Using Volume Measurement for Measuring Health Care in the SNA

How health care systems should be organized and associated financial challenges be addressed is the subject of considerable debate in developed countries, including Japan. An important aspect in this context is the measurement of health care output, which would also be useful in the measurement of productivity. Measuring health care output accurately not only makes it possible to examine the role and significance of public health insurance and measure its qualitative effects, but would also improve the measurement of gross domestic product(GDP). An important approach in this context is the volume approach to measuring health care output. Against this background, the aim of this study is to examine if and how measures of health care output could be used in the Japanese System of National Accounts (JSNA) and to present materials for implementing the measurement of health care output. The results indicate that when estimating output employing a cost-weighted output index (CWOI) using the number of patients, there are no large changes which can be observed, because the annual changes in the number of patients are also small. On the other hand, when employing a quality-adjusted cost-weighted output index (QACWOI) using the survival rate of cancer patients, some interesting results are obtained. Specifically, it is found that the rate of increase in the QACWOI was larger than that in the CWOI. Moreover, the rate of increase in the QACWOI was smaller than that in health care expenditure. To measure health care output overall, it would be necessary to decide on a measurement criterion for each type of medical treatment or surgery. On the other hand, if it were possible to change the estimation approach used for the JSNA to employ medical treatment units, it would be possible to partly reflect the results obtained here. This study shows one potential avenue for using the volume measurement approach for measuring quality-adjusted health care output.