History and Profile of Diagnosis Procedure Combination (DPC): Development of a Real Data Collection System for Acute Inpatient Care in Japan

Abstract

DPC, which is an acronym for "Diagnosis Procedure Combination," is a patient classification method developed in Japan for inpatients in the acute phase of illness. It was developed as a measuring tool intended to make acute inpatient care transparent, aiming at standardization of Japanese medical care, as well as evaluation and improvement of its quality. Subsequently, this classification method came to be used in the Japanese medical service reimbursement system for acute inpatient care and appropriate allocation of medical resources. Furthermore, it has recently contributed to the development and maintenance of an appropriate medical care provision system at a regional level, which is accomplished based on DPC data used for patient classification. In this paper, we first provide an overview of DPC. Next, we will look back at over 15 years of DPC history; in particular, we will explore how DPC has been refined to become an appropriate medical service reimbursement system. Finally, we will introduce an outline of DPC-related research, starting with research using DPC data.

Keywords: DPC-based Per-Diem Payment System (DPC/PDPS); Diagnosis Procedure Combination (DPC); Japan; health policy; patient classification system.

Figure 1.. Structure of Diagnosis Procedure Combination codes (as of 2020)

Figure 2.. Composition of DPC-based medical service fee payment (bundled component and fee-for-service component)

Figure 3.. Method of setting the medical service fee points by the length of hospital stay

Figure 4.. Structure of first Diagnosis Procedure Combination codes (as of Apr 2003)

Figure 5.. Composition of DPC-based medical service fee payment (as of 2003)