{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T01:39:54Z","timestamp":1776994794275,"version":"3.51.4"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Japan Health Insurance Association"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Health Econ Rev"],"DOI":"10.1186\/s13561-026-00753-9","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T06:05:38Z","timestamp":1773727538000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medical care cost dynamics during COVID-19 pandemic: financial implications for Japanese health insurance system"],"prefix":"10.1186","volume":"16","author":[{"given":"Yuji","family":"Hiramatsu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Frui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroo","family":"Ide","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"753_CR1","unstructured":"World Health Organization. WHO Director-General\u2019s opening remarks at the media briefing on COVID-19\u201311. March 2020. https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. Accessed 11 Dec 2024."},{"key":"753_CR2","doi-asserted-by":"publisher","first-page":"e060390","DOI":"10.1136\/bmjopen-2021-060390","volume":"12","author":"S Yamaguchi","year":"2022","unstructured":"Yamaguchi S, Okada A, Sunaga S, Kurakawa KI, Yamauchi T, Nangaku M, et al. Impact of COVID-19 pandemic on healthcare service use for non-COVID-19 patients in Japan: retrospective cohort study. BMJ Open. 2022;12:e060390. https:\/\/doi.org\/10.1136\/bmjopen-2021-060390.","journal-title":"BMJ Open"},{"key":"753_CR3","doi-asserted-by":"publisher","unstructured":"Akashi J, Hino A, Tateishi S, Nagata T, Tsuji M, Ogami A, et al. Spread of infection and treatment interruption among Japanese workers during the COVID-19 pandemic: A cross-sectional study. Front Public Health. 2022;10. https:\/\/doi.org\/10.3389\/fpubh.2022.921966.","DOI":"10.3389\/fpubh.2022.921966"},{"key":"753_CR4","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.1007\/s11606-022-07422-7","volume":"37","author":"T Aoki","year":"2022","unstructured":"Aoki T, Matsushima M. The Ecology of Medical Care During the COVID-19 Pandemic in Japan: a Nationwide Survey. J GEN INTERN MED. 2022;37:1211\u20137. https:\/\/doi.org\/10.1007\/s11606-022-07422-7.","journal-title":"J GEN INTERN MED"},{"key":"753_CR5","doi-asserted-by":"publisher","first-page":"476","DOI":"10.2188\/jea.JE20220032","volume":"32","author":"S Yagome","year":"2022","unstructured":"Yagome S, Sugiyama T, Inoue K, Igarashi A, Bouchi R, Ohsugi M, et al. Influence of the COVID-19 Pandemic on Overall Physician Visits and Telemedicine Use Among Patients With Type 1 or Type 2 Diabetes in Japan. J Epidemiol. 2022;32:476\u201382. https:\/\/doi.org\/10.2188\/jea.JE20220032.","journal-title":"J Epidemiol"},{"key":"753_CR6","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1007\/s11606-020-06413-w","volume":"36","author":"R Ikesu","year":"2021","unstructured":"Ikesu R, Miyawaki A, Sugiyama T, Nakamura M, Ninomiya H, Kobayashi Y. Trends in Diabetes Care during the COVID-19 Outbreak in Japan: an Observational Study. J GEN INTERN MED. 2021;36:1460\u20132. https:\/\/doi.org\/10.1007\/s11606-020-06413-w.","journal-title":"J GEN INTERN MED"},{"key":"753_CR7","doi-asserted-by":"publisher","first-page":"e29458","DOI":"10.1097\/MD.0000000000029458","volume":"101","author":"T Maeda","year":"2022","unstructured":"Maeda T, Nishi T, Harada M, Tanno K, Nishiya N, Asayama K, et al. Influence of the COVID-19 pandemic on regular clinic visits and medication prescriptions among people with diabetes: Retrospective cohort analysis of health care claims. Medicine. 2022;101:e29458. https:\/\/doi.org\/10.1097\/MD.0000000000029458.","journal-title":"Medicine"},{"key":"753_CR8","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1186\/s12913-025-12798-3","volume":"25","author":"T Ishikawa","year":"2025","unstructured":"Ishikawa T, Kako A, Sato J, Hattori J, Yoshimoto H, Kitsuregawa M, et al. Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysis. BMC Health Serv Res. 2025;25:721. https:\/\/doi.org\/10.1186\/s12913-025-12798-3.","journal-title":"BMC Health Serv Res"},{"key":"753_CR9","doi-asserted-by":"publisher","first-page":"2411","DOI":"10.1038\/s41598-025-87072-x","volume":"15","author":"F Endo","year":"2025","unstructured":"Endo F, Hiramatsu Y, Ide H. Impact of the COVID-19 pandemic on utilization of mental health services among children and adolescents using an interrupted time series analysis. Sci Rep. 2025;15:2411. https:\/\/doi.org\/10.1038\/s41598-025-87072-x.","journal-title":"Sci Rep"},{"key":"753_CR10","unstructured":"Ministry of Health, Labour and, Welfare J, Overview of National Medical Expenditure for Fiscal Year. 2022. https:\/\/www.mhlw.go.jp\/toukei\/saikin\/hw\/k-iryohi\/22\/. Accessed 3 Sept 2025."},{"key":"753_CR11","unstructured":"OECDData Explorer \u2022 Health expenditure and financing. https:\/\/data-explorer.oecd.org\/. Accessed 24 July 2025."},{"key":"753_CR12","doi-asserted-by":"publisher","first-page":"e045343","DOI":"10.1136\/bmjopen-2020-045343","volume":"11","author":"R Moynihan","year":"2021","unstructured":"Moynihan R, Sanders S, Michaleff ZA, Scott AM, Clark J, To EJ, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open. 2021;11:e045343. https:\/\/doi.org\/10.1136\/bmjopen-2020-045343.","journal-title":"BMJ Open"},{"key":"753_CR13","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1016\/j.pcd.2021.05.011","volume":"15","author":"S Seidu","year":"2021","unstructured":"Seidu S, Kunutsor SK, Cos X, Khunti K. Indirect impact of the COVID-19 pandemic on hospitalisations for cardiometabolic conditions and their management: A systematic review. Prim Care Diabetes. 2021;15:653\u201381. https:\/\/doi.org\/10.1016\/j.pcd.2021.05.011.","journal-title":"Prim Care Diabetes"},{"key":"753_CR14","doi-asserted-by":"publisher","first-page":"1314","DOI":"10.1038\/s41591-022-01750-1","volume":"28","author":"C Arsenault","year":"2022","unstructured":"Arsenault C, Gage A, Kim MK, Kapoor NR, Akweongo P, Amponsah F, et al. COVID-19 and resilience of healthcare systems in ten countries. Nat Med. 2022;28:1314\u201324. https:\/\/doi.org\/10.1038\/s41591-022-01750-1.","journal-title":"Nat Med"},{"key":"753_CR15","doi-asserted-by":"publisher","unstructured":"Tuczy\u0144ska M, Matthews-Kozanecka M, Baum E. Accessibility to Non-COVID Health Services in the World During the COVID-19 Pandemic: Review. Front Public Health. 2021;9. https:\/\/doi.org\/10.3389\/fpubh.2021.760795.","DOI":"10.3389\/fpubh.2021.760795"},{"key":"753_CR16","doi-asserted-by":"publisher","unstructured":"Nguyen D, Kavanagh S, Bowe S, Tan E, Moodie M, Gao L. Impact of COVID-19 on hospitalization for heart failure: a perspective from Victoria, Australia. Eur J Cardiovasc Nurs. 2025;zvae180. https:\/\/doi.org\/10.1093\/eurjcn\/zvae180.","DOI":"10.1093\/eurjcn\/zvae180"},{"key":"753_CR17","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s13561-021-00353-9","volume":"12","author":"Y Hiramatsu","year":"2022","unstructured":"Hiramatsu Y, Ide H, Tsuchiya A, Furui Y. Examining proximity to death and health care expenditure by disease: a Bayesian-based descriptive statistical analysis from the National Health Insurance database in Japan. Health Econ Rev. 2022;12:6. https:\/\/doi.org\/10.1186\/s13561-021-00353-9.","journal-title":"Health Econ Rev"},{"key":"753_CR18","doi-asserted-by":"crossref","unstructured":"Klugman SA, Panjer HH, Willmot GE. Loss Models. Wiley Online Library. 2008. https:\/\/onlinelibrary.wiley.com\/doi\/book\/10.1002\/9780470391341. Accessed 24 July 2025.","DOI":"10.1002\/9780470391341"},{"key":"753_CR19","unstructured":"Ministry of Health. Labour and Welfare, Japan. Health Insurance and Seamen\u2019s Insurance Business Status Report: Summary of Results. https:\/\/www.mhlw.go.jp\/stf\/seisakunitsuite\/bunya\/iryouhoken\/database\/seido\/kenpo_zyoukyou_b.html#gaiyo. Accessed 21 Aug 2025."},{"key":"753_CR20","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s12874-021-01235-8","volume":"21","author":"AL Schaffer","year":"2021","unstructured":"Schaffer AL, Dobbins TA, Pearson S-A. Interrupted time series analysis using autoregressive integrated moving average (ARIMA) models: a guide for evaluating large-scale health interventions. BMC Med Res Methodol. 