2000 Volume 7 Pages 37-64
The inclusive payment system (IPS) in outpatients' cares was introduced in the health care reform in 1996. However, the system was not for controlling health care costs and therefore costs increased rapidly. In this paper, merits and demerits of the IPS are pointed out in the first half. The system has an incentive to decrease intensity of care and has wide variety. The effectiveness of the IPS is criticized in the empirical basis. Furthermore, the effects of IPS on the cases of elder and infant outpatients are analyzed from theoretical and empirical points. The results are summarized as follows: (1) The option of the IPS has contributed to the increase of health care costs according with the high price level of medical care. This option is questionable and inconsistent with the idea of the IPS. (2) The behavior of hospitals is tested in the IPS. The selection of the IPS options and its intensity (length of care) are consistent with the incentive mechanism. Actually, the length of care decreased in elder outpatients with the monthly IPS and it increased in infant outpatients with the daily IPS. These results indicate further consideration of incentive mechanism is necessary to discuss the health care reform.
