Updated on 2024/04/22

写真a

 
FU, Rong
 
Affiliation
Faculty of Commerce, School of Commerce
Job title
Associate Professor
Degree
経済学博士 ( 早稲田大学 )

Research Experience

  • 2023.09
    -
    Now

    Waseda University   School of Commerce

  • 2020.04
    -
    2023.08

    Waseda University   School of Commerce

  • 2019.04
    -
    2020.03

    Waseda University   School of Political Science and Economics

Professional Memberships

  •  
     
     

    Japanese Health Economics Association

  •  
     
     

    American Economic Association

  •  
     
     

    Japanese Economic Association

Research Areas

  • Economic policy   Health Economics
 

Papers

  • The impact of reducing formal care benefits on caregivers’ well-being: evidence from Japan

    Rong Fu, Dung Duc Le, Yoko Ibuka

    Review of Economics of the Household    2024.02  [Refereed]

    Authorship:Lead author, Corresponding author

     View Summary

    <jats:title>Abstract</jats:title><jats:p>This study examines the impact of reducing formal care benefits on the well-being of informal caregivers, contributing to the ongoing discourse about establishing sustainable and adequate levels of formal care. We utilize a reform introduced in Japan’s public long-term care insurance system, which curtailed formal care benefits for a group of recipients with low care needs. Employing a difference-in-difference approach with fixed effects on a nationally representative sample of coresident informal caregivers, we explore both the overall and temporal effects of this reform. Our findings reveal that the reform had an adverse impact on caregivers’ physical well-being, leading to diminished mobility and stability. The impact on caregivers’ mental well-being was less clear, reflecting a competing influence of stress and the psychological rewards associated with caregiving. The decline in physical well-being endured over time, while the effects on mental well-being were transient. Additionally, female caregivers exhibited greater vulnerability compared to their male counterparts, experiencing more significant deterioration in both physical and mental well-being. Alarmingly, the reform also negatively influenced the well-being of care recipients, suggesting that reducing formal care benefits does not yield positive outcomes for either caregivers or recipients. This study underscores the necessity of accounting for caregivers’ well-being when evaluating the cost-effectiveness of reducing formal care benefits and advocates for policies aimed at safeguarding female caregivers from health and financial challenges.</jats:p>

    DOI

  • Long-term Care in Japan

    Rong Fu, Toshiaki Iizuka, Haruko Noguchi

       2023.11

    Authorship:Lead author

    DOI

  • Convergence and persistent contrasts in the determinants of working-age women in Sweden and Japan living alone since the 1990s

    Glenn Sandström, Mojgan Padyab, Haruko Noguchi, Rong Fu

    Genus   79 ( 1 )  2023.05  [Refereed]

    Authorship:Last author

     View Summary

    Abstract

    The increase in one-person households (OPHs) in the developed world is often seen as the result of a trend in which individualistic values and behaviors are replacing family solidarity. Nordic countries have been identified as frontrunners in this development. In Asia, equally developed countries like Japan retain elements of a strong-family system and an asymmetrical gender regime, simultaneously as they are experiencing rapid increases in OPHs. This article aims to uncover how the demographic and socioeconomic composition of OPHs have developed since the 1990s among working-age women in Sweden and Japan. Our results show that, in particular, civil status and income play different roles for OPH-living in Sweden and Japan. In contrast to Japan, the level of OPHs remained stable over time in Sweden, and even declined among women with high incomes. This suggests that the negative association between family formation and women’s economic activity is temporary and only prevails as long as society has not adapted to the convergence of men’s and women’s socioeconomic roles. The findings are discussed in light of the “second demographic transition” and “dual equilibrium theory”.

