

Erschienen in:

01.08.2014 | Original Article

Factors affecting regional variations in hospitalization expenditures of elderly residents in Japan

verfasst von: Etsu Goto, Jason Lee, Noriko Sasaki, Yuichi Imanaka

Erschienen in: Journal of Public Health | Ausgabe 4/2014

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Abstract

Aim

The aim of this study was to examine the possible effects of healthcare resource factors, socioeconomic factors, and sociodemographic factors on variations in hospitalization expenditures of elderly patients in Japan at different levels of urbanization.

Subject and methods

A secondary analysis was conducted using data obtained from a regional health care cost report and the Portal Site of Official Statistics of Japan. The regional unit of analysis used was the secondary medical care area. We divided these areas into three groups based on their levels of urbanization (low, middle, and high urbanization), indicated by their respective population densities of inhabitable areas. Multiple linear regression models were used to analyze the candidate factors affecting per capita hospitalization expenditures of elderly residents.

Results

The significance and magnitude of associations were observed to vary according to different levels of urbanization. Our findings showed that medical resource factors and sociodemographic factors were more influential in areas of low urbanization, whereas the number of hospital beds and socioeconomic factors appeared more influential in high urbanization areas.

Conclusion

Policies designed to contain healthcare expenditures should take regional characteristics and levels of urbanization into account in order to support the development and implementation of region-specific improvements that ensure affordable healthcare for the elderly.

Angulo AM, Barberán R, Egea P, Mur J (2011) An analysis of health expenditure on a microdata population basis. Econ Model 28:169–180CrossRef

Beatty K, Harris JK, Barnes PA (2010) The role of interorganizational partnerships in health services provision among rural, suburban, and urban local health departments. J Rural Health 26:248–258PubMedCrossRef

Brown MM, Brown GC, Sharma S, Smith H, Hollands AF (2001) Physician manpower and health care expenditures in the United States: a thirty-year perspective. J Health Care Finance 27:55–64PubMed

Cabinet office, Government of Japan (2005) Implementation of measures for an aging society (in Japanese). http://www8.cao.go.jp/kourei/whitepaper/w-2005/zenbun/pdf/h17_1chap2_3_20.pdf. Accessed 19 November 2013

Crivelli L, Filippini M, Mosca I (2006) Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons. Health Econ 15:535–541PubMedCrossRef

Fujiwara Y, Hoshi T (1998) Review of prefectural differentials of inpatient medical cost for the elderly (in Japanese with English abstract). Jpn J Public Health 45:1050–1058

Fujiwara Y, Hoshi T, Shinkai S, Kita T (2000) Regulatory factors of medical care expenditures for older people in Japan: analysis based on secondary medical care areas in Hokkaido. Health Policy 53:39–59PubMedCrossRef

Goetghebeur MM, Forrest S, Hay JW (2003) Understanding the underlying drivers of inpatient cost growth: a literature review. Am J Manag Care 9:SP3–SP12PubMed

Greene WH (2002) Econometric analysis, 5th edn. Prentice Hall, Englewood Cliffs, NJ, pp 10–18

Greiner KA, Li C, Kawachi I, Hunt DC, Ahluwalia JS (2004) The relationships of social participation and community ratings to health and health behaviors in areas with high and low population density. Soc Sci Med 59:2303–2312PubMedCrossRef

Hay JW (2003) Hospital cost drivers: an evaluation of 1998–2001 state-level data. Am J Manag Care 9:SP13–SP24PubMed

Innami I (1997) The structural determinants of Japanese health care expenditures and the explanation for its regional gap (in Japanese with English abstract). J Health Care Soc 7(3):53–82

Jia H, Cowper DC, Tang Y, Litt E, Wilson L (2012) Postacute stroke rehabilitation utilization: are there differences between rural–urban patients and taxonomies? J Rural Health 28:242–247PubMedCrossRef

Jiménez-Rubio D, Smith PC, Van Doorslaer E (2008) Equity in health and health care in a decentralised context: evidence from Canada. Health Econ 17:377–392PubMedCrossRef

Kagamimori S, Gaina A, Nasermoaddeli A (2009) Socioeconomic status and health in the Japanese population. Soc Sci Med 68:2152–2160PubMedCrossRef

Kroneman M, Siegers JJ (2004) The effect of hospital bed reduction on the use of beds: a comparative study of 10 European countries. Soc Sci Med 59:1731–1740PubMedCrossRef

