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Title: The use of diagnosis related groups in the management of acute hospitals : an international study
Author: Alzahrani, A. M. M.
Awarding Body: University College of Swansea
Current Institution: Swansea University
Date of Award: 1991
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This thesis covers the development and application of a system for classifying patients into groups on the basis of their types of disease and the average scale of resources used in their treatment. The system is known as the Diagnosis Related Groups classification, and as the name indicates, patients are first assigned to a specific grouping, or 'Major Diagnostic Category', according to the diagnoses recorded on the discharge abstract. This, plus the design feature which classifies cases by organ system, makes the DRGs clinically meaningful as well as aiming to produce groups which are homogeneous in terms of their resource utilisation. The DRGs, first developed to cover patients in acute hospitals, permit the measurement of case mix - the mix of patient types treated over a given time. Complexity of case mix has a bearing on the resources consumed in a hospital, and is important in planning services, monitoring performance, and the costing of patient care. The DRG classification was created in the USA by researchers at Yale University. This, and its subsequent refinement in answer to criticisms which identified weaknesses and alternative systems put forward, are described in chapters 1 and 2. An overview of the international scene is dealt with in chapter 3, whilst chapter 4 looks at how the US Government adopted DRGs as the basis of payment for the treatment of publicly funded patients. Chapters 5-8 focus on the application of DRGs in France, the Netherlands, Australia and the UK. A case study of progress made and problems met in implementing a DRG project in West Glamorgan Health Authority is given in Chapters 9 and 10. Finally, an account of health care in the Kingdom of Saudi Arabia is given in Chapter 11, with a general review of progress made over the past quarter century, as background to a provisional view of the potential for DRGs in that country, and recommendations on how to proceed in Chapter 12. The conclusion from the survey of literature on the DRGs is that the classification is the best case mix measurement system currently available, and that its various applications can make it an extremely useful management tool. There is potential for further development, and through its implementation in an increasing number of countries, international comparisons become possible which could be of worldwide benefit in improving the effectiveness of health care provision.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available