2016 Volume 53 Issue 4 Pages 207-216
There are large regional differences in the health care costs for the late elderly in Japan. These regional differences could cause welfare loss, and various policies have been formulated to correct these differences. In particular, “inpatient health care costs” is the most important that contributes to the aforementioned regional differences in the health care costs. Although numerous analyses of the factors affecting the regional differences in inpatient health care costs have been conducted, none of the studies has analyzed such factors according to the type of bed. Therefore, the purpose of this study was to clarify the influence of inpatient health care costs for the late elderly according to the type of bed on the regional differences in health care costs.
The coefficient of variations and maximum/minimum ratio were calculated to identify the locations of the regional differences, and the explanatory power of each factor for regional differences in the inpatient health care costs was assessed using multilevel analysis of the proportional changes in variance. Data from health insurance claims submitted to Fukuoka Prefecture Wide-Area Association of Latter-Stage Elderly Healthcare were used for the study. The study period was 5 years, from fiscal year 2010 to fiscal year 2014.
Regional differences in the admission rates were relatively greater for mental care and long-term care beds. It was found that the admission rates could explain approximately 80% of the regional differences in the inpatient health care costs for all types of beds. The regional differences in the long-term care and mental care beds were better explained by length of hospital stay, and the regional differences in the beds by DPC （Diagnosis Procedure Combination）payments were better explained by the inpatient health care costs per day.
