mini传媒

Published on December 24, 2020
Job titles and other details are as of the time of publication.
(The interview was conducted in Japanese and was thereafter translated into English.)

Utilizing big data in the healthcare and nursing care sectors to formulate healthcare policy

My main research themes are healthcare policy and health economics. In this field, I have conducted empirical analyses on various topics, including estimating the effects of medical insurance policies, labor markets in healthcare and nursing care, payment systems for hospitals, regional healthcare policies at the local government level, and medical insurance financing.

The healthcare and nursing care sectors have already entered an era where vast amounts of data are ready to be utilized (the era of big data). I continue my research with the aim of utilizing this valuable social resource to formulate policies in collaboration with researchers in the adjacent fields of epidemiology, medical sociology, and political science.

When I first began my research in this field, there was a significant divide between healthcare experts and economics experts. However, the global pandemic caused by COVID-19 rapidly narrowed that divide.

I serve as a healthcare policy advisor to the Tokyo Metropolitan Government, and attend meetings related to healthcare policy in Tokyo. Through meeting discussions with practicing physicians, I sense a significant demand for economic approaches. I will later share the specific requests of the physicians.

Identifying my research theme from the perspective of what society needs

Truth be told, my encounter with economics was almost accidental.

While studying at the Faculty of Commerce at the university, I spent my early years as a literary youth, belonging to a literature club. In a moment of youthful folly, I even wrote and submitted an unreadable novel to a literary magazine. However, since I was not confident in my ability to thrive in a literary world, I sought an area that I could dedicate myself to, and that is when I encountered economics. As I worked on assignment papers in my economics classes, I became deeply engrossed by the field.

The process of crafting a grand narrative toward a conclusion, structuring chapters, and creating a lively writing style to engage readers was enjoyable, whether for a novel or an academic paper. I found joy in this endeavor and was eager to learn more. In my third year, I joined an economics study group focused on the theme of social security.

For someone who had given up on literature, the crucial question I had to ask was, “What does society need?” It was already clear at the time that, despite being the world’s leading advanced aging society, Japanese research in this area had fallen behind. This underscored the pressing societal need for such research.

I was convinced that by putting forth my best effort, I could conduct research and write papers that would be beneficial to Japan. I therefore chose social security and decided to study the healthcare and nursing care sectors from an economic perspective.

Overcoming the adversity of limited data and references, inspired by a Proust aphorism

At the outset of my research, I struggled with the limited availability of healthcare-related data.

Most of the raw data before aggregation was retained by the government, and researchers could only access aggregated data. I found the papers using the aggregated data less impactful than papers from abroad. Furthermore, since the data from medical expense statements are maintained by local governments, negotiations to access the data were always challenging.

In Sweden, for instance, not only statements of medical expenses, but also individual income information is available for research purposes. In Taiwan, healthcare data can be integrated with demographic data and various household information. In contrast, Japan did not collect data in a way that made it available for policymaking.

Given these circumstances, I focused my master’s thesis not on “healthcare,” but on “nursing care and labor” as it was an easier topic to collect data on. Although writing my master’s thesis under such conditions was frustrating, the publication of my thesis allowed me to transition to the Institute for Health Economics and Policy at the age of 27, and I was finally able to access a variety of data.

With an environment for easy data collection in place, my next challenge was to write compelling papers. Due to the limited number of researchers in the field of health economics in Japan, there was a lack of accumulated know-how and expertise on how to effectively share Japanese insights internationally. While diligently writing papers, I spent my days unable to shake off the anxiety of whether researchers abroad would value my papers.

As an aside, when I face challenging times—at that time and even now—reading classical literature serves as a source of solace. I often revisit Marcel Proust’s In Search of Lost Time, which I saved my pocket money to buy during high school. One of the book’s many aphorisms is “Love is space and time measured by the heart.” Compared with Baruch Spinoza’s “Love is a joy accompanied by the idea of an external cause,” Proust’s words stand out in defining the essential emotion as separate from the “object” that exists outside oneself. Even when my research is not going well and the “object” feels to be slipping away, these words gently remind me to come back to myself.

In my late twenties, a time of considerable anxiety, this aphorism became an important source of inspiration as I sought to regain my motivation.

Both researchers around the world and policymakers in Japan are eager for insights from health economics research

Returning to the main point, I am convinced, despite my anxiety, that there is a demand for research in health economics both in Japan and internationally. As an advanced aging society, Japan has the largest database in the world, at least in terms of sample size. If we can integrate other datasets and promote their utilization, we will be able to conduct research with a significant international impact. There is keen anticipation worldwide for the findings of this research.

Research that gains international recognition will eventually reach policymakers in Japan through various media. If it becomes widely recognized that the challenges Japan faces are common to countries around the world, policymakers will be motivated to vigorously engage in healthcare policy. I believe that framing research findings in this way is a key responsibility of researchers.

Fortunately, the state of data utilization in Japan has improved over the past five to ten years. There has been an increase in collaborations where supervising professors in the field of health economics work with graduate students and junior researchers to collect data.

Historically, the fields of healthcare and social sciences, including economics, have had different outlets for publishing research papers. This separation has hindered the establishment of collaborative relationships that leverage insights from both fields. Even when valuable data is available in medicine or public health, it often remains overlooked by economists. Conversely, while economists are highly motivated to study changes in human behavior, they may not prioritize the implications for healthcare settings or policies, and they may miss opportunities for collaboration as a result.

Given the pressing issue of an aging population, however, an increasing number of researchers, including those in economics, recognize more than ever the need to understand adjacent fields such as public health and the implications (i.e., potential impacts) for policy and societal relevance.

Healthcare challenges posed by the pandemic can no longer be viewed as someone else’s problems in the context of economics

Unexpectedly, the onset of the COVID-19 pandemic in 2020 further narrowed the divide between the healthcare and economics sectors. For instance, questions regarding the economic consequences of infection control measures and the costs arising from safety protocols required joint contributions from the two sectors.

In Japan, many hospitals are private entities, creating an urgent need for their operational conditions to be analyzed. As a healthcare policy advisor to the Tokyo Metropolitan Government, I am currently examining data entrusted to me by the government. For economists, the current state of Japan’s healthcare system during the pandemic is no longer someone else’s problem.

The pandemic may prove to be an opportunity for health economics to develop into a more interdisciplinary field. I personally envision a discipline where researchers from diverse backgrounds contribute their intellectual resources under the theme of “What can we discern from the data?”

As I mentioned at the outset, the healthcare and nursing care sectors have already entered the era of big data. While more data continues to be generated, it is essential to nurture more researchers capable of data analysis in order to avoid this data from becoming a “buried resource.”

While the immediate challenges presented by the pandemic are significant, Japan also faces the fundamental issue of an aging population. The peak of this aging trend is projected for 2040. Young researchers in their twenties today will be in their prime by then, with numerous opportunities to thrive as experts in health economics.

I hope to see a growing number of young researchers who can rise to the challenges of both Japanese society and the global community.