The Medical Income and Expenditure Associated with Acute Pancreatitis Under DPC Circumstances in Japan

Abstract

Under DPC (diagnosis procedure combination) circumstances in Japan, especially for acute pancreatitis, it is said that many hospitals will have reduced income, according to a report from the pancreatitis research group of the Ministry of Health, Labour and Welfare (MHLW) of Japan, 2009. We thought we should better understand the current situations of medical income and expenditure associated with acute pancreatitis in an Emergency and Critical Care Medical Center, and we should elucidate the problems of an inadequate system. We retrospectively evaluated 39 cases that were coded for the DPC system under the code name of acute pancreatitis. The total balance of all cases ran into the red to the tune of-JPY 4704660. 16 cases (41.0%), with a loss being seen in 23 cases (59.0%). In the profit cases the average amount was (JPY) 29954.3 with an average loss of (JPY) 225388.3 in the other unprofitable cases. Under the MHLW severity assessment of acute pancreatitis, mild cases accounted for 31 (79.5%) and severe cases for 8 (20.5%). A loss was made in 16 cases of mild acute pancreatitis and 7 cases of severe pancreatitis. The mean length of hospital stay was 11.8 days in the profitable cases and 22.7 days for those cases in which a deficit was seen. Severe pancreatitis cases have a tendency to create a negative balance under the current DPC/PDPS system. To avert the risk of hospitals going into the red financially as far as the treatment of acute pancreatitis patients is concerned, readjustment of the severity assessment of the current DPC system is required.