ArticleInternational journal for equity in health2019
Co-insurance and health care utilization in Japanese patients with rheumatoid arthritis: a discontinuity regression approach.
Article in International journal for equity in health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 12 citations in OpenAlex.
- Japanese hematologists' and oncologists' perceptions of patient preferences for shared decision-making.BMC research notes · 2026Article
- Impacts of cost-sharing rate increment on the expenditure of outpatient care among older adults: quasi-experimental study of cost-sharing reform in Japan.BMC health services research · 2026Article
- The optimal co-insurance rate for outpatient drug expenses of Iranian health insured based on the data mining method.International journal for equity in health · 2024Article
- Inequalities in unmet health care needs under universal health insurance coverage in China.Health economics review · 2024Article
- Does the immediate reimbursement of medical insurance reduce the socioeconomic inequality in health among the floating population? Evidence from China.International journal for equity in health · 2023Article
- Cost-Sharing Effects on Hospital Service Utilization Among Older People in Fukuoka Prefecture, Japan.International journal of health policy and management · 2022Article
- Impact of the 2014 coinsurance rate revision for the elderly on healthcare resource utilization in Japan.Health economics review · 2021Article
- Affordable and equitable access to subsidised outpatient medicines? Analysis of co-payments under the Additional Drug Package in Kyrgyzstan.International journal for equity in health · 2019Article
- Estimating Prevalence and Healthcare Utilization for Treatment-Resistant Depression in Japan: A Retrospective Claims Database Study.Drugs - real world outcomes · 2018Article
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCo-insurance rates in Japan decrease when patients turn 70 years of age. We aim to compare changes in medical demand for Japanese patients with rheumatoid arthritis (RA) at age 70 prior to 2014, when there was a reduction in co-insurance rates from 30 to 10%, with changes in medical demand at age 70 after 2014 when co-insurance rates decreased from 30% to only 20%.
methodsWe used administrative data from large Japanese hospitals. We employed a discontinuity regression (RD) approach to control for unobserved endogeneity in the data.
resultsWe identified a total of 7343 patients with RA, 4905 (67%) turned age 70 before April, and found that a 20% decrease in co-insurance was associated with increased utilization of more expensive biologic RA drugs, more outpatient visits and higher total medical costs. However, a 10% decrease in co-insurance for patients who turned 70 after 2014 did not significantly change demand for medical services.
conclusionsFor the younger cohort, we did not observe any changes in medical demand after a price decrease. We therefore conclude that the economic goal of cost sharing, namely a behavioural change towards lower health-care utilization, is not achieved in this particular cohort of chronic patients.
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