富　蓉

研究種別：

2017年-0月-2019年-0月

配分額：￥2210000

研究種別：

2019年-0月-2022年-0月

配分額：￥3380000

2018年度

研究成果概要：After several revisions, I summarize the findings in an article entitled "Moral Hazard under Zero Price Policy: Evi...After several revisions, I summarize the findings in an article entitled "Moral Hazard under Zero Price Policy: Evidence from Japanese Long-term Care Claims Data" and submitted it to the European Journal of Health Economics. 

2017年度共同研究者：Haruko NOGUCHI

研究成果概要：I have summarized the findings in a manuscript entitled "Moral Hazard under Zero Price Policy: Evidence from Japane...I have summarized the findings in a manuscript entitled "Moral Hazard under Zero Price Policy: Evidence from Japanese Long-term Care Claims Data"and submitted it to the Journal of Public Economics.

2019年度共同研究者：Haruko Noguchi, Yichen Shen

研究成果概要：In 2003, Japan experienced a reform from the fee-for-service system to the blended payment system, a system where o...In 2003, Japan experienced a reform from the fee-for-service system to the blended payment system, a system where only some procedures within inpatient care are required to be paid with the prospective payment system. Exploiting the reform, we investigate the impact of the blended payment system on cost and health outcomes. Using 1997 to 2010 health insurance claims, we show that the blended payment system does not cost less than the fee-for-service system and induces health deteriorations. The deteriorations in health are moderate in comparison with the prospective payment system. The failure to contain cost and the deterioration of health is driven by providers' compensation seeking behaviors that cause a shift of procedures paid via prospective payment system to procedures paid via the fee-for-service system. Our findings point to further reform of the blended payment system to restrict provider incentive to seeking compensations.

2020年度

研究成果概要：Countries seeking to move away from a purely fee‐for‐service (FFS) systemmay consider a hybrid approach whereby onl...Countries seeking to move away from a purely fee‐for‐service (FFS) systemmay consider a hybrid approach whereby only some procedures are paid byFFS while others are paid prospectively. Yet little evidence exists whether sucha hybrid payment system contains overall costs without adverse influences onhealth outcomes. In 2003, Japan experienced a reform from FFS to a hybridpayment system in which only some inpatient procedures were paid prospectively.We exploit this reform to test how such a hybrid system affectsoverall costs and health outcomes. Briefly, we find that healthcare providersresponded opportunistically to the reform, moving some procedures out of thebundled inpatient setting to FFS services, leading to no reduction in cost.There was some evidence of a moderate deterioration in health outcomes, interms of a decline in the probability of symptoms being cured at discharge. Insum, our results suggest that in some cases, a hybrid payment system can benon‐superior to either FFS or a prospective payment system.