Expenditures In Japan Research Articles

Hierarchical Bayes small‐area estimation with an unknown link function

AbstractArea‐level unmatched sampling and linking models have been widely used as a model‐based method for producing reliable estimates of small‐area means. However, one practical difficulty is the specification of a link function. In this paper, we relax the assumption of a known link function by not specifying its form and estimating it from the data. A penalized‐spline method is adopted for estimating the link function, and a hierarchical Bayes method of estimating area means is developed using a Markov chain Monte Carlo method for posterior computations. Results of simulation studies comparing the proposed method with a conventional approach based on a known link function are presented. In addition, the proposed method is applied to data from the Survey of Family Income and Expenditure in Japan and poverty rates in Spanish provinces.

Revealing the bilateral dependencies and policy implication of food production of Japan and China: From the perspective of Food-Energy-Water nexus

The world food price crisis in 2007/08 has aroused worldwide attention to the global food price volatility and food self-sufficiency issues. This paper modelled the entire environment of food production and transaction from a holistic view by a Food-Energy-Water (FEW) nexus in order to reveal the hidden connections related to the food self-sufficiency issue, including the interdependencies of food production with its restraining factors (hybrid energy, hybrid water), other production sectors, and international exchanges. This paper mapped all direct and indirect flows in the FEW nexus and projected a potential Emission Trading Scheme (ETS) to figure out the impacts of policies on FEW nexus flows, nexus robustness, total input of all sectors, and household expenditures in Japan and China. The results show that the pattern of food-related extraction flows was more imbalanced than the pattern of hybrid energy flows, due to the high dependence of Japan on the food supply of China (16.11% of total food-related extractions). An ETS may increase Japan’s total household expenditure on imported goods from China in the fields of sugar refining (1.3096%), processing vegetable oils and fats (0.1164%), processing of meat cattle (0.1010%), as well as slightly decrease the system robustness of the total nexus.

Financial Imbalances in Regional Disaster Recovery Following Earthquakes—Case Study Concerning Housing-Cost Expenditures in Japan

In the aftermath of the 1995 Kobe Earthquake, a large-scale effort towards reconstruction of houses damaged by the quake was required. This led to increased mortgage, thereby financially plaguing a number of earthquake victims and inhibiting their long-term sustainability and self-supported recovery. The current framework of housing reconstruction assistance provided by the Japanese government does not account for regional disparities in cost and other socioeconomic factors. This study proposes a technique for estimating the cost of reconstructing household units damaged in an earthquake by considering the effects of construction methods influenced by regional climatic zones. The financial constraints on rebuilding resources have been estimated by considering the annual regional income and household savings, as determined by social factors and employment opportunities. The susceptibility of regions to the occurrence of earthquakes has also been factored in the calculation of recovery costs. Together, these factors are used to provide a more complete picture of economic costs associated with earthquake recovery in different regions of Japan, thereby revealing large disparities in the difficulty and financial burden involved in the reconstruction of household units. Results of this study could be used to develop a robust system for earthquake-recovery assistance that accounts for differences in recovery costs between different regions, thereby improving the speed and quality of post-earthquake recovery.

Association Between Advanced Care Management and Progression of Care Needs Level in Long-Term Care Recipients: Retrospective Cohort Study.

BackgroundLong-term care insurance systems in Japan started a special senior care program overseen by qualified care managers (also known as advanced care managers). However, the relationship between advanced care management and outcomes in long-term care recipients remains unknown.ObjectiveWe aimed to compare the outcome of long-term care recipients using facilities with advanced care management and conventional care management, in terms of care needs level progression.MethodsWe conducted a retrospective cohort study using the Survey of Long-Term Care Benefit Expenditures in Japan. We identified those aged ≥65 years who were newly designated a care need level of 3, and received long-term care services between April 2009 and March 2014 in Tokyo. We compared survival without progression of care needs level between the groups, with and without advanced care management, using the Kaplan-Meier method. Factors affecting the outcomes were determined using a multivariable logistic regression model fitted with a generalized estimating equation.ResultsOf 45,330 eligible persons, 12,903 (28.46%) received long-term care based on advanced care management. The average duration of progression-free survival was 17.4 (SD 10.2) months. The proportions of five-year cumulative progression-free survival were 41.2% and 32.8% in those with and without advanced care management, respectively. The group with advanced care management had significantly lower care needs levels (odds ratio 0.77, 95% CI, 0.72-0.82, P<.001).ConclusionsAdvanced care management was significantly associated with improved care needs levels.

