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首页> 外文期刊>Journal of the Japanese and International Economies >Gatekeeper incentives and demand inducement: An empirical analysis of care managers in the Japanese long-term care insurance program
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Gatekeeper incentives and demand inducement: An empirical analysis of care managers in the Japanese long-term care insurance program

机译：关门人激励和需求诱因：日本长期护理保险计划中护理经理的实证分析

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摘要

This study analyzes the incentives and supplier-induced demand of care managers, who are intermediaries between consumers and service providers in the Japanese social insurance program for long-term care. Care managers can be considered as pure gatekeepers, in that their function is limited to referral people to specialists and they themselves do not provide care. Care managers are rewarded by capitation, which is considered as a cost-effective payment mechanism for insurers. However, many care managers actually work for firms that also operate as service providers. Service providers are rewarded by a fee for-service payment and can have a motivation to induce excess consumer demand. The violation of the neutrality of care managers might result in a financial burden on social insurance. In this study, we empirically test whether there is a positive correlation between care manager density and care costs, which might imply the existence of supplier-induced demand. Our results show a positive correlation, particularly in the case of care managers who work for firms that jointly operate in service provision sectors. Based on these results, we conduct a quantitative analysis, and show that the demand induced by care managers might produce a considerable financial burden on social insurance. (C) 2016 Elsevier Inc. All rights reserved.
机译：这项研究分析了护理经理的激励机制和供应商引起的需求，这些经理是日本社会保险计划中长期护理的消费者和服务提供者之间的中介。护理经理可以被视为纯粹的看门人，因为他们的职能仅限于将人员推荐给专家，而他们本身并不提供护理。护理人员会因人头而获得奖励，人头被认为是保险公司的一种经济高效的支付机制。但是，实际上许多护理经理都为同时充当服务提供者的公司工作。服务提供商将获得一定的服务费报酬，并且可能会诱使过度的消费者需求。违反护理经理的中立性可能会给社会保险造成财务负担。在这项研究中，我们通过经验检验护理经理的密度和护理成本之间是否存在正相关，这可能暗示着供应商诱发的需求的存在。我们的结果显示出正相关，特别是在为在服务提供部门共同经营的公司工作的护理经理的情况下。基于这些结果，我们进行了定量分析，结果表明护理经理引起的需求可能会对社会保险产生可观的财务负担。 （C）2016 Elsevier Inc.保留所有权利。

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