3月7日（木）にて、上智大学経済学部と人間の安全保障研究所共催のセミナーを開催致します。

ご報告内容に関しましては、以下の通りになっております。

　 報告者：Rong Fu 氏（早稲田大学）

　 　日時：3月7日（木）17：00－18：30

　 　会場：2号館11階経済学部会議室B

        Title： How Did Hospitals Respond to Prospective Payment System under the Japanese Universal Healthcare System? (with Haruko NOGUCHI)

Abstract：This research evaluates performances of Japan's inpatient prospective payment system (PPS) in terms of the impacts on medical payment, operational efficiency, and healthcare quality. We focus on a group of hospitals enrolled mandatorily into the program in 2003,  for which the  change in reimbursement method is an exogenous shock. Applying difference-in-difference approach to a set of nationally representative datasets, we find evidence that the PPS does not contain the medical costs as expected, because the program is adopted only to part of procedures in inpatient care and has no interference with those in outpatient care. The hospitals could respond in a "real" fashionーreduce volume of the procedures paid PPS to avoid deficit; or in a "nominal" fashionーassign the procedures paid PPS from inpatient care to outpatient care. We also find a decline of length of stay (LOS) among the hospitals enrolled in the program, indicating an improvement on operational efficiency. The reduction is larger at upper quantiles of the LOS. Finally, we confirm a moderate deterioration in healthcare quality.  Following the program adoption, the hospitals become more likely to discharge patients with symptoms lightened or uncharged, rather than being fully cured.