| Title | Medical Schools, Access to Doctors, and Health Outcomes: Evidence from the "One Prefecture, One Medical School Policy" in Japan |
| Date | June 04, 2020 (Thursday) 16:30-18:00 |
| Location | via Zoom |
| Abstract | Geographical inequality in access to doctors has been a long-standing problem in many countries. Even though various policies have been implemented to provide more doctors to doctor-scarce areas, empirical evidence on the effectiveness of such policies is at best mixed, and we know surprisingly little about the impacts of these policies on health outcomes. In this research, taking advantage of a unique policy intervention in Japan called the "One Prefecture, One Medical School Policy" implemented in the 1970s, I investigate the effects of establishing a medical school and an associated university hospital on access to doctors and mortality rates in targeted prefectures. To estimate causal effects, I use newly digitized prefecture-level panel data from 1960 to 1999 and employ an event study and the difference-in-differences method. My findings are two-fold. First, the establishment of a medical school and a university hospital together increased the number of doctors per capita in treated prefectures, closing 87% of the gap that existed between treated and control prefectures before the policy intervention. Second, the mortality rates in treated prefectures began to decline, not when a university hospital was established but when new medical graduates began to work as interns at the hospital, closing 26% of the pre-intervention gap between the treated and control prefectures. Cause-specific mortality analyses further indicate that such mortality effects were limited to acute and intractable diseases. The timing of the decline in mortality rates suggests an important complementarity between high-tech hospital facilities and newly trained human capital. |
| Paper | |
| Slide | |
| Note | Registration link: https://zoom.us/webinar/register/WN_JrUYXJqeTwOin9_zzTAnvg |