[The Current Status of the Department of Neuropsychiatry at Osaka Medical College].

Abstract

Since there is a growing need for psychiatric treatment in general hospitals, the decreas- ing number of treatment beds has become a marked problem in Japan. One of the financial reasons is a difference in the reimbursement of medical fees between medical treatments in physical departments of the same hospital. Our neuropsychiatry department has accepted patients with psychiatric disorders suffering from various physical complications in order to meet local or hospital demand ; however, it is the case that the psychiatric ward has been required to decrease the number of beds from the aspect of management rationalization. According to the comparative analysis of four practical cases treated on our ward, the reim- bursement of medical fees was much lower than medical fees for the same treatment if patients had been treated on general physical wards. This result is considered to show one of the difficulties of maintaining psychiatric wards in general hospitals. It is essential to improve the reimbursement of medical fees for psychiatric wards. Moreover, we propose introducing the DPC (Diagnostic Procedure Combination) into treatment, especially on psychiatric wards. The demand for psychiatric treatment at general hospitals will increase in the future due to Japan having the world's most rapidly aging society. Maintaining a clinical budget equal to the available resources will help avoid a decreasing number of beds.