{
    "abstract": "In April 2020, the Japanese government introduced a Specific Medical Fee for managing secondary dysmenorrhea (SD). This initiative provided financial incentives to medical facilities that provide appropriate management of SD with hormonal therapies. We aimed to assess how this policy affects the management processes and outcomes of patients with SD.\nUsing a large Japanese administrative claims database, we identified outpatient visits of patients diagnosed with SD from April 2018 to March 2022. We used an interrupted time-series analysis and defined before April 2020 as the pre-introduction period and after April 2020 as the post-introduction period. Outcomes were the monthly proportions of outpatient visits due to SD and hormonal therapy among women in the database and the proportions of outpatient visits for hormonal therapy and continuous outpatient visits among patients with SD.\nWe identified 815\u2009477 outpatient visits of patients diagnosed with SD during the pre-introduction period and 920\u2009183 outpatient visits during the post-introduction period. There were significant upward slope changes after the introduction of financial incentives in the outpatient visits due to SD (+0.29% yearly; 95% confidence interval, +0.20% to +0.38%) and hormonal therapies (+0.038% yearly; 95% confidence interval, +0.030% to +0.045%) among the women in the database. Similarly, a significant level change was observed after the introduction of continuous outpatient visits among patients with SD (+2.68% monthly; 95% confidence interval, +0.87% to +4.49%).\nGovernment-issued financial incentives were associated with an increase in the number of patients diagnosed with SD, hormonal therapies, and continuous outpatient visits.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.",
            "firstname": "Risa",
            "initials": "R",
            "lastname": "Ishida"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.\nDepartment of Reproductive Medicine, Chiba University, Chiba, Japan.",
            "firstname": "Kaori",
            "initials": "K",
            "lastname": "Koga"
        },
        {
            "affiliation": "Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.",
            "firstname": "Hiroyuki",
            "initials": "H",
            "lastname": "Ohbe"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.",
            "firstname": "Gentaro",
            "initials": "G",
            "lastname": "Izumi"
        },
        {
            "affiliation": "Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.",
            "firstname": "Hiroki",
            "initials": "H",
            "lastname": "Matsui"
        },
        {
            "affiliation": "Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.",
            "firstname": "Hideo",
            "initials": "H",
            "lastname": "Yasunaga"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.",
            "firstname": "Yutaka",
            "initials": "Y",
            "lastname": "Osuga"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024 The Authors. Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.",
    "doi": "10.1111/jog.15946",
    "journal": "The journal of obstetrics and gynaecology research",
    "keywords": [
        "drug costs",
        "dysmenorrhea",
        "interrupted time series analysis",
        "policy",
        "reimbursement mechanisms"
    ],
    "methods": null,
    "publication_date": "2024-04-10",
    "pubmed_id": "38597093",
    "results": "We identified 815\u2009477 outpatient visits of patients diagnosed with SD during the pre-introduction period and 920\u2009183 outpatient visits during the post-introduction period. There were significant upward slope changes after the introduction of financial incentives in the outpatient visits due to SD (+0.29% yearly; 95% confidence interval, +0.20% to +0.38%) and hormonal therapies (+0.038% yearly; 95% confidence interval, +0.030% to +0.045%) among the women in the database. Similarly, a significant level change was observed after the introduction of continuous outpatient visits among patients with SD (+2.68% monthly; 95% confidence interval, +0.87% to +4.49%).",
    "title": "Impact of government-issued financial incentive to medical facilities on management of secondary dysmenorrhea.",
    "xml": "<Element 'PubmedArticle' at 0x788504417510>"
}