Containing Health Care Costs in Japan

Section III: Technology and Costs

CHAPTER 9 Section III Technology and Costs Comparison of Hospital Admission Rates between Japan and the United States Toshihiko Hasegawa SUM MA R Y Japan spends a lower percentage of its GDP on health care expenditures than does the United States. But judging from the statistical data such as number of physician visits, average length of stay in hospitals, and number of hospital beds, Japan should be spending more than the United States. One of the few exceptions is the hospital admission rate, which is much higher in the United States. Analysis of the official statistical data reveals that this is due mainly to the difference in the surgical admission rate. Background According to the Organization for Economic Cooperation and Development (OECD) statistics, U.S. health care expenditures were 11.2% of GDP in 1987 versus 6.8% in Japan (OECD 1992); the ratio of the United States is 1.65 times that of Japan. However, when statistics on health care services are compared, the rate of contact or visits to physicians on an outpatient basis in 1986 was 5.3 per person per year in the United States, and 12.8 in Japan (Health Care Financing Administration 1989). Furthermore, the average length ofstay in a general hospital in 1984 was 6.6 days in the United States and 40.9 in Japan (OECD 1992). Comparison of statistics on health care facilities in the two countries reveals that the number of hospitals per 100,000 people in 1987 was 2.9 in the United States and 8.0 in Japan, and that the number of hospital beds per 1,000 people in 1987 was 5.3 in the United States and 15.2 in Japan (including those beds in Japanese clinics) (Ministry of Health and Welfare [MHW] 1986a, 1989a, 1992a; U.S. Department of Health and Human Services 1992). The rate in Japan is approximately three times that of the United States. These statistical data on health care services and facilities imply that health expenditures should be higher in Japan than in the United States (table 1). One of the few figures in which the rate is higher in the United States than in Japan is the per-capita annual hospital admission rate, which is 0.157 for nonfederal short-stay hospitals in 1984 in the United States (U.S. Department of 101 Section III Technology and Costs CHAPTER 9 Comparison of Hospital Admission Rates between Japan and the United States Toshihiko Hasegawa SUM MAR Y Japan spends a lower percentage of its GDP on health care expenditures than does the United States. But judging from the statistical data such as number of physician visits, average length of stay in hospitals, and number of hospital beds, Japan should be spending more than the United States. One of the few exceptions is the hospital admission rate, which is much higher in the United States. Analysis of the official statistical data reveals that this is due mainly to the difference in the surgical admission rate. Background According to the Organization for Economic Cooperation and Development (OECD) statistics, U.S. health care expenditures were 11.2% of GDP in 1987 versus 6.8% in Japan (OECD 1992); the ratio of the United States is 1.65 times that of Japan. However, when statistics on health care services are compared, the rate of contact or visits to physicians on an outpatient basis in 1986 was 5.3 per person per year in the United States, and 12.8 in Japan (Health Care Financing Administration 1989). Furthennore, the average length ofstay in a general hospital in 1984 was 6.6 days in the United States and 40.9 in Japan (OECD 1992). Comparison of statistics on health care facilities in the two countries reveals that the number of hospitals per 100,000 people in 1987 was 2.9 in the United States and 8.0 in Japan, and that the number of hospital beds per 1,000 people in 1987 was 5.3 in the United States and 15.2 in Japan (including those beds in Japanese clinics) (Ministry of Health and Welfare [MHW] 1986a, 1989a, 1992a; U.S. Department of Health and Human Services 1992). The rate in Japan is approximately three times that of the United States. These statistical data on health care services and facilities imply that health expenditures should be higher in Japan than in the United States (table 1). One of the few figures in which the rate is higher...