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

Yoshinori Nakata (Teikyo University, Tokyo, Japan)
Tatsuya Yoshimura (Department of Anesthesia, Shin-Yurigaoka General Hospital, Kawasaki, Japan)
Yuichi Watanabe (Graduate School of Public Health, Teikyo University, Tokyo, Japan)
Hiroshi Otake (Department of Anesthesiology, Showa University School of Medicine, Tokyo, Japan)
Giichiro Oiso (Hamamatsu University School of Medicine, Hamamatsu, Japan)
Tomohiro Sawa (Medical Information and System Research Center, Teikyo University, Tokyo, Japan)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 13 July 2015



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.


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.


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


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



Nakata, Y., Yoshimura, T., Watanabe, Y., Otake, H., Oiso, G. and Sawa, T. (2015), "Resource utilization in surgery after the revision of surgical fee schedule in Japan", International Journal of Health Care Quality Assurance, Vol. 28 No. 6, pp. 635-643.



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