Quality of Medicine and Diagnosis Procedure Combination (DPC) Payment System: A Survey

Author: Eiichi YABATA ; Hisao TAMAKI
Publication Type:Journal Article
MeSH: Medicine; payment; System; Diagnostic; With quality
From:Journal of the Japanese Association of Rural Medicine 2009;58(1):26-33
CountryJapan
Language:Japanese
Abstract: DPC is the diagnosis dominant classification defined by diagnosis and procedures. The comprehensive daily payment system by DPC is being implemented in 731 hospitals across Japan. Of the hospitals affiliated with the Japanese Federation of Agricultural Cooperatives for Health and Welfare, 24 hospitals introduced this system in 2008. In September 2008 we mailed a questionnaire to them, and 23 hospitals responded. The mean of the comprehensive pay amounted to 105% of the piece rate. The average length of hospital stay shortened from 15.7 to 14.2 days. The bed occupancy rate decreased from 86.5 to 81.4%. For the preservation of the bed usage, most of the respondents said it was essential to keep in contact with neighboring hospitals and clinics. The adaptation rate of clinical pathways was only 29%. The proportion of generic drugs was 5.9%. In the DPC payment system it is necessary to maintain both the quality of medicine and the cost-effectiveness.