Japanese Government Builds Survey Modeled on AHRQ's Data Sets
The Institute for Health Economics and Policy, an independent health care policy research organization founded by Japan's Ministry of Health, Welfare, and Labour, has conducted a medical care expenditure survey to improve the health care delivery and financing system in Japan. The survey is modeled after AHRQ's Medical Panel Expenditure Survey (MEPS).
According to Naohiro Mitsutake, PhD, Associate Director of the Institute's research department, the information and advice the Japanese researchers received from AHRQ "were valuable in the design of our study. We believe it is very important to investigate health care expenditure related to health status change and to know the social and economic status of individuals."
The Japanese researchers turned to MEPS-which collects data on the specific health services that Americans use, how frequently they use them, the cost of these services, and how they are paid, as well as data on the cost, scope, and breadth of health insurance held by and available to U.S. workers-to reach their ultimate goal. They felt the government should have a panel design database, but needed a carefully designed survey methodology before beginning to collect data.
The initial Japanese pilot study, known as MEPS-J, was conducted by Institute researchers in 2008 and 2009 to test feasibility and capture new information on health care spending in the country. The study's findings showed significant private health insurance spending in a country where all residents are covered by public health insurance. While all residents of Japan are covered by one of the public health insurance programs, most residents under age 75 incur a 30 percent copayment at the time of service. Private insurance companies offer policies that cover some of those copayments. "In our MEPS-J survey, we found that more than 70 percent of respondents had one of the private insurance policies, which cover part of the out-of-pocket payments," says Mitsutake. "The high rate of private insurance coverage was not previously known."
Mitsutake adds, "In Japan, the government has several datasets which are regularly surveyed, such as the Patient Survey, the Survey of Medical Institutions, and Medical Care Claims Survey." However, there were no panel design surveys that included health care utilization as well as health status over time. "We are very grateful to receive such important advice from AHRQ," he says.