Evaluation of the Performance of Health Systems by Prefecture

Abstract

OBJECTIVES: To clarify the performance of health systems (performance), the state of prefectures was investigated. METHODS: Using the method developed by the Organisation for Economic Co-operation and Development, we conducted the study using 27 indicators. To evaluate the performance, we examined the signal-to-noise ratio of transcription (η) by integrating indicators using the Mahalanobis-Taguchi method. The η was separated by a median. The ratio of prefectures in East or West Japan and the presence or absence of ordinance-designated cities were studied using the chi-square test. Furthermore, the correlation among the total component η (T-η), each component η, and expenditures, and the correlation between T-η and life expectancy, were studied. RESULTS: The T-η positively correlated with the risk factors (RF)-η and the resources (R)-η, and negatively correlated with the health status (HS)-η. The number pf prefectures without ordinance-designated cities where the T-η and RF-η exceeded the median was large. The number of prefectures with ordinance-designated cities where the HS-η exceeded the median was also large. In addition, there were many prefectures where the T-η was in the top 25% in West Japan. There were positive correlations between the total expenditures and the T-η, the expenditures and the RF-η, and the expenditures and the R-η. There was a negative correlation between the expenditures and the HS-η, and the T-η and the life expectancy. CONCLUSIONS: For life expectancy, prefectures with too good performance were recognized. In these prefectures, correction of resources is necessary.