Takahashi Hakuo
Department of Clinical Sciences and Laboratory Medicine, Kansai Medical University, Moriguchi 570-8507.
Rinsho Byori. 2003 Sep;51(9):871-7.
The Japanese health insurance system has been praised because of the comprehensive coverage of medical costs. The long lifespan of Japanese, the longest in the world, however, because economic conditions are getting worse and medical costs are increasing with the increase of aged people in Japan, the health insurance system is under pressure. The Japanese government is going to start to reduce costs of medical care by applying a system like the DRG/PPS system in the USA, called Diagnosis Procedure Combination(DPC), next year in university hospitals. Under the DPC system, laboratory tests will be non-profit. We have to change the management style of clinical laboratories to cut costs for tests and labor as much as possible, choose tests selectively, respond rapidly to clinical needs, and utilize information technology efficiently for processing of laboratory data. Therefore, corresponding to changes in the medical care system, laboratory medicine has been changing. Commercial clinical laboratories are expanding their pressure in hospitals, and in-hospital laboratories are having a very hard time coping with the pressure. Since laboratory medicine is an essential part of clinical practice, we do not have to be antagonistic.
日本的医疗保险制度因其对医疗费用的全面覆盖而受到赞誉。然而，日本人的寿命是世界上最长的，由于经济状况日益恶化，且随着日本老年人口的增加医疗费用不断上涨，医疗保险制度面临压力。日本政府将于明年在大学医院推行一种类似美国诊断相关分组/按病种付费（DRG/PPS）系统的制度，即诊断程序组合（DPC），以开始降低医疗成本。在DPC系统下，实验室检查将是非营利性的。我们必须改变临床实验室的管理方式，尽可能削减检查和人力成本，有选择地进行检查，迅速响应临床需求，并有效利用信息技术处理实验室数据。因此，对应医疗体系的变化，检验医学一直在发生改变。商业临床实验室在医院施加的压力不断增大，医院内部实验室很难应对这种压力。由于检验医学是临床实践的重要组成部分，我们不必相互对立。
