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

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

No 341, PIE/CIS Discussion Paper from Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University

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.

Keywords: health care in Japan; physician-induced demand; two-part model; acute myocardial infarction (AMI); Tokai Acute Myocardial Infarction Study (TAMIS) (search for similar items in EconPapers)
JEL-codes: I11 (search for similar items in EconPapers)
Pages: 32 pages
Date: 2007-11
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://hermes-ir.lib.hit-u.ac.jp/hermes/ir/re/14653/pie_dp341.pdf
https://hermes-ir.lib.hit-u.ac.jp/hermes/ir/re/14653/pie_dp341_graph.pdf

Related works:
Journal Article: Regional variations in medical expenditure and hospitalization days for heart attack patients in Japan: evidence from the Tokai Acute Myocardial Study (TAMIS) (2008)
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:hit:piecis:341

Access Statistics for this paper

More papers in PIE/CIS Discussion Paper from Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University Contact information at EDIRC.
Bibliographic data for series maintained by Digital Resources Section, Hitotsubashi University Library ().