3．集中治療の経済的側面を考える—制度の理解とデータの活用

Economic aspects of intensive care

今日の集中治療医には，ICUのマネジメントが求められるようになってきた。そのためには本邦の診断群分類に基づく1日当たり定額報酬算定制度および，病院の収益構造とICUの収支を理解するうえで必要な原価計算を行う必要がある。近年は医薬品や医療機器について費用対効果評価が導入されている。すでに超高齢社会が課題となっている本邦において，我々集中治療医はどのように患者を収容していくべきか，そしてどこへ向かうべきか考察したい。

Intensive care physicians are increasingly being asked not only to treat patients but also to manage both the medical and business aspects of the ICU. It is necessary to understand the Diagnosis Procedure Combination / Per-Diem Payment System in Japan and to perform cost calculations as necessary to understand the profit structure of the hospital and the revenue and expenditures of the intensive care unit. Cost-effectiveness evaluation has recently been introduced to the medical field. We have to consider how we should accommodate patients balancing treatment and management in our super-aging society that has already become a social problem in Japan.