<b>7. Example of Healthcare Database Utilization: The Diagnosis Procedure Combination Database </b> / 薬剤疫学

ABSTRACT

The Diagnosis Procedure Combination(DPC) is a case-mix classification system for hospitalized patients, which is linked with lump-sum payment system called the Diagnosis Procedure Combination/Per-Diem Payment System(DPC/PDPS). The DPC Study Group works on the DPC data utilization project for research purpose, independently of Ministry of Health, Labour and Welfare, Japan. The database contains discharge data and administrative claim data, including diagnoses, comorbidities and complications coded with ICD-10(International Classification of Diseases and Related Health Problems, Tenth Revision) codes; procedures; duration of anesthesia; volume of blood transfusion; drugs and devices used; length of stay; discharge status; costs; and detailed clinical information(body height/weight; smoking index; Japan Coma Scale; cancer stage; modified Rankin Scale; Hugh-Johns classification; NYHA classification for heart failure, severity index for angina pectoris/myocardiac infarction, pneumonia, and acute pancreatitis; and Child-Pugh classification for liver cirrhosis). In this report, we introduced two studies using the DPC database (i) the effect of fondaparinux on the prophylaxis of postoperative pulmonary embolism and (ii) the effect and cost of gabexate mesylate on the treatment of acute pancreatitis. In addition, we compared the DPC database with the US administrative databases(including the Nationwide Inpatient Sample database and the Medicare claim database) and discussed the tasks for the future set to the DPC database to further enhance clinical studies and health services research in Japan. (Jpn J Pharmacoepidemiol 2012; 17(2) 163-169)