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New Medical Schools, Access to Doctors and Health Outcomes : Evidence from Japan

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  • HOSHI, Kisho

Abstract

We investigate the effects of the medical school and the associated university hospital constructions in the 1970s on access to doctors and mortality, using the prefecture-level panel data of Japan and an event study design that exploits an exogenous variation in the pre-war location of medical schools. We find the long-term effect of an increase in doctors, and the effect closes the gap in the access to doctors that existed between treated and control prefectures before the policy intervention. We also find a decline in mortality for acute and intractable diseases after the establishment of the university hospital. Our results suggest that opening medical schools in rural areas are a potential policy to mitigate geographical disparities in access to doctors. Our results also indicate that the university hospital and the new medical graduates played an important role in decreasing mortality rates.

Suggested Citation

  • HOSHI, Kisho, 2023. "New Medical Schools, Access to Doctors and Health Outcomes : Evidence from Japan," CEI Working Paper Series 2023-05, Center for Economic Institutions, Institute of Economic Research, Hitotsubashi University.
    • Handle: RePEc:hit:hitcei:2023-05
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    File URL: https://hermes-ir.lib.hit-u.ac.jp/hermes/ir/re/79845/wp2023-05.pdf
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    1. Fang, Pengqian & Dong, Siping & Xiao, Jingjing & Liu, Chaojie & Feng, Xianwei & Wang, Yiping, 2010. "Regional inequality in health and its determinants: Evidence from China," Health Policy, Elsevier, vol. 94(1), pages 14-25, January.
    2. Angus Deaton, 2003. "Health, Inequality, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 41(1), pages 113-158, March.
    3. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    4. Jonathan Gruber & Nathaniel Hendren & Robert M. Townsend, 2014. "The Great Equalizer: Health Care Access and Infant Mortality in Thailand," American Economic Journal: Applied Economics, American Economic Association, vol. 6(1), pages 91-107, January.
    5. Bolduc, Denis & Fortin, Bernard & Fournier, Marc-Andre, 1996. "The Effect of Incentive Policies on the Practice Location of Doctors: A Multinomial Probit Analysis," Journal of Labor Economics, University of Chicago Press, vol. 14(4), pages 703-732, October.
    6. Liu, Hong & Fang, Hai & Zhao, Zhong, 2013. "Urban–rural disparities of child health and nutritional status in China from 1989 to 2006," Economics & Human Biology, Elsevier, vol. 11(3), pages 294-309.
    7. Steven Simoens & Jeremy Hurst, 2006. "The Supply of Physician Services in OECD Countries," OECD Health Working Papers 21, OECD Publishing.
    8. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    9. Viscusi, W Kip & Aldy, Joseph E, 2003. "The Value of a Statistical Life: A Critical Review of Market Estimates throughout the World," Journal of Risk and Uncertainty, Springer, vol. 27(1), pages 5-76, August.
    10. Andrea Park Chung & Martin Gaynor & Seth Richards-Shubik, 2017. "Subsidies and Structure: The Lasting Impact of the Hill-Burton Program on the Hospital Industry," The Review of Economics and Statistics, MIT Press, vol. 99(5), pages 926-943, December.
    11. Or, Zeynep & Wang, Jia & Jamison, Dean, 2005. "International differences in the impact of doctors on health: a multilevel analysis of OECD countries," Journal of Health Economics, Elsevier, vol. 24(3), pages 531-560, May.
    12. Santosh Kumar & Emily A. Dansereau & Christopher J. L. Murray, 2014. "Does distance matter for institutional delivery in rural India?," Applied Economics, Taylor & Francis Journals, vol. 46(33), pages 4091-4103, November.
    13. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    14. Gusmano, Michael K. & Weisz, Daniel & Rodwin, Victor G. & Lang, Jonas & Qian, Meng & Bocquier, Aurelie & Moysan, Veronique & Verger, Pierre, 2014. "Disparities in access to health care in three French regions," Health Policy, Elsevier, vol. 114(1), pages 31-40.
    15. Goodman, D.C. & Fisher, E. & Slukel, T.A. & Chang, C.-H., 1997. "The distance to community medical care and the likelihood of hospitalization: Is closer always better?," American Journal of Public Health, American Public Health Association, vol. 87(7), pages 1144-1150.
    16. Kondo, Ayako & Shigeoka, Hitoshi, 2013. "Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan," Journal of Public Economics, Elsevier, vol. 99(C), pages 1-23.
    17. John Robst, 2001. "A note on the relationship between medical care resources and mortality," Applied Economics Letters, Taylor & Francis Journals, vol. 8(11), pages 737-739.
    18. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    19. John Gardner, 2022. "Two-stage differences in differences," Papers 2207.05943, arXiv.org.
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    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I19 - Health, Education, and Welfare - - Health - - - Other

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