Journal of Nippon Medical School: Vol.71 No.3 page.217

Journal of Nippon Medical School

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ArticleTitle 特定機能病院等における包括評価について

AuthorList 木山輝郎¹, 田尻孝¹, 吉行俊郎¹, 谷合信彦¹, 内田英二¹, 徳永昭²

Affiliation ¹日本医科大学大学院医学研究科臓器病態制御外科学
²日本医科大学付属第二病院消化器病センター

Language JA

Volume 71

Issue 3

Year 2004

Page 217-220

Received July 18, 2003

Accepted September 10, 2003

Keywords comprehensive medical insurance system, Diagnosis Procedure Combination (DPC), International Statistical Classification of Diseases and Related Health Problems (ICD-10), standardization of clinical practice

Abstract A Nobel medical payment system, the Diagnosis Procedure Combination (DPC), was implemented in Nippon Medical School Hospital and 81 other specific-function hospitals in 2003. This payment system depends on the length of hospital stay and diagnosis and medical procedures, and differs from the existing payment system, which depends on a piece rate. The daily payment differs for among almost 2,500 groups of DPC defined by the International Statistical Classification of Diseases and Related Health Problems (ICD-10), and procedures, such as operations (K and J codes of the existing payment system). One of the most important outcomes may be a decrease in lengths of hospital stay, because the range of mean lengths of stay in specific-function hospitals has been officially stated to be 14 to 30 days, and the difference between the longest and shortest mean is almost double. The new medical payment system should stimulate competition among hospitals. In order to decrease the length of stay, we developed clinical pathways for patients undergoing surgery, such as laparoscopic cholecystectomy, gastrectomy, and inguinal hernia operations, as well as clinical protocols for the surgical procedures, such as percutaneous transhepatic cholangiodrainage (PTCD) and percutaneous endoscopic gastrostomy (PEG). Health care is undergoing a challenging transition, and we must improve patient care and clinical practice.

Correspondence to Teruo Kiyama, Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
kiyama@nms.ac.jp

ArticleTitle	特定機能病院等における包括評価について
AuthorList	木山輝郎¹, 田尻孝¹, 吉行俊郎¹, 谷合信彦¹, 内田英二¹, 徳永昭²
Affiliation	¹日本医科大学大学院医学研究科臓器病態制御外科学 ²日本医科大学付属第二病院消化器病センター
Language	JA
Volume	71
Issue	3
Year	2004
Page	217-220
Received	July 18, 2003
Accepted	September 10, 2003
Keywords	comprehensive medical insurance system, Diagnosis Procedure Combination (DPC), International Statistical Classification of Diseases and Related Health Problems (ICD-10), standardization of clinical practice
Abstract	A Nobel medical payment system, the Diagnosis Procedure Combination (DPC), was implemented in Nippon Medical School Hospital and 81 other specific-function hospitals in 2003. This payment system depends on the length of hospital stay and diagnosis and medical procedures, and differs from the existing payment system, which depends on a piece rate. The daily payment differs for among almost 2,500 groups of DPC defined by the International Statistical Classification of Diseases and Related Health Problems (ICD-10), and procedures, such as operations (K and J codes of the existing payment system). One of the most important outcomes may be a decrease in lengths of hospital stay, because the range of mean lengths of stay in specific-function hospitals has been officially stated to be 14 to 30 days, and the difference between the longest and shortest mean is almost double. The new medical payment system should stimulate competition among hospitals. In order to decrease the length of stay, we developed clinical pathways for patients undergoing surgery, such as laparoscopic cholecystectomy, gastrectomy, and inguinal hernia operations, as well as clinical protocols for the surgical procedures, such as percutaneous transhepatic cholangiodrainage (PTCD) and percutaneous endoscopic gastrostomy (PEG). Health care is undergoing a challenging transition, and we must improve patient care and clinical practice.
Correspondence to	Teruo Kiyama, Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan kiyama@nms.ac.jp