Effect of Regional Cooperation on Efficiency of Medical Care Delivery in Secondary Medical Areas of Japan

The Japanese population is aging and requires regional health facilities to cooperate to use medical resources efficiently. This study evaluated the impact of regional cooperation on the efficiency of medical care delivery in secondary medical areas. The discharge adjustment implementation rate of each secondary medical area was used as a proxy for regional cooperation. The study data were obtained from publicly available sources. The efficiency scores of secondary medical areas were calculated using the input-oriented Banker–Charnes–Cooper model for Data Envelopment Analysis. The inputs used were the number of general beds and the average length of hospital stay for each secondary medical area. The outputs used were the number of discharged patients and inpatient medical expenses per person. In addition, the relationship between discharge adjustment implementation rates and efficiency scores were assessed using tobit multiple regression analysis. The models were adjusted for the 7 variables. Ten secondary medical areas had an efficiency score of 1.00 (i.e., highest efficiency). Tobit regression analysis was performed on the 340 secondary medical areas for which efficiency scores were obtained. The discharge adjustment implementation rates and efficiency scores were significantly positively correlated (p = 0.032). While studies that quantitatively evaluate regional cooperation and efficiency are limited, these findings suggest that implementing regional cooperation may improve the efficiency of medical care delivery in secondary medical areas.