The Japanese Journal of Clinical Dialysis Vol.20 No.13(1)

Theme Pros and Cons of DRG/PPS in Dialysis Therapy
Title Can Japanese dialysis treatment become world model ? -- reimbursement system and dialysis outcome
Publish Date 2004/12
Author Takashi Akiba Department of Blood Purification, Kidney Center, Tokyo Women's Medical University
[ Summary ] This review attempted to describe the superiority of dialysis therapy in Japan as compared to the rest of the world and the quality assurance provided by the medical reimbursement system for dialysis therapy. The Dialysis Outcomes and Practice Pattern Study (DOPPS) is an international observational study on hemodialysis practices for end-stage renal disease patients. This research indicated that dialysis practices in Japan, compared with other 6 other nations, could not be termed "the best over all, concerning dialysis treatment", and indicated some possibilities for improving our practices through the lessons learned from other countries. The time-frame for dialysis health expenditures was abolished in 2002. This was a part of the comprehensive payment system for dialysis health fees, i. e., the establishment of chronic maintenance dialysis medicine management fees established in 1992, including the (partial) comprehensive payment system for the outpatient hemodialysis established in 1994. In contrast, the Diagnostic Procedure Combination (DPC), a Japanese DRG / PPS system, was introduced in university hospitals in 2003. We are facing huge, previously unexperienced waves of patients, which we might not be able to cope with. Dealing with this issue may help us cope with the waves of expected patients who will need ESRD care.
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