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