[Cost analysis on stomach cancer treatment in Japanese hospitals]

In an effort to further the discussion of DRG/PPS, we performed a coat analysis on stomach cancer cases in Japanese hospitals. We analyzed individual in-patient data (both clinical and financial) to research the amount of variation in treatment and costs.

The data was taken from two hospitals. In order to compare the daily cost/revenue of each episode of operation/hospitalization, we analyzed the data that was stored for reimbursement purposes by using patient ID numbers. We also simulated the cost/revenue in cases where the length of stay could be shortened with clinical pathways created by Japanese hospitals.

(1) There is a common pattern for the operation/hospitalization of stomach cancer cases if the patient's condition, like severity, is well controlled. However, there is still a noticeable difference in the length of stay for patients both before and after the operation. (2) Hospitals are currently losing money by having extended patients' lengths of stay. Simulation results indicate that hospitals can reduce losses, even become profitable, by shortening the patient's length of stay.

The potentiality of implementing a standard treatment process and/or a fixed payment system, like DRG/PPS, is high, because there is a common a pattern among the treatment process. More research must be completed in this area, specifically on the significant variations in lengths of stay and the methodology for standardization of treatment. Furthermore, clinical outcomes research must also be done.