Comprehensive geriatric intervention program with and without weekly class-style exercise: research protocol of a cluster randomized controlled trial in Kyoto-Kameoka Study.

ObjectiveThe number of long-term care (LTC) users and the associated expenditures in Japan are increasing dramatically. The national government recommends LTC prevention through activation of communities. However, there is no clear evidence of the effect of population-based comprehensive geriatric intervention program (CGIP) for restraints of LTC users and the associated expenditures in the future. The aims of the current paper are to describe the study protocol and progress of a cluster randomized controlled trial (RCT) with a CGIP in Kameoka City.MethodsThe cluster RCT involved random allocation of regions as intervention (n=4,859) and nonintervention (n=7,195). Participants were elderly persons aged ≥65 years without LTC certification who had responded to a mailing survey. The residents living in intervention regions were invited to a physical check-up, and 1,463 people participated (30.3%). These individuals were invited to the CGIP, and 526 accepted. The CGIP comprised instructions on: 1) low-load resistance training using bodyweight, ankle weights, and elastic bands; 2) increasing daily physical activity; 3) oral motor exercise and care; and 4) a well-balanced diet based on a program from Ministry of Health, Labour and Welfare. We allocated the intervention regions randomly into home-based self-care program alone (HB group, 5 regions, n=275) and home-based program+weekly class-style session (CS group, 5 regions, n=251). We evaluated the effects of the CGIP at 12 weeks and at 12 or 15 months on physical function, and are conducting follow-up data collection for an indefinite period regarding LTC certification, medical costs, and mortality.Results and discussionThe study was launched with good response rates in each phase. Participants of both groups significantly increased their step counts by ~1,000 per day from the baseline during the CGIP. This RCT will provide valuable information and evidence about effectiveness of a community-based CGIP.

Estimated expenditures for hip fractures using merged healthcare insurance data for individuals aged \u2265\u200975 years and long-term care insurance claims data in Japan

SummaryLittle is known about hip fracture expenditure in Japan. Using claims data obtained from a core city near Tokyo, we estimated the mean healthcare expenditure and monthly long-term care expenditure post-hip fracture to be ¥2,600,000 (US$29,500) and ¥113,000 (US$1290), respectively.PurposeWe aimed to estimate healthcare and long-term care expenditures post-hip fracture in Japan.MethodsHealthcare insurance claims data for adults aged ≥ 75 years were merged with long-term care insurance claims data. We analyzed the data of hip fracture patients who were admitted to non-diagnosis procedure combination/per-diem payment system (DPC/PDPS) hospitals in a core city near Tokyo between April 2012 and September 2013. We estimated healthcare expenditure, namely, the difference between total payments 6 months pre- and 6 months post-hip fracture, and monthly long-term care expenditure for those who did not use long-term care insurance pre-hip fracture, but who commenced long-term care insurance post-hip fracture. We also performed multiple linear regressions to examine the associations of healthcare or long-term care expenditure with various factors.ResultsThe estimated mean healthcare (n = 78) and monthly long-term care (n = 42) expenditures post-hip fracture were ¥2,600,000 (US$29,500) and ¥113,000 (US$1290), respectively. In multiple linear regressions, healthcare expenditure was positively associated with longer duration of hospital stay (p = 0.036), and negatively associated with higher Charlson Comorbidity Index scores (p = 0.015). Monthly long-term care expenditure was positively associated with higher care-needs level post-hip fracture (p = 0.022), and usage of institutional care services (p < 0.001).ConclusionsThis is the first study to estimate healthcare and long-term care expenditures post-hip fracture using claims data in Japan. Further studies are needed that include healthcare claims data at both DPC/PDPS and non-DPC/PDPS hospitals to capture the lifelong course of long-term care required post-hip fracture.

