HEALTH-CARE RESOURCE GROUPS - VERSION 2

Background Casemix groupings have been increasingly used to manage res ources in health services over the last ten years. Internationally, Di agnosis Related Groups (DRGs) have been widely implemented and adapted , and within the National Health Service (NHS), this has led to the de velopment of Healthcare Resource Groups (HRGs). These are groupings of in-patient episodes which are similar in cost and clinical meaning de veloped for use in internal resource management and contracting. HRGs Version 2 were released in August 1994, and are being used for costing for contracting in England. Methods Professionally led Clinical Worki ng Groups were convened and provided with analyses based on the nation al hospital discharge dataset, In discussion, they agreed definitions of groupings based on International Classification of Disease diagnosi s, Office of Population Censuses and Surveys procedure codes, age, and discharge status. These proposals were widely circulated within the N HS and ratified by the relevant colleges and professional associations . Results A total of 528 HRGs were defined, grouped into 16 Chapters. This includes five 'U groups' which are used to cover various errors i n the records, HRGs Version 2 are able to explain a greater proportion of the variation in length of stay of hospital in-patients than HRGs Version 1, DRGs or ANDRGs (Australian National DRGs). Conclusion The d evelopment of a national set of casemix groups for resource management and costing has been undertaken with involvement and commitment from the medical profession. Further work is required to develop appropriat e groupings for care of the elderly, mental illness services, communit y services, out-patients, radiotherapy, etc. When completed, these sho uld provide a consistent currency for purchasers and providers to use in discussing contracts.