[Deterioration of Healthcare Service Quality Provided by Occupational Physicians Due to Dumping by Health Checkup and Switching Health Checkup Organizations].

Q3 Medicine
Minoru Sugita, Toshihiro Kawamoto, Masayuki Tatemichi, Yuichi Miwa, Hiroshi Kurihara, Toshio Sasaki, Michiko Miyakawa
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引用次数: 0

Abstract

Introduction: From 2007, competitive bidding for procurement became widely employed by the Japanese Government, and health check providers for government workers are selected every year by this method. Deterioration of health check quality due to excessive price competition is a serious concern. The National Federation of Industrial Health Organization (Zeneiren) conducted an investigative research on the contracting of health check providers and occupational physicians in workplaces in 2015-2016 in an effort to prevent low-cost but low-quality health checks. The report of the research is available on the homepage of Zeneiren. In this paper, we provide a brief overview of the report, and deterioration of health check quality due to dumping by and switching of health check providers is discussed from economic and legal viewpoints.

Method: Information was obtained from articles in print and on the Internet.

Results: A questionnaire survey of health check providers revealed that excessive discounts due to both competitive bidding and demand from companies commissioning health checks occurred on a routine basis, and some providers were concerned about worsening business conditions in the future. In a separate questionnaire survey of occupational physicians, it was discovered that they were able to evaluate the quality of health checks, whereas administrative officials responsible for selecting the providers were seldom able to adequately evaluate the health check quality, resulting in contracting providers of questionable quality, which in turn caused considerable dissatisfaction on the part of occupational physicians. Moreover, when health check providers were switched, the reporting format of health check results changed. The physicians did not favor such a change because of the considerably increased workload involved in coordinating past and current data and the risk of decreased occupational health service quality.

Discussion: Dumping makes the management of health check providers very difficult and is a cause of loss of social capital. If health check providers of good quality withdraw from the market, the supply of high-quality health checks decreases. This corresponds to external diseconomy caused by dumping on the part of the health check providers and loss of social surplus (economic surplus).

Conclusions: To avoid deterioration of occupational health service due to low-quality health checks and changes in the reporting format, occupational physicians must actively engage in the selection of health check providers of good quality.

【因体检倾倒和体检机构转换导致职业医师医疗服务质量下降】。
导言:从2007年开始,日本政府广泛采用竞争性招标采购方式,每年都采用这种方式为政府工作人员选择健康检查提供者。过度的价格竞争导致的体检质量恶化是一个严重的问题。全国工业卫生组织联合会(Zeneiren)在2015-2016年开展了一项调查研究,调查工作场所的健康检查提供者和职业医生的签约情况,以防止低成本、低质量的健康检查。该研究报告可在Zeneiren的主页上找到。本文对该报告进行了简要概述,并从经济和法律的角度对健康检查提供者的倾销和转换导致的健康检查质量的恶化进行了讨论。方法:资料来源于印刷品和网络。结果:对健康检查提供者进行的问卷调查显示,由于竞争性招标和委托健康检查的公司的需求,过高的折扣经常发生,一些提供者担心未来的商业状况会恶化。在对职业医生进行的另一项问卷调查中发现,他们能够评估健康检查的质量,而负责选择提供者的行政官员很少能够充分评估健康检查的质量,从而导致签约质量可疑的提供者,这反过来又引起职业医生的极大不满。此外,当切换运行状况检查提供者时,运行状况检查结果的报告格式也会发生变化。医生们不赞成这样的改变,因为要协调过去和现在的数据,工作量大大增加,而且有降低职业卫生服务质量的风险。讨论:倾销使健康检查提供者的管理非常困难,是社会资本损失的一个原因。如果高质量的健康检查提供者退出市场,高质量的健康检查的供应就会减少。这与健康检查提供者的倾销和社会剩余(经济剩余)的损失造成的外部不经济相对应。结论:为避免因健康检查质量低和报告格式改变而导致职业卫生服务恶化,职业医师必须积极参与选择质量好的健康检查提供者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Japanese Journal of Hygiene
Japanese Journal of Hygiene Medicine-Medicine (all)
CiteScore
0.90
自引率
0.00%
发文量
7
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