title: [A DRG/PPS simulation in the medical care of tuberculosis].
abstract: OBJECTIVE
  To study the expected usefulness of the introduction of the DRG-PPS (Diagnosis-Related Group/Prospective Payment System, in which an insurer pays a fixed medical fee per hospitalization) into the current medical care of tuberculosis (TB) in Japan.
  
  
  METHODS
  The medical fees were reviewed for all TB inpatients at 19 hospitals under the National Hospital Organization who were discharged in either June 2007 or February 2008. The sum of the fixed fee by the DRG was assumed based on the bivariate regression analysis of each patient's hospital days and his or her total actual fees during the hospital stay under the current (fee for care) system, since it was difficult to directly calculate the daily fees for every patient that would be the basis of DRG-PPS.
  
  
  RESULTS
  Linear regression analysis estimated that the medical fees (including fees for the medical examinations and the treatments) for a hospital stay of 60 days, which is the standard for TB treatment, was 1,192,470 yen (19,870 yen per person per day) in June 2007, and 1,167,600 yen (19,460 yen per person per day) in February 2008.
  
  
  CONCLUSIONS
  If we assume an average medical fee of about Y1.1-1.2 million yen for the standard hospital care of TB, the economic balance of the hospitals is negative, with a deficit of 0.6-0.7 million yen, given the estimated expenses of 1.8 million yen (i.e., 30,000 yen per person per day x 60 days).
  
  
  CONCLUSIONS
  If the DRG-PPS is to be implemented based on the current medical fee rating system, the hospital administrators could not accept its introduction to the TB medical care service as it is, because it may undermine the economic management of hospitals.
authors.affiliation: Katsuyuki Tobise, National Hospital Organization Sapporo Minami National Hospital, 1814 Shirakawa, Minami-ku, Sapporo-shi, Hokkaido 061-2276 Japan. tobise@a1.mbn.or.jp
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Tobise
authors.forename: Mamoru
authors.initials: M
authors.lastname: Miyairi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Shinobu
authors.initials: S
authors.lastname: Waga
authors.forename: Shimao
authors.initials: S
authors.lastname: Fukai
authors.forename: Fumio
authors.initials: F
authors.lastname: Yamagishi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Hideki
authors.initials: H
authors.lastname: Yotsumoto
authors.forename: Masao
authors.initials: M
authors.lastname: Tano
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishimura
authors.forename: Takuya
authors.initials: T
authors.lastname: Kurasawa
authors.forename: Kouji
authors.initials: K
authors.lastname: Sagami
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ueoka
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Nishimura
authors.forename: Michio
authors.initials: M
authors.lastname: Ueno
authors.forename: Teruaki
authors.initials: T
authors.lastname: Mori
authors.forename: Seiji
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Sakatani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003953:Diagnosis-Related Groups; D006801:Humans; D007564:Japan; D008875:Middle Aged; D011445:Prospective Payment System; D014376:Tuberculosis / Q000191:economics / Q000628:therapy*