Sigesa grouping DRG

DESCRIPTION

The Diagnosis Related Groups (DRGs) are a patient classification system that structures hospital activity, by classifying patients into groups that are clinically similar and are expected to use the same level of hospital resources. Their effectiveness and proven logic have made them a market standard in more than 20 countries worldwide.

In Sigesa we work with several 3MTM DRG grouping families (AP, APR and IR). We analyze our client needs, and recommend them the family that best suits them, considering the ICD system in use in their country and the specific data analysis they want to perform.

DRGs allow payers, providers and health authorities to:


Analyze activity of a care setting


Compare against standards


Study disease frequency, clinical practices and morbidity


Analyze quality of care, length of stay and readmission rates


Create financing models, analyze costs incurred and budget activity

In the shift from volume to value-based healthcare, measuring patient health status and costs over time and across care settings is a challenge. In Sigesa we work with 3MTM Clinical Risk Groups (CRGs) to help our clients stratify populations into clinically meaningful groups of individuals based on their inpatient and ambulatory diagnosis and procedure codes, pharmaceutical data and functional health status in a given period of time.

Among other benefits, the use of CRG systems allows to:


Implement morbidity risk-adjusted capitative financing models


Evaluate effectiveness of healthcare systems


Monitor population health status


Assign resources to care settings based on health status of their assigned population


Monitor incidence rates of chronic diseases


Analyze frequency patterns and resource consumption


Link cost and quality of care per capita

Sigesa grouping DRG

Grouping Algorithms

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