Programme Evaluation of Unemployment Benefits in Japan: An Average Treatment Effect Approach

Empirical results show that unemployment benefits (UB) recipients significantly change to worse job conditions with respect to wages and firm size, but change to better job conditions with respect to occupation, position, industry, and residence. While the effects for occupation are not significant, UB recipients have a significant tendency to stay the same. In other words, results of other conditions imply that they reduce the reservation wage to get better conditions with respect to occupation, industry and residence. This means strong inertia in these aspects.

Empirical Research on the Demand for Influenza Vaccination Among the Elderly,

Purpose: This paper analyses what factors determine the demand for vaccination among the elderly as a high risk group. Using the estimation results, this paper then evaluates how legal requirements and/or subsidies affect their demand. Methods: Original data were obtained from two surveys, conducted by the author, given to two groups: elderly people living with descendants, and elderly people living without descendants. The surveys contained information about the elderly, the household, experience of influenza during the last season, immunization during this time, and a hypothetical questionnaire about immunization for purposes of Conjoint Analysis. Three estimations are performed for actual behaviour, Conjoint Analysis and Joint Estimation, the latter combining the first two estimations. Results: Among estimation results, factors such as cost, number of immunizations, availability of immunization at night or on the weekend, and legal requirements heavily affect the demand for immunization. Experience of influenza and immunization in the preceding season is one of the most important determinants. In addition, the superiority of the Joint Estimation method is confirmed. Conclusions: The estimation results imply that about 8.9 million elderly people will have a demand for vaccination if there is no cost and it is legally recommended. If the cost is 6000 yen (about US$50) and there is no legal recommendation, demand for vaccination will be reduced to about 3.2 million elderly people. An increase in cost from free vaccination to just 500 yen (about US$4) depresses demand from 1.6 million elderly people. On its own, legal recommendations for vaccination can push up demand by 2.0 million elderly persons.

Should the Coinsurance Rate be Increased in the Case of the Common Cold? _An Analysis Based on an Original Survey_,

This article examines the choice of health care in Japan by patients suffering from the common cold. Original data were obtained from a survey conducted by the authors. Empirical results show that the price elasticity of demand for medical services is between 0.23 and 0.36. This estimated price elasticity suggests that if the new medical insurance reform plan were to increase the coinsurance rate by 10% both for those insured and their and dependants, national medical costs may be reduced by, at most, 43 billion yen (358 million US dollars); correspondingly, this could increase the demand for over-the-counter (OTC) medicine, at most, by 8.8 billion yen (73.3 million US dollars). This result implies that medical services and OTC medications are substitutes. Moreover, a tenfold increase in the provision of information on drugs could reduce national medical costs by 60 billion yen (500 million US dollars) at most, with a corresponding increase in the demand for OTC medications by about 6.9 billion yen (57.5 million U.S. dollars).

Horizontal Inequity in Health Care Utilization in Japan,

International comparisons of horizontal inequity in health have recently become one of the most pertinent issues in health economics. Japan has not been included in these international comparisons. This omission is rectified in this paper, which focuses on Japan. Moreover, we consider its dynamics over six years from 1992 to 1998. The dynamics has never considered in this fields. In a rigorous international comparison, we cannot find any horizontal inequity in health in Japan and almost similar to Belgium.

Analysis of Health and Activity Limitation Index (HALex), Its Distribution, andIts Distribution by Income in Japan, 1989 and 1998,

It is a widely shared view in the population health field that the future of the analysis of population health lies in the assessment both of the length of life and health-adjusted quality of life, and the parallel examination of the average health and health distribution within a population. Using a nationally representative sample of the 1989 and 1998 wave of the Japanese Comprehensive Survey of Living Conditions of the People on Health and Welfare (CSLC), this research aims to conduct such assessment of the health of Japanese people: examination of the average health-adjusted quality of life, its distribution, and its distribution by income share. This study departs from previous health inequality analyses in the following two ways: (1) construction of a health state measure in the CSLC equivalent to the Health and Activity Limitation Index (HALex) and its application to health inequality analysis, and (2) inclusion of the dead in health inequality analysis. This study found that between 1989 and 1998 overall in Japan the HALex on average slightly reduced (0.005 reduction), its inequality by income slightly reduced (0.002 reduction in the difference between the top 20% and bottom 20% income share groups), and its inequality measured by the Gini Coefficient slightly increased (0.002 increase). Women's HALex was almost always lower than men's, except in earlier ages younger than ten years old. The HALex was more unequally distributed among women than men and in older ages. This analysis shows that the success in the improvement in the length of life in Japan did not always coincide with the improvement in the health-adjusted quality of life and provides a basis for the future population health research.

