抗菌剤使用に着目したDPC病院における肺炎治療に関するベンチマーク  [in Japanese] BENCHMARK FOR THE TREATMENT OF PNEUMONIA AT DPC HOSPITALS FOCUSING ON THF USE OF ANTIMICROBIALS  [in Japanese]

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Abstract

DPCデータを用い肺炎治療における抗菌剤の使用状況をベンチマークし,抗菌剤の使用が病院の財政面に与える影響について検証した。入院期間ごとに,DPC導入により増収した患者の割合,増減比(包括報酬額/出来高換算報酬額),各医療行為の報酬が出来高換算報酬総額に占める割合を比較検討した。また,抗菌剤の使用動向,入院期間区分ごとの出来高換算報酬および注射総額の平均値,出来高換算報酬総額に占める注射総額の割合(以下「注射比率」とする),増減比を一覧し,抗菌剤の使用状況と病院の増減収との関連について比較検討した。<br>抗菌剤の使用動向を入院期間別に比較すると,いずれの病院においても入院の経過とともに変化が見られ,増減比が高い病院ほど注射比率が低い傾向が認められた。したがって,当該DPCコードでは,抗菌剤の使用動向が病院の財政面に影響を与えていることが示唆された。

The status of the use of antimicrobials for the treatment of pneumonia was benchmarked by using diagnosis procedure combination (DPC) data, and the effects from the use of antimicrobials on the financial aspects of hospitals were examined. For each period of hospitalization, the percentage of patients who brought greater income to the hospital through the introduction of DPC, increase-decrease ratios (comprehensive payment/payment based on performance) and the percentage of payment for each medical action to the total payment based on performance were comparatively evaluated. Furthermore, a survey was made on the trends in the use of antimicrobials, payment based on performance and the average for the total expense for injections for each segment of hospitalization, the percentage of the total payment for injections to the total payment based on performance (hereafter “injection ratio”), and the increase-decrease ratio. The comparative evaluation covered the correlation between the use of antimicrobials and increase and decrease in hospital revenue.<br>When the trend in the use of antimicrobials was compared according to the length of stay at hospitals, changes were noted with the course of hospitalization in each hospital. It was also noted that the ratio in injections given is inversely related to the greater increase-decrease ratios in these hospitals. Thus, it was suggested that according to the DPC codes, the trends in the use of antimicrobials have effects on the financial management of hospitals.

Journal

  • Journal of the Japan Society for Healthcare Administration

    Journal of the Japan Society for Healthcare Administration 47(2), 61-68, 2010-04-01

    Japan Society for Healthcare Administration

References:  12

Codes

  • NII Article ID (NAID)
    10031187573
  • NII NACSIS-CAT ID (NCID)
    AA12296781
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    1882594X
  • NDL Article ID
    10702878
  • NDL Source Classification
    ZS7(科学技術--医学) // ZE5(社会・労働--社会問題・社会保障)
  • NDL Call No.
    Z19-40
  • Data Source
    CJP  NDL  J-STAGE 
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