Revision of critical pathway of extracorporeal shock wave lithotripsy (ESWL) in urinary stone disease for adaptation to Diagnosis Procedure Combination (DPC)

概要

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The aim of this study is to confirm the practice of efficient medical care by adapting our revised critical pathway to DPC. Seventy-nine patients with urinary stones, who were treated between September 2006 and February 2007 by using critical pathway of extracorporeal shock wave lithotripsy (ESWL), were investigated. Of those 79 patients, 63 were treated by using the pre-revision critical pathway (BR group) and 16 by using the critical pathway after revision (AR group). We also compared the fee for the treatment between the former payment system and the DPC reimbursement system in both groups. In addition we compared the quality, safety and efficiency of the medical care in both groups. In the BR group, the fee of the DPC reimbursement system was significantly lower than that of the former payment system. However, there was no difference between the two payment system fees in the AR group. Although laboratory and X-ray examinations as well as administration of medicine were retrenched, efficient medical care was performed without disadvantages to patients. Our results suggest that for pursuing better medical care quality and safety revision of critical pathways is necessary.
特定非営利活動法人日本医療マネジメント学会の論文