Abstract
Increasing medical expense has been a strong pressure on Japanese public finance, and recent journalism and research have suggested that it may be partly a result of “unnecessary health care”. While there are large disparities in medical expenses among prefectures, the disparities don’t correlate with the residents’ health, but rather correlate with the number of beds. These facts suggest that the increase of medical expenses may not be driven by demand but supply. However, there are still insufficient empirical evidence, and very few studies have tried to observe the existence of excess medical cares. In this study, we conducted a survey of hospital physicians in the top five and bottom five prefectures in age-adjusted per-capita medical expenditure. We measured the tendency toward unnecessary care in the participants’ attitudes and practices and the hospital management policies they are working for, and tested whether the tendency is stronger in prefectures with higher medical expenditure. As a result, non-negligible percentages of physicians answered that some medical tests and treatments are required for managerial reasons rather than medical needs, and that their hospitals don’t place the highest priority on patients’ well-being. In addition, in the areas with high medical expenditure, hospital management tends to focus on maximizing profits, maintaining the number of hospitalizations, and avoiding lawsuits and claims. These results suggest that unnecessary health care can exist in the regions with higher medical expenditure.
