Goto, Rei

写真a

Affiliation

Graduate School of Business Administration (Hiyoshi)

Position

Professor
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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 】

  • 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.

  • The relationship between long COVID, labor productivity, and socioeconomic losses in Japan: A cohort study

    Konishi S., Masaki K., Shimamoto K., Ibuka Y., Goto R., Namkoong H., Chubachi S., Terai H., Asakura T., Miyata J., Azekawa S., Nakagawara K., Tanaka H., Morita A., Harada N., Sasano H., Nakamura A., Kusaka Y., Ohba T., Nakano Y., Nishio K., Nakajima Y., Suzuki S., Yoshida S., Tateno H., Fukunaga K.

    IJID Regions 14 2025.03

    　View Summary

    Objectives: We examined shifts in labor productivity and their economic ramifications among adult patients with long COVID in Japan. Methods: A total of 396 patients were categorized into three groups based on symptom progression: non-long COVID, long COVID recovered, and long COVID persistent. Patient-reported outcomes were assessed at three time intervals: 3, 6, and 12 months after COVID-19 diagnosis. Labor productivity was gauged through presenteeism and absenteeism, measured using the World Health Organization Health and Work Performance Questionnaire. Results: Long COVID was observed in 52.7% of patients, and 29.3% of all the patients continued to experience long COVID symptoms 1 year after diagnosis. At all three time points (3, 6, and 12 months after diagnosis), the long COVID persistent group showed a statistically significant difference in absolute presenteeism compared with the non-long COVID and long COVID recovered groups (P <0.01). Economic loss owing to decrease in labor productivity was calculated as $21,659 per year in the long COVID persistent group and $9008 per year in the long COVID recovered group (P <0.01). Conclusion: The study's results revealed a notable decline in labor productivity over time, underscoring the importance of early detection and intervention to mitigate the socio-economic repercussions of long COVID, in addition to its health implications.

  • Utilisation of outpatient care immediately before emergency admission for ambulatory care-sensitive conditions in Japan: a retrospective observational study

    Nagashima R., Kato H., Matsuzaki T., Nagahama T., Goto R.

    BMJ Open 15 ( 1 )  2025.01

    　View Summary

    Objective This study assessed whether patients with potentially preventable emergency admissions had limited access to outpatient care immediately before admission and whether they received appropriate outpatient care during their outpatient visits. Design Retrospective observational study. Setting Linked outpatient and inpatient care records obtained from a nationwide claims database in Japan. Participants Patients who experienced emergency admissions for ambulatory care-sensitive conditions between April 2005 and March 2020. Patient and regional characteristics were examined to assess the types of patients who faced difficulties with outpatient visits and receiving outpatient care related to the disease that resulted in admissions (hereafter referred to as admission-related outpatient care). Main outcome measures (1) Whether patients had an outpatient visit during the 2 weeks preceding admission and (2) whether patients received admission-related outpatient care during the 2 weeks before admission. Results This study included 18 449 emergency admissions for ambulatory care-sensitive conditions, representing 16.3% (18 449/113 669) of all emergency admissions in our data. Among patients with emergency admissions for ambulatory care-sensitive conditions, 37.4% did not have an outpatient visit within the 2 weeks preceding admission and 29.9% did not receive admission-related outpatient care despite having an outpatient visit. In total, 67.4% did not receive admission-related outpatient care during the 2 weeks preceding admission. Patients in their 40s and 50s were less likely to have outpatient visits and receive admission-related outpatient care before admission. No evidence associates regional characteristics with outpatient visits and receiving admission-related outpatient care before admission. Conclusion Most patients who underwent emergency admissions for ambulatory care-sensitive conditions did not have an outpatient visit or receive admission-related outpatient care, despite having an outpatient visit immediately before admission. Our findings suggest that emergency admissions may be prevented by improving access to timely and effective outpatient care.

  • Health utility value of overactive bladder in Japanese older adults

    Yoshioka T., Omae K., Funada S., Minami T., Goto R.

