Current status of DPC adaptive critical path for lobectomy in lung cancer
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概要
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In order to practice efficient medical management by DPC, we examined the current DPC adaptive critical path for lobectomy in lung cancer. From January to December 2005, 57 primary lung cancer patients who were treated using a lobectomy critical path and who were reimbursed by DPC were analyzed. Critical path was set up according to the following schedule: two days for antibiotics administration, three days for drainage, and 21 days of hospital stay taking the DPC group II hospital stay into account. Total direct cost was calculated based on the charge. Cost per patient showed 1, 792, 170 yen in DPC and 1, 668, 698 yen in fee for service (FFS) reimbursement. DPC/FFS ratio was 107.6%. Two patients showed less than100% DPC/FFS ratios. One patient received examination for distant metastasis under general anesthesia and the other was a trans-admission case from the general internal medicine division. DPC/FFS ratio was negatively correlated to hospital stay; longer hospital stay was related to lower DPC/FFS ratio. There were 43 (75.3%) cases who were discharged within DPC group II and they showed significantly higher cost per day compared to those in the DPC group III (80, 255 yen versus70, 824 yen). In order to maintain a high DPC/FFS ratio, the DPC adaptive critical path should be scheduled within group II of hospital stay, and rational use and shift from inpatient to outpatient ward of laboratory examinations seem important.
- 特定非営利活動法人 日本医療マネジメント学会の論文
特定非営利活動法人 日本医療マネジメント学会 | 論文
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