218k views
1 vote
What is the system that classifies patients by age, diagnosis, and surgical procedure and produces 300 different categories used for predicting the use of hospital resources?

User Lashaun
by
7.8k points

1 Answer

5 votes

Final answer:

The Diagnosis-Related Group (DRG) system classifies patients based on age, diagnosis, and surgical procedures to predict hospital resource use and helps determine reimbursement rates for healthcare services.

Step-by-step explanation:

The system that classifies patients by age, diagnosis, and surgical procedure, and that produces 300 different categories used for predicting the use of hospital resources, is known as the Diagnosis-Related Group (DRG) system. DRGs are part of a health care payment system designed to identify the "products" that a hospital provides. The DRGs are assigned by a "grouper" program that processes information from a patient's health records, including the principal diagnosis, secondary diagnoses, surgical procedures, comorbidities and complications, and patient demographics.

It's vital for hospitals to properly code diagnoses and procedures because DRG classifications have a direct impact on the hospital's reimbursement for each patient's stay. Health care providers must balance the costs of treatments and diagnoses, patient quality of life, and risks to individual privacy when developing policies and conducting their operations.

User Sfelber
by
7.9k points