DRGs is the abbreviation of English "Diagnosis Related Groups". Classification related to disease diagnosis.
The method is to divide patients into 5-6 diagnosis-related groups according to their age, sex, length of stay, clinical diagnosis, symptoms, operation, severity of disease, complications and prognosis, and then decide how much compensation should be given to the hospital.
DRGs is recognized as one of the more advanced payment methods in the world today.
The basic way is to see a doctor first, then pay for it, and it costs less to see a doctor, and hospitals earn more money.
the basic starting point for p>DRGs to be used in the payment system of medical expenses is that the payer of medical insurance does not pay according to the actual expenses of patients in hospital (that is, according to the service items), but according to the disease-related groups into which the patients are classified according to the conditions such as disease type, severity and treatment methods. There will be different DRG codes corresponding to different conditions, different patients and different treatment methods.
Significance of p>DRGs:
1. Standardize the utilization of medical resources through the formulation of unified payment standards for disease diagnosis and classification.
2. It is helpful to encourage hospitals to strengthen medical quality management, force hospitals to actively reduce costs, shorten hospitalization days and reduce induced medical expenses for profit, which is beneficial to cost control.
3. Effectively reduce the management difficulty and cost of medical insurance institutions.
4. It is beneficial to macro-forecast and control medical expenses.
5. It provides a scientific and comparable classification method for the evaluation of medical quality.
Reference: Baidu Encyclopedia entry DRGs.