Current status and issues of the extended diagnosis procedure combination (DPC) hospitalization period II after gastrointestinal cancer surgery

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  • Otsuka Shinya
    Department of Gastroenterogical Surgery, National Hospital Organization Fukuyama Medical Center
  • Iwagaki Hiromi
    Department of Gastroenterogical Surgery, National Hospital Organization Fukuyama Medical Center

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  • 胃癌・大腸癌手術におけるDPC入院期間 II 越えの現状と課題
  • イガン ・ ダイチョウガン シュジュツ ニ オケル DPC ニュウイン キカン Ⅱ コエ ノ ゲンジョウ ト カダイ

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<p>Reducing the length of postoperative stays in acute care hospitals is very important. We assessed prolonged hospital stays in relation to therapy for gastrointestinal cancer. We surgically treated 136 patients with gastric cancer (GC) and 266 with colon cancer (CC) at our hospital between January 2015 and December 2016. The average hospital stay after surgery for GC and CC was 20.0 and 18.0 days, respectively, and 57 (42%) and 105 (39%) patients, respectively, remained for prolonged diagnosis procedure combination (DPC) hospitalization period II. The main reason for prolonged hospital stays among 79% and 92% of patients with GC and CC, respectively, was patient factors associated with postoperative complications. However, preventing complications and promoting close ties with transfer hospitals helped to reduce postoperative stays beyond DPC hospitalization period II between 2015 and 2016 from 35 (50%) to 22 (33%) patients with GC, and from 68 (51%) to 37 (22%) of those with CC. More patients with various comorbidities or advanced gastrointestinal cancer are undergoing these procedures. Complications need to be avoided, and primary and transfer hospital collaboration should be optimized to further reduce the length of hospital stays.</p>

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