Background: To drill down into why per capita health expenditures vary
between the US and Japan, this exploratory
study compares the price, volume and composition of services provided to
inpatients for two procedures in an academic hospital in the US, and one in
Japan. Methods: Detailed analysis of the amount reimbursed and services
delivered was made from claims data for 449 acute myocardial infarction treated
with coronary stents placed by percutaneous coronary intervention (PCI) and
115 heart valve dysfunction with heart valve replacement (HVR) cases in
Johns Hopkins Hospital (JHH) Baltimore, Maryland, and 34 PCI and 21 HVR cases
in Keio University Hospital (KUH), Tokyo. Results: After making appropriate adjustments, the reimbursed amount per discharge at JHH was significantly higher (Wilcoxon ranksum test, p < 0.01) for both medical conditions. This was due to more use of higher
priced technology and higher prices for the same technology at JHH compared
with KUH. However, medical imaging was performed more frequently at KUH and the
reimbursed amounts per unit for the devices were higher at KUH. Analysis of
room and board costs showed that the higher staffing level and wages of nurses
at JHH was compensated by its shorter average length of stay for PCI, but not
for HVR. Conclusion: Detailed analysis of the reimbursed amount and the
utilization of services are needed to understand
international variations in healthcare spending.
Cite this paper
Inokuchi, T. , Ikegami, N. , Gupta, V. , Rao, S. and Anderson, G. (2013) Comparison of price, volume and composition of services provided to inpatients for two procedures between a US and a Japanese academic hospital. Health
, 703-711. doi: 10.4236/health.2013.54093
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