Abstract
The purpose of this paper is to clarify the feature of prefectural variations in inpatient medical expenses for the elderly over the period 1983-1999 in Japan, and to examine whether the major determinants proposed by Chino and Sugino (2002)are appropriate or not. As Japan is faced with a rapidly aging population, the problem of regional differences is one of the serious issues in terms of medical resource allocation as well as income distribution. This issue becomes more complicated after the introduction of the long-term care insurance system, i. e. the year 2000, but will be made clear through the empirical results of this study.
The results of the paper are as follows. First, prefectural differe n ces in inpatient medical expenses per elderly person were still large over the period 19831999, and stability in terms of prefectural ranking was also found through the period. This also holds to hospitalization rates for the elderly, which is one of composition elements for inpatient medical expenses. Next, with regard to independent variables, we examine which variables are the major determinants of inpatient medical expenditure for the elderly by using 1999 data. In this estimation, we employ as a dependent variable not only inpatient medical expenses per elderly person but also two alternative variables, the numbers of inpatient medical bills per elderly person and the rates of elderly inpatient numbers to the population by prefecture, to investigate the appropriateness of independent variables adopted in the former paper. The empirical results show that these variables are appropriate as the major determinants of inpatient medical expenditure per elderly person at the prefectural level.
