The Effects of Medical Factors on Transfer Deficits in Public Assistance in Japan: A Quantile Regression Analysis
AbstractIn countries where local governments are heavily involved in financing health care for the indigent, regional disparities in local revenues may adversely affect the access of the poor to medical care. It is thus important to examine how central governments provide funds for such local medical needs. In Japan, local governments finance all medical costs for the poor through their Public Assistance (PA) programs. Using the unique mechanism of the Japanese system of central grants, I construct a measure of "transfer deficit" which shows the portion of the PA expenditures that fails to be secured by the central grants. The distribution of such a measure provides important information to assess the regional equity in financing local programs. The results suggest a compromise on the regional equity in financing medical care for the indigent. Then, I explore the determinants of the deficit measure by performing a quantile regression analysis. Since no effects of potential determinants imply that the central grants well accommodate changes in local needs, finding such effects helps evaluate the performance of the transfer system. The results shows that, among others, the number of PA households and the factors related to mental illness of PA recipients have positive impacts that attenuate toward the top of the conditional quantile of the transfer deficit. I will elaborate on plausible causes of such attenuating responses.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by CIRJE, Faculty of Economics, University of Tokyo in its series CIRJE F-Series with number CIRJE-F-816.
Length: 32 pages
Date of creation: Aug 2011
Date of revision:
Contact details of provider:
Postal: Hongo 7-3-1, Bunkyo-ku, Tokyo 113-0033
Web page: http://www.cirje.e.u-tokyo.ac.jp/index.html
More information through EDIRC
Other versions of this item:
- Masayoshi Hayashi, 2011. "The effects of medical factors on transfer deficits in Public Assistance in Japan: a quantile regression analysis," International Journal of Health Care Finance and Economics, Springer, vol. 11(4), pages 287-307, December.
- H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
- H71 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Taxation, Subsidies, and Revenue
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Win Lin Chou & Zijun Wang, 2009. "Regional inequality in China's health care expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages S137-S146, July.
- Gamper-Rabindran, Shanti & Khan, Shakeeb & Timmins, Christopher, 2010. "The impact of piped water provision on infant mortality in Brazil: A quantile panel data approach," Journal of Development Economics, Elsevier, vol. 92(2), pages 188-200, July.
- Magnussen, Jon & Hagen, Terje P. & Kaarboe, Oddvar M., 2007.
"Centralized or decentralized? A case study of Norwegian hospital reform,"
Social Science & Medicine,
Elsevier, vol. 64(10), pages 2129-2137, May.
- Magnussen, Jon & Hagen, Terje P. & Kaarbøe, Oddvar M., 2006. "Centralized or decentralized? A case study of Norwegian hospital reform," Working Papers in Economics 02/06, University of Bergen, Department of Economics.
- Richard Scheffler & Richard Smith, 2006. "The impact of government decentralization on county health spending for the uninsured in California," International Journal of Health Care Finance and Economics, Springer, vol. 6(3), pages 237-258, September.
- Tauhidur Rahman, 2008. "Determinants of public health expenditure: some evidence from Indian states," Applied Economics Letters, Taylor & Francis Journals, vol. 15(11), pages 853-857.
- Joan Costa-Font & Jordi Pons-Novell, 2007.
"Public health expenditure and spatial interactions in a decentralized national health system,"
John Wiley & Sons, Ltd., vol. 16(3), pages 291-306.
- Joan Costa Font & Jordi Pons Novell, 2005. "Public Health Expenditure and Spatial Interactions in a Decentralized National Health System," Working Papers in Economics 139, Universitat de Barcelona. Espai de Recerca en Economia.
- Leigh, Andrew, 2008.
"Estimating the impact of gubernatorial partisanship on policy settings and economic outcomes: A regression discontinuity approach,"
European Journal of Political Economy,
Elsevier, vol. 24(1), pages 256-268, March.
- Andrew Leigh, 2007. "Estimating the Impact of Gubernatorial Partisanship on Policy Settings and Economic Outcomes: A Regression Discontinuity Approach," CEPR Discussion Papers 556, Centre for Economic Policy Research, Research School of Economics, Australian National University.
