Strategy for adapting to DPC system in treatment and examination for hematological diseases

Diagnosis Procedure Combination (DPC) has been introduced since April 2003. This article introduces several efforts for adapting to DPC in hematological diseases, which the author is involved in, in Tohoku University Hospital. DPC forces the hospitals to shorten admission period of each patient, because longer stay result in less incomes. Therefore, one of the most effective strategies for adapting to DPC is to perform chemotherapy at out-patient clinic. According to this strategy, a center specialized for anti-cancer chemotherapy was set up at out-patient clinic in Tohoku University Hospital. Another effective strategy is an introduction of clinical path. Each department of Tohoku University Hospital, including hematology, has prepared its original clinical path. The first clinical path by hematology department is a path for R-CHOP, which is a standard treatment for CD20-positive non-Hodgkin B-cell lymphoma. Some examinations for hematological diseases are also being renewed. First, examination sets for treatment of clinical diseases, including hematological diseases, have been proposed and submitted to physicians by department of clinical laboratory, and are being refined by them. Second, an examination system limited to the patients, who are receiving anti-cancer chemotherapy, has been set to shorten their waiting time before treatment. From now on, DPC system may change the system of University Hospital more widely, however, we should not allow it to change a most important and fundamental role of University Hospital, which is to perform clinical research and advanced treatment.