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 ?
Yet, most countries only make a distinction between patients with and without CCs, while the French GHM (homogeneous patient groups) system (26) differentiates between four levels of CCs and the German Diagnosis-Related Groups (G-DRG system) calculates cumulative Patient Clinical Complexity Levels (PCCLs) (27,28).
Nursing dependency, Diagnosis-Related Groups and length of hospital stay.
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.
Under PPS, Medicare payments to most hospitals for Part A inpatient operating costs are made on the basis of a predetermined, fixed rate for each diagnosis-related group.
The diagnosis-related group (DRG) system for hospitals and the resource-based relative value scale (RBRVS) for physicians were the new payment methods of the 1980s, but they are being replaced rapidly by capitation and other forms of prepayment (e.
The following are the diagnosis-related group (DRG) numbers and descriptions of the 23 procedures identified in the RAND study but not included in Table 2:
Italy's policy on pharmaceutical prices is not encouraging for manufacturers of branded drugs: constant price cuts have eroded pharmaceutical sales; manufacturers are legally obligated to reduce their prices to hospitals; Italy's diagnosis-related group system is a great concern to physicians; reference pricing is another pharmaceutical restriction.
The number of hospitalizations annually has increased by over 50% in the past 10 years; heart failure is the most common Medicare diagnosis-related group.
The Deficit Reduction Act of 2005 mandates that all US hospitals report POA information for secondary claims, creating at least two reduced payment diagnosis-related group, (DRGs), for all post-admitting infections.
Hospital payments would be made on a modified diagnosis-related group (DRG) basis.
and Picis configured the software to adhere to applicable German health care requirements, including the new German government Diagnosis-Related Group (DRG) coding, automated scoring (including TISS 28 and SAPS II) and several other country-specific functionalities.