Physician-Induced Demand for Treatments for Heart Attack Patients in Japan: Evidence from the Tokai Acute Myocardial Study (TAMIS)

Percutaneous Transluminal Coronary Angioplasty, henceforth (PTCA) for patients with acute myocardial infarction (AMI)—a high-tech treatment—is more frequently used in Japan than in other developed countries. This paper adopts the two-phase model to examine whether the high PTCA use is driven by the self-interest of physicians, or by behavioral character. After controlling for a patient’s detailed characteristics, we found that increases in the relative numbers of hospitals and physicians are significantly related to physician-initiated expenditures and the effect is higher for high-tech treatments. The results based on municipal-level aggregated data also support this conclusion. JEL classification: I11