[Role of the medical institution in comprehensive medical care].
The diagnosis procedure combination (DPC) of Japan started in April 2003. It is a unique "per day" payment system that evolved from diagnosis-related group and prospective payment system, which was a "per case" system. After a trial of two years, various undesirable problems of DPC have been revealed. A review of those problems in major diagnostic classifications (16) is in progress. The main problems are: 1) the medical institution-specific coefficient; 2) up-coding; and 3) consideration for expensive medical equipment such as during cardiac catheterization. The inclusive payment system is described and the problems of DPC are discussed.
Ouchi
Masahiro
M
Social Insurance Medical Fee Payment Fund of Miyagi, Japan.
D003191:Comprehensive Health Care / Q000191:economics / Q000592:standards; D003362:Cost-Benefit Analysis; D003953:Diagnosis-Related Groups / Q000145:classification* / Q000191:economics; D006268:Health Facilities / Q000191:economics / Q000592:standards; D006801:Humans; D007564:Japan; D007902:Length of Stay / Q000191:economics; D011445:Prospective Payment System; D011787:Quality of Health Care