Sheill A
Westmead Hospital, NSW.
Aust Health Rev. 1993;16(2):186-92.
Diagnosis Related Groups (DRGs) can be used either as a system of management information or as a method of funding hospitals. They cannot be used as both, for the incentives which are generated if hospitals are reimbursed by DRG encourage misclassification and game playing. It is argued that the major problem facing the Australian hospital system is social, not technical, efficiency. Funding by casemix focuses on the latter. If efficiency of either sort is to be improved, managers and clinicians need a common language which links casemix to cost and outcome. Used as a management information system, DRGs meet this need, but to do so effectively they should not be burdened with the additional responsibility of hospital reimbursement.
诊断相关分组（DRGs）既可以用作管理信息系统，也可以作为医院的一种筹资方法。但不能同时用于这两个目的，因为如果医院按诊断相关分组获得报销，所产生的激励措施会助长错误分类和投机行为。有人认为，澳大利亚医院系统面临的主要问题是社会效率而非技术效率。按病例组合筹资关注的是后者。如果要提高任何一种效率，管理人员和临床医生都需要一种将病例组合与成本及结果联系起来的通用语言。用作管理信息系统时，诊断相关分组满足了这一需求，但要有效做到这一点，它们不应承担医院报销的额外责任。
