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  6. Frequency of Medical Service Usage and Perceived Weight of Medical Bills

Frequency of Medical Service Usage and Perceived Weight of Medical Bills:

Simulation of elderly income, medical demand, and perceived weight

April 2013
Senior Research Associate Toshiaki Kouno
Part-time lecturer, Komazawa University Department of Economics



This paper uses individual data(*1) from health surveys conducted on elderly people to determine the factors which cause them to feel that medical fees are burdensome; simulations were run using this data. Taking into consideration the endegeneity between the two variables of medical service usage frequency and perceived weight of medical bills, the method of two-stage least squares was used, and the relationships among usage frequency, income level, meaningful living, and subjective health level were made clear. The results of the mathematical analysis show that: increased usage frequency increases perceived weight of bills; medical services are superior goods and so higher income leads to more frequent use; subjective health level affects usage frequency, but does not directly affect perceived weight of bills; and elderly people who do not have a raison d’etre use medical services more than those who do. Based on the above results, a simulation was performed to determine what a super-aged society of 2030 might look like, as well as how changes in meaningful living and health levels would affect the perceived burden of medical bills. The simulation suggests that people’s health will continue to bipolarize; the number of elderly who are unable to work for health reasons will increase from 890,000 to 1,630,000, and creating somewhere for them to go is an important issue; and more elderly people will feel burdened by medical bills.


  • (*1) The data used in this report were obtained from a study by the Cabinet Office’s Director-General for Policies on Cohesive Society entitled “Health surveys conducted on elderly people”; the study was provided by the Social Science Japan data archive at the Center for Social Research and Data Archives, Institute of Social Science, University of Tokyo.

More Information

  • The full text is unavailable in English for this report.
    The original Japanese full text is here [912 KB].