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.
Medicine ; payment ; System ; Diagnostic ; With quality

The comprehensive daily payment system by DPC developed the standardization of medical care and cost-effectiveness. We can exchange intelligence of other hospitals through the benchmark. Clinical pathways were useful for both the standardization and cost-benefit analysis. The production of pathways improved the communication between hospital employees. The excessive shortening of the average length of hospital stay decreased the rate of bed usage. The DPC payment system leaves much room for improvement in the quality of medical treatment and care.
payment ; System ; Combined ; Procedures ; Hospitals