2021;21:58. https:\/\/doi.org\/10.1186\/s12874-021-01235-8.","journal-title":"BMC Med Res Methodol"},{"key":"753_CR21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v027.i03","volume":"27","author":"RJ Hyndman","year":"2008","unstructured":"Hyndman RJ, Khandakar Y. Automatic Time Series Forecasting: The forecast Package for R. J Stat Softw. 2008;27:1\u201322. https:\/\/doi.org\/10.18637\/jss.v027.i03.","journal-title":"J Stat Softw"},{"key":"753_CR22","unstructured":"Statistics Bureau of Japan. 2020 Summary of the results and statistical tables. https:\/\/www.stat.go.jp\/english\/data\/kokusei\/2020\/summary.html. Accessed 9 Jan 2026."},{"key":"753_CR23","doi-asserted-by":"publisher","first-page":"321","DOI":"10.31662\/jmaj.2023-0040","volume":"6","author":"S Yamaguchi","year":"2023","unstructured":"Yamaguchi S, Atarashi T, Okada A, Nasu S, Yamauchi T, Arase Y, et al. Impact of the COVID-19 Pandemic on Health Check-ups: A Nationwide Questionnaire Survey in 639 Healthcare Facilities in Japan Society of Ningen Dock. JMA J. 2023;6:321\u201331. https:\/\/doi.org\/10.31662\/jmaj.2023-0040.","journal-title":"JMA J"},{"key":"753_CR24","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.clbc.2023.01.001","volume":"23","author":"K Adachi","year":"2023","unstructured":"Adachi K, Kimura F, Takahashi H, Kaise H, Yamada K, Ueno E, et al. Delayed Diagnosis and Prognostic Impact of Breast Cancer During the COVID-19 Pandemic. Clin Breast Cancer. 2023;23:265\u201371. https:\/\/doi.org\/10.1016\/j.clbc.2023.01.001.","journal-title":"Clin Breast Cancer"},{"key":"753_CR25","doi-asserted-by":"publisher","first-page":"n1135","DOI":"10.1136\/bmj.n1135","volume":"373","author":"J Bodilsen","year":"2021","unstructured":"Bodilsen J, Nielsen PB, S\u00f8gaard M, Dalager-Pedersen M, Speiser LOZ, Yndigegn T, et al. Hospital admission and mortality rates for non-covid diseases in Denmark during covid-19 pandemic: nationwide population based cohort study. BMJ. 2021;373:n1135. https:\/\/doi.org\/10.1136\/bmj.n1135.","journal-title":"BMJ"},{"key":"753_CR26","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/S1470-2045(20)30388-0","volume":"21","author":"C Maringe","year":"2020","unstructured":"Maringe C, Spicer J, Morris M, Purushotham A, Nolte E, Sullivan R, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol. 2020;21:1023\u201334. https:\/\/doi.org\/10.1016\/S1470-2045(20)30388-0.","journal-title":"Lancet Oncol"},{"key":"753_CR27","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.23687","author":"N Kurra","year":"2022","unstructured":"Kurra N, Woodard PI, Gandrakota N, Gandhi H, Polisetty SR, Ang SP, et al. Opportunistic Infections in COVID-19: A Systematic Review and Meta-Analysis. Cureus. 2022. https:\/\/doi.org\/10.7759\/cureus.23687.","journal-title":"Cureus"},{"key":"753_CR28","doi-asserted-by":"publisher","first-page":"2010","DOI":"10.1377\/hlthaff.2020.00980","volume":"39","author":"JD Birkmeyer","year":"2020","unstructured":"Birkmeyer JD, Barnato A, Birkmeyer N, Bessler R, Skinner J. The Impact Of The COVID-19 Pandemic On Hospital Admissions In The United States. Health Aff. 2020;39:2010\u20137. https:\/\/doi.org\/10.1377\/hlthaff.2020.00980.","journal-title":"Health Aff"},{"key":"753_CR29","doi-asserted-by":"publisher","unstructured":"Martinez F, Papi A, Welte T, Singh D, Galkin D, Guasconi A et al. COPD Exacerbations Before and During COVID-19 in France, Germany, Italy, the UK and the US. COPD 2024;Volume 19:1433\u201345. https:\/\/doi.org\/10.2147\/COPD.S451009","DOI":"10.2147\/COPD.S451009"},{"key":"753_CR30","doi-asserted-by":"publisher","first-page":"3100","DOI":"10.1186\/s12889-024-20594-7","volume":"24","author":"O Niemenoja","year":"2024","unstructured":"Niemenoja O, \u00c4mm\u00e4l\u00e4 A-J, Riihij\u00e4rvi S, Lillrank P, Bono P, Taimela S. The impact of COVID-19 on private healthcare service utilisation: time series analysis in the capital region of Finland during 2020\u20132022. BMC Public Health. 