Containing Health Care Costs in Japan

Section V: Health Behavior and Attitudes

Section V Health Behavior and Attitudes CHAPTER 19 Paradoxical Comparison of Health Care Needs, Utilization, and Costs between Japan and the United States Hiroko Akiyama SUM MA Ry Health care needs appear lower in Japan than in the United States, but Japanese health care utilization is higher, though health care costs are lower. This paper explores explanations of the paradox by focusing on the behavior of health care consumers based on a U.S.-Japan cross-national interview survey on illness behaviors . 1 In addition, 10% of the survey sample kept health diaries for four weeks. The data indicate that although Japanese reported fewer illness symptoms, they visited physicians more often and also engaged in a wide range of self-treatment. The diaries suggest that Japanese took such actions at earlier stages ofillness than Americans . The results are discussed in the context of health care policies and health care financing and delivery systems in the two nations. The conclusion is that although excessive use of primary care services is certainly a concern, frequent physician visits might have led to early intervention (including self-treatment) in illnesses, preventing the development of serious illnesses and eventually containing the volume of more expensive, high-technology medicine in Japan. Introduction A comparison ofnational health statistics in the United States and Japan indicates a paradoxical contrast: despite lower health care needs (self-reported morbidity) as compared with the United States, Japanese health care utilization is higher, but its health care costs are lower. Although there is no single good measure of health care needs for a crossnational comparison, the self-reported morbidity statistics are probably the best indicator among the available measures. A comparison of the prevalence of a variety ofillnesses found in the National Health Interview Surveys (United States) and the National Health Surveys and Comprehensive Survey ofLiving Conditions (Japan) over the years consistently indicates that, in most categories of illness, a larger proportion of Americans than Japanese reported illnesses at all ages. Despite fewer self-reported illnesses, the Japanese, on the average, visit a 201 Section V Health Behavior and Attitudes CHAPTER 19 Paradoxical Comparison of Health Care Needs, Utilization, and Costs between Japan and the United States Hiroko Akiyama SUM MAR Y Health care needs appear lower in Japan than in the United States, but Japanese health care utilization is higher, though health care costs are lower. This paper explores explanations of the paradox by focusing on the behavior of health care consumers based on a U.S.-Japan cross-national interview survey on illness behaviors . 1 In addition, 10% of the survey sample kept health diaries for four weeks. The data indicate that although Japanese reported fewer illness symptoms, they visited physicians more often and also engaged in a wide range of self-treatment. The diaries suggest that Japanese took such actions at earlier stages ofillness than Americans . The results are discussed in the context of health care policies and health care financing and delivery systems in the two nations. The conclusion is that although excessive use of primary care services is certainly a concern, frequent physician visits might have led to early intervention (including self-treatment) in illnesses, preventing the development of serious illnesses and eventually containing the volume of more expensive, high-technology medicine in Japan. Introduction A comparison ofnational health statistics in the United States and Japan indicates a paradoxical contrast: despite lower health care needs (self-reported morbidity) as compared with the United States, Japanese health care utilization is higher, but its health care costs are lower. Although there is no single good measure of health care needs for a crossnational comparison, the self-reported morbidity statistics are probably the best indicator among the available measures. A comparison of the prevalence of a variety ofillnesses found in the National Health Interview Surveys (United States) and the National Health Surveys and Comprehensive Survey ofLiving Conditions (Japan) over the years consistently indicates that, in most categories of illness, a larger proportion of Americans than Japanese reported illnesses at all ages. Despite fewer self-reported illnesses, the Japanese, on the average, visit a 201 ...