Laditka JN, Laditka SB, Probst JC (2009) Health care access in rural areas: evidence that hospitalization for ambulatory care-sensitive conditions in the United States may increase with the level of rurality. Health Place 15:731–740PubMedCrossRef

Martín JJM, del Amo Gonzalez MPL, Dolores Cano Garcia M (2011) Review of the literature on the determinants of healthcare expenditure. Appl Econ 43:19–46CrossRef

Ministry of Education, Culture, Sports, Science and Technology (2006) List of academic medical centers (in Japanese). http://www.mext.go.jp/a_menu/koutou/kaikaku/chiiki/gijiroku/06030308/002.htm. Accessed 19 November 2013

Ministry of Health, Labour and Welfare (2002) Survey of medical institutions (in Japanese). http://www.e-stat.go.jp/SG1/estat/NewList.do?tid=000001030908. Accessed 19 November 2013

Ministry of Health, Labour and Welfare (2010) Survey on the trend of medical care expenditures (in Japanese). http://www.mhlw.go.jp/topics/medias/year/10/dl/iryouhi_data.pdf. Accessed 19 November 2013

Ministry of Health, Labour and Welfare (2011) Interim evaluation of progress in the plan for efficient medical expenditure (in Japanese). http://www.mhlw.go.jp/bunya/shakaihosho/iryouseido01/pdf/shinchoku_keikaku.pdf. Accessed 19 November 2013

Organisation for Economic Co-operation and Development (2013) Elderly population by region. http://www.oecd-ilibrary.org/content/book/factbook-2013-en. Accessed 19 November 2013

Pudrovska T, Anishkin A (2013) Early-life socioeconomic status and physical activity in later life: evidence from structural equation models. J Aging Health 25:383–404PubMedCrossRef

Ross NA, Wolfson MC, Dunn JR, Berthelot JM, Kaplan GA, Lynch JW (2000) Relation between income inequality and mortality in Canada and in the United States: cross sectional assessment using census data and vital statistics. Br Med J 320:898–902CrossRef

Shain M, Roemer MI (1959) Hospital costs relate to the supply of beds. Mod Hosp 92:71–73, 168PubMed

Shakai hoken kenkyuu sho (2004) Regional health care cost (in Japanese). Shakai hoken kenkyuu sho, Tokyo

Statistics Bureau (2000) National population census (in Japanese). http://www.e-stat.go.jp/SG1/estat/NewList.do?tid=000000030001. Accessed 19 November 2013

Statistics Bureau (2002b) National survey of prices (in Japanese). http://www.e-stat.go.jp/SG1/estat/List.do?bid=000001006111. Accessed 19 November 2013

Statistics Bureau (2011) Basic resident register (in Japanese). http://www.e-stat.go.jp/SG1/estat/GL08020103.do?_toGL08020103_&listID=000001068598. Accessed 19 November 2013

Statistics Bureau (2002a) Statistical observations of shi, ku, machi, mura (in Japanese). Statistics Bureau Management and Coordination Agency, Tokyo

Thornton JA, Rice JL (2008) Determinants of healthcare spending: a state level analysis. Appl Econ 40:2873–2889CrossRef

Une H (1996) Medical expenditure of the elderly and factors related to its geographical variations within Fukuoka prefecture (in Japanese with English abstract). Jpn J Public Health 43:28–36

Wagstaff A, Van Doorslaer E (2000) Income inequality and health: what does the literature tell us? Annu Rev Public Health 21:543–567PubMedCrossRef

Wang Z (2009) The determinants of health expenditures: evidence from US state-level data. Appl Econ 41:429–435CrossRef

Young AE, Cifuentes M, Wasiak R, Webster BS (2009) Urban–rural differences in work disability following occupational injury: are they related to differences in healthcare utilization? Occup Environ Med 51:204–212CrossRef

Zweifel P, Breyer F, Kifmann M (2009) Health economics, 2nd edn. Springer, Heidelberg, Germany, pp 457–474CrossRef

Titel: Factors affecting regional variations in hospitalization expenditures of elderly residents in Japan
verfasst von: Etsu Goto
Jason Lee
Noriko Sasaki
Yuichi Imanaka
Publikationsdatum: 01.08.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Public Health / Ausgabe 4/2014
Print ISSN: 2198-1833
Elektronische ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-014-0621-z

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Factors affecting regional variations in hospitalization expenditures of elderly residents in Japan

Abstract

Aim

Subject and methods

Results

Conclusion

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Aim

Subject and methods

Results

Conclusion

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