An evaluation of diagnosis-related group severity and complexity refinement.
McGuire, Thomas E
Date of Pub
In 1988, an ambitious and extensive project was undertaken in New Jersey to evaluate severity class adjustment of the all-payer
prospective payment system. Another project objective was to evaluate alternative strategies for refining diagnosis-related
groups (DRGs). The evaluation presented here includes a comparison of DRG refinement using Computerized Severity Index classes
and Yale University complexity classes. Statistical methods and payment simulations are used to assess the impact of DRG refinement
and consequent revenue changes. When a high volume subset of DRGs is refined, simulated payment shifts between hospitals on
the order of 5 percent of total hospital costs are indicated by this analysis.
Severity of Illness Index : Comorbidity : Costs and Cost Analysis/statistics & numerical data : Diagnosis-Related Groups/classification
: Economics, Hospital/statistics & numerical data : Evaluation Studies : Hospital Bed Capacity : Medicare/organization & administration
: Models, Theoretical : New Jersey : Reimbursement Mechanisms : Rural Population : Suburban Population : United States : Urban