Ouchi Masahiro
Social Insurance Medical Fee Payment Fund of Miyagi, Japan.
Nihon Geka Gakkai Zasshi. 2005 Oct;106(10):637-40.
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.
日本的诊断程序组合（DPC）于2003年4月启动。它是一种独特的“每日”支付系统，由诊断相关组和前瞻性支付系统演变而来，后者是一种“每例”系统。经过两年的试行，DPC的各种不良问题已被揭示。目前正在对主要诊断分类（16种）中的这些问题进行审查。主要问题有：1）医疗机构特定系数；2）高编；3）对心脏导管插入术等昂贵医疗设备的考量。文中描述了包容性支付系统并讨论了DPC的问题。
