Clinical Indicators and DPC Data

Kobayashi Mia, Ikeda Shunya, Fujimori Kenji

doi:10.4091/iken.20.5

A plan for evaluation of the quality of medical care is needed in order to provide medical services of good quality for patients. In general, in medical quality assurance and medical quality improvement, clinical indicators on processes (i.e., provision of medical services) and outcomes (i.e., effectiveness of provision of medical services) for evaluation are utilized. This paper discussed the feasibility of utilization of DPC data referring to the actual conditions of the U.S. in which many clinical indicators on medical care for hospitalization are utilized.<br>In the U.S, a government agency, non-profit organizations and private insurance companies conduct evaluation of the quality of medical care utilizing clinical indicators, and feed back the results to hospitals and clinicians. Some of them also do public reporting. Moreover, the systems of pay for performance have been introduced. However, while the evaluation of quality of medical care contributes to quality assurance and improvement, it is pointed out that the systems of public reporting and pay for performance cause adverse selection and inadequate medical care.<br>In Japan, we can grasp the information of medical care based on a standardized form. However, there is a limitation that we cannot obtain sufficient information for appropriate evaluation. Therefore, trigger indicators for showing signs for improvement on problems and tasks should be extracted from DPC data, and in combination with other data sourses, it is important to establish a system for conducting standardization and quality improvement of medical care considering those results.

Clinical Indicators and DPC Data

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