    DOI

    Scopus

  • COVID‐19's Lockdown and Crime Victimization: The State of Emergency under the Abe Administration

    Yichen Shen, Rong Fu, Haruko Noguchi

    Asian Economic Policy Review   16 ( 2 ) 327 - 348  2021.07  [Refereed]

    DOI

    Scopus

    14
    Citation
    (Scopus)
  • The best of both worlds? The economic effects of a hybrid fee‐for‐service and prospective payment reimbursement system

    Rong Fu, Yichen Shen, Haruko Noguchi

    Health Economics   30 ( 3 ) 505 - 524  2021.03  [Refereed]

    Authorship:Lead author, Corresponding author

     View Summary

    Abstract

    Countries seeking to move away from a purely fee‐for‐service (FFS) system may consider a hybrid approach whereby only some procedures are paid by FFS while others are paid prospectively. Yet little evidence exists whether such a hybrid payment system contains overall costs without adverse influences on health outcomes. In 2003, Japan experienced a reform from FFS to a hybrid payment system in which only some inpatient procedures were paid prospectively. We exploit this reform to test how such a hybrid system affects overall costs and health outcomes. Briefly, we find that healthcare providers responded opportunistically to the reform, moving some procedures out of the bundled inpatient setting to FFS services, leading to no reduction in cost. There was some evidence of a moderate deterioration in health outcomes, in terms of a decline in the probability of symptoms being cured at discharge. In sum, our results suggest that in some cases, a hybrid payment system can be non‐superior to either FFS or prospective payment system.

    DOI

    Scopus

    3
    Citation
    (Scopus)
  • Differences in cancer patients’ work-cessation risk, based on gender and type of job: Examination of middle-aged and older adults in super-aged Japan

    Shuhei Kaneko, Haruko Noguchi, Rong Fu, Cheolmin Kang, Akira Kawamura, Shinsuke Amano, Atsushi Miyawaki

    PLOS ONE   15 ( 1 ) e0227792 - e0227792  2020.01

    DOI

    Scopus

    3
    Citation
    (Scopus)
  • Moral hazard under zero price policy: evidence from Japanese long-term care claims data

    Rong Fu, Haruko Noguchi

    The European Journal of Health Economics   20 ( 6 ) 785 - 799  2019.08  [Refereed]

    Authorship:Lead author, Corresponding author

    DOI

    Scopus

    12
    Citation
    (Scopus)
  • How do cardiovascular diseases harm labor force participation? Evidence of nationally representative survey data from Japan, a super-aged society

    Rong Fu, Haruko Noguchi, Shuhei Kaneko, Akira Kawamura, Cheolmin Kang, Hideto Takahashi, Nanako Tamiya

    PLOS ONE   14 ( 7 ) e0219149 - e0219149  2019.07  [Refereed]  [International journal]

    Authorship:Lead author, Corresponding author

     View Summary

    OBJECTIVE: To evaluate how cardiovascular diseases harm labor force participation (LFP) among the Japanese population and verify the validity of plasma biomarkers as instrumental variables of cardiovascular diseases after adjusting for a broad set of confounders including dietary intake. DESIGN: Using nationally representative repeated cross-sectional surveys in Japan, the Comprehensive Survey of Living Conditions and National Health and Nutrition Survey, with plasma biomarkers as instrumental variables for quasi-randomization. SETTING: Onset of cardiovascular diseases in those receiving regular treatment for hypertension, intracerebral hemorrhage, intracerebral infarction, angina pectoris, myocardial infarction, or other types of cardiovascular diseases. PARTICIPANTS: A total of 65,615 persons aged ≥ 20 years (35,037 women and 30,578 men) who completed a survey conducted every three years from 1995 through 2013. MAIN OUTCOME MEASURES: Respondent employment and weekly working hours during each survey year. RESULTS: Cardiovascular diseases significantly and remarkably reduced the probability of working by 15.4% (95% CI: -30.6% to -0.2%). The reduction in working probability was detected for women only. Respondents aged ≥ 40 years were less likely to work once diagnosed and the reduction was enlarged for those aged ≥ 65 years, while those aged < 40 years appeared to be unaffected. Probability of engaging in manual labor significantly decreased once diagnosed; however, no impact was found for cognitive occupations. Among employed respondents, the adverse effects of cardiovascular diseases decreased working hours by five hours per week. Validity of the biomarker instrumental variables was generally verified. CONCLUSIONS: A vicious circle is suggested between LFP and unfavorable health. However, the effects vary across age, sex, and occupation type, even after adjusting for causal effects, which could cause a downward bias in LFP impact. ATTRIBUTES: cardiovascular disease, labor force participation, instrumental variable method as quasi-randomization, plasma biomarker, Comprehensive Survey of Living Conditions, National Health and Nutrition Survey.