Characteristics of R&amp;D expenditures in Japan's pharmaceutical industry

Characterized by a high level of R&D expenditure, pharmaceutical firms are also subject to specific risks that are reflected in their financial policies. In contrast to other firms, whose investments are directly related to internal cash flows, Japanese pharmaceutical companies do not appear to rely on this source of funds to undertake R&D investments. Our analysis reveals that R&D expenses largely depend on the firm's size and the strength of its balance sheet. More precisely, high levels of debt appear to hold back R&D expenditure, especially when debt has a short-term maturity. These results highlight the importance of funding risky investments with the adequate type of capital to avoid putting firms in financial distress. Despite the risk, R&D investments seem to be justified by the fact that they are generally associated with higher sales growth. However, the difficult conditions prevailing in Japan's pharmaceutical industry make these benefits less visible.

Small area estimation via unmatched sampling and linking models

The authors use an empirical Bayes (EB) approach to small area estimation under area-level unmatched sampling and linking models. Model parameters are estimated by a unified expectation and maximization (EM) algorithm and used to obtain EB estimators of area parameters. Results are extended to a nonparametric linking model based on a spline approximation. Approximate EB estimators that are computationally simpler are also obtained. Different bootstrap approaches to estimating the mean squared error (MSE) of the EB estimators are proposed. Results of a simulation study on the performance of the proposed methods are presented. Proposed methods are applied to data from a survey of family income and expenditure in Japan and poverty rates in Spanish provinces.

Should co-payments for financially deprived patients be lowered? Primary care physicians\u2019 perspectives using a mixed-methods approach in a survey study in Tokyo

BackgroundJapan’s stagnant economy has produced increasing income disparities, and the effect of poverty on health and health-care utilization is a significant issue. Co-payments could be a trade-off for patients when seeking medical care and limit health-care utilization. We sought primary care physicians’ experiences in dealing with financially deprived patients and their perspectives about reducing co-payments by low-income patients.MethodsWe used a convergent mixed-methods approach in a mail survey; it was distributed to 1989 primary care physicians practicing in areas with the highest proportions of socially disadvantaged individuals in Tokyo. The survey items included an open-ended question, seeking the participants’ perspectives about reducing co-payments by low-income patients from the current 30%, and closed questions, asking their experience of patient behavior related to financial burdens during the previous 6 months.ResultsWe analyzed the responses of 365 physicians. Sixty-two percent of the primary care physicians agreed with lowering co-payments for financially deprived patients; however, the remainder disagreed or were uncertain. Those who disagreed were less likely to have experienced patient behavior related to financial burdens. The participants suggested challenges and potential measures for reducing co-payments by low-income patients in light of tight governmental financial resources and rapidly increasing health-care expenditures in Japan. The physicians were also concerned about the moral hazard in health-care utilization among patients receiving social welfare who obtain care at no cost.ConclusionsFrom their experience in having dealt with low-income patients, the majority of physicians were positive about lowering co-payments by such patients; the remainder were negative or uncertain. It may be necessary to raise awareness of patients’ socioeconomic status among primary care physicians as a possible deterrent for seeking care. To maintain health-care equity, policy makers should consider balancing co-payments among individuals with differing financial levels and health-care needs.

The relationship between globalisation and military expenditures: evidence from Eastern Asia

This study explores the causal linkages between military expenditure and globalisation in seven Eastern Asian countries (China, Japan, Korea, Malaysia, the Philippines, Singapore, and Thailand) by analysing the seven countries for the period 1989–2012. Panel causality was examined to explain dependency and heterogeneity across countries. The results of one-way Granger causality show that globalisation influenced military expenditures in Japan, Korea, and Thailand. Moreover, military expenditure caused globalisation only in Singapore. However, the result shows that there is no causal interaction between globalisation and military expenditure in any of the studied Eastern Asian countries. The findings of this study could provide important policy implications for the Eastern Asian countries under study.

