Atsushi Miyawaki, a specially appointed researcher at the Graduate School of Medicine, the University of Tokyo, said that the full subsidy for pediatric medical expenses promoted by local governments has increased drug costs for children in good health and increased overall medical costs. , Professor Renki Kobayashi and others have found out.Researchers Miyawaki and his colleagues believe that the increase in overall medical expenses can be curbed by providing a certain amount of self-pay for medical expenses.
Researchers Miyawaki and colleagues investigated medical expenses from April 2013 to January 4 using the National Health Insurance receipt data of 1 students who were in the first to fifth grades of elementary school in April 5 in western Japan.During the period in this prefecture
・ If the monthly outpatient medical expenses exceed the upper limit, the excess will be fully subsidized.
・ Fully subsidize drug costs regardless of the number of consultations
Two pediatric medical expenses subsidies have been implemented, and their effects have been analyzed.
The subsidies did not have a statistically significant effect on outpatient and inpatient care costs, but increased drug costs by 16%.Factors recognized as statistically significant changes included a 1% decrease in outpatient care costs per visit, a 7% increase in monthly prescription probability, and a 7% decrease in generic drug share. rice field.
Next, when the target children were divided into two groups according to their health condition and analyzed, an increase in drug costs associated with the medical cost subsidy was observed only in the group with good health condition.
Researchers Miyawaki et al. Said that the subsidy for drug costs was generous for children in relatively good health, and that the subsidy for those who had few opportunities to receive medical services caused an increase in drug costs. It is believed that the increase in overall medical expenses can be curbed by selectively subsidizing children who need more.
Paper information:[Health Policy] Effect of a medical subsidy on health service utilization among schoolchildren: A community-based natural experiment in Japan
