{"title":"New Medical Schools, Access to Physicians, and Health Outcomes: Evidence From Japan","authors":"Kisho Hoshi","doi":"10.1002/hec.70132","DOIUrl":null,"url":null,"abstract":"<p>We analyse the impact of the construction of medical schools and associated university hospitals in Japan during the 1970s, which was primarily driven by ‘One Prefecture, One Medical School Policy’ (OPOMS). We find that the number of physicians increased significantly in prefectures where a medical school was built, and this effect persisted for more than 20 years. Moreover, we uncover suggestive evidence that the establishment of university hospitals may lead to a reduction in the overall mortality rate, especially among the elderly. Our results also indicate that the improvement in health outcomes is likely attributed to access to high-quality care resulting from the opening of university hospitals, rather than an overall increase in the utilisation of healthcare services.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 11","pages":"1693-1733"},"PeriodicalIF":2.0000,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70132","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health economics","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hec.70132","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/8/3 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
Abstract
We analyse the impact of the construction of medical schools and associated university hospitals in Japan during the 1970s, which was primarily driven by ‘One Prefecture, One Medical School Policy’ (OPOMS). We find that the number of physicians increased significantly in prefectures where a medical school was built, and this effect persisted for more than 20 years. Moreover, we uncover suggestive evidence that the establishment of university hospitals may lead to a reduction in the overall mortality rate, especially among the elderly. Our results also indicate that the improvement in health outcomes is likely attributed to access to high-quality care resulting from the opening of university hospitals, rather than an overall increase in the utilisation of healthcare services.
期刊介绍：
This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems.
Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses.
Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.
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