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KMID : 1170320130190020039
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Korean Journal of Health Economics and Policy
2013 Volume.19 No. 2 p.39 ~ p.60
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Expansion of Japan’s DPC and its Lessons for Korea
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Jeong Hyoung-Sun
Cho Lan
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Abstract
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Japan`s Diagnosis Procedure Combination(DPC/PDPS) is a payment system unique to the country, and most characteristically Japanese in view of the DRG payment system throughout the world. While there is a ``bundling part`` having a per diem score diagnosis by diagnosis, the ``non-bundled (free-for-service) items`` are also widely accepted. The ``bundling part`` assigns a high score for a brief stay of hospitalization, thus promoting shortened ALOS. Moreover, ``hospital coefficients`` are prepared to compensate for any monetary loss due to the application of the DPC/PDPS and, on a long term basis, a wide range of incentives are provided to absorb and reflect various additional payments that are already applied under the current fee-for-service system. Though it is a voluntary participating system, many hospitals hope to join the program, meeting participation conditions such as submission of required data. The most outstanding achievement is its building of a database having plenty of clinical information from medical records and payment claims submitted by both DPC-applying and DPC-preparing hospitals to the Ministry. Japan`s DPC system is appraised as stably operative and progressive by succeeding in inducing consensus of interested parties in policy decision-making, and securing a high rate of participation of tertiary hospitals within a short period of time. This conveys a strong message to the Korea`s health insurance system that has failed to inch forward due to the medical providers` opposition in spite of having made efforts to introduce the DRG payment system for a long period of time.
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KEYWORD
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DRG(Diagnosis Related Group), DPC/PDPS(Diagnosis Procedure Combination/ Per Diem Payment System), bundling payment, New Bundling Payment, fee-for-service
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