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Evaluation of the DPC-based inclusive payment system in Japan for cataract operations by a new model

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  • Nawata, K.
  • Kawabuchi, K.

Abstract

We propose a new model for analyzing the length of hospital stay when variances are heterogeneous. This model is an alternative to the conventional models such as Cox's proportional hazard model and can be used to address various problems of survival analysis. The model is a heteroskedastic version of the Box–Cox transformation model and is estimated by the tobit maximum likelihood method, and its estimation can be easily done using a standard statistical package program. Using the proposed model, we analyze the effects of the diagnosis procedure combination/per diem payment system (DPC/PDPS) on the length of hospital stay following cataract operations in Japan. Data collected from six general hospitals before and after the introduction of the system are analyzed. The number of patients is 2677.

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  • Nawata, K. & Kawabuchi, K., 2013. "Evaluation of the DPC-based inclusive payment system in Japan for cataract operations by a new model," Mathematics and Computers in Simulation (MATCOM), Elsevier, vol. 93(C), pages 76-85.
    • Handle: RePEc:eee:matcom:v:93:y:2013:i:c:p:76-85
    DOI: 10.1016/j.matcom.2012.08.004
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    References listed on IDEAS

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    1. Showalter, Mark H, 1994. "A Monte Carlo Investigation of the Box-Cox Model and a Nonlinear Least Squares Alternative," The Review of Economics and Statistics, MIT Press, vol. 76(3), pages 560-570, August.
    2. Nawata, Kazumitsu & Nitta, Ayako & Watanabe, Sonoko & Kawabuchi, Koichi, 2006. "An analysis of the length of stay and effectiveness of treatment for hip fracture patients in Japan: Evaluation of the 2002 revision of the medical service fee schedule," Journal of Health Economics, Elsevier, vol. 25(4), pages 722-739, July.
    3. Okamura, Shinichi & Kobayashi, Ryota & Sakamaki, Tetsuo, 2005. "Case-mix payment in Japanese medical care," Health Policy, Elsevier, vol. 74(3), pages 282-286, November.
    4. Nawata, Kazumitsu & Ii, Masako & Ishiguro, Aya & Kawabuchi, Koichi, 2009. "An analysis of the length of hospital stay for cataract patients in Japan using the discrete-type proportional hazard model," Mathematics and Computers in Simulation (MATCOM), Elsevier, vol. 79(9), pages 2889-2896.
    5. Nawata, Kazumitsu, 1994. "Estimation of sample selection bias models by the maximum likelihood estimator and Heckman's two-step estimator," Economics Letters, Elsevier, vol. 45(1), pages 33-40, May.
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    Cited by:

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    6. Galina Besstremyannaya, 2015. "Heterogeneous effect of residency matching and prospective payment on labor returns and hospital scale economies," Discussion Papers 15-001, Stanford Institute for Economic Policy Research.
    7. Fengrong Liu & Jiayu Chen & Chaozhu Li & Fenghui Xu, 2023. "Cost Sharing and Cost Shifting Mechanisms under a per Diem Payment System in a County of China," IJERPH, MDPI, vol. 20(3), pages 1-12, January.
    8. Galina Besstremyannaya, 2014. "Heterogeneous effect of coinsurance rate on healthcare costs: generalized finite mixtures and matching estimators," Discussion Papers 14-014, Stanford Institute for Economic Policy Research.
    9. Galina Besstremyannaya, 2015. "The adverse effects of incentives regulation in health care: a comparative analysis with the U.S. and Japanese hospital data," Working Papers w0218, Center for Economic and Financial Research (CEFIR).
    10. Galina Besstremyannaya, 2015. "The adverse effects of incentives regulation in health care: a comparative analysis with the U.S. and Japanese hospital data," Working Papers w0218, New Economic School (NES).
    11. Galina Besstremyannaya, 2014. "The efficiency of labor matching and remuneration reforms: a panel data quantile regression approach with endogenous treatment variables," Working Papers w0206, New Economic School (NES).

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