New Medical Schools, Access to Physicians, and Health Outcomes: Evidence From Japan

We analyse the impact of the construction of medical schools and associated university hospitals in Japan during the 1970s, which was primarily driven by 'One Prefecture, One Medical School Policy' (OPOMS). We find that the number of physicians increased significantly in prefectures where a medical school was built, and this effect persisted for more than 20 years. Moreover, we uncover suggestive evidence that the establishment of university hospitals may lead to a reduction in the overall mortality rate, especially among the elderly. Our results also indicate that the improvement in health outcomes is likely attributed to access to high-quality care resulting from the opening of university hospitals, rather than an overall increase in the utilisation of healthcare services.

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Publication Details

Journal
Health Economics
Published
2026-08-03
DOI
https://doi.org/10.1002/hec.70132
Primary Topic
Occupational and Professional Licensing Regulation
Type
article
Field-Weighted Citation Impact
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article

New Medical Schools, Access to Physicians, and Health Outcomes: Evidence From Japan

Kisho Hoshi
Health Economics
Occupational and Professional Licensing Regulation
article

New Medical Schools, Access to Physicians, and Health Outcomes: Evidence From Japan

Kisho Hoshi
article en

Abstract

We analyse the impact of the construction of medical schools and associated university hospitals in Japan during the 1970s, which was primarily driven by 'One Prefecture, One Medical School Policy' (OPOMS). We find that the number of physicians increased significantly in prefectures where a medical school was built, and this effect persisted for more than 20 years. Moreover, we uncover suggestive evidence that the establishment of university hospitals may lead to a reduction in the overall mortality rate, especially among the elderly. Our results also indicate that the improvement in health outcomes is likely attributed to access to high-quality care resulting from the opening of university hospitals, rather than an overall increase in the utilisation of healthcare services.

Health Economics
University of British Columbia (CA)
Good health and well-being
Openalex Percentile: Top 4%
Occupational and Professional Licensing Regulation
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