Cost-effectiveness analysis and its application for policy evaluation for medicine or public health

In comparison to the policy for other field, the policy for medicine and public health is to consider the value of life or the value of the quality of life. Quality of life is very well known as a concept of QOL. Also, Quality Adjusted Life of Years (QALY) which integrates QOL over life of years is widely used as a measure of the value of life. Cost-effectiveness analysis for medicine and public health adopts two approaches to incorporate value of QOL or QALY. We summarize those advantage and disadvantage briefly at first. Unfortunately, cost-effectiveness analysis has not been committed and operated as an official rule for the method of policy evaluation for medicine or public health in Japan, yet. Thus we show some researches about it which examines ex post or ex ante policy evaluation using cost-effectiveness analysis. In other countries, some political decision making in medicine or public health is based on cost-effectiveness analysis. However, the pressure of the financial deficit will require more accountability about evidence. Therefore, cost-effectiveness analysis must be more important even in political decision making in medicine or public health in Japan.medicine, public health, Quality of Life, public health, cost-effectiveness, Japan

An Empirical Study of Alcoholic Consumption and Labor Productivity in Japan

This paper examines the relationship between labor productivity and alcohol consumption based on research conducted with a limited sample of workers who drink alcohol. Estimation results show that in the case of males, the amount of alcohol consumed significantly raises labor productivity, with an elasticity of approximately 0.13. In females, we cannot reach the firm conclusion. Conversely, the reverse relationship between labor productivity and alcohol consumption cannot be confirmed. Moreover, an awareness of appropriate alcohol consumption supports the sixth strategy of the Health Japan 21 policy, which is to reduce national alcohol consumption by about 20%.

International Comparison of Subjective Health Evaluation - USA, UK and Japan -,

This paper tries to calculate quality of life (QOL) from subjective health evaluations in Japan following Cutler and Richardson (1997) and Groot (2000). It then extends the model in several ways. Firstly, while previous studies define the domain of OL in an ad hoc manner, i.e. excluding "excellent" or "very poor" respondents, this paper suggests a more rigorous alternative measure. Secondly, heterogeneity among individuals that is inevitable in micro-data is accounted for in the estimation process. Thirdly, economic variables such as income or job status that are considered to affect subjective health status are also accounted for. The estimation results show the following: using the same model as previous work, similar tendencies are found, but coefficients are smaller for many symptoms and diseases. Economic variables help to clarify the effect of symptoms or diseases on subjective health evaluation. The QOL measures defined in this paper are smaller for most symptoms and diseases, and thus the measures in previous research are likely to overestimate of damage to QOL by symtoms and diseases and may be inappropriate.

Comparison Between Treatment Outcomes in Ischaemic Heart Disease Using Surveys of Medical Care in Japan,

Objective The treatments of ischaemic heart disease have drastically changed due to the developments in coronary-anterial bypass graft operations and coronary intervention procedures. The treatment outcomes of these procedures are compared using observational data. Method The data used are microdata from Surveys of Medical Care (SMC) in Japan from 1992 to 1998, which are claim data, not using a randomized controlled trial. Hence, endogeneity in the choice of treatment should be important and thus both the instrumental variables method and the nonparametric propensity score matching method are adopted for estimation. Result Although the instrumental variables method and nonparametric propensity score matching method produce different results in many cases, predominance of the latter over the instrumental method is confirmed. Although claimed with some reservations, patients treated with precutaneous transluminal coronary angioplasty (PTCA) have significantly lower possibility of severe heart failure than those treated with coronary artery by-pass grafting (CABG). The results of comparing invasive procedures with preserving treatment depend on the existence of constraints. In data for more acute situations, invasive procedures have a significantly higher possibility of severe heart failure than preserving treatment.