2013 Volume 24 Issue 2 Pages 86-107
This paper investigates the distribution patterns of medical care and long-term care expenditures in Japan by using the complete set of claim bill data provided by the public insurers of Fukui Prefecture from fiscal years 2003-07. Our research confirmed the well-known fact that a major portion of medical care expenditures are concentrated on a few heavy users. The expenditures on long-term care services, on the other hand, are more equally distributed among users.
We also found that medical care and long-term care expenditures have a weak, but negative relationship, because heavy users of inhospital services and those of institutional long-term care were mutually exclusive. Excluding these heavy users turned the association null, or a weakly positive one. These associations were confirmed by use of seeming unrelated regression analysis.
Finally, we analyzed the longitudinal change in the distribution of expenditures by utilizing the sample of fiveyear survivors in the dataset. Results showed that the expenditures for the top 10% of high-cost medical care users tend to wane considerably within a relatively short period, while that of high-cost long-term care users remains at a high level for a longer period.
