Where are DRGs going?

The diagnosis related groups (DRG) classification of acute inpatient episodes was developed in the United States to meet the perceived needs of the U.S. hospital sector. Thus far, it has been used in Australia without significant modification. In this paper, we assess the DRG system in terms of basic principles of classification design and suggest some possible revisions which might be considered if there were reason to contemplate major changes for Australia. We conclude by making some suggestions on the process of managing the development of DRGs in Australia.

The refined diagnosis related groups system: an early look at its potential for Australia.

The DRG patient classification system is widely used in Australia, and its use is likely to increase. However, it has some weakness, including the failure to adequately take account of variations in resource use among patients in the same classes. A new version, called the Refined DRG (or RDRG) system became available in January 1989. Inter alia, it makes better use of data on secondary diagnoses; and defines three or four levels of resource use intensity for all major types of conditions, rather than just two levels for fewer types of conditions. The new system is briefly described. Some preliminary results of its use on Australian data are presented, which suggest that it does have advantages in terms of increased homogeneity of resource use in classes. If the RDRG system is to replace the DRG system as the international standard, there are some important implications for Australia. In particular, it would seem to be advisable for health agencies to plan for its imlementation on a national basis.