Resource utilization in surgery after the revision of surgical fee schedule in Japan

Int J Health Care Qual Assur. 2015;28(6):635-43. doi: 10.1108/IJHCQA-01-2015-0002.


Purpose: The purpose of this paper is to examine whether the current surgical reimbursement system in Japan reflects resource utilization after the revision of fee schedule in 2014.

Design/methodology/approach: The authors collected data from all the surgical procedures performed at Teikyo University Hospital from April 1 through September 30, 2014. The authors defined the decision-making unit as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of medical doctors who assisted surgery, and the time of operation from skin incision to closure. An output was defined as the surgical fee. The authors calculated surgeons' efficiency scores using data envelopment analysis.

Findings: The efficiency scores of each surgical specialty were significantly different (p=0.000).

Originality/value: This result demonstrates that the Japanese surgical reimbursement scales still fail to reflect resource utilization despite the revision of surgical fee schedule.

Keywords: Efficiency; Fee schedule revision; Japan; Resource efficiency; Surgeons’ efficiency; Surgical reimbursement system.

MeSH terms

  • Efficiency, Organizational
  • Fee Schedules*
  • Humans
  • Insurance, Health, Reimbursement / economics
  • Insurance, Health, Reimbursement / statistics & numerical data*
  • Japan
  • Medicine / statistics & numerical data*
  • Operating Rooms / economics
  • Operating Rooms / statistics & numerical data*
  • Surgical Procedures, Operative / economics
  • Surgical Procedures, Operative / statistics & numerical data*