Impact of the Japanese Diagnosis Procedure Combination-based Payment System in Japan

Wang, Kai; Li, Ping; Chen, Ling; Kato, Ken; Kobayashi, Makoto; Yamauchi, Kazunobu

doi:10.1007/s10916-008-9220-2

Cited by 66 publications

(54 citation statements)

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“…The hospitals operate 40,000 beds and are registered as Diagnosis Procedure Combination (DPC) hospitals. The DPC is a Diagnosis-Related Group (DRG)-like flat fee system that was introduced in 2003 for big hospitals in Japan [14]. Costs that occur outside this hospital network are not captured.…”

Section: Methodsmentioning

confidence: 99%

Persistence with Biological Disease-modifying Antirheumatic Drugs and Its Associated Resource Utilization and Costs

Sruamsiri

Kameda

Mahlich

2018

Drugs - Real World Outcomes

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ObjectiveThe study assessed persistence rates of biological disease-modifying antirheumatic drugs (bDMARDs) for the treatment of rheumatoid arthritis in Japan and compared resource utilization and treatment costs between persistence and non-persistence groups.MethodsData were extracted from a Japanese claims database between 2009 and 2015. bDMARD-naïve patients were identified and included in the final analysis. Survival analysis was used to estimate 1-year persistence rates for current bDMARDs. Propensity score matching was applied to control for potential treatment selection bias. Resource utilization and healthcare costs were calculated 1 year before and after initiation of bDMARDs and compared between persistence and non-persistence groups.ResultsA total of 6153 bDMARD-naïve patients were identified and the overall 1-year persistence rate was 85% (95% CI 84–86). Overall, 1-year outpatient visits increased from 10 at baseline to 16 after bDMARD treatment, while the number of hospital admissions declined from 3.3 to 1.6. The non-persistence group had a larger increase in outpatient visits after bDMARD initiation compared with the persistence group (8–16 vs. 10–16, respectively) and a smaller decrease in hospital admissions (3.1–1.9 vs. 3.5–1.4, respectively). Persistence was associated with a reduction in total healthcare costs of US$760.ConclusionsJapanese bDMARD-naïve patients with RA have a high persistence rate with those treatments. The reduction in medication costs in non-persistent patients is offset by higher hospitalization costs, making non-persistence more expensive.Electronic supplementary materialThe online version of this article (10.1007/s40801-018-0139-8) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Persistence with Biological Disease-modifying Antirheumatic Drugs and Its Associated Resource Utilization and Costs

Sruamsiri

Kameda

Mahlich

2018

Drugs - Real World Outcomes

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“…These general ward hospitals operate 40,000 beds and are registered as Diagnosis Procedure Combination (DPC) hospitals. The DPC is a diagnosis-related group (DRG)-like flat fee system introduced in 2003 for comprehensive hospitals in Japan by the Japanese Medical Care Act [29]. The time span of the analysis was from 1 July 2013 to 30 June 2015.…”

Section: Methodsmentioning

confidence: 99%

Drug Utilization of Japanese Patients Diagnosed with Schizophrenia: An Administrative Database Analysis

et al. 2017

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Background and objectivePatient characteristics require consideration for optimal treatment in order to achieve clinical remission for an improved quality of life and social functioning. Prior evidence supports long-acting injectable antipsychotics (LAIs) in the relapse prevention of schizophrenia. This study aimed to characterize Japanese patients diagnosed with schizophrenia and to compare the outcomes of LAIs and oral antipsychotics (AP) in re-hospitalization or emergency room visit rates.MethodsDiagnostic Procedure Combination (DPC) designated hospital data in Japan with ICD-10 code F20x between July 2013 and June 2015 were obtained from the Medical Data Vision Co. Ltd. Patients were divided into sub-groups in order to filter co-diagnostic conditions. Differences across sub-groups were assessed using a Chi square test or ANOVA. The incidence rate ratio (IRR) was calculated to compare the re-hospitalization (30 days post discharge) or emergency room visit rates between pharmacotherapy groups of oral versus LAI or typical versus atypical within LAI patients. Adjusted estimates were provided by propensity scores that were assigned for age, gender, and Charlson co-morbidity index (CCI) scores.ResultsA quarter of the data sourced were attributed to co-diagnosis with dementia/delirium with antipsychotic prescriptions despite reported risks of antipsychotic use. After adjusting for age, gender, and co-morbidity, LAI reduced re-hospitalization and emergency (ER) visit rates more than oral APs (LAI vs. oral IRR = 0.38 (95% CI 0.17–0.74), IRR = 0.56 (95% CI 0.34–0.91), respectively).ConclusionThe study findings demonstrate usage of DPC hospital data in schizophrenia pharmacotherapy based on classification of co-diagnoses. In comparison with oral APs only, LAI utilization can provide an opportunity for reduced re-hospitalization and ER visit rates among patients with schizophrenia.

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“…The DPC is a diagnosis-related group-like flat fee system that was introduced in 2003 for big hospitals in Japan. 28 The time span of our analysis was from April 2012 to March 2014.…”

Section: Data Sourcementioning

confidence: 99%

Persistence with Biologic Agents for the Treatment of Rheumatoid Arthritis in Japan

Mahlich¹,

Sruamsiri²

2016

Value in Health

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Impact of the Japanese Diagnosis Procedure Combination-based Payment System in Japan

Cited by 66 publications

References 0 publications

Persistence with Biological Disease-modifying Antirheumatic Drugs and Its Associated Resource Utilization and Costs

Persistence with Biological Disease-modifying Antirheumatic Drugs and Its Associated Resource Utilization and Costs

Drug Utilization of Japanese Patients Diagnosed with Schizophrenia: An Administrative Database Analysis

Persistence with Biologic Agents for the Treatment of Rheumatoid Arthritis in Japan

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