Effects of disease diagnosis and operative procedure on grouping of diagnosis related groups(DRGs)

Objective To learn the impacts of major diagnosis, other diagnoses, major surgery and other surgeries on the grouping of DRGs, and to optimize the DRGs data grouping quality by analyzing the main influencing factors of DRGs. Methods Based on regrouping results of the 1 940 questionable cases which have been corrected, using SPSS 13.0 to study the impacts of the questions found on the grouping of DRGs. Results 438 Patient records affecting DRGs grouping were regrouped according to major diagnosis, other diagnoses, major surgery and other surgeries. Influences of the above four groups on the grouping vary in general. For comparison between two groups, P>0.007 1 between main surgery and other surgeries; while P<0.007 1 for comparison between other groups. Conclusion The highest influence of grouping was found in questionable major diagnosis, much higher than such other factors as other diagnoses, major surgery and other surgeries. This conclusion conforms to the steps of basic DRGs grouping logic-sorting the cases according to major diagnosis first of all. Correct naming of surgery influences DRGs grouping, but the influence extent of major surgery and other surgeries is close. Key words: Diagnosis; Surgery; DRGs