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Regional Variations in Medical Expenditure and Hospitalization Days for Heart Attack Patients in Japan: Evidence from the Tokai Acute Myocardial Study (TAMIS)

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  • Noguchi, Haruko
  • 野口, 晴子
  • ノグチ, ハルコ
  • Shimizutani, Satoshi
  • 清水谷, 諭
  • シミズタニ, サトシ
  • Masuda, Yuichiro
  • 益田, 雄一郎

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.

Suggested Citation

  • Noguchi, Haruko & 野口, 晴子 & ノグチ, ハルコ & Shimizutani, Satoshi & 清水谷, 諭 & シミズタニ, サトシ & Masuda, Yuichiro & 益田, 雄一郎, 2007. "Regional Variations in Medical Expenditure and Hospitalization Days for Heart Attack Patients in Japan: Evidence from the Tokai Acute Myocardial Study (TAMIS)," PIE/CIS Discussion Paper 341, Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University.
    • Handle: RePEc:hit:piecis:341
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    Cited by:

    1. Satoshi Shimizutani & Hiroyuki Yamada & Haruko Noguchi & Yuichiro Masuda & Masafumi Kuzuya, 2013. "Exploring the causal relationship between length of stay in hospitals and treatment outcome: Evidence from Japanese AMI patients," OSIPP Discussion Paper 13E006, Osaka School of International Public Policy, Osaka University.
    2. Reo Takaku & Atsushi Yamaoka, 2019. "Payment systems and hospital length of stay: a bunching-based evidence," International Journal of Health Economics and Management, Springer, vol. 19(1), pages 53-77, March.
    3. Noguchi, Haruko & Shimizutani, Satoshi, 2009. "Supplier density and at-home care use in Japan: Evidence from a micro-level survey on long-term care receivers," Japan and the World Economy, Elsevier, vol. 21(4), pages 365-372, December.

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    More about this item

    Keywords

    health care in Japan; physician-induced demand; two-part model; acute myocardial infarction (AMI); Tokai Acute Myocardial Infarction Study (TAMIS);
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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