title: Regional variations in medical expenditure and hospitalization days for heart attack patients in Japan: evidence from the Tokai Acute Myocardial Study (TAMIS).
abstract: In Japan, the use of percutaneous transluminal coronary angioplasty (PTCA) for the treatment of acute myocardial infarction (AMI) is extraordinarily frequent, resulting in large medical expenditure. Using chart-based data and exploiting regional variations, we explore what factors explain the frequent use of PTCA, employing propensity score matching to estimate the average treatment effects on hospital expenditure and hospital days. We find that the probability of receiving PTCA is affected by the density of medical resources in a region. Moreover, expenditure is higher for treated patients while there are no significant differences in hospitalization days, implying that the frequent use of PTCA is economically motivated.
authors.affiliation: Department of Theoretical Social Security Research, National Institute of Population and Social Security Research, Hibiya Kokusai Building 6th Floor, 2-2-3 Uchisaiwai-cho, Chiyoda-ku, Tokyo 100-0011, Japan. h.noguchi@ipss.go.jp
authors.forename: Haruko
authors.initials: H
authors.lastname: Noguchi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shimizutani
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Masuda
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000191:economics*; D017721:Hospital Costs; D006801:Humans; D007564:Japan; D007902:Length of Stay; D009203:Myocardial Infarction / Q000191:economics* / Q000601:surgery; D012111:Residence Characteristics