Yagihara Toshikatsu, Kobayashi Junjiro, Ogino Hitoshi, Kagisaki Koji, Hanai Sotaro
Department of Cardiovascular Surgery, Natinal Cardiovascular Center, Suita, Japan.
Nihon Geka Gakkai Zasshi. 2005 Oct;106(10):641-4.
After a new medical expense system "DPC (Diagnosis Procedure Combination)" had been introduced in 2003, the change in the medical treatment fee was evaluated according to each cardiovascular surgical field. Application of the DPC is limited to hospitalization fee in the general ward by a fixed daily amount The former payment system remains for operation, anesthesia, and some invasive examinations such as cardiac catheterization, therefore, the influence of the DPC introduction on cardiovascular surgery was minimum. A lot of problems are still left, however, for the classification of diagnosis, especially in a congenital heart disease, and the fee setting of intensive care. It is required also to reconsider serious cases, advanced complications and methods of life support. In the field of cardiovacular surgery, the treatment is so risky and so expensive, that more detailed analysis should be necessary by establishment of data base system.
2003年引入新的医疗费用系统“诊断程序组合（DPC）”后，根据每个心血管外科领域对医疗费用的变化进行了评估。DPC的应用仅限于普通病房按固定每日金额计算的住院费用。手术、麻醉以及一些侵入性检查（如心导管检查）仍采用以前的支付系统，因此，引入DPC对心血管手术的影响最小。然而，在诊断分类方面，尤其是先天性心脏病以及重症监护费用设定方面，仍然存在许多问题。还需要重新考虑重症病例、晚期并发症和生命支持方法。在心血管外科领域，治疗风险高且费用昂贵，因此有必要通过建立数据库系统进行更详细的分析。
