1999 Volume 5 Pages 49-73
Of the DRG alternatives examined, we have found that the AP-DRGs are the preferred alternative. The data in Japan are not sufficiently complete to support the APR-DRGS, and we believe that the HCFA-DRGs are not as clinically sophisticated as the AP-DRGs and may not be as well accepted by the medical community. As there is a clear intention in Japan to develop Japanese specific DRGs, the AP-DRGs represent a sound starting point for this effort. In addition, beginning with the AP-DRGs saves time and money since one does not need to duplicate efforts, while allowing Japanese clinicians to focus on the clinical differences between Japan and the United States.
Though the provision of extended care in acute care hospitals was a problem in calculating DRG weights, we were able to compute reasonable weights based on topdown costing methods. However, these weights should be based on more cases and data from more hospitals to be certain that they will be accepted nationwide. A stratified random sample of about 300 hospitals would be ideal for this purpose. In addition, any weights will need to be carefully reviewed by a small group of physicians before they are considered for use in Japan.
