Reid B
School of Health Services Management, University of New South Wales, Kensington, Australia.
Health Policy. 1991 Mar;17(2):133-49. doi: 10.1016/0168-8510(91)90050-8.
The Diagnosis Related Group (DRG) classification system is widely used to describe the casemix of acute care hospitals, making it possible to compare the casemix of hospitals from different countries. However, in order to fully understand these comparisons, it is necessary to clarify the impact which the different coding systems used in various countries may have had on the results. The DRG system is based on codes from the International Classification of Diseases 9th Revision Clinical Modification (ICD9CM). Countries which use other coding systems convert, i.e. map, their codes into the nearest ICD9CM equivalent before allocating the DRGs. The impact of mapping on both medical and surgical DRGs is discussed and new titles are given for the affected DRGs. As far as possible, problems caused by mapping are distinguished from those caused by differences in coding practices. Based on the analysis of the classification systems, the mapping tables and the resulting DRG data, it is concluded that using mapped data does not have a great impact on the DRGs. Only 37 DRGs (7.8%), 15 medical and 22 surgical classes, are affected by mapping problems. However, while the scale of these problems is not large, given the large number of different surgical classification systems currently in use in Europe, the introduction of a standard surgical classification system for Europe is recommended.
诊断相关分组（DRG）分类系统被广泛用于描述急症医院的病例组合，从而能够比较不同国家医院的病例组合。然而，为了充分理解这些比较结果，有必要阐明各国使用的不同编码系统可能对结果产生的影响。DRG系统基于《国际疾病分类第九版临床修订本》（ICD9CM）的编码。使用其他编码系统的国家在分配DRG之前，会将其编码转换（即映射）为最接近的ICD9CM等效编码。本文讨论了映射对医疗和外科DRG的影响，并为受影响的DRG赋予了新的名称。尽可能将映射引起的问题与编码实践差异引起的问题区分开来。基于对分类系统、映射表及由此产生的DRG数据的分析，得出结论：使用映射数据对DRG的影响不大。只有37个DRG（7.8%）受到映射问题的影响，其中15个是医疗类，22个是外科类。然而，尽管这些问题的规模不大，但鉴于欧洲目前使用大量不同的外科分类系统，建议为欧洲引入一个标准的外科分类系统。
