DRGs: a recent refinement to an old method.

In this review of disease classification schemes, the authors argue that the recently promulgated diagnosis related groups (DRGs) method of reimbursing Medicare patient care is the culmination of a tradition with antecedents going back thousands of years. They describe the historical development of disease classification schemes, beginning with ancient pathological descriptions corresponding to modern disease classification, attempts in the seventeenth and eighteenth centuries to gather statistical information on mortality to better understand the causes of death, and the activity leading to the development of the International Classification of Diseases, on which the DRG methodology is based. The authors then review 20th-century attempts to estimate nursing requirements by relating disease classification schemes to patient care needs.