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ESRI Discussion Paper Series No.147

Physician-Induced Demand for Treatments for Heart Attack Patients in Japan:
Evidence from the Tokai Acute Myocardial Study (TAMIS)

June, 2005
 
Haruko Noguchi
(Associate Professor, Faculty of Social Science, Toyo-Eiwa University)
Satoshi Shimizutani
(Associate Professor at the Institute of Economic Research, Hitotsubashi University)
Yuichiro Masuda
(Medical Doctor at Department of Geriatrics Graduate School of Medicine of NagoyaUniversity)

(Abstract)

    Percutaneous Transluminal Coronary Angioplasty, henceforth (PTCA) for patients with acute myocardial infarction (AMI)-a high-tech treatment-is more frequently used in Japan than in other developed countries. This paper adopts the two-phase model to examine whether the high PTCA use is driven by the self-interest of physicians, or by behavioral character. After controlling for a patient's detailed characteristics, we found that increases in the relative numbers of hospitals and physicians are significantly related to physician-initiated expenditures and the effect is higher for high-tech treatments. The results based on municipal-level aggregated data also support this conclusion.

JEL classification: I11
Key words:health care in Japan; physician-induced demand; patient initiated choices; two-phases model; acute myocardial infarction (AMI); Tokai Acute Myocardial Infarction Study (TAMIS)



Structure of the whole text(PDF-Format 1File)
full text(145KB)
Abstract---------------------------------------------------------------------- 1
1. Introduction---------------------------------------------------------------- 2
2. Previous Studies on PID--------------------------------------------------- 5
3. Data----------------------------------------------------------------------- 8
4. Empirical Specification and Measurements--------------------------------- 11
5. Empirical Results----------------------------------------------------------- 14
6. Conclusions---------------------------------------------------------------- 17
References------------------------------------------------------------------- 18
Notes------------------------------------------------------------------------ 23
Tables


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