Goto, Rei

写真a

Affiliation

Graduate School of Business Administration ( Hiyoshi )

Position

Professor

Other Affiliation 【 Display / hide 】

  • Graduate School of Health Management

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Career 【 Display / hide 】

  • 1998.05
    -
    2000.03

    Kobe City General Hospital, Resident in Medicine

  • 2005.04
    -
    2007.03

    Konan University, Faculty of Economics, Lecturer

  • 2007.04
    -
    2012.03

    Konan University, Faculty of Economics, Associate Professor

  • 2012.04
    -
    2016.03

    Kyoto University, The Hakubi Institute of Advanced Research, Associate Professor

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Academic Background 【 Display / hide 】

  • 1992.04
    -
    1998.03

    Kyoto University, School of Medicine

    University, Graduated, Other

  • 2000.04
    -
    2005.03

    Kyoto University, Graduate School of Economics

    Graduate School, Completed, Doctoral course

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Academic Degrees 【 Display / hide 】

  • 学士（医学）, Kyoto University, Coursework, 1998.03

  • 博士（経済学）, Kyoto University, Coursework, 2006.05

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Licenses and Qualifications 【 Display / hide 】

  • Physician, 1998.04

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Research Areas 【 Display / hide 】

  • Humanities & Social Sciences / Economic policy

  • Humanities & Social Sciences / Public economics and labor economics

  • Life Science / Medical management and medical sociology

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Research Keywords 【 Display / hide 】

  • health technology assessment

  • health policy

  • health economics

  • behavioral economics

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Books 【 Display / hide 】

  • Health Economics

    後藤励, 井深陽子, 有斐閣, 2020.03

  • 医療レジリエンス　－医学アカデミアの社会的責任－

    FUKUHARA Shunichi,GOTO Rei,NAKAYAMA Takeo,KAWAKAMI Koji,FUKUMA Shingo, 医学書院, 2015

  • 日本のお医者さん研究

    MORI Takeshi,GOTO Rei, 東洋経済新報社, 2012

  • 医療経済学講義

    GOTO Rei, 東京大学出版会, 2011

    Scope: 第１０章　生活習慣と行動変容

  • 健康行動経済学

    YODA Takanori,GOTO Rei,NISHIMURA Shuzo, 日本評論社, 2009

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Papers 【 Display / hide 】

  • Difference in time and risk preferences: physicians and general population across genders

    Kasahara S., Kato H., Goto R.

    Health Economics Review 15 ( 1 )  2025.12

    　View Summary

    Background: The alignment of preferences between physicians and patients can cause variations in treatment decision-making, thereby affecting health outcomes. However, research on the differences in preferences between physicians and the general population is scarce. This study examines the risk and time preferences of physicians compared with those of the general population, exploring the influence of gender concordance on health outcomes and decision-making in healthcare. Methods: We conducted an online field experiment in October and November 2022 in Japan and analyzed the responses of 469 individuals, including physicians and the general population. The survey was stratified by age and gender to align with the demographics of physicians nationally. Participants’ preferences were measured across the health and monetary domains by using a modified multiple price list test format. Results: The findings revealed that physicians tended to be more risk-averse than the general population in the health and monetary domains, although no statistically significant differences were observed. Physicians were found to be statistically significantly future-oriented, particularly regarding their significant health or monetary gains. Furthermore, while the female general population was more risk-averse in both domains, a gender difference in the physician group was observed only in the monetary domain. Conclusion: The results affirm that preference differences between physicians and the general population exist in Japan and clarify the unique preference traits of female physicians.

  • Primary Care Physician Characteristics and Low-Value Care Provision in Japan

    Miyawaki A., Mafi J.N., Abe K., Klomhaus A., Goto R., Kitajima K., Sato D., Tsugawa Y.

    JAMA Health Forum 6 ( 6 )  2025.06

    　View Summary

    Importance: Evidence is limited regarding the physician characteristics associated with the provision of low-value services in primary care, especially outside of the US. Objective: To measure physician-level use of 10 low-value care services that provide no net clinical benefit and to investigate the characteristics of primary care physicians who frequently provide low-value care in Japan. Design, Setting, and Participants: This cross-sectional analysis used a nationwide electronic health record database linked with claims data in Japan to assess visits by adult patients (age ≥18 years) to a solo-practice primary care physician from October 1, 2022, through September 30, 2023. Data analysis was performed from June 2024 to February 2025. Main Outcomes and Measures: Multivariable-adjusted composite rate of low-value care services delivered per 100 patients per year, aggregated across 10 low-value measures, after accounting for case mix and other characteristics. Results: Among 2542630 patients (mean [SD] age, 51.6 [19.8] years; 58.2% female) treated by 1019 primary care physicians (mean [SD] age 56.4 [10.2] years; 90.4% male), 436317 low-value care services were identified (17.2 cases per 100 patients overall). Nearly half of these low-value care services were provided by 10% of physicians. After accounting for patient case mix, older physicians (age ≥60 years) delivered 2.1 per 100 patients (95% CI, 1.0-3.3) more low-value care services than those younger than 40 years; not board-certified physicians delivered 0.8 per 100 patients (95% CI, 0.2-1.5) more than general internal medicine board-certified physicians; physicians with higher patient volumes delivered 2.3 per 100 patients (95% CI, 1.5-3.2) more than those with low patient volumes; and physicians practicing in Western Japan delivered 1.0 per 100 patients (95% CI, 0.5-1.5) more than those in Eastern Japan. Conclusions and Relevance: The findings of this cross-sectional analysis suggest that low-value care services were common and concentrated among a small number of primary care physicians in Japan, with older physicians and not board-certified physicians being more likely to provide low-value care. Policy interventions targeting at a small number of certain types of physicians providing large quantities of low-value care may be more effective and efficient than those targeting all physicians uniformly.

