Study on emergency hospitalization in the DPC system

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  • Tarasawa Kunio
    Graduate School of Health and Welfare Sciences, International University of Health and Welfare

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Other Title
  • DPCにおける緊急入院に関する研究
  • DPCにおける緊急入院に関する研究 : 帝王切開分娩の母とその児を対象として
  • DPC ニ オケル キンキュウ ニュウイン ニ カンスル ケンキュウ : テイオウ セッカイ ブンベン ノ ハハ ト ソノ ジ オ タイショウ ト シテ
  • ——In mothers who underwent Caesarean delivery and their babies——
  • ——帝王切開分娩の母とその児を対象として——

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Abstract

In order to elucidate the influence of emergency hospitalization of obstetric patients on the hospital management, we used 12-month data, including the DPC (Diagnosis Procedure Combination) data, obtained from a public hospital (A) and conducted a comparative analysis of planned and emergency hospitalizations, an analysis of factors that might influence the fees for medical services, and an analysis of neonates admitted to the hospital with some disease in cases where the payment system of the fee for Caesarean delivery was transitioned from a fee-for-services payment to the DPC. The results of the analyses revealed that the fees for medical services decreased by 1% in emergency hospitalizations, but increased by 3% in planned hospitalizations where the payment was transitioned to the DPC system. It was found that emergency hospitalization was a factor that decreased the fees for medical services when the payment system was transitioned from the fee-for-services payment to the DPC. It was also estimated that the fees for medical services in neonates who were admitted to the pediatrics department with disease decreased by about 8% in the case where mothers were emergently hospitalized, and decreased by about 12% in the case where mothers underwent planned hospitalization. It was considered important to give consideration to the ratio balance between planned and emergency hospitalizations in patients undergoing Caesarean delivery and monitor the occurrence rate of medical events, including emergency hospitalizations, that would place the hospital management at a disadvantage and decrease the income.

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