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Healthcare Acronym: DRG - Diagnosis Related Group

July 27, 2012 1700 No of hits
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Healthcare Acronym: DRG - Diagnosis Related Group

The modern United States healthcare industry is gargantuan, supporting thousands of hospitals and hundreds of thousands of patients at any given time. Without adequate classification systems, hospitals would soon find themselves overwhelmed by the patients at hand, as well as unable to plan for future patient circulation and track hospital expenses. Diagnostic Related Group (DRG) is a patient classification system developed to group patients by the distinct diagnoses they receive.

As a diagnosis-based system, DRG attempts to relate predominant patient types to a hospital's total expenses. For example, if a hospital frequently treats patients with serious heart conditions, financial projections can be made regarding total heart patient costs in addition to breaking costs down by specific condition. This helps with the maintenance of adequate hospital bed space, monitoring and diagnostic equipment, and staffing. Further DRG distinctions are made regarding the patient's gender, sex, age, principal diagnosis, presence of complications, discharge status, and potential treatment.

DRG was first developed for Medicare in the early 1980s as a prospective payment system that tracked cases at a predetermined rate of discharge. This allowed for hospitals to determine how much they were paid by Medicare, because patients grouped in each DRG category generally possess similar medical conditions. Using DRG diagnostic, treatment, and demographic data helped hospitals gain a clearer understanding of how much each category of patient cost in terms of hospital resources and Medicare dollars. Financial projections could then be made based on how many of each category of patients were presently admitted in a given hospital.

Since the 1980s, medical technology has made incredible advances due in large part to vast increases in computational power. This has fundamentally changed the way patients are treated, from the length of a typical surgical procedure and recovery period to how long a successful diagnosis takes. DRG classification systems had to evolve to account for greatly increased patient rotation. Present DRG groupings include All Patient DRG, Refined DRG, Medicare DRG, Severity DRG, All Patient-Severity-Adjusted DRG, All Patient Refined DRG, and International-Refined DRG. Within these classification systems there are many specific groupings and further categorization. New DRG groupings occur to match new methods of treatment, and older DRGs are constantly subject to revision based on changes in hospital treatment and financial obligations.

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The modern United States healthcare industry is gargantuan, supporting thousands of hospitals and hundreds of thousands of patients at any given time. Without adequate classification systems, hospitals would soon find themselves overwhelmed by the patients at hand, as well as unable to plan for...

By: Richard Martine Created 75 months ago

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