There are a number of Diagnosis-Related Group (DRG) classification systems that have evolved over the past 2 decades, each with their own strengths and weaknesses. DRG systems are used for case-mix trending, utilization management and quality improvement, comparative reporting, prospective payment, and price negotiations. For any of these applications it is essential to know the accuracy with w...

reimbursement for healthcare has utilized a variety of payment mechanisms with varying degrees of effectiveness. whether these mechanisms are used singly or in combination, it is imperative that the resulting systems remunerate on the basis of the quantity, complexity, and quality of care provided. expanding the role of the electronic medical record (emr) to monitor provider practice, patient r...

diagnosis-related group (drg) systems across europe are very heterogeneous, in particular because of different classification variables and algorithms as well as costing methodologies. but, given the challenge of increasing patient mobility within europe, health systems are forced to incorporate a common patient classification language in order to compare and identify similar patients e.g. for ...

background as part of the eurodrg project, researchers from eleven countries (i.e. austria, england, estonia, finland, france, germany, ireland, netherlands, poland, sweden, and spain) compared how their diagnosis-related groups (drg) systems deal with cholecystectomy patients. the study aims to assist surgeons and national authorities to optimize their drg systems.   methods national or region...

Diagnosis Related Groups (DRGs) are currently being introduced on a national scale as a prospective reimbursement scheme in Swiss in-patient hospital care, replacing any remaining retrospective day-rate arrangements. DRGs are expected to promote transparency and efficiency while helping to contain health care costs. The governmental decision to introduce DRGs has caused considerable controversy...

This paper reports the results of an evaluation study of the Australian National Diagnosis Related Groups (AN-DRGs). The evaluation was based on statistical rather than clinical criteria with the principal goal being to provide information for the future development of the classification system. As well as comparing versions 1.0 to 3.0 of AN-DRGs, the project included a comparison of these syst...

Pediatric-modified diagnosis-related groups (PM-DRGs) were designed to describe more accurately than DRGs differences in severity of illness and charges across pediatric patients. We report on an evaluation of PM-DRGs for use in prospective payment systems (PPSs). Data on pediatric discharges (i.e., patients 17 years of age or under) from 5 States and a national sample of 43 hospitals were used...

In October 1998, the definition of a transfer in Medicare's hospital prospective payment system was expanded to include several post-acute care (PAC) providers in 10 high-volume PAC diagnosis-related groups (DRGs). In this methodological article, the authors respond to a congressional mandate to consider more DRGs in the definition. Empirical results support expansion to many more DRGs that are...

given limited health sources, how to make drgs (diagnosis related groups) more feasible is a big question in developing countries. this study contributes to the debate on how to bridge the pay-for-service and drgs during the transitional period of payment reform.from 2008 to 2012, 20740 patients with cirrhosis or duodenal ulcer disease were chosen as sample. using multiple linear regression ana...