Goto, Rei



Graduate School of Business Administration (Hiyoshi)



Other Affiliation 【 Display / hide

  • Center of Health Economics and Health Technology Assessment, KGRI

  • Graduate School of Health Management

Career 【 Display / hide

  • 1998.05

    Kobe City General Hospital, Resident in Medicine

  • 2005.04

    Konan University, Faculty of Economics, Lecturer

  • 2007.04

    Konan University, Faculty of Economics, Associate Professor

  • 2012.04

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

Academic Background 【 Display / hide

  • 1992.04

    Kyoto University, School of Medicine

    University, Graduated, Other

  • 2000.04

    Kyoto University, Graduate School of Economics

    Graduate School, Completed, Doctoral course

Academic Degrees 【 Display / hide

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

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

Licenses and Qualifications 【 Display / hide

  • Physician, 1998.04


Research Areas 【 Display / hide

  • Humanities & Social Sciences / Economic policy

  • Humanities & Social Sciences / Public economics and labor economics

  • Life Science / Medical management and medical sociology

Research Keywords 【 Display / hide

  • health technology assessment

  • health policy

  • health economics

  • behavioral economics


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

display all >>

Papers 【 Display / hide

  • Effect of Nudge-Based Intervention on Adherence to Physician Visit Recommendations and Early Health Outcomes among Individuals Identified with Chronic Kidney Disease in Screens

    Fukuma S., Sasaki S., Taguri M., Goto R., Misumi T., Saigusa Y., Tsugawa Y.

    Journal of the American Society of Nephrology : JASN (Journal of the American Society of Nephrology : JASN)  33 ( 1 ) 175 - 185 2022.01

     View Summary

    BACKGROUND: Although CKD screening programs have been provided in many settings, little is known as to how we can effectively translate those screening programs into improved health. METHODS: We conducted a randomized clinical trial on national health screening for CKD in Japan between April 2018 and March 2019. A total of 4011 participants in CKD screening programs aged 40-63 years were randomly assigned to two interventions or the control, with a ratio of 2:2:1, respectively: (1) the nudge-based letter that contained a message on the basis of behavioral economics, (2) the clinical letter including general information about CKD risks, and (3) the control (informed only of the screening results). The main outcome was adherence to a recommended physician visit within 6 months of the intervention. The secondary outcomes were eGFR, proteinuria, and BP 1 year after the intervention. RESULTS: Compared with the control group, the probability of undergoing a recommended physician visit was higher among participants who received the nudge-based letter (19.7% for the intervention group versus 15.8% for the control; difference, +3.9 percentage points [pp]; 95% CI, +0.8 to +7.0; P=0.02) and the clinical letter (19.7% versus 15.8%; difference, +3.9 pp; 95% CI, +0.8 to +7.0; P=0.02). We found no evidence that interventions were associated with improved early health outcomes. CONCLUSIONS: The behavioral economics intervention tested in this large RCT had limited effect on changing behavior or improving health outcomes. Although the approach has promise, this study demonstrates the challenge of developing behavioral interventions that improve the effectiveness of CKD screening programs.Clinical Trial registry name and registration number: University Hospital Medical Information Network Clinical Trial Registry, UMIN000035230.

  • Real-world effectiveness of screening programs for age-related macular degeneration: amended Japanese specific health checkups and augmented screening programs with OCT or AI

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

    Japanese Journal of Ophthalmology (Japanese Journal of Ophthalmology)  66 ( 1 ) 19 - 32 2022.01

    ISSN  00215155

     View Summary

    Purpose: To investigate the effectiveness of screening and subsequent intervention for age-related macular degeneration (AMD) in Japan. Study design: Best-case-scenario analysis using a Markov model. Methods: The clinical effectiveness and cost-effectiveness of screening for AMD were assessed by calculating the reduction proportion of blindness and the incremental cost-effectiveness ratio (ICER). The Markov model simulation began at screening at the age of 40 years and ended at screening at the age of 90 years. The first-eye and second-eye combined model assumed annual state-transition probabilities in the development and treatment of AMD. Data on prevalence, morbidity, transition probability, utility value, and treatment costs were obtained from previously published reports. Sensitivity analysis was performed to assess the influence of the parameters. Results: In the base-case analysis, screening for AMD every 5 years, beginning at age 40 years and ending at age 74 years (reflecting the screening ages of the current Japanese legal “Specific Health Checkups”) showed a decrease of 40.7% in the total number of blind patients. The screening program reduced the number of blind people more than did the additional AREDS/AREDS2 formula supplement intake. However, the ICER of screening versus no screening was ¥9,846,411/QALY, which was beyond what people were willing to pay (WTP) in Japan. Sensitivity analysis revealed that neither OCT nor AI improved the ICER, but the scenario in which the prevalence of smoking decreased by 30% improved the ICER (¥4,655,601/QALY) to the level under the WTP. Conclusions: Ophthalmologic screening for AMD is highly effective in reducing blindness but is not cost-effective, as demonstrated by a Markov model based on real-world evidence from Japan.

  • Examining the association between menstrual symptoms and health-related quality of life among working women in Japan using the EQ-5D

    Shimamoto K., Hirano M., Wada-Hiraike O., Goto R., Osuga Y.

