6. CONCLUSION
So far, we have conducted surveys of four local governments. Except for Kamaishi
City, their B/C ratios are approximately 0.5, that is, benefits cover only half of the costs.
In addition, regarding the frequency of usage of the device, Kamaishi City also has a
much higher ratio than the other local governments. Thus, Kamaishi City reveals quite
specific characteristics. This is due to their efforts to promote usage such as a users’
association which organizes events to enhance consciousness towards health, and the
participation by medical doctors in this system, which increases the users’ reliance on
the system.
It is clear from our previous studies that the telehealth system is useful for
consultation and maintaining the good health of the elderly and patients suffering from
chronic diseases who are in stable condition, but it is not for curing disease. It
therefore has a psychological effect such as providing a sense of relief to its users by the
knowledge of being monitored by a medical institution 24 hours a day. This makes it
difficult to estimate its benefits in concrete terms. We are only able to provide
concrete amounts to this effect in this paper.
To date, Japanese local governments implementing this system have not charged
any fee, except for Kamaishi City. They all receive subsidies from the central
government. Kamaishi City, for example, receives subsidies from the Ministry of
Welfare through collaboration in two of its projects -- Special Project for Promoting
Regional Health, and Pilot Project for Promoting Tele-Medicine. Katsurao Village
received subsidies from the Ministry of Welfare and Ministry of Agriculture, Nishiaizu
from the Ministry of Welfare, Land Planning Agency, and the Ministry of Agriculture,
and Sangawa from the Ministry of Welfare and Ministry of Agriculture. Due to the
current severe budget situation in Japan, however, local governments can no longer rely on such subsidies. For sustainability of the tele- health system from a financial point of
view, a new framework is required. Reimbursement using medical insurance is one
possibility. In order for such reimbursement to be realized, analyses such as the
Cost-Benefit Analysis carried out in this paper provides a theoretical foundation.
Regarding the methodology of the analysis, in this paper we selected four regions,
applied CVM to each telehealth system, and made a comparison of the results. This is,
however, is not the most appropriate method. It is necessary to pool the data of the
four regions, and then proceed with the analysis. This is our further task.