OBJECTIVES: In the Judo-therapeutic field, their costs are partly covered by National Health Insurance System via fee-for-service reimbursement, which does not necessarily reflect actual costs. Therefore, the actual situation of medical practice in Judo-therapy Clinics (bone-setting clinics) is analyzed by comparison between the actual costs calculated by micro-costing methods and .reimbursement cost calculated by fee-forservice system. METHODS: The basis of this study is a bidirectional evaluation of single medical intervention in terms of actual cost and reimbursed cost for single treatment with following methods: 1) All receipts are collected from the participating bone-setting clinics for a fi xed period of time; 2) Along with collection of receipts, information on the medical interventions is recorded by region with regard to "how long" and "who" performed them; 3) The tentative cost of medical intervention is calculated based on the data in 2) above and the data of wage for the engaged persons. In other words, the tentative cost is calculated as the practitioner's wage per unit time multiplied by the time consumed; 4) The cost-based amount of individual medical intervention is calculated by adding indirect costs (wage for other staff than practitioner, cost for operation/maintenance of judo-therapy clinic) to the data in 3); and 5) Standard critical paths are made for several diseases, based on which medical expense for each therapy model is calculated in terms of both receipt-based amount and costbased amount, and a comparison of amount is made between them. RESULTS: Therapies in a total of 1646 regions were recorded, based on which a comparison was made using four diseases (lumbar sprain, neck sprain, femoral contusion, back contusion) as models. The receipt-based medical expense was JPY9030 (US$100) for all diseases, while the cost-based medical expense widely varied from JPY22,057 to JPY22,950 (US$245 to US$255). CONCLUSIONS: There was a significant difference between the insurance benefit amount and the actual cost of medical intervention in judo-therapy.
Tarumoto, N., Igarashi, A., Tarumoto, E., Harada, T., & Fukuda, T. (2010). PMS5 MICRO-COSTING OF JUDO-THERAPY CLINICS IN JAPAN—MULTI CENTERED COST ANALYSIS. Value in Health, 13(7), A558. https://doi.org/10.1016/s1098-3015(11)73340-x