    DOI PubMed

    Scopus

    2
    Citation
    (Scopus)
  • Does the positive relationship between health and marriage reflect protection or selection? Evidence from middle-aged and elderly Japanese

    Rong Fu, Haruko Noguchi

    Review of Economics of the Household     1 - 14  2018.03  [Refereed]

    Authorship:Lead author, Corresponding author

     View Summary

    This study investigates the marriage protection and selection effects among middle-aged and elderly Japanese. Using 9 years of a longitudinal data set from a nationally representative survey in Japan from 2005 to 2013, we extract 15,242 respondents aged 50–59 years in the baseline year. We utilize positive self-rated health to present subjective health status and lifestyle diseases to present objective health status. Using dynamic panel data approach to control for endogeneity issue, we find that being married does protect respondents’ subjective health, in terms of a higher probability of self-ratings of “very good” or “good” health statuses. Nonetheless, we find that marriage deteriorated their objective health in terms of a higher probability of having lifestyle diseases. Regarding the selection effect, better subjective health is found to select middle-aged and elderly Japanese into marriage, but such influence is fairly modest. Although objective health status also selects respondents into marriage, it positively affects women but adversely affects men. The findings provide a more comprehensive understanding of the relationship between marriage and health, which may have substantial implications for health-related public policies for middle-aged and elderly people in Japan.

    DOI

    Scopus

    12
    Citation
    (Scopus)
  • Spillover effect of Japanese long-term care insurance as an employment promotion policy for family caregivers

    Rong Fu, Haruko Noguchi, Akira Kawamura, Hideto Takahashi, Nanako Tamiya

    Journal of Health Economics   56   103 - 112  2017.12  [Refereed]

    Authorship:Lead author, Corresponding author

     View Summary

    We evaluate a spillover effect of the Japanese public long-term care insurance (LTCI) as a policy to stimulate family caregivers’ labor force participation. Using nationally representative data from 1995 to 2013, we apply difference-in-difference propensity score matching to investigate the spillover effect in two periods: before and after the introduction of the LTCI in 2000 and before and after its major amendment in 2006. Our results show that the LTCI introduction has significant and positive spillover effects on family caregivers’ labor force participation and the effects vary by gender and age. In contrast, the LTCI amendment is found to have generally negative spillover effects on their labor force participation. We draw attention to these spillover effects, as expanding labor market supply to sustain the economy would be a priority for Japan and other rapidly aging countries in the coming decades.

    DOI PubMed

    Scopus

    43
    Citation
    (Scopus)
  • Relation between social network and psychological distress among middle-aged adults in Japan: Evidence from a national longitudinal survey

    Rong Fu, Harkuo Noguchi, Hirokazu Tachikawa, Miyuki Aiba, Shin Nakamine, Akira Kawamura, Hideto Takahashi, Nanako Tamiya

    SOCIAL SCIENCE & MEDICINE   175   58 - 65  2017.02  [Refereed]

    Authorship:Lead author, Corresponding author

     View Summary

    It is widely documented that psychological distress is negatively associated with social networks involvement. However, despite the theoretical postulations that social networks are crucial for alleviating psychological distress, no study has yet empirically confirmed the causality of this relationship. Thus, we used the random-effects generalized least squares method to investigate the effect of one- and two-year lagged values for involvement in social networks on psychological distress. Nine years of longitudinal data were extracted from a nationally representative survey in Japan ("The Longitudinal Survey of Middle-aged and Older Persons"). We utilized the Kessler 6 (K6) score to measure psychological distress among 15,242 respondents aged 50-59 years in the baseline year (2005), and stratified participants into three layers of social networks: inner (well-established friendship ties and participating in hobby activates), intermediary (neighborly ties), and outer (involvement in community activities). We found highly significant and negative associations between all three layers and K6 scores, with the strongest association being for the inner layer. We further observed that one-year lagged involvement in the inner and intermediary layers led to significantly lower K6 scores. However, the protective influences of social networks generally diminished over time. In addition, the protective influences of social network involvement on psychological distress were stronger for women than for men. Furthermore, involvement in social networks was especially important for improving mental health among people with psychological distress. These findings would be important for policymaking to prevent mental health deterioration among middle-aged adults in Japan. (C) 2017 Elsevier Ltd. All rights reserved.

