Over the past 20 yr, many countries have introduced case-mix evaluation system. Some of them have fully used it for case based payment for hospital, and others partially used it for hospital payment in combined with regional health planning. The NHS countries have introduced it mainly for improving the efficiency of health system. On the contrary most of the social insurance countries have introduced it in order to control the medical expenditures, even though such expectations have not been

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... ays realized. The introduction of DRGs must be considered from the viewpoint of managerial innovation. The introduction of casemix system has apparently changed the way of thinking and behavior of hospital managers, physicians and policy makers as well as relationships among them. The continuous innovation of information technology will further influence the case-mix based management system. This will make it possible to cover all range of health services by case-mix system in nearly future.