What are diagnostic related grouping DRGs

DRGS (Diagnosis Related Groups) is a classification of diagnosis related to (disease), which is based on the patient's age, gender, length of hospital stay, clinical diagnosis, condition, surgery, disease severity, comorbidities and complications.

and prognosis, the patient is divided into 500-600 diagnosis-related groups, and then the hospital is determined how much compensation should be paid.

DRGS is recognized as one of the most advanced payment methods in the world today.

One. The guiding ideology of DRGS is to achieve the standardization of medical resource utilization through the formulation of a unified fixed payment standard for disease diagnosis and classification. It will help motivate hospitals to strengthen medical quality management.

Forcing hospitals to actively reduce costs, shorten the number of days of hospitalization, and reduce induced medical expenses in order to obtain profits, which is conducive to cost control.

In the process of implementation, many countries have found a further advantage: an effective reduction in health insurance.

the difficulty and cost of managing the institution; It is conducive to macro-level and control of medical costs; It provides a scientific and comparable classification method for the evaluation of medical quality.

The basic starting point of the DRGS medical expense payment system is that the payer of medical insurance does not pay according to the actual cost of the patient in the hospital (i.e., according to the service item), but according to the patient's disease-related grouping according to the type of disease, severity, means, etc. Depending on the condition, the patient, and the means, there will be different DRG codes.

<>1.It divides patients into 500-600 diagnosis-related groups according to factors such as age, gender, length of hospital stay, clinical diagnosis, symptoms, surgery, disease severity, comorbidities and complications and prognosis. That is to say, DRGS is a payment system in which the medical insurance institution reaches an agreement with the hospital on the payment standard of the disease, and the hospital admits the patients participating in the medical insurance, and the medical insurance institution pays the hospital for the prepayment standard of the disease, and the excess part is borne by the hospital.

2.This payment method takes into account the interests of patients, hospitals, medical insurance and other aspects. The effect is:

Control costs, ensure quality, and improve management level. Encourage hospitals to strengthen medical quality management, force hospitals to actively reduce costs, shorten the number of days of hospitalization, and reduce induced medical expenses in order to obtain profits, which is conducive to cost control. It has also brought a revolution to hospital management, promoted the development of hospital quality management, economic management, information management and other disciplines, and emerged advanced management methods such as clinical pathways, strategic cost management, and digital hospitals.