DRG grouping by machine learning: from expert-oriented to data-based method
DRG grouping by machine learning: from expert-oriented to data-based method (BMC).
Diagnosis-related groups (DRGs) are a payment system that could effectively solve the problem of excessive increases in healthcare costs which are applied as a principal measure in the healthcare reform in China. However, expert-oriented DRG grouping is a black box with the drawbacks of upcoding and high cost.
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Conclusions
As a new potential option, the data-based grouping meets the requirements of
the DRGs system and has the advantages of high transparency and low cost in the
design and update process.
Quelle: BMC, 09.11.2021