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dc.contributor.authorNishi, Akihiro
dc.contributor.authorMcWilliams, J. Michael
dc.contributor.authorNoguchi, Haruko
dc.contributor.authorHashimoto, Hideki
dc.contributor.authorTamiya, Nanako
dc.contributor.authorKawachi, Ichiro
dc.date.accessioned2019-08-29T04:44:43Z
dc.date.issued2012
dc.identifier.citationNishi, Akihiro, J Michael McWilliams, Haruko Noguchi, Hideki Hashimoto, Nanako Tamiya, and Ichiro Kawachi. 2012. “Health Benefits of Reduced Patient Cost Sharing in Japan.” Bulletin of the World Health Organization 90 (6): 426–35. https://doi.org/10.2471/blt.11.095380.
dc.identifier.issn0042-9686
dc.identifier.issn0366-4996
dc.identifier.issn1564-0604
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:41275520*
dc.description.abstractObjective To assess the effect on out-of-pocket medical spending and physical and mental health of Japan's reduction in health-care cost sharing from 30% to 10% when people turn 70 years of age.Methods Study data came from a 2007 nationally-representative cross-sectional survey of 10 293 adults aged 64 to 75 years. Physical health was assessed using a 16-point scale based on self-reported data on general health, mobility, self-care, activities of daily living and pain. Mental health was assessed using a 24-point scale based on the Kessler-6 instrument for nonspecific psychological distress. The effect of reduced cost sharing was estimated using a regression discontinuity design.Findings For adults aged 70 to 75 years whose income made them ineligible for reduced cost sharing, neither out-of-pocket spending nor health outcomes differed from the values expected on the basis of the trend observed in 64- to 69-year-olds. However, for eligible adults aged 70 to 75 years, out-of-pocket spending was significantly lower (P<0.001) and mental health was significantly better (P<0.001) than expected. These differences emerged abruptly at the age of 70 years. Moreover, the mental health benefits were similar in individuals who were and were not using health-care services (P=0.502 for interaction). The improvement in physical health after the age of 70 years in adults eligible for reduced cost-sharing tended to be greater than in non-eligible adults (P=0.084).Conclusion Reduced cost sharing was associated with lower out-of-pocket medical spending and improved mental health in older Japanese adults.
dc.language.isoen_US
dc.publisher
dash.licenseLAA
dc.titleHealth benefits of reduced patient cost sharing in Japan
dc.typeJournal Article
dc.description.versionVersion of Record
dc.relation.journalBulletin of the World Health Organization
dash.depositing.authorKawachi, Ichiro::3b17e788dad605ac69e3dd457b6c41ac::600
dc.date.available2019-08-29T04:44:43Z
dash.workflow.comments1Science Serial ID 24166
dc.identifier.doi10.2471/BLT.11.095380
dash.source.volume90;6
dash.source.page426


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