Getting the mix right.
Clinical codes are the building blocks used to describe each patient's stay in hospital. These codes can then be grouped to generate Diagnosis Related Groups (DRGs), each representing a group of patients with conditions requiring similar resources. Through DRGs, a hospital is able to gain a detailed understanding of the number and type of patients they treat (case mix). Hospitals and government departments then analyse this data to determine performance, quality, pricing and reimbursement, and to inform decision making, health service planning, utilisation management and epidemiology.