Japanese Journal of Health Economics and Policy
Online ISSN : 2759-4017
Print ISSN : 1340-895X
Volume 20, Issue 2
Displaying 1-4 of 4 articles from this issue
Editorial
Special Contributions
  • Yasuhide Nakamura
    2009 Volume 20 Issue 2 Pages 63-72
    Published: 2009
    Released on J-STAGE: January 29, 2025
    JOURNAL OPEN ACCESS
    Global issues such as environment poverty, human rights, reproductive health and rights, HIV/AIDS, and gender and development are closely related to health in the world. UN Millennium Development Goals (MDGs) set up eight goals for all UN Member States to meet the goals by the year 2015. The target 4 (reduce child mortality) , target 5 (improve maternal health) and target 6 (combat HIV/ AIDS, malaria and other diseases) are health problems.
    In 2008, Japan will host two major conferences, the Fourth Tokyo International Conference on African Development (TICAD IV) and the G8 Hokkaido Toyako Summit. At this important diplomatic juncture, Japan called for a stronger engagement of the international community in global health. After the Okinawa Summit in 2000, international awareness to tackle infectious diseases has increased. We, however, still face serious challenges in maternal, newborn, and child health.
    Human security is a concept that is very relevant to international collaboration in the 21st century. It is vitally important that we should focus on the health of individuals and protect them, and strive to empower individuals and communities through health-system strengthening. It is essential to promote a human-centered approach to strike at the root of the problem, especially through the promotion of research and development and strengthening of health systems, including human resource development.
    Japan was a developing country just after the Second World War. There were a high prevalence of many kinds of infectious diseases and many children died before their first birthday. Individuals, families and the community also made efforts against infectious diseases and maternal and child health through formal and informal collaboration. Japan should share its experience with developing countries by the researches based on the analysis of social and medical sciences.
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Original Article
  • Shinichi Noto, Takamoto Uemura
    2009 Volume 20 Issue 2 Pages 73-84
    Published: 2009
    Released on J-STAGE: January 29, 2025
    JOURNAL OPEN ACCESS

    In recent years,the study which used cost utility analysis is increasing. In cost utility analysis,quality-adjusted life years (QALYs) which is calculated by health utility score is used. For measuring the health utility score,there are direct method and an indirect method. Recently,it is often used the multi-attribute healthy status classification systems in an indirect method. However,in Japan,the data accumulation and examination of the validity of the instrument is not enough. This study investigated change of the health utility score for the sub-acute rehabilitation patient,and examined the validity of the Japanese version Health Utilities Index Mark3 (HUI3). A total of 521 patients hospitalized in the sub-acute rehabilitation ward of 5 hospitals,such as cerebrovascular disorder and hip fracture completed the HUI3. Mean utility score was 0.10 at hospitalization,0.33 at leaving hospital respectively,and the improvement difference was 0.22. Moreover,in comparison of single score of HUI3,the ambulation attribute and the cognition attribute became low and were 0.31,0.61 at the hospitalization,and 0.57,0.69 at the leaving hospital respectively. The attribute which showed the improvement regardless of diagnosis at duration of hospitalization were only ambulation and emotion. Moreover,the correlation between health utility score measured by HUI3 and Barthel Index was r= 0.724-0.768 (p< 0.001). These data indicate the health utility score measured by HUI3 had usefulness as an outcome index for rehabilitation. Moreover,about Japanese version HUI3,construct validity was checked and it was suggested that using for future health economics analysis was possible.

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  • –With an Emphasis on the Effects of the Elderly Health Care System–
    Mari Kan
    2009 Volume 20 Issue 2 Pages 85-108
    Published: 2009
    Released on J-STAGE: January 29, 2025
    JOURNAL OPEN ACCESS

    This paper investigates whether there are disparities in health care demand and in health per se by socioeconomic status (SES) among the elderly in Japan using Grossman's health investment framework. My research gives special attention to the effect of becoming eligible for the Elderly Health Care System (EHCS), since this system offers medical services with a negligible co-payment after turning to 70 years old. A positive relationship between SES and health has been consistently observed around the world. This relationship had not drawn much attention in Japan,probably because a universal health insurance system was established in 1961,and/or there was a myth that Japanese society was so equal. My research focuses on the effects of personal income,educational attainment, and occupation. The results,which are based on the National Survey of the Japanese Elderly (NSJE), show that income does not have an effect on frequency of physician visits for men or women. Men with longer formal education visit physicians more often,although education dose not have any effects among women. It can be said that there is no suppressed demand due to the type of health insurance because we do not see disparities in health care use across occupational groups. As for the effects of EHCS,it is found that those engaged in farming when they were younger increase the frequency of physician visits after they become eligible for the EHCS. Despite the fact that income does not influence the demand for health care,it heavily influences men's health. In line with previous studies,the wealthier the healthier. Men engaged in manual work or self-employed for along time are more likely to report poor health. This also agrees with previous research results. Among the Japanese elderly,education does not have a direct influence on their health.

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