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Pré-Publication, Document De Travail Année : 2023

A lesson from the process of simplifying a complex DRG classification by users

Carine Milcent

Résumé

The paper aims to present the simpler empirical way of using the French-DRG classification, a complex system used to classify patients based on their pathology, medical, surgical, and obstetric management. The classification is further divided by the severity level and management mode. The classification consists of 2,500 groups, but we found that only a few groups, less than 500, are used to code 80% of hospital activity. Based on this finding, we suggest simplifying the DRG classification and completing it with a fee-for-service reimbursement for procedures out of the competitive market by stylized facts. We also found that the mechanisms in place to prevent patient selection and cream-skimming only apply to a very small number of stays. This further supports our suggestion to simplify the DRG classification system.
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Dates et versions

hal-04347797 , version 1 (15-12-2023)

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  • HAL Id : hal-04347797 , version 1

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Carine Milcent. A lesson from the process of simplifying a complex DRG classification by users. 2023. ⟨hal-04347797⟩
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