The Effect of Central Grants Reform on Local Government Expenditures in Japan: A Demand System Approach

The Effect of Central Grants Reform on Local Government Expenditures in Japan: A Demand System Approach

A NEW HEALTH TECHNOLOGY ASSESSMENT SYSTEM FOR JAPAN? SIMULATING THE POTENTIAL IMPACT ON THE PRICE OF SIMEPREVIR.

Japanese authorities have announced a plan to introduce a health technology assessment (HTA) system in 2016. This study assessed the potential impact of such a policy on the price of the antivirologic drug simeprevir. Taking the antivirologic drug simeprevir as an example, we compared the current Japanese price with hypothetical prices that might result if a U.K. (cost-utility) or German (efficiency frontier) style HTA assessment was in place. The simeprevir unit price under the current Japanese pricing scheme is 13,122 Japanese yen (equivalent to 109.35 U.S. dollars as of April 2015). Depending on the selection of comparators and the pricing method, and assuming that HTA will be used as a basis for price setting, the estimated prices of simeprevir vary up to four times higher than under the current Japanese pricing scheme. Although the analysis is based on only one drug, it cannot be taken for granted that a new HTA system would reduce public healthcare expenditure in Japan.

An Empirical Analysis of Local Public Cultural Expenditures in Japan

An Empirical Analysis of Local Public Cultural Expenditures in Japan

How do household characteristics affect appliance usage? Application of conditional demand analysis to Japanese household data

Although both appliance ownership and usage patterns determine residential electricity consumption, it is less known how households actually use their appliances. In this study, we conduct conditional demand analyses to break down total household electricity consumption into a set of demand functions for electricity usage, across 12 appliance categories. We then examine how the socioeconomic characteristics of the households explain their appliance usage. Analysis of micro-level data from the Nation Survey of Family and Expenditure in Japan reveals that the family and income structure of households affect appliance usage. Specifically, we find that the presence of teenagers increases both air conditioner and dishwasher use, labor income and nonlabor income affect microwave usage in different ways, air conditioner usage decreases as the wife's income increases, and microwave usage decreases as the husband's income increases. Furthermore, we find that households use more electricity with new personal computers than old ones; this implies that the replacement of old personal computers increases electricity consumption.

A Re-examination of the Consumption-based Capital Asset Pricing Model: The Case of US and Japan

This paper re-tests the classic consumption-based capital asset pricing model (CCAPM) by extending US quarterly samples and adding the Japanese case. Using the generalized method of moments (GMM) methodology developed by Hansen and Singleton (1982), we obtain the following findings. (1) First, in the case of the CCAPM with consumption for nondurable goods in the US, the discount rate parameters generally show plausible values; however, the risk aversion parameters show unstable values in general. Further, by the J -tests, the estimated CCAPMs with consumption for nondurable goods in the US are always supported. (2) Second, in the case of the CCAPM with consumption for nondurable goods and services in the US, although the parameters of discount rate generally show plausible values, the risk aversion parameters are unstable. In addition, judging the results of the J -tests, all estimated CCAPMs with consumption for nondurable goods and services in the US are supported. (3) Finally, as for the CCAPM with private final consumption expenditures in Japan, the parameters of discount rate take plausible values; on the other hand, the risk aversion parameter values are unstable in general. Regarding the model validity, our estimated CCAPMs for Japan are mostly supported by the J -tests.

Japanese Social Expenditure under Rapid Population Ageing

Japan is suffering from low fertility for more than two decades, and Japanese social security system needs a structural reform to be more effective and sustainable. In this paper, we discussed structural issues in the Japanese social security system, which will provide the basis for containing social expenditure in Japan. Some Japanese benefits, such as child-rearing support and benefit for low income families as well as long-term care benefit, need to be increased. On the other hand, it is important to incorporate right incentives in the system for healthcare and LTC services, and new forms of solidarity are indispensable to make Japanese social security system sustainable.