  • Introduction

    Suzuki Wataru, Goto Rei

    Iryo To Shakai (The Health Care Science Institute)  35 ( 1 ) 5 - 10 2025.04

    ISSN  09169202

  • Efficacy of aqueous olanexidine compared with alcohol-based chlorhexidine for surgical skin antisepsis regarding the incidence of surgical-site infections in clean-contaminated surgery: a randomized superiority trial

    Takeuchi M., Obara H., Furube T., Kawakubo H., Kitago M., Okabayashi K., Fujisaki H., Aoyama J., Morimoto Y., Amemiya R., Sano J., Nakadai J., Goto R., Sato Y., Kitagawa Y.

    British Journal of Surgery 112 ( 4 )  2025.04

    ISSN  00071323

    　View Summary

    Background: Surgical-site antisepsis is used to prevent surgical-site infections (SSIs). Although several guidelines have indicated the efficacy of antiseptics, such as chlorhexidine, povidone-iodine, and olanexidine, in reducing the SSI rate, an optimal recommendation is still not established. The aim of this study was to evaluate the efficacy of aqueous olanexidine compared with chlorhexidine-alcohol as the optimal antiseptic for preventing SSI in clean-contaminated surgery. Methods: This multicentre randomized trial for surgical skin antisepsis in clean-contaminated gastrointestinal and hepatobiliary-pancreatic surgeries in five hospitals evaluated the efficacy of olanexidine and chlorhexidine-alcohol. The primary endpoint was 30-day SSI. Secondary outcomes included the occurrence of SSI types, intervention-related toxicity, and reoperation caused by SSI. Results: Overall, 700 patients from five institutions underwent randomization; 347 received olanexidine and 345 received chlorhexidine-alcohol in the full analysis set. The 30-day SSI rate was 12.4% (43 of 347) in the olanexidine group and 13.6% (47 of 345) in the chlorhexidine-alcohol group (adjusted risk ratio (aRR) 0.911 (95% c.i. 0.625 to 1.327); P = 0.626). No significant differences were observed between the groups regarding the secondary outcomes, including the occurrence of superficial incisional SSI, deep incisional SSI, organ/space SSI, and reoperation caused by SSI. Overall adverse effects were seen in two patients (0.58%) in the olanexidine group and in three patients (0.87%) in the chlorhexidine-alcohol group (aRR 0.663 (95% c.i. 0.111 to 3.951)). Conclusion: Olanexidine did not significantly reduce the occurrence of overall SSI compared with chlorhexidine-alcohol. Nevertheless, these findings provide valuable insights for developing novel surgical SSI management protocols. Registration number: UMIN 000049712 (University Hospital Medical Information Network Clinical Trials Registry).

  • Cost-effectiveness of AI-based diabetic retinopathy screening in nationwide health checkups and diabetes management in Japan: A modeling study

    Akune Y., Kawasaki R., Goto R., Tamura H., Hiratsuka Y., Yamada M.

    Diabetes Research and Clinical Practice 221 2025.03

    ISSN  01688227

    　View Summary

    Aims: We evaluated the cost-effectiveness of artificial intelligence (AI)-based diabetic retinopathy (DR) screening in Japan. This evaluation compared the simultaneous introduction of AI in nationwide health checkups, namely “specific health check-ups in Japan” (SHC), and diabetes complication management (AI-case) with the current situation where AI is not being introduced (conventional-case) from the healthcare payer's perspective. Methods: A cost-effectiveness analysis was conducted using a new individual-based state transition model. Model parameters, including the incidence and progression of DR, health utility values, and costs of screening and treatment, were based on literature data and expert opinion. The analysis estimated quality-adjusted life years (QALYs), cumulative costs, and incremental cost-effectiveness ratios (ICER). Results: The ICER comparing the AI-case with conventional-case was estimated to be JPY 1,598,244/QALY (USD 11,375/QALY), which is below the willingness-to-pay threshold of JPY 5 million/QALY (USD 35,584/QALY). Scenario analyses revealed that ICERs for the AI-based DR screening in SHC-only condition was JPY 1,895,226/QALY (USD 13,488/QALY) and JPY 3,960,839/QALY (USD 28,189/QALY) in diabetes management-only condition. Conclusions: The introduction of AI-based DR screening for SHC and diabetes management was cost-effective compared to the current situation in Japan.

