Reid B, Palmer G, Aisbett C
School of Health Information Management, University of Sydney.
Health Inf Manag. 1999;29(3):113-7. doi: 10.1177/183335830002900307.
The Diagnosis Related Group (DRG) system is now used extensively in Australia to classify acute inpatients for many applications, including payments to hospitals. The quality of the inpatient separation data affects the performance of the DRG version, especially its predictive validity. Data from the State of Maryland, in the United States, contain more secondary diagnosis and procedure codes than Australian data. A comparison of the performance of DRG versions using data from Australia and Maryland allowed us to answer the following research question: What impact did these additional codes have on the performance of the DRGs? The best performance in predictive validity (R2) was obtained using the Maryland data no matter which DRG version was used. Casemix-adjusted code counts showed that more diagnoses were coded in Maryland. The most plausible reason for this was that conditions were not being recorded comprehensively by doctors in the medical record in Australia.
诊断相关分组（DRG）系统目前在澳大利亚被广泛用于对急性住院患者进行分类，以用于许多应用，包括向医院付款。住院患者分类数据的质量会影响DRG版本的性能，尤其是其预测效度。美国马里兰州的数据包含比澳大利亚数据更多的二级诊断和程序代码。使用来自澳大利亚和马里兰州的数据对DRG版本的性能进行比较，使我们能够回答以下研究问题：这些额外的代码对DRG的性能有什么影响？无论使用哪种DRG版本，使用马里兰州的数据在预测效度（R2）方面都取得了最佳性能。病例组合调整后的代码计数显示，马里兰州编码的诊断更多。最合理的原因是澳大利亚的医生在病历中没有全面记录病情。