Attitudes toward Education Expenditures in Japan: Comparisons with Social Security and Welfare Services Expenditures

This paper examines people’s attitudes toward public spending on education in Japan. It is well known that Japan has the smallest public education expenditure relative to GDP among the OECD countries, and this may yield unequal opportunities in education. The tax burden in Japan is small compared to those in OECD countries, and there may be no room to distribute public spending on education without a tax increase. The following three issues should be considered concurrently: people’s attitudes toward public expenditure on education, people’s attitudes toward the balance between tax burden and public services, and people’s trust in the government. In order to find simple patterns in these attitudinal responses, latent-class analysis was employed using data captured through the Japanese General Social Surveys conducted in 2010. As a result, four latent classes were found. The largest class accounted for over 40% of the sample, and members of this group think that the government should increase public expenditure on education and social security, even if tax increases are required. The same group, however, distrusted the government. Trust in small-government policy seemed to be weak among the Japanese people, because in all the latent classes, the majority of people wanted the government to improve public services, even if this would require tax increases. However, those who preferred no improvement in public services and did not trust the government were more likely to have a lower-level socioeconomic background, even though they would be the beneficiaries of those services. People who did not have children were less likely to agree with increasing public expenditure on education, because among the Japanese people, child-birth and child-rearing might be considered individual rather than social issues.

Health-care expenditure, GDP and share of the elderly in Japan: a panel cointegration analysis

By employing a panel data set of 47 prefectures in Japan, this article investigates the cointegrating relationship between health-care expenditure, GDP and population share of the elderly by using panel cointegration tests developed by Pedroni (1999). Our empirical result shows that there is a cointegrating relationship between the three variables. We also estimate the effects of GDP and share of the elderly on health-care expenditure by employing the group-mean fully modified ordinary least-squares (FMOLS) method of Pedroni (2001) and find that the coefficient on the share of the elderly is positively significant. These findings highlight the importance of addressing the issue of an ageing society to curb rising health-care expenditures in Japan.

Trends and Determinants of Social Expenditure in Korea, Japan and Taiwan

AbstractSocial expenditure analyses have always been a central topic of research for welfare states in Western Europe, with more institutional approaches added to such studies later in time. Research on welfare states in Japan, South Korea and Taiwan, on the contrary, has a shorter history, and attention has been paid more on understanding politico‐economic institutions on a case‐by‐case basis, instead of focusing on social expenditure causes and dynamics. This study aims to contribute to the literature with an up‐to‐date comparative perspective in the study of public social expenditures in Japan, South Korea and Taiwan, in a two‐fold way. First, after discussing briefly the state of art of research on welfare in East Asia, descriptive data on public social expenditure trends in Korea, Japan and Taiwan are presented in comparison with industrialized welfare states in the West. Second, a pooled cross‐sectional regression analysis for panel data is run to uncover the determinants of social expenditure in Korea, Japan and Taiwan. A new comparative dataset has been constructed by merging secondary data on public social expenditures and socio‐economic and political variables made publicly available by the Organisation for Economic Co‐operation and Development, the World Bank, the Asian Development Bank and the Taiwanese national government. Results seem to suggest that there is a serious need of better conceptualizing political determinants of welfare expenditures in East Asia, since they will probably represent the most important field for welfare development in these countries in years to come.

Japan׳s prefectural digital divide: A multivariate and spatial analysis

This study of the digital divide within Japan utilizes data from the country׳s 47 prefectures for multivariate and spatial analysis of distributions of information and communication technology (ICT) variables. The paper constructs an exploratory conceptual model of technology utilization and expenditures in Japan, induced from prior literature. Ten dependent ICT utilization and expenditure factors are posited to be related to 12 independent demographic, economic, infrastructure, education, innovation and openness factors. The relationship of the independent to dependent factors is moderated by analysis of spatial patterns of technology utilization to examine proximities and reduce spatial bias. Based on the model, a multivariate analysis identifies correlates of the nation׳s digital divide, including patents registered by Japanese citizens, newspaper circulation, students and pupils per capita, household expenditures on education, rural/urban status, and Japan׳s aged population structure which has wide generational gaps. Spatial clusters and outliers of ICTs in prefectures are analyzed, with attention to their policy impacts. Findings suggest modifications to the conceptual model. Implications of findings for the country׳s official national technology planning policies are considered and recommendations made to expand them.