    DOI PubMed

    Scopus

    22
    Citation
    (Scopus)
  • A Revisit to the Grossman Model with Endogenous Health Depreciation

    Rong FU

    Economics Bulletin    2016.12  [Refereed]

    Authorship:Lead author, Corresponding author

  • Does Marriage Make Us Healthier? Inter-Country Comparative Evidence from China, Japan, and Korea

    Rong Fu, Haruko Noguchi

    PLOS ONE   11 ( 2 )  2016.02  [Refereed]

    Authorship:Lead author, Corresponding author

     View Summary

    Objectives
    This study focuses on East Asian countries and investigates the difference in the marriage premium on the health-marriage protection effect (MPE) between younger and older generations and the intra-couple education concordance effect (ECE) on the health of married individuals. This study used inter-country comparative data from China, Japan, and Korea.
    Methods
    This study focused on individuals (n = 7,938) in China, Japan, and Korea who were sampled from the 2010 East Asian Social Survey. To investigate MPE and ECE, four health indicators were utilized: a physical and mental components summary (PCS and MCS), self-rated health status (Dself), and happiness level (Dhappy). Ordinary least squares regression was conducted by country-and gender-specific subsamples.
    Results
    We found that the MPE on PCS, MCS, and Dself was more significant for the older generation than for the younger generation in both China and Japan, whereas the results were inconclusive in Korea. With regard to the ECE on happiness (Dhappy), for both men and women, couples tend to be happier when both the husband and the wife are well educated ("higher balanced marriage") compared to couples with a lower level of educational achievement ("lower balanced marriage"). Significant benefits from a "higher balanced marriage" on MCS and Dself were observed for women only. In contrast, no statistically significant differences in health status were observed between "higher balanced marriage" couples and couples with different levels of educational achievements ("upward marriage" or "downward marriage").
    Conclusions
    This study found that (1) the MPE was more significant for the older generation, and (2) the health gap, particularly the happiness gap, between higher-and lower-balanced married couples was significant. The inter-country comparative findings are useful to explain how the role of marriage (and therefore of family) on health has been diluted due to the progress of industrialization and modernization.

    DOI PubMed

    Scopus

    27
    Citation
    (Scopus)

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Research Projects

  • A comprehensive investigation of the incentives and policies in the Japanese generic drug market

    日本学術振興会  科学研究費助成事業

    Project Year :

    2022.04
    -
    2026.03
     

    富 蓉

  • Sustainable system design for health care and long-term care - Utilization of administrative big data through international comparative studies

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research

    Project Year :

    2022.04
    -
    2026.03
     

  • Research for Analysis of Factors Affecting Changes in the Structure of Medical Care Costs Based on Increasing Longevity Using Receipt Data, etc.: Empirical Research on Estimating the Elasticity of Policy Change as a "Natural Experiment."

    The Ministry of Health, Labour and Welfare  Health Labour Sciences Research Grant・Policy Science Research (Research for the Promotion of Policy Science)

    Project Year :

    2022.04
    -
    2024.03
     

    Zentaro Yamagata, Toru Asahi, Hayato Yamana, Akira kawamura, Bing Nui, Yuta Toyoma, Rong Fu, Masato Oikawa

  • Cost, Length of Stay, and Health Outcome: A Comprehensive Evaluation of Prospective Payment System in Japan

    日本学術振興会  科学研究費助成事業 若手研究

    Project Year :

    2019.04
    -
    2022.03
     

    富 蓉

     View Summary

    In 2019, the research emphases were loaded to the construction of datasets and medical costs effect of the DPC/PDPS. By appropriate extracting and collating, datasets were settled down in June. During the process, we also summarized basic statistics for investigations on medical costs, LOS, and healthcare quality, respectively. Briefly, we found that healthcare providers responded opportunistically to the reform, moving some procedures out of the bundled inpatient setting to FFS cares, leading to no reduction in cost. There was some evidence of a deterioration in health outcomes, though mortality was not affected. In sum, the results suggest that in some cases, a hybrid payment system can be non-superior to either FFS or prospective payment system. We presented the results at international Health Economics Association and drafted the manuscript for publication.

