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该研究的目的是通过比较英国、澳大利亚和美国的病例组合系统来判别英国卫生保健资源分类法(HRGs)各版本修订时可能存在的设计改进。该研究数据囊括了英国2001年至2002年574个国家健康服务(NHS)急诊医院的超过1 200万住院病人以及日间病例病人的出院记录。这些数据用HRG3.1版本、HRG3.5版本、美国的(APDRG)以及澳大利亚的AR-DRG这四种病例组合系统进行分类。这些分类的统计学表现用方差缩减(RIV)数据测试。与其他三个分类系统相比,澳大利亚的AR-DRG有分类数量最多的优势,产生的总体RIV结果也最好。每个系统内部各章节的比较结果显示每个系统都有一些章节的RIV值高于其他系统相同章节的RIV值。通过比较研究成功找出HRG各版本中改进设计的变化,以及HRG的进一步修订应关注那些具有最大改进潜力的章节。
The purpose of this study was to identify possible design improvements that could exist in the revision of various editions of the UK’s Health Care Resource Classification (HRGs) by comparing case-pooling systems in the United Kingdom, Australia and the United States. The study includes more than 12 million hospitalized patients from 574 National Health Service (NHS) emergency hospitals in the United Kingdom from 2001 to 2002, and discharge records for daytime patients. These data were categorized using the four case combination systems HRG 3.1, HRG 3.5, APDRG in the United States and AR-DRG in Australia. The statistical