TY - JOUR
T1 - How efficient are surgical treatments in Japan? The case of a high-volume Japanese hospital
AU - Watanabe, Yuichi
AU - Noguchi, Haruko
AU - Nakata, Yoshinori
N1 - Funding Information:
We would like to sincerely thank to Teikyo University Hospital, which allowed us to utilize the valuable data. We also gratefully acknowledge the financial support from Waseda Institute of Social & Human Capital Studies (WISH) for travel expenses to present this paper at an international academic conference, and appreciate the Waseda Institute of Political Economy (WINPEC) for its financial support. Our special thanks go to Dr. Akira Kawamura for providing valuable comments, and Dr. Hiroyuki Kawaguchi for discussing our paper at the 2018 Annual Conference of the Japan Health Economics Association (JHEA). Further, we would like to extend appreciation to those who participated in the 5th European Health Economics Association (EuHEA) PhD Student-Supervisor and Early Career Researcher Conference for their helpful comments and suggestions. We take full responsibility for any errors.
Funding Information:
We would like to sincerely thank to Teikyo University Hospital, which allowed us to utilize the valuable data. We also gratefully acknowledge the financial support from Waseda Institute of Social & Human Capital Studies (WISH) for travel expenses to present this paper at an international academic conference, and appreciate the Waseda Institute of Political Economy (WINPEC) for its financial support. Our special thanks go to Dr. Akira Kawamura for providing valuable comments, and Dr. Hiroyuki Kawaguchi for discussing our paper at the 2018 Annual Conference of the Japan Health Economics Association (JHEA). Further, we would like to extend appreciation to those who participated in the 5th European Health Economics Association (EuHEA) PhD Student-Supervisor and Early Career Researcher Conference for their helpful comments and suggestions. We take full responsibility for any errors.
Funding Information:
This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Number 17 K09247 to Dr. Yoshinori Nakata. Acknowledgments
Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Japan’s healthcare expenditures, which are largely publicly funded, have been growing dramatically due to the rapid aging of the population as well as the innovation and diffusion of new medical technologies. Annual costs for surgical treatments are estimated to be approximately USD 20 billion. Using unique longitudinal clinical data at the individual surgeon level, this study aims to estimate the technical efficiency of surgical treatments across surgical specialties in a high-volume Japanese teaching hospital by employing stochastic frontier analysis (SFA) with production frontier models. We simultaneously examine the impacts of potential determinants that are likely to affect inefficiency in operating rooms. Our empirical results show a relatively high average technical efficiency of surgical production, with modest disparity across surgical specialties. We also demonstrate that an increase in the number of operations performed by a surgeon significantly reduces operating room inefficiency, whereas the revision of the fee-for-service schedule for surgical treatments does not have a significant impact on inefficiency. In addition, we find higher technical efficiency among surgeons who perform multiple daily surgeries than those who perform a single operation in a day. We suggest that it is important for hospital management to retain efficient surgeons and physicians and provide efficient healthcare services given the competitive Japanese healthcare market.
AB - Japan’s healthcare expenditures, which are largely publicly funded, have been growing dramatically due to the rapid aging of the population as well as the innovation and diffusion of new medical technologies. Annual costs for surgical treatments are estimated to be approximately USD 20 billion. Using unique longitudinal clinical data at the individual surgeon level, this study aims to estimate the technical efficiency of surgical treatments across surgical specialties in a high-volume Japanese teaching hospital by employing stochastic frontier analysis (SFA) with production frontier models. We simultaneously examine the impacts of potential determinants that are likely to affect inefficiency in operating rooms. Our empirical results show a relatively high average technical efficiency of surgical production, with modest disparity across surgical specialties. We also demonstrate that an increase in the number of operations performed by a surgeon significantly reduces operating room inefficiency, whereas the revision of the fee-for-service schedule for surgical treatments does not have a significant impact on inefficiency. In addition, we find higher technical efficiency among surgeons who perform multiple daily surgeries than those who perform a single operation in a day. We suggest that it is important for hospital management to retain efficient surgeons and physicians and provide efficient healthcare services given the competitive Japanese healthcare market.
KW - 62P20, 97M40
KW - Japanese fee-for-service system
KW - Operating rooms
KW - Stochastic frontier analysis
KW - Surgical production
KW - Technical efficiency
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U2 - 10.1007/s10729-020-09507-3
DO - 10.1007/s10729-020-09507-3
M3 - Article
C2 - 32578001
AN - SCOPUS:85086784069
SN - 1386-9620
VL - 23
SP - 401
EP - 413
JO - Health Care Management Science
JF - Health Care Management Science
IS - 3
ER -