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J.Jpn. Surg. Soc.. 106(10): 637-640, 2005


Feature topic

ROLE OF THE MEDICAL INSTITUTION IN COMPREHENSIVE MEDICAL CARE

Social Insurance Medical Fee Payment Fund of Miyagi, Japan

Masahiro Ouchi

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.


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