When Was DPC Introduced?

DPC/PDPS was introduced in April 2003 at 82 hospitals, including advanced treatment hospitals. It began as a system for acute inpatient care that uses diagnosis groups reflecting disease characteristics and severity, combining per-diem bundled payments with fee-for-service payments.

The number of participating hospitals subsequently expanded in stages, reaching 360 hospitals in 2006, 1,390 hospitals in 2010, and 1,730 hospitals in 2018.

As of June 2026, there are 1,685 DPC hospitals. DPC still does not apply to all hospitals. Hospitals participate in the DPC system after meeting specified requirements, including those related to the provision of acute inpatient care and the continuous submission of DPC data, and completing the required procedures.

References

1. Ministry of Health, Labour and Welfare, “History of the Introduction of DPC/PDPS”

   • DPC/PDPS was introduced in April 2003 at advanced treatment hospitals. The document also describes the bundled-payment trial conducted at 10 national hospitals and other institutions beginning in 1998.
   • https://www.mhlw.go.jp/file/06-Seisakujouhou-12400000-Hokenkyoku/0000039615.pdf

2. Ministry of Health, Labour and Welfare, “Changes in the Number of DPC Hospitals”

   • Shows the growth in the number of DPC hospitals following the introduction of the system, including 82 hospitals in FY2003, 360 in FY2006, and 1,390 in FY2010.
   • https://www.mhlw.go.jp/content/12404000/001502561.pdf

3. Ministry of Health, Labour and Welfare, “Minutes of the 649th General Meeting of the Central Social Insurance Medical Council, April 8, 2026”

   • Reports 1,685 DPC hospitals as of June 2026, a decrease of 76 hospitals from the previous year, and discusses operation of the system following the FY2026 revision.
   • https://www.mhlw.go.jp/stf/newpage_73042.html

4. Ministry of Health, Labour and Welfare, “Procedures for Participation in the DPC System” (March 27, 2026; Hoi-hatsu No. 0327-1)

   • Specifies the requirements for DPC hospitals and procedures for participation in the DPC system for FY2026.
   • https://www.mhlw.go.jp/web/t_doc?dataId=00tc9897&dataType=1&pageNo=1

5. Ministry of Health, Labour and Welfare, “FY2026 Revision of Medical Fees”

   • Provides DPC-related notifications, notices, definition tables, and other materials for the FY2026 medical fee revision.
   • https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000188411_00074.html