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      Preliminary Examination of an Appropriate Price Calculation Method and Medical Treatment Costs for Foreign Visitors in Japan

      research-article
      * , Study Group: Research on Appropriate Medical Treatment Prices for Foreigners Visiting Japan
      International Journal of Environmental Research and Public Health
      MDPI
      market price, health insurance, foreign patients, cost accounting, pharyngitis, external injury

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          Abstract

          This study proposes a method for calculating the appropriate medical treatment price level for foreign visitors (FVs) in Japan. Hospital management costs and foreign prices were analyzed from a market principles perspective to determine the medical treatment price. The study involved two stages: a preliminary survey and an extended survey, supplemented by an international survey. Relatively frequent diseases were selected, and the costs incurred by hospitals for the treatment of FVs were analyzed though data from three hospitals, covering 24 outpatients and 4 inpatients. Payments made by three insurance companies for overseas medical institution services for Japanese tourists with pharyngitis were analyzed. This study shows that the appropriate medical treatment prices for FVs, considering profits, were 1.22–4.26 times higher compared with prices under Japan’s public health insurance plans. Furthermore, these prices were 1.31–4.26 times higher for outpatients with pharyngitis and external injury and 1.22–3.66 times higher for inpatients with appendicitis and femoral fractures. The price of pharyngitis treatment in 12 countries was USD 20.32–158.75 per patient for Japanese tourists, whereas FVs paid 60.24 dollars (1.13 times higher than Japan’s public healthcare price) in Japan. This study shows it was appropriate to set the ideal price level for FVs higher than that for Japanese patients.

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          Most cited references17

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          Use and Misuse of Cost-Effectiveness Analysis Thresholds in Low- and Middle-Income Countries: Trends in Cost-per-DALY Studies

          Objectives To determine what thresholds are most often cited in the cost-effectiveness literature for low- and middle-income countries (LMICs), given various recommendations proposed and used in the literature to date, and thereafter to assess whether studies appropriately justified their use of threshold values. Methods We reviewed the contents of the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, a repository of all English language cost-per-disability-adjusted life-year averted studies indexed in PubMed. Our review included all catalogued cost-per-disability-adjusted life-year studies published from 2000 through 2015. We restricted attention to studies that investigated interventions in LMICs. Results Our analysis identified 381 studies (80%) focused on LMICs. Of these studies, 250 (66%) cited the World Health Organization’s 1 to 3 times gross domestic product per capita threshold. A full-text review of 60 (24%) of these articles (randomly selected) revealed that none justified use of this threshold in the particular country or countries studied beyond citing (generic) guideline documents. Conclusions Cost-effectiveness analysis can help inform health care spending, but its value depends on incorporating assumptions that are valid for the applicable setting. Rather than rely on commonly used, generic economic thresholds, we encourage authors to use context-specific thresholds that reflect local preferences.
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            An overview of the development and refinement of the Resource-Based Relative Value Scale. The foundation for reform of U.S. physician payment.

            Responding to distortions in payment rates between services, policymakers in the United States have sought a systematic and rational foundation for determining physician fees. One such approach to paying physicians, the Resource-Based Relative Value Scale (RBRVS), determines fees by measuring the relative resource costs required to produce them. On January 1, 1992, the Medicare program implemented a new payment system for physician services based on the RBRVS. This article provides a brief history of the RBRVS and a summary of the methods and data used to derive it. This overview represents the culmination of 6 years of research by the Harvard RBRVS study team and provides a road map to the study's concepts and definitions. The overview also provides a context for the articles in this issue that describe five major studies undertaken since 1988. The study's overall results are presented in the last article of the series.
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              Purchasing Power Parities and the Size of World Economies: Results from the 2017 International Comparison Program

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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                29 May 2021
                June 2021
                : 18
                : 11
                : 5837
                Affiliations
                Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; hehp-labo@ 123456umin.ac.jp
                Author notes
                [* ]Correspondence: ttakura@ 123456m.u-tokyo.ac.jp ; Tel.: +81-35-800-9523
                [†]

                Special note: Study group was a committee formed as part of a government-affiliated subsidy project, and held a number of discussions related to this research.

                Author information
                https://orcid.org/0000-0002-5987-9254
                Article
                ijerph-18-05837
                10.3390/ijerph18115837
                8199040
                34072299
                644dea84-a544-40fc-be71-abc62f7cfffd
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 12 April 2021
                : 27 May 2021
                Categories
                Article

                Public health
                market price,health insurance,foreign patients,cost accounting,pharyngitis,external injury

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