Hatfield D
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In 1982, the Tax Equity and Fiscal Responsibility Act modified the Section 223 Medicare Hospital reimbursement limits to include a case mix adjustment based on DRG's. In 1983, Congress amended the Social Security Act to include a national DRG-based hospital prospective payment system for all Medicare patients. In the view of many physicians and administrators the current formulation of DRG's constitute a workable and clinically coherent set of classifications that relate a hospital's case mix to the resources used and costs incurred by the hospital. DRG's are delineated based on principal diagnosis, secondary diagnosis, surgical procedures, age and the discharge status of the patients treated. Through DRG's, hospitals are able to gain an understanding of the patients they treat, the costs incurred and within reason, can anticipate the services required for specific illness. The classification of DRG's is a constantly evolving process. As coding procedures change, as more comprehensive data is collected, and as medical technology and treatment practices change, DRG's will need to be re-examined and revised. The following bibliography and glossary of terms highlights several key words and phases which are relevant to the overall discussion of DRG's.
1982年,《税收公平与财政责任法案》修改了第223条医疗保险医院报销限额,将基于诊断相关组(DRG)的病例组合调整纳入其中。1983年,国会修订了《社会保障法》,为所有医疗保险患者建立了基于全国DRG的医院前瞻性支付系统。在许多医生和管理人员看来,当前的DRG分类构成了一套可行且临床连贯的分类体系,将医院的病例组合与医院使用的资源和产生的成本联系起来。DRG是根据主要诊断、次要诊断、外科手术、年龄和所治疗患者的出院状态来划分的。通过DRG,医院能够了解所治疗的患者情况、产生的成本,并在合理范围内预测特定疾病所需的服务。DRG的分类是一个不断发展的过程。随着编码程序的变化、收集到更全面的数据以及医疗技术和治疗方法的改变,DRG需要重新审视和修订。以下参考书目和术语表突出了与DRG整体讨论相关的几个关键词和阶段。