diagnosis-related group


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di·ag·no·sis-re·lat·ed group (DRG),

a program in the U.S. for billing for medical and especially hospital services by combining diseases into groups according to the resources needed for care, arranged by diagnostic category. A dollar value is assigned to each group as the basis of payment for all cases in that group, without regard to the actual cost of care or duration of hospitalization of any individual case, as a mechanism to motivate health-care providers to cut costs.

diagnosis-related group (DRG)

a group of patients classified for measuring a medical facility's delivery of care. The classifications, used to determine Medicare payments for inpatient care, are based on primary and secondary diagnosis, primary and secondary procedures, age, and length of hospitalization. See also prospective payment system.

diagnosis-related group

Managed care A prospective payment system used by Medicare and other insurers to classify illnesses according to diagnosis and treatment; DRGs are used to group all charges for hospital inpatient services into a single 'bundle' for payment purposes. See DRGs.

di·ag·no·sis-re·lat·ed group

(DRG) (dī-ăg-nō'sis-rĕ-lā'tĕd grūp)
A classification of patients by diagnosis or surgical procedure (sometimes including age) into major diagnostic categories (each containing specific diseases, disorders, or procedures) for the purpose of determining payment of hospitalization charges, based on the premise that treatment of similar medical diagnoses generates similar costs.

di·ag·no·sis-re·lat·ed group

(DRG) (dī-ăg-nō'sis-rĕ-lā'tĕd grūp)
U.S. billing program for medical and especially hospital services by combining diseases into groups according to the resources needed for care, arranged by diagnostic category.
References in periodicals archive ?
Researchers have identified that the neonatal diagnosis-related groups (DRGs) explain only 16 to 22 percent (Phibbs et al.
Table 5 Ability (R-squared x 100) to predict hospitalization charges for models based on diagnosis-related groups (DRG), purpose of admission (POA), and complexity indicators: Lung, colon, and breast cancer Model Lung Colon Breast DRG only 22.
Diagnosis-related groups (DRGs)--The patient classification system used by Medicare to place patients into 477 mutually exclusive and exhaustive patient groups based on information from the discharge record such as the principal diagnosis, surgical procedure, age, sex, discharge status, and the presence or absence of an additional diagnosis.
Potential for inpatient-outpatient substitution with diagnosis-related groups
What has been seen in Europe since the early 1990s is a discernible shift from the use of global budgets in hospital financing to activity based methods of payment such as diagnosis-related group (DRG) schemes.
The Department of Justice had been investigating certain hospital billings to Medicare for inpatient stays reimbursed under the diagnosis-related group system from Jan.
In the future, analytics will be used for various diagnosis-related groups, modes of care, and other services to help Good Samaritan define additional cost effective care solutions to prevent readmissions and other potentially negative outcomes.
The cost to the health ministry to send patients to the German hospitals is based on diagnosis-related groups (DRGs), an EU-standard tool for categorising and calculating costs per kinds of treatments.
The current trend is that of diagnosis-related groups (DRGs), which help hospitals minimise patient visits to their premises, increasing the need for efficient analytics solutions.
The new system, conceived to facilitate efficiency and competition, was built upon the concept of diagnosis-related groups and established fixed-hospital reimbursement based primarily on a patient's diagnosis.
In the hospital, the sources primarily include the Centers for Medicare and Medicaid Services core measures, diagnosis-related groups and International Classification of Diseases codes for diagnoses, and itemized bills for services.
Under Medicare, hospitals generally receive fixed payments for inpatient stays based on diagnosis-related groups (DRG), a system that classifies stays by patient diagnoses and procedures.