  • Empirical study on the socioeconomic impact of lifestyle-related disease prevention by industry and region

    The Ministry of Health, Labour and Welfare  Health Labour Sciences Research Grant・Comprehensive research on cardiovascular disease, diabetes, and other lifestyle-related diseases.

    Project Year :

    2019.04
    -
    2021.03
     

    Toru Asahi, Toshihide Awatani, Akira Kawamura, Kenichiro Tamaki, Chie Hanaoka, Rong Fu

  • he effect of 2006 Long-term Care Insurance Amendment on Cost Containment: an empirical evidence from nationally representative claims data

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research Grant-in-Aid for Research Activity Start-up

    Project Year :

    2017.08
    -
    2019.03
     

    FU RONG

     View Summary

    We evaluate the presence and magnitude of moral hazard in Japan’s public long-term care insurance (LTCI) market. Using monthly LTCI claim records from January 2006 to December 2015 linked to concurrent death records, we construct a sample by propensity score matching insured individuals who copay 10% of their fees to those with no required copayments, and we implement fixed-effect estimations. We find that a ten-percentage-point reduction in the copayment rate increases monthly costs by 10.2 thousand yen, corresponding to a price elasticity of about -0.1. Insured individuals with no copayments tend to use more services and have more utilization days than those with copayments do.

  • Empirical Study on the sustainability of health care system for supporting divergent lives under the super-aged and popluation decreasing society

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (B)

    Project Year :

    2015.04
    -
    2018.03
     

    IZUMIDA Nobuyuki, SHIRASE Yumika, Kuroda Ashiya, Ibuka Yoko, Imahori Mayumi, Kawakami Tetsu, Kawamura Akira, Kurihara Takashi, Nishida Kiheiji, Hamaaki Junnya, Fu Rong, Yashio Hiroyuki, Watanabe Yuichi

     View Summary

    Universal health coverage (UHC) assures the access to the health care services for all of residents with various life styles/employment status. It is very important to keep the function of UHC even in the population decreasing super-aged society. This study considered the health insurance system, function of health insurers and the way of cost sharing of health care, with empirical results using individual data.
    Empirical studies in this research project showed the results as follows; 1)Burden of social insurance premium was lowered for lower income classes this 10 years. 2)However there was exceptional individuals in those income class with very high burden of social insurance premium. 3)Lowered premium burden did not necessarily improve the rate of unpaid social insurance premium. 4)In view of service utilization, upper limitation of coinsurance rate keeps the assurrance of access to the health care services.

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Syllabus

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Research Institute

  • 2022
    -
    2024

    Waseda Center for a Carbon Neutral Society   Concurrent Researcher

  • 2020
    -
    2031

    Research Institute of Business Administration   Concurrent Researcher

Internal Special Research Projects

  • Undermining Brand Loyalty: Synergy between the Physician, Pharmacist, and Patient in Generic Drug Use

    2023  

     View Summary

    We submitted the results to Health Affairs.

  • Evaluating incentives in the Japanese ge neric drug market

    2022   Ayame

     View Summary

    Encouraging generic drugs (GD) over brand-name drugs is an appealing strategy for reducing medical expenditures. Numerous studies have been conducted on the distinct roles of pharmacist, physician, and patient in the use of GD (Dunne and Dunne, 2015, BMC Medicine). They reveal that pharmacists have the most favorable view of GD; physicians are willing to prescribe GD under certain conditions, and patients avoid using GD frequently. However, the literature overlooks the potential interaction between the three stakeholders and its effect on GD. We intend to contribute to the literature by demonstrating the relationship between such stakeholder interaction and GD use.Compared to pharmacies with a low hospital concentration, those with a moderate, a high, and a very high hospital concentration use 1-percentage-point (ppt), 2.4-ppt, and 1.4-ppt more GD, respectively. Meanwhile, GD use varies little with the patient concentration level: in comparison to pharmacies with a low patient concentration, GD use is 0.4-ppt higher for those with a high patient concentration but 0.9-ppt lower for those with a very high patient concentration. Increases in GD use are more pronounced in pharmacies where older, male, and low-income patients are overrepresented.&nbsp;&nbsp;The results indicate that the association between pharmacies’ GD use and hospital concentration differs greatly from the association between the GD use and patient concentration. A stronger interaction between hospitals and pharmacies may increase GD use, whereas a very close relationship between patients and pharmacies may hinder GD use. The findings highlight the importance of interaction between the stakeholders in promoting GD use.

