Diagnosis Procedure Combination as an Infrastructure for the Clinical Study

Abstract

The Japanese government has introduced the casemix system for the acute-care hospitals since 2003. The applied casemix system is DPC (Diagnostic Procedures Combination) that was newly developed in Japan. The basic idea of DPC is to classify a patient by the combination of diagnosis and procedures conducted within the hospitalization. The first key of classification is diagnosis, and then types of procedures are considered to decide a particular group. One of the main purposes of DPC project is to implement a standardized dataset of in-patient acute care. The keywords are transparency and accountability. Using this framework, we can evaluate the process of medical services. The DPC project collects the three types of information: Form 1 is a clinical summary that contains information on diagnosis and severity. E file has information of the bundled charge of procedure and F-file indicates the detail of bundled procedures. Form 1, E-file and F-file are matched according to the ID number that is unique for each discharged case. Using these data, we can describe the process of each in-patient treatment. As the DPC scheme covers more than 8 million of acute in-patients cases in Japan, it has become one of the important sources of information for clinical analyses, such as patterns of pharmaceutical use and interventional treatments. Furthermore, DPC database can be used for a large-scale multi-center post-marketing clinical study. It is expected that more epidemiologists would have much interest for use of DPC data for studies of clinical epidemiology and health service researches.

Increase in avoidable hospital admissions after the Great East Japan Earthquake

“…In this retrospective two-stage cross-sectional study, patient data for this study were extracted from the Japanese Diagnosis Procedure Combination inpatient database 21 22. The database includes data from ∼7 million inpatients at more than 1000 hospitals, which represents ∼50% of all discharges from acute care hospitals in Japan.…”

Risks and Benefits of Stress Ulcer Prophylaxis for Patients With Severe Sepsis*

“…Data for this study were extracted from the Japanese Diagnosis Procedure Combination database (19,20). The database has been used extensively for clinical epidemiology research (21,22).…”

Two Case Studies of the Use of Oreong-san for a Chronic Subdural Hematoma

“…The details of the database have been described elsewhere [12]. In brief, the database includes discharge abstracts and administrative claims data for approximately 7 million inpatients per year, collected from more than 1,000 hospitals, representing approximately 50% of all inpatient admissions 2 Evidence-Based Complementary and Alternative Medicine to acute-care hospitals in Japan.…”