    BJUI Compass 6 ( 1 )  2025.01

    　View Summary

    Objectives: To determine the health utility values (HUVs) of overactive bladder (OAB), defined as urinary urgency, usually accompanied by urinary daytime or nocturnal frequency, with or without urinary incontinence, among adults aged ≥65 years and to assess the HUV decrements (disutilities) of OAB according to its severity. Methods: This cross-sectional Internet-based study was conducted between 2 and 9 November 2023, with quota sampling with equal probability for each sex and age group (age 65–74 years and ≥75 years). OAB was defined as an urgency score of ≥2 points and a total score of ≥3 points based on the Overactive Bladder Symptom Score. OAB severity was categorized as mild (total score, ≤5 points) or moderate-to-severe (total score, 6–15 points). HUVs were measured using the EuroQol five-dimension five-level value set for the Japanese population. Multivariable linear regression models were fitted to estimate the covariate-adjusted disutilities of OAB. We selected eight covariates (age, sex, body mass index, education, income, smoking, alcohol use, and comorbidities) as potential confounders based on previous studies. The sample size was determined based on previous studies without statistical power calculations. Results: Among the 998 participants (51.9% male; mean age, 73.2 years), 158 (15.9%) had OAB, of whom 87 (8.8%) had moderate-to-severe OAB. The mean HUVs for participants with mild and moderate-to-severe OAB were 0.874 and 0.840, respectively, which were lower compared with the HUV for those without OAB (0.913). After adjusting for relevant covariates, disutilities (95% confidence intervals [CIs] and p values) for mild and moderate-to-severe OAB were −0.0334 (−0.0602 to −0.0066, p = 0.014) and −0.0591 (−0.0844 to −0.0339, p < 0.001), respectively. Conclusions: Consistent with previous HUV studies on OAB, our results demonstrated that the prevalence of OAB was associated with substantially lower HUV. The results demonstrate that increased OAB severity is associated with greater disutility.

  • Research Study on the Cost Structure and Break-Even Point of Mechanical Thrombectomy in Japan

    Yamasaki Bumpei, Goto Rei, Imamura Hirotoshi, Sasanuma Jinichi

    Journal of Neuroendovascular Therapy (The Japanese Society for Neuroendovascular Therapy)  19 ( 1 ) n/a 2025

    ISSN  18824072

    　View Summary

    <p><b>Objective:</b> Mechanical thrombectomy (MT) is an important procedure in the treatment of acute cerebral infarction, and its effectiveness depends largely on timely intervention after the onset. In the United States, a tiered accreditation system of stoke centers has been established to provide MT efficiently. In Japan, however, despite the large number of medical institutions performing MT, the establishment of a tiered accreditation system has yet to be seen. The low number of cases treated per institution raises concerns about the economic sustainability of MT in Japan because significant capital and human resource investment are required. This study aims to investigate the cost structure of MT procedure and the break-even point in 2 different hospital settings in Japan.</p><p><b>Methods:</b> We conducted a detailed cost analysis of MT at 2 distinct hospitals: Hospital A, a large public hospital in a government-designated city, and Hospital B, a private non-profit hospital in the Tokyo metropolitan area. Data collection involved face-to-face interviews with department heads and a structured survey based on the Japanese Hospital Accounting Standards, focusing on material, labor, and facility-related costs. Break-even points were calculated considering both fixed and variable costs, with adjustments made for the shared use of facilities in Hospital B.</p><p><b>Results:</b> The total cost per case was 349256 yen in Hospital A and 245150 yen in Hospital B, respectively. The total cost per case was elevated to 559866 yen assuming only MT was performed at Hospital B. This figure was significantly higher than the reimbursement price of MT (331500 yen). The number of procedures needed to exceed the break-even point for MT was approximately 290 cases per year in Hospital A and 125 cases per year in Hospital B, respectively.</p><p><b>Conclusion:</b> We conducted a break-even analysis of MT based on an interview survey. The number of cases required to cross the break-even point for MT alone was much higher than the actual number of MT procedures being performed in the 2 hospitals.</p>

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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

    2024

  • RESEARCH SEMINAR IN BUSINESS ENVIRONMENT

    2024

  • QOL AND COST ANALYSIS

    2024

  • PRINCIPLES OF HEALTH MANAGEMENT

    2024

  • JOINT SEMINAR ON HEALTH MANAGEMENT

    2024

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