  • The analysis of the changes in medical treatment pattern after the 2018 medical fee schedule amendment

    2021  

     View Summary

    This research aims to clarify how the2018 amendment of the medical service fee schedule alters medical practicestyles and to clarify the behavioral discrepancies among medical institutionsby comparing the changes in medical treatment styles caused by the amendment.We examined the role of reimbursement as a means of guiding medical treatmentstyles in a desirable direction.

  • A Comprehensive Evaluation of the Hospital Payment System in Japan

    2020  

     View Summary

    Countries seeking to move away from a purely fee‐for‐service (FFS) systemmay consider a hybrid approach whereby only some procedures are paid byFFS while others are paid prospectively. Yet little evidence exists whether sucha hybrid payment system contains overall costs without adverse influences onhealth outcomes. In 2003, Japan experienced a reform from FFS to a hybridpayment system in which only some inpatient procedures were paid prospectively.We exploit this reform to test how such a hybrid system affectsoverall costs and health outcomes. Briefly, we find that healthcare providersresponded opportunistically to the reform, moving some procedures out of thebundled inpatient setting to FFS services, leading to no reduction in cost.There was some evidence of a moderate deterioration in health outcomes, interms of a decline in the probability of symptoms being cured at discharge. Insum, our results suggest that in some cases, a hybrid payment system can benon‐superior to either FFS or a prospective payment system.

  • The effect of nonproprietary name prescription on the adoption of generic drugs: evidence from cardiovascular drugs

    2020  

     View Summary

    We use all claim records related to the utilizationof cardiovascular agents (i.e., all agents with&nbsp;薬効分類コード211-219) from April 2009 to March 2019. Weplan to construct a medical institution-patient-month panel dataset. For eachyear between 2009 and 2019, we focus on drugs with multisource up to date (i.e.,both brand-name and generic versions are available). For each brand-name drug,we pair at least one generic drug to it with the same dosage form and strength. There are three possible pairs for a specific class of drugs, i.e., beta-blockers.Pair I contains three drugs: a brand-name tablet with strength at 20mg, and twogeneric-version tablets with the same strength. Essentially, a pair can havemore than two brand-name/generic drugs. Pair II differs from Pair I, despitethe same strength (20mg), because of the different dosage form (capsule). PairIII differs from Pair II, despite the same dosage form (capsule), because thestrength of the brand name is 10mg. Thus, there could be multiple pairs for aspecific class of drugs.

  • Cost,Length of Stay,and Health Outcome:A comprehensive evaluation of Prospective Payment System in Japan

    2019   Haruko Noguchi, Yichen Shen

     View Summary

    In 2003, Japan experienced a reform from the fee-for-service system to the blended payment system, a system where only some procedures within inpatient care are required to be paid with the prospective payment system. Exploiting the reform, we investigate the impact of the blended payment system on cost and health outcomes. Using 1997 to 2010 health insurance claims, we show that the blended payment system does not cost less than the fee-for-service system and induces health deteriorations. The deteriorations in health are moderate in comparison with the prospective payment system. The failure to contain cost and the deterioration of health is driven by providers' compensation seeking behaviors that cause a shift of procedures paid via prospective payment system to procedures paid via the fee-for-service system. Our findings point to further reform of the blended payment system to restrict provider incentive to seeking compensations.

  • The effect of 2006 Long-term Care Insurance Amendment on Cost Containment: an empirical evidence from nationally representative claims data

    2018  

     View Summary

    After several revisions, I summarize the findings in an article entitled "Moral Hazard under Zero Price Policy: Evidence from Japanese Long-term Care Claims Data" and submitted it to the European Journal of Health Economics.&nbsp;

  • Moral hazard in the long-term care market: evidence from Japanese claims data

    2017   Haruko NOGUCHI

     View Summary

    I have summarized the findings in a manuscript entitled "Moral Hazard under Zero Price Policy: Evidence from Japanese Long-term Care Claims Data"and submitted it to the Journal of Public Economics.

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