Effect of reducing cost sharing for outpatient care on children’s inpatient services in Japan

Effect of reducing cost sharing for outpatient care on children’s inpatient services in Japan Background: Assessing the impact of cost sharing on healthcare utilization is a critical issue in health economics and health policy. It may affect the utilization of different services, but is yet to be well understood. Objective: This paper investigates the effects of reducing cost sharing for outpatient services on hospital admissions by exploring a subsidy policy for children’s outpatient services in Japan. Methods: Data were extracted from the Japanese Diagnosis Procedure Combination database for 2012 and 2013. A total of 366,566 inpatients from 1390 municipalities were identified. The impact of expanding outpatient care subsidy on the volume of inpatient care for 1390 Japanese municipalities was investigated using the generalized linear model with fixed effects. Results: A decrease in cost sharing for outpatient care has no significant effect on overall hospital admissions, although this effect varies by region. The subsidy reduces the number of overall admissions in low-income areas, but increases it in high-income areas. In addition, the results for admissions by type show that admissions for diagnosis increase particularly in high-income areas, but emergency admissions and ambulatory-care-sensitive-condition admissions decrease in low-income areas. Conclusions: These results suggest that outpatient and inpatient services are substitutes in low-income areas but complements in http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Health Economics Review Springer Journals

Effect of reducing cost sharing for outpatient care on children’s inpatient services in Japan

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2017 by The Author(s).
Subject
Medicine & Public Health; Public Health; Health Economics; Public Finance; Pharmacoeconomics and Health Outcomes; Economic Policy; Health Care Management
eISSN
2191-1991
D.O.I.
10.1186/s13561-017-0165-3
Publisher site
See Article on Publisher Site

Abstract

Background: Assessing the impact of cost sharing on healthcare utilization is a critical issue in health economics and health policy. It may affect the utilization of different services, but is yet to be well understood. Objective: This paper investigates the effects of reducing cost sharing for outpatient services on hospital admissions by exploring a subsidy policy for children’s outpatient services in Japan. Methods: Data were extracted from the Japanese Diagnosis Procedure Combination database for 2012 and 2013. A total of 366,566 inpatients from 1390 municipalities were identified. The impact of expanding outpatient care subsidy on the volume of inpatient care for 1390 Japanese municipalities was investigated using the generalized linear model with fixed effects. Results: A decrease in cost sharing for outpatient care has no significant effect on overall hospital admissions, although this effect varies by region. The subsidy reduces the number of overall admissions in low-income areas, but increases it in high-income areas. In addition, the results for admissions by type show that admissions for diagnosis increase particularly in high-income areas, but emergency admissions and ambulatory-care-sensitive-condition admissions decrease in low-income areas. Conclusions: These results suggest that outpatient and inpatient services are substitutes in low-income areas but complements in

Journal

Health Economics ReviewSpringer Journals

Published: Aug 15, 2017

References

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