As one of the internationally recognized advanced and scientific payment methods, DRG is an important means to effectively control the unreasonable growth of medical expenses, establish a new compensation mechanism in public hospitals, achieve a win-win situation for medical insurance and patients, and promote the transformation of graded diagnosis and treatment service mode. In recent years, some areas in China have also explored the reform of DRG payment methods, but there are many versions, great differences in technical standards, and great differences in operability and effectiveness. As a key technology, the reform of DRG payment method has also become one of the important responsibilities of the National Medical Insurance Bureau since its establishment. To this end, the National Medical Insurance Bureau organized an expert group to form the grouping standards and technical specifications for the reform of DRG payment methods for medical insurance.
As a complex technology, grouping needs to be combined with clinical experience and statistical verification. On the basis of clinical diagnosis and treatment classification and operation technology, disease diagnosis, operation and operation should follow the principle of "similar clinical features and similar resource consumption", and check and calculate with statistical analysis to realize the classification refinement from MDC to ADRG to DRG.
Based on the grouping standards and technical specifications issued by the National Medical Insurance Bureau, the official WeChat account will provide the latest version of grouping query service with the development of the industry.
Technical specification for group payment of DRG community health service.
Subdivision of National Medical Insurance Disease Diagnosis Related Group (CHS-DRG) (version 1.0)