Since April 1, 2014, our hospital, as a “DPC hospital” designated by the Minister of Health, Labour and Welfare, claims hospital fees according to “Diagnosis Procedure Combination or Per Diem Payment System (DPC/PDPS)”
In the past, fees for each treatment (medication, injection, examination, operation, etc.) were totaled to calculate medical expenses according to “a fee-for-service system.” Under DPC/PDPS, diseases are classified depending on types of diseases, whether an operation (treatment) was performed or not, presence or absence of a complication, etc., and payment is according to comprehensive payment (rounding off) based on daily hospital fees predetermined for each classification. According to this system, hospital fees are calculated by combining the comprehensive part (medication, injection, treatment, examination, etc.) and the fee-for-service part depending on contents of treatments, etc., based on diseases and state of diseases of inpatients. On the other hand, charges, such as cost of meals, private ward charge, and documentation charge, etc., which are not covered by health insurance, are claimed as in the past.
|Formula||Medical expense for hospitalization
= comprehensive part x days in hospital x coefficient per medical institution* + fee-for-service part
*Coefficient per medical institution: A certain coefficient determined for each hospital depending on its functions. This makes medical expenses different with each hospital even if diagnosis and treatment are the same.