An Empirical Study on the Use of Diagnosis Related Group Tools for Grouping Adjustments in Large Public Hospitals

ObjectiveTo analyze the disease group structure and its trends in key departments of large public hospitals using diagnosis related group (DRG) data, explore the key points of intervention and optimization of disease groups in departments, and further promote the rational allocation of department resources.MethodsWe retrospectively collected DRG data from two surgical departments in a large public hospital in Beijing from 2017 to 2023. When the case mix index (CMI) of the two surgical departments declined, interventions such as performance appraisal, department education, and hospital publicity were promptly adopted. The changesin CMI values were observed and the trends in disease group weights, time consumption index, cost consumption index, and mortality rate in low-risk groups were analyzed.ResultsAfter the interventions, in surgical department Ⅰ, the proportion of patients with lower-weight diseases, such as major thyroid surgery (KD1), significantly decreased, while that of patients with higher-weight di