    BMC Women's Health (BMC Women's Health)  21 ( 1 )  2021.12

     View Summary

    Background: Menstrual symptoms have been identified as a substantial burden among women of reproductive age, affecting their health status and quality of life globally. A range of menstrual symptoms have been studied as they affect the health-related quality of life (HRQoL), showing variations across specific menstrual symptoms and study settings. A major concern is demonstrated due to menstrual symptoms in women’s professional and social life, and consequently societal and economic loss for women and the society at large. Yet evidence is scarce that estimates the index form HRQoL score related to menstrual symptoms that is needed for health economic evaluations. Methods: This study aims to investigate the association between menstrual symptoms and the HRQoL among working women in Japan in an index form, using a self-reporting questionnaire (n = 6048). The EQ-5D-3L (EuroQoL 5-dimension 3-level) is used that is a widely used tool to measure health outcomes for health economic evaluations globally. Multivariate regression analysis is conducted to assess the association between the HRQoL score and specific nineteen physical and mental conditions related to menstruation (e.g., pain, heavy bleeding, concentration, negative affect). Results: The index form HRQoL score for menstrual symptoms is estimated as 0.682 in the study population (where a score one suggests perfect health). The association of the HRQoL score varies substantially across the menstrual symptoms. Several of the physical conditions and disorders show a substantial negative association with the HRQoL score. Also, most of the mental and psychological issues are significantly and negatively related to the HRQoL score. Conclusions: This study suggests that HRQoL is substantially and negatively affected by menstruation among working women in Japan. Distinct variations of negative influences across menstrual symptoms underscore the multi-dimensional nature of menstruation and consequently the need of collective interventions to address these difficulties. The evidence of HRQoL continues to be an important area for future research on women’s health and health economic evaluations to inform effective and efficient resource allocations for relevant health policies and financing strategies.

  • Medical costs according to the stages of colorectal cancer: an analysis of health insurance claims in Hachioji, Japan

    Utsumi T., Horimatsu T., Nishikawa Y., Hoshino N., Takahashi Y., Goto R., Kashihara S., Fukuyoshi J., Nakayama T., Seno H.

    Journal of Gastroenterology (Journal of Gastroenterology)  56 ( 10 ) 903 - 913 2021.10

    ISSN  09441174

     View Summary

    Background: Although the effect of the early detection of colorectal cancer (CRC) on medical costs needs to be clarified, there are few reports on the actual medical costs of CRC patients in Japan. We aimed to identify medical costs according to CRC stage, using health insurance claims. Methods: This observational study included CRC patients who had received specific treatment for CRC, which was defined by the procedure code and the claim computer processing system code associated with the treatment of CRC. CRC patients who underwent endoscopic or radical surgical treatment were defined as the curable group and those with palliative treatment, including palliative chemotherapy, as the non-curable group. Total medical costs and medical costs of specific treatments for CRC for 3 years were measured using the claims held by Hachioji City from May 2014 to July 2019. Results: This study included 442 patients in the curable group, including 267 patients who underwent endoscopic treatment, and 175 patients who underwent radical surgical treatment, and 161 patients in the non-curable group. The mean (standard deviation) total medical costs in the curable and non-curable groups were 2,130 (2,494) and 8,279 (5,600) thousand Japanese Yen (JPY), respectively. The mean (standard deviation) medical costs for the specific treatment of CRC in the curable and non-curable groups were 408 (352) and 3,685 (3,479) thousand JPY, respectively. Conclusions: We clarified the actual medical costs of CRC in curable and non-curable groups. These results suggest the effect of early detection of CRC in reducing medical costs.

  • First-year healthcare resource utilization costs of five major cancers in Japan

    Watanabe T., Goto R., Yamamoto Y., Ichinose Y., Higashi T.

    International Journal of Environmental Research and Public Health (International Journal of Environmental Research and Public Health)  18 ( 18 )  2021.09

    ISSN  16617827

     View Summary

    Reports on the expenditure of cancer treatments per patient using comprehensive data remain unavailable in Japan. This study aimed to use Japan’s cancer registry data and health service utilization data for evaluating the disease-specific, per-patient costs of five major cancers—stomach, lung, colorectal, liver, and breast cancers. We used a database linking the 2017 data from a hospital-based cancer registry and the health service utilization data from the Diagnosis Procedure Combination survey. All patients who started their first treatment course at each hospital were included. The costs were calculated using the total volume of the health services provided and the unit fee information included in the data. We analyzed 304,698 patients. Lung cancer had the highest healthcare cost per-patient for the first year of diagnosis and the longest median hospitalization duration. Conversely, breast cancer showed the lowest cost and the shortest median hospitalization duration. However, in the first month after diagnosis, colorectal cancer showed the highest cost. Subsequently, the gaps between the costs of the five common cancers drastically diminished. The cancer type having the longest hospitalization duration had the highest overall healthcare resource utilization costs. This information is essential for care planning and research studies.

display all >>

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

Reviews, Commentaries, etc. 【 Display / hide

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

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


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


Courses Taught 【 Display / hide











display all >>