DRG in the European countries

-Lesson from French experience-

Abstract

Among the developed countries, it is a common problem how to control the medical expenditures. In order to harmonize such cost containment programs with the improvement of medical services, we need an appropriate information system that reflects both clinical and economic aspects. The DRG is such an information tool that was originally developed in the USA, and is widely used among other developed countries. Since 1999, the Japanese Ministry of Health, Labor and Welfare has been conducting a social experiment of DRG. Although the usefulness of DRG as a tool for effective hospital administration has been established, further consideration is required in order to decide how to apply the DRG to the existed health system of each country. In this article, the author summarizes the findings of our research on the DRG in Europe held by IHEP (1999-2000), and intends to summarize the requirements for introduction of the DRG based system into Japan. According to my personal opinion, in the case of Japan where a social insurance scheme is generalized based on the fee-for-services, it is more appropriate to introduce the European type of DRG based system such as the combination of DRG and global budgeting in France, instead of the American DRG/PPS system that is combined with the managed care.