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[Effect of DPC based payment and its future].

Shinya Matsuda1

  • 1Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Japan.

Nihon Geka Gakkai Zasshi
|November 3, 2005
PubMed
Summary
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The implementation of Diagnosis Procedure Combination (DPC) based payments in hospitals has led to reduced average length of stay and resource utilization. Importantly, evidence of under-treatment has not been observed despite cost containment incentives.

Area of Science:

  • Health Economics
  • Hospital Management
  • Healthcare Policy

Background:

  • The Diagnosis Procedure Combination (DPC) based bundle payment scheme has been in effect for acute care hospitals since 2003.
  • Special function hospitals are also included in this payment model.
  • The Central Social Insurance Medical Council's DPC scientific committee monitors its impact.

Purpose of the Study:

  • To evaluate changes in hospital services following the introduction of DPC-based payments.
  • To assess the effects of cost containment incentives on patient care.

Main Methods:

  • Analysis of hospital service data before and after DPC implementation.
  • Review of resource utilization metrics, including laboratory tests, radiological examinations, drugs, and supplies.

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  • Monitoring for evidence of under-treatment.

    • Main Results:

    • A reduction in the Average Length of Stay (ALOS) was observed.
    • Decreased utilization of resources such as laboratory tests, radiological examinations, drugs, and supplies was noted.
    • No evidence of under-treatment due to cost containment incentives was found.

    Conclusions:

    • DPC-based payment schemes can effectively reduce ALOS and resource use in acute care settings.
    • Current evidence suggests that cost containment incentives within the DPC model have not led to detrimental under-treatment.
    • The DPC payment scheme appears to be a viable strategy for managing hospital costs without compromising patient care quality.