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Papers, etc., Registered in KOARA 【 Display / hide 】

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Reviews, Commentaries, etc. 【 Display / hide 】

  • Cost-effectiveness comparison between blood biomarkers and conventional tests in Alzheimer's disease diagnosis

    Noda K., Lim Y., Goto R., Sengoku S., Kodama K.

    Drug Discovery Today (Drug Discovery Today)  29 ( 3 )  2024.03

    ISSN  13596446

    　View Summary

    Dementia management has evolved with drugs such as lecanemab, shifting management from palliative care to early diagnosis and intervention. However, the administration of these drugs presents challenges owing to the invasiveness, high cost and limited availability of amyloid-PET and cerebrospinal fluid tests for guiding drug administration. Our manuscript explores the potential of less invasive blood biomarkers as a diagnostic method, with a cost-effectiveness analysis and a comparison with traditional tests. Our findings suggest that blood biomarkers are a cost-effective alternative, but with lower accuracy, indicating the need for multiple specific biomarkers for precision. This underscores the importance of future research on new blood biomarkers and their clinical efficacy.

  • Re: Letter to the Editor of Public Health in response to ‘Effect of influenza vaccine subsidies for older adults on vaccination coverage and mortality before and during the COVID-19 pandemic: An ecological study in Japan’

    Ando T., Ibuka Y., Goto R., Haruta J., Le D.D., Fujishima S.

    Public Health (Public Health)  227   e3 - e4 2024.02

    ISSN  00333506

  • Health-related quality of life assessment in children for economic evaluation

    HONDA Kimiko, SHIROIWA Takeru, GOTO Rei, FUKUDA Takashi

    Journal of the National Institute of Public Health (National Institute of Public Health)  71 ( 3 ) 264 - 275 2022.08

    ISSN  1347-6459

    　View Summary

    <p>The use of quality-adjusted life year (QALY) as a measure of benefit is recommended in economic evaluation, which aims to provide evidence for the appropriate allocation of health care resources. This allows for an easier comparison of interventions' effects in different fields. A QALY value is calculated by weighting the life years (LYs) by the quality of life (QOL) score, which is determined by preference-based measure (PBM) and converted from 0 to 1. The QOL score should be obtained through domestic surveys because it reflects the value in the country's general population. In Japan, the data of the QOL scores for adults have been accumulated in recent years. However, few studies for children have been conducted due to various issues in evaluating pediatric health-related QOL (HRQOL). The PBM process for obtaining the QOL score can be divided into “measurement” and “valuation” of the health state to be evaluated. This process is implemented at once in direct methods, whereas it is carried out separately in indirect methods. Direct methods include the rating scale, the time trade-off, and the standard gamble, but children's feasibility, reliability, and validity must be thoroughly investigated. In indirect methods, which is currently the mainstream in general, multi-attribute utility instruments (MAUIs) are used, consisting of a questionnaire to measure the health state and a value set to value the measured health state. However, most MAUIs are designed for adult use and are not suitable for pediatric use because the questions are inappropriate, and the value set is intended to value adult health. In recent years, some MAUIs for pediatric use have been developed. Nevertheless, due to translations and the value set, these are not available in all countries. Additionally, there are no existing MAUIs available for children aged 3 years. Furthermore, issues concerning “measurement,” such as which domains should be assessed and how, and by whom, and issues concerning “valuation,” such as whose preferences should be reflected in developing the value set, and which perspectives should be used, remain. There have been no MAUIs for pediatric use in Japan, but the Japanese version of the EuroQol 5-dimension Youth version (EQ-5D-Y) and its value set have recently been published. It is necessary to fully understand the challenges and limitations in measuring and interpreting the QOL score in children.</p>

  • 【すぐそこまで来た,医師の働き方改革-課題と実現可能性】医師の働き方改革とお金の問題

    後藤 励

    病院 ((株)医学書院)  81 ( 2 ) 127 - 129 2022.02

    ISSN  0385-2377

  • Comment on “Health and Public Health Implications of COVID-19 in Asian Countries”

    Goto R.

    Asian Economic Policy Review (Asian Economic Policy Review)  17 ( 1 ) 39 - 40 2022.01

    ISSN  18328105

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

  • Platform development of claim data analysis for economic analysis of health policy

    2015.04
    -
    2018.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Principal investigator

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Courses Taught 【 Display / hide 】

  • SEMINAR IN BUSINESS ENVIRONMENT

    2025

  • RESEARCH SEMINAR IN BUSINESS ENVIRONMENT

    2025

  • PRINCIPLES OF HEALTH MANAGEMENT

    2025

  • JOINT SEMINAR ON HEALTH MANAGEMENT

    2025

  • INTERNATIONAL FIELD A (EMBA)

    2025

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