Annual changes in dental expenditure in Japan was analyzed on the basis of data on consumer household spending and the number of patients treated in dental clinics obtained from surveys on household economy，national cost of medical care and patient surveys since 1978. The characteristic features of the trend is discussed in this paper.

Dental expenditure initially increased in parallel with an increase in gross domestic expenditure (GDE). In 1988 and thereafter，however，the rate of increase in dental expenditure was lower than that of increase in GDE. The proportion of dental expenditure to overall consumer spending increased until 1987，and remained at similar levels thereafter. Dental expenditure was higher in families in which the householder was in late middle age, and there was a large difference among different income groups.

With regard to patients treated in dental clinics，the number of patients addressed by the Elderly Health Law and the number of patients aged 70 years or older increased to almost the same degree，w hile the number of patients who paid dental care at their own expense and dental care cost not covered by health insurance decreased throughout the 1990s.

Thus，it is apparent that dental expenditure accounts for a certain portion of consumer spending，but it varies largely among households according to the income，suggesting that it is more susceptible than general health expenditure to variations in consumer spending and alterations of the health insurance system. Both the number of patients who paid dental care at their own expense and the payment for such dental care were found to be gradually decreasing after the enactment of the Elderly Health Law，in contrast to increase in the number of elderly patients.

This paper focuses on reference pricing systems that set a reference price on each group of drugs, considered as "equivalent." Assuming proper groupings, I examine the effects of reference pricing systems on R&D in terms of R&D incentives and R&D funds. When a reference price is set at the average price of a group of drugs, consisting of different ingredients, the system possibly affords more incentives for R&D of non-innovative drugs than that of innovative drugs, while the system does not necessarily have negative effects on R&D funds. On the other hand, when a reference price is set at a lower level, the system affords more incentives for R&D of innovative drugs than that of non-innovative drugs, while the system has negative effects on R&D funds. Moreover, setting a reference price on a group of drugs which ingredients are identical has negative impacts on R&D funds of R&D-oriented pharmaceutical firms, although the effects on the relative incentives for R&D of innovative drugs can't be identified. Finally, this paper suggests some ideal forms of reference pricing systems.

This paper aims to discuss medical care and social welfare in the aging society by two extension of the standard input-output method，i.e., an analysis of interdependence between service and goods-producing sectors, and an interindustry multiplier analysis relates to the income/consumption nexus.

The method employed herein is to partition off the original Leontief inverse in terms of the combined effects of "internal multipliers", "external multipliers" of service and goods-producing sectors，and their induced sub-multipliers. Such a model conveys not only the ultimate total multiplier effects of interindustry propagation but also the disjoined effects separating into partial multipliers. The another method employed is to formulate in the form of the original interindustry Leontief inverse multiplied by a "subjoined inverse". This additional subjoined inverse reflects the effects of endogenous changes in the consumption demand of household sector of the economy.

The purposes of this study are to examine the structure of the health care economy among public economies in relation to its institutional background, and to determine the characteristics of synergetic interactions within the pair-wise economic linkages of public service activities, in comparison with private service activities, in relation to recent trends in the aging welfare economy.

In recent years, many nations try to introduce "new public management" to reform government or public sector management. "New public management" which is public management principle including result-oriented, decentralization, effciency, market-driven needs to measure objective outcomes by the public activities, it is necessary for central governmental departments in Japan to establish performance measurement and reflecting ways of measurement-results to public programs' planning.

It is necessary legally to systematize performance measurement indicators, quantitative / qualitative evaluation methods for policy evaluation, by fixed division to evaluate, in accordance with the resources devoted into the program and in the case of emergent programs.

In the United States of America, to evaluate policy, GPRA has been enacted. Federal Government departments and agencies initiate program performance reform in setting program goals, measuring program performance against those goals, and reporting publicly on their progress.

To evaluate policies objectively and to measure the performances, enhancement of administrative management abilities, collection of data on performances and development of ways for performance measurement are critical, with great efforts and with many trials. It is necessary to make appropriate plans and improve the accuracy for performance measurement in the business cycle so called Plan-Do-See cycle.