2024;24:3100. https:\/\/doi.org\/10.1186\/s12889-024-20594-7.","journal-title":"BMC Public Health"},{"key":"753_CR31","doi-asserted-by":"publisher","unstructured":"Dadashi M, Khaleghnejad S, Abedi Elkhichi P, Goudarzi M, Goudarzi H, Taghavi A, et al. COVID-19 and Influenza Co-infection: A Systematic Review and Meta-Analysis. Front Med. 2021;8. https:\/\/doi.org\/10.3389\/fmed.2021.681469.","DOI":"10.3389\/fmed.2021.681469"},{"key":"753_CR32","doi-asserted-by":"publisher","first-page":"e39181","DOI":"10.2196\/39181","volume":"11","author":"T Ishikawa","year":"2022","unstructured":"Ishikawa T, Sato J, Hattori J, Goda K, Kitsuregawa M, Mitsutake N. The Association Between Telehealth Utilization and Policy Responses on COVID-19 in Japan: Interrupted Time-Series Analysis. Interact J Med Res. 2022;11:e39181. https:\/\/doi.org\/10.2196\/39181.","journal-title":"Interact J Med Res"},{"key":"753_CR33","doi-asserted-by":"publisher","first-page":"113190","DOI":"10.1016\/j.psychres.2020.113190","volume":"291","author":"M Luo","year":"2020","unstructured":"Luo M, Guo L, Yu M, Jiang W, Wang H. The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public \u2013 A systematic review and meta-analysis. Psychiatry Res. 2020;291:113190. https:\/\/doi.org\/10.1016\/j.psychres.2020.113190.","journal-title":"Psychiatry Res"},{"key":"753_CR34","unstructured":"Japan Medical Association Research Institute. 8th Survey on Attitudes toward Medical Care in Japan. https:\/\/www.jmari.med.or.jp\/result\/working\/post-4027\/. Accessed 8 Aug 2025."},{"key":"753_CR35","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1097\/JOM.0000000000002486","volume":"64","author":"M Suka","year":"2022","unstructured":"Suka M, Shimazaki T, Yamauchi T, Yanagisawa H. Increased Health Risk in Office Workers in the COVID-19 Era: Comparison of One-Year Incidence of Health Problems Before and During the COVID-19 Pandemic. J Occup Environ Med. 2022;64:271. https:\/\/doi.org\/10.1097\/JOM.0000000000002486.","journal-title":"J Occup Environ Med"},{"key":"753_CR36","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s12199-021-00957-x","volume":"26","author":"M Suka","year":"2021","unstructured":"Suka M, Yamauchi T, Yanagisawa H. Changes in health status, workload, and lifestyle after starting the COVID-19 pandemic: a web-based survey of Japanese men and women. Environ Health Prev Med. 2021;26:37. https:\/\/doi.org\/10.1186\/s12199-021-00957-x.","journal-title":"Environ Health Prev Med"},{"key":"753_CR37","doi-asserted-by":"publisher","first-page":"e64159","DOI":"10.2196\/64159","volume":"26","author":"Y Sugawara","year":"2024","unstructured":"Sugawara Y, Hirakawa Y, Iwagami M, Kuroki H, Mitani S, Inagaki A, et al. Issues in the Adoption of Online Medical Care: Cross-Sectional Questionnaire Survey. J Med Internet Res. 2024;26:e64159. https:\/\/doi.org\/10.2196\/64159.","journal-title":"J Med Internet Res"}],"container-title":["Health Economics Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13561-026-00753-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13561-026-00753-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13561-026-00753-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T01:15:16Z","timestamp":1776993316000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13561-026-00753-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["753"],"URL":"https:\/\/doi.org\/10.1186\/s13561-026-00753-9","relation":{},"ISSN":["2191-1991"],"issn-type":[{"value":"2191-1991","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"20 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by the ethics committee of the Institute for Future Initiatives at The University of Tokyo (Approval No. 23\u2013122). The requirement for informed consent was waived by the same ethics committee because the research data were anonymized. All study methods were implemented in accordance with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"51"}}