DRG - sporedata/researchdesigneR GitHub Wiki
General description
Diagnosis-related group (DRG) is a case-mix complexity method used to classify patients with comparable clinical diagnoses in an effort to reduce hospital expenses and establish payor reimbursement rates. For instance, Medicare doesn't reimburse the hospital for all its expenses; instead, it pays a predetermined sum depending on a patient's DRG. This method encourages the hospital to minimize care costs.
The DRG system gives CMS a structural foundation to start pushing for greater standards of care across the U.S. healthcare sector. DRG continues to urge hospitals to increase the effectiveness of patient care while discouraging over-treating patients in order to receive greater payment rates, a behavior that had grown customary.