2024/05/26 更新

写真a

フ ヨウ
富 蓉
所属
商学学術院 商学部
職名
准教授
学位
経済学博士 ( 早稲田大学 )
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経歴

  • 2023年09月
    -
    継続中

    早稲田大学   商学部   准教授

  • 2020年04月
    -
    2023年08月

    早稲田大学   商学部   専任講師

  • 2019年04月
    -
    2020年03月

    早稲田大学   政治経済学部   講師(任期付)

所属学協会

  •  
     
     

    日本医療経済学会

  •  
     
     

    アメリカ経済学会

  •  
     
     

    日本経済学会

研究分野

  • 経済政策   医療経済学
 

論文

  • 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年02月  [査読有り]

    担当区分:筆頭著者, 責任著者

     概要を見る

    <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

    National Bureau of Economic Research    2023年11月

    担当区分:筆頭著者

    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年05月  [査読有り]

    担当区分:最終著者

     概要を見る

    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年07月  [査読有り]

    DOI

    Scopus

    14
    被引用数
    (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年03月  [査読有り]

    担当区分:筆頭著者, 責任著者

     概要を見る

    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
    被引用数
    (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年01月

    DOI

    Scopus

    3
    被引用数
    (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年08月  [査読有り]

    担当区分:筆頭著者, 責任著者

    DOI

    Scopus

    12
    被引用数
    (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年07月  [査読有り]  [国際誌]

    担当区分:筆頭著者, 責任著者

     概要を見る

    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
    被引用数
    (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年03月  [査読有り]

    担当区分:筆頭著者, 責任著者

     概要を見る

    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
    被引用数
    (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年12月  [査読有り]

    担当区分:筆頭著者, 責任著者

     概要を見る

    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

    47
    被引用数
    (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年02月  [査読有り]

    担当区分:筆頭著者, 責任著者

     概要を見る

    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
    被引用数
    (Scopus)
  • A Revisit to the Grossman Model with Endogenous Health Depreciation

    Rong FU

    Economics Bulletin    2016年12月  [査読有り]

    担当区分:筆頭著者, 責任著者

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

    Rong Fu, Haruko Noguchi

    PLOS ONE   11 ( 2 )  2016年02月  [査読有り]

    担当区分:筆頭著者, 責任著者

     概要を見る

    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
    被引用数
    (Scopus)

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共同研究・競争的資金等の研究課題

  • 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

    研究期間:

    2022年04月
    -
    2026年03月
     

    富 蓉

  • 医療・介護の持続可能な制度設計へ向けて-多国間比較研究による行政データの利活用

    日本学術振興会  科学研究費助成事業

    研究期間:

    2022年04月
    -
    2026年03月
     

    野口 晴子, 山縣 然太朗, 朝日 透, 山名 早人, 川村 顕, 富 蓉, 及川 雅斗

  • レセプトデータ等を用いた、長寿化を踏まえた医療費の構造の変化に影響を及ぼす要因分析等のための研究(政策変更を「自然実験」とする弾力性の推計に係る実証研究)

    厚生労働省  厚生労働省科学研究費補助金・政策科学総合研究(政策科学推進研究)

    研究期間:

    2022年04月
    -
    2024年03月
     

    山縣然太朗, 朝日透, 山名早人, 川村顕, 牛冰, 遠山祐太, 富蓉, 及川雅斗

  • 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

    研究期間:

    2019年04月
    -
    2022年03月
     

    富 蓉

     概要を見る

    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.

  • 産業別・地域別における生活習慣病予防の社会経済的な影響に関する実証研究

    厚生労働省  厚生労働科学研究費補助金・循環器疾患・糖尿病等生活習慣病対策総合研究

    研究期間:

    2019年04月
    -
    2021年03月
     

    朝日 透, 阿波谷 敏英, 川村 顕, 玉置 健一郎, 花岡 智恵, 富 蓉

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

    日本学術振興会  科学研究費助成事業 研究活動スタート支援

    研究期間:

    2017年08月
    -
    2019年03月
     

    富 蓉

     概要を見る

    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.

  • 超高齢・人口減少社会において多様な生活者を支える医療保障の持続性を目指す実証研究

    日本学術振興会  科学研究費助成事業 基盤研究(B)

    研究期間:

    2015年04月
    -
    2018年03月
     

    泉田 信行, 田近 栄治, 山田 篤裕, 森田 朗, 藤井 麻由, 高久 玲音, 野口 晴子, 大津 唯, 白瀬 由美香, 黒田 有志弥, 井深 陽子, 今堀 まゆみ, 河上 哲, 川村 顕, 栗原 崇, 西田 喜平次, 濱秋 純哉, 富 蓉, 八塩 裕之, 渡邉 雄一

     概要を見る

    国民介保険は被用者以外の多様な生活(雇用)形態にある者に対して医療アクセスを保障する機能を持つ。超高齢・人口減少の状態にあっても支払い可能な保険料でその機能が維持されることは重要である。本研究では、加入・利用しやすい公的医療保険制度の持続を目指して、医療費の負担のあり方、日本における保険制度・保険者のあり方について、データを用いた実証分析を行い、その結果を踏まえた上で検討を行った。
    低い所得階級において社会保険料負担が軽減されつつも、必ずしもそれが未納率を改善する効果を持ち得ていない可能性がある一方、高額療養費制度により医療サービス利用へのアクセスは保証されている可能性が示唆された。

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現在担当している科目

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学内研究所・附属機関兼任歴

  • 2022年
    -
    2024年

    カーボンニュートラル社会研究教育センター   兼任センター員

  • 2020年
    -
    2031年

    産業経営研究所   兼任研究所員

特定課題制度(学内資金)

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

    2023年  

     概要を見る

    We submitted the results to Health Affairs.

  • Evaluating incentives in the Japanese ge neric drug market

    2022年   Ayame

     概要を見る

    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年  

     概要を見る

    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.

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

    2020年  

     概要を見る

    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.

  • A Comprehensive Evaluation of the Hospital Payment System in Japan

    2020年  

     概要を見る

    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.

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

    2019年   Haruko Noguchi, Yichen Shen

     概要を見る

    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年  

     概要を見る

    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年   Haruko NOGUCHI

     概要を見る

    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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