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Nonprofit and For-profit Providers in Japan's At-home Care Industry: Evidence on Quality of Service and Household Choice

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  • Haruko Noguchi
  • Satoshi Shimizutani

Abstract

In 2000, government deregulation along with the introduction of the long-term insurance scheme for the first time allowed for-profit providers of at-home care for the elderly to compete directly with nonprofit operators. According to the contract failure hypothesis, we would expect consumers to prefer nonprofit providers over their for-profit counterparts as a result of information asymmetry and non-distributional constraints. This study takes advantage of household level data to examine whether households' choice of care provider is biased toward nonprofits. We find that nonprofit providers to command a larger market share, but this is at least partly explained by having operated in the market longer and by continuing restrictions in medical and institutional care that confer various advantages on nonprofit providers. However, we do find that user with better knowledge of providers tend to favor for-profit providers, suggesting that measures to reduce information asymmetries may help to provide a more level playing field.

Suggested Citation

  • Haruko Noguchi & Satoshi Shimizutani, 2005. "Nonprofit and For-profit Providers in Japan's At-home Care Industry: Evidence on Quality of Service and Household Choice," Hi-Stat Discussion Paper Series d04-73, Institute of Economic Research, Hitotsubashi University.
  • Handle: RePEc:hst:hstdps:d04-73
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    References listed on IDEAS

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    1. Shimizutani, Satoshi & Suzuki, Wataru, 2007. "Quality and efficiency of home help elderly care in Japan: Evidence from micro-level data," Journal of the Japanese and International Economies, Elsevier, vol. 21(2), pages 287-301, June.
    2. Olivia S. Mitchell & John Piggott & Satoshi Shimizutani, 2004. "Aged-Care Support in Japan: Perspectives and Challenges," NBER Working Papers 10882, National Bureau of Economic Research, Inc.
    3. Newhouse, Joseph P, 1970. "Toward a Theory of Nonprofit Institutions: An Economic Model of a Hospital," American Economic Review, American Economic Association, vol. 60(1), pages 64-74, March.
    4. Gertler, Paul J., 1989. "Subsidies, quality, and the regulation of nursing homes," Journal of Public Economics, Elsevier, vol. 38(1), pages 33-52, February.
    5. David Easley & Maureen O'Hara, 1983. "The Economic Role of the Nonprofit Firm," Bell Journal of Economics, The RAND Corporation, vol. 14(2), pages 531-538, Autumn.
    6. SHIMIZUTANI Satoshi & NOGUCHI Haruko, 2002. "Earnings and Quality Differentials in For-Profit versus Nonprofit Long-Term Care: Evidence from Japan's Long-Term Care Market," ESRI Discussion paper series 017, Economic and Social Research Institute (ESRI).
    7. George A. Akerlof, 1970. "The Market for "Lemons": Quality Uncertainty and the Market Mechanism," The Quarterly Journal of Economics, Oxford University Press, vol. 84(3), pages 488-500.
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    Cited by:

    1. Noguchi, Haruko & Shimizutani, Satoshi, 2007. "Nonprofit/for-profit status and earning differentials in the Japanese at-home elderly care industry: Evidence from micro-level data on home helpers and staff nurses," Journal of the Japanese and International Economies, Elsevier, vol. 21(1), pages 106-120, March.
    2. 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.
    3. Katsuyoshi Nakazawa, 2013. "Differential market entry determinants for for-profit and nonprofit long-term care providers," MAGKS Papers on Economics 201313, Philipps-Universit├Ąt Marburg, Faculty of Business Administration and Economics, Department of Economics (Volkswirtschaftliche Abteilung).
    4. Matthew A. COLE & Robert J R ELLIOTT & OKUBO Toshihiro & Eric STROBL, 2013. "The Future of Long-term Care in Japan," Discussion papers 13064, Research Institute of Economy, Trade and Industry (RIETI).
    5. NOGUCHI Haruko & SATOSHI Shimizutani, 2005. "Supplier-Induced Demand in Japan's At-home Care Industry: Evidence from Micro-level Survey on Care Receivers," ESRI Discussion paper series 148, Economic and Social Research Institute (ESRI).
    6. Satoshi Shimizutani, 2006. "Japan's Long-term Care Insurance Program: An Overview," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 142(V), pages 23-28.
    7. Tokunaga, Mutsumi & Hashimoto, Hideki, 2013. "Factors affecting the entry of for-profit providers into a price regulated market for formal long-term care services: A case study from Japan," Social Science & Medicine, Elsevier, vol. 76(C), pages 143-149.

    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • L8 - Industrial Organization - - Industry Studies: Services

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