Abstract
‘Diagnosis Related Group/Prospective Payment System’ (DRG/PPS in Japan) has started on 1 November 1997 at 8 national and 2 social insurance hospitals. At that time, the system consisted of only 183 DRG and PPS was applied to all of them. (30% or less of in-patients were eligible for DRG/PPS) Then, based on 2 years of data, DRG were revised in April 2001 into 532 of which 267groups were linked to PPS, and the ICD-10 codes replaced ICD-9 codes.
In this symposium, Professor S. Matsuda, University of Occupational and Environmental Health, explained how DRG were used in France and other European countries, and presented the project on development of new DRG system suitable to health insurance scheme in Japan. I. Suzuki, MD, and K. Yoshida, MD, the vice directors of two national hospitals, showed from view point of hospital management that the effect of current DRG was difficult to assess because some DRG were inadequately classified and PPS were not always cost-related. However, they indicated that a small decrease in average period of hospitalization has led to improvement in balance of working revenues and expenses. K. Yoshida, MD, also added that adoption of clinical paths to DRG would be more useful. Mr. M, Anan, health information administrator, who has analyzed the clinical data provided by doctors, emphasized the importance of accurate application of the ICD-10 codesto each diagnosis with collaboration between doctors and information administrators.
DRG/PPS is now a vital factor that has begun to change health insurance scheme in Japan; therefore, we, as workers at national medical institutions should have stronger interest in the system for further understanding and actively participate in the project.