- Roger Koenker & Kevin F. Hallock, 2001.
Journal of Economic Perspectives,
American Economic Association, vol. 15(4), pages 143-156, Fall.
- Matthew Sutton & Peter Lock, 2000. "Regional differences in health care delivery: implications for a national resource allocation formula," Health Economics, John Wiley & Sons, Ltd., vol. 9(6), pages 547-559.
- Moscone, Francesco & Knapp, Martin & Tosetti, Elisa, 2007. "Mental health expenditure in England: A spatial panel approach," Journal of Health Economics, Elsevier, vol. 26(4), pages 842-864, July.
- Moshe Buchinsky, 1998. "Recent Advances in Quantile Regression Models: A Practical Guideline for Empirical Research," Journal of Human Resources, University of Wisconsin Press, vol. 33(1), pages 88-126.
- Shanti Gamper-Rabindran & Shakeeb Khan & Christopher Timmins, 2010. "The Impact of Piped Water Provision on Infant Mortality in Brazil: A Quantile Panel Data Approach," Working Papers 10-04, Duke University, Department of Economics.
- Luca Crivelli & Massimo Filippini & Ilaria Mosca, 2006. "Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 535-541.
- Montero-Granados, Roberto & de Dios Jiménez, Juan & Martín, José, 2007. "Decentralisation and convergence in health among the provinces of Spain (1980-2001)," Social Science & Medicine, Elsevier, vol. 64(6), pages 1253-1264, March.
- Adam Wagstaff & Magnus Lindelow, 2007. "Progressivity in the financing of decentralized government health programs: a decomposition," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1271-1275.
- Patrick Royston, 1992. "Comment on sg3.4 and an Improved D'Agostino Test," Stata Technical Bulletin, StataCorp LP, vol. 1(3).
- Gerdtham, Ulf-G. & Jonsson, Bengt, 2000. "International comparisons of health expenditure: Theory, data and econometric analysis," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 1, pages 11-53 Elsevier.
- Joan Costa-Font & Ana Rico, 2006. "Devolution and the Interregional Inequalities in Health and Healthcare in Spain," Regional Studies, Taylor & Francis Journals, vol. 40(8), pages 875-887.
- Joan Costa-Font, 2010. "Does devolution lead to regional inequalities in welfare activity?," Environment and Planning C: Government and Policy, Pion Ltd, London, vol. 28(3), pages 435-449, June.
- Dolores Jiménez-Rubio & Peter C. Smith & Eddy Van Doorslaer, 2008. "Equity in health and health care in a decentralised context: evidence from Canada," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 377-392.
- Sara Moreira & Pedro Pita Barros, 2010. "Double health insurance coverage and health care utilisation: evidence from quantile regression," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1075-1092, September.
- Di Matteo, Livio & Di Matteo, Rosanna, 1998. "Evidence on the determinants of Canadian provincial government health expenditures: 1965-1991," Journal of Health Economics, Elsevier, vol. 17(2), pages 211-228, April.
- David Cantarero, 2005. "Decentralization and health care expenditure: the Spanish case," Applied Economics Letters, Taylor & Francis Journals, vol. 12(15), pages 963-966.
- Imai, Hirohisa & Hosomi, Jun & Nakao, Hiroyuki & Tsukino, Hiromasa & Katoh, Takahiko & Itoh, Toshihiro & Yoshida, Takahiko, 2005. "Characteristics of psychiatric hospitals associated with length of stay in Japan," Health Policy, Elsevier, vol. 74(2), pages 115-121, October.
- Chung, Woojin & Oh, Sun-Min & Suh, Tongwoo & Lee, Young Moon & Oh, Byoung Hoon & Yoon, Chung-Won, 2010. "Determinants of length of stay for psychiatric inpatients: Analysis of a national database covering the entire Korean elderly population," Health Policy, Elsevier, vol. 94(2), pages 120-128, February.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (CIRJE administrative office).
If references are entirely missing, you can add them using this form.