TOG Glossary

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Diagnosis Related Groups (DRGs)

A system used to classify hospital cases into one of approximately 500 groups, also referred to as DRGs, that are expected to have similar hospital resource use. Developed for Medicare as part of the prospective payment system, DRGs are assigned by a “grouper” program based on ICD diagnoses, procedures, age, sex, discharge status, and the presence of complications or comorbidities. Used in the US since 1983, DRGs determine how much Medicare pays the hospital, since patients within each category are clinically similar and are expected to use the same level of hospital resources.