PMID- 15332535
OWN - NLM
STAT- MEDLINE
DCOM- 20040903
LR  - 20061115
IS  - 0385-0684 (Print)
IS  - 0385-0684 (Linking)
VI  - 31
IP  - 8
DP  - 2004 Aug
TI  - [Case mix based payment and DPC from an international perspective].
PG  - 1152-7
AB  - The basic principle of Diagnosis Related Groups (DRG) is to classify patients 
      according to the combination of diagnosis and procedures. The first DRG developed 
      by research at Yale University was adopted for the per-case-payment American 
      Medicare scheme for hospital fees under a DRG/PPS (prospective payment system). 
      This scheme has been refined continuously and adopted as payment systems in other 
      countries. The DPC-based reimbursement scheme in Japan consists of two 
      components; a DPC component and a Fee-For-Service (FFS) component. The DPC 
      component corresponds to the "so-called" hospital fee, includes the hospital 
      basic charge, the pharmaceuticals and supplies used in wards, lab-test, 
      radiological examination, and any procedures costing less than 10,000 yen. The 
      FFS component corresponds to the charges for surgical procedures, pharmaceuticals 
      and supplies used in operation rooms, and procedures costing more than 10,000 
      yen. For the DPC component, a per diem payment schedule is set for each DPC 
      group. One of the most important objectives in introducing the DPC scheme is to 
      ameliorate the transparency of hospital activities in Japan. The DPC system is 
      expected to make hospital services measurable, and then to provide a common 
      ground for discussion among interest groups over the optimal policy to maintain a 
      sustainable Japanese medical care system. However, in order to keep DPC more 
      reliable, much must be done to refine the DPC version 3. For example, development 
      of CCP (Co-morbidity-Complication-Procedure) matrix is now ongoing to more 
      properly describe the resource consumption of each DPC group. It is also 
      important how to evaluate nursing services, ICU services and expensive drugs and 
      materials within the DPC sheme.
FAU - Matsuda, Shinya
AU  - Matsuda S
AD  - Dept of Preventive Medicine and Community Health, School of Medicine, University 
      of Occupational and Environmental Health, Fukuoka, Japan.
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Gan To Kagaku Ryoho
JT  - Gan to kagaku ryoho. Cancer & chemotherapy
JID - 7810034
SB  - IM
MH  - Austria
MH  - Diagnosis-Related Groups/*economics
MH  - Financial Management, Hospital
MH  - France
MH  - Humans
MH  - Japan
MH  - Length of Stay
MH  - Prospective Payment System/*economics
MH  - United States
EDAT- 2004/08/31 05:00
MHDA- 2004/09/04 05:00
CRDT- 2004/08/31 05:00
PHST- 2004/08/31 05:00 [pubmed]
PHST- 2004/09/04 05:00 [medline]
PHST- 2004/08/31 05:00 [entrez]
PST - ppublish
SO  - Gan To Kagaku Ryoho. 2004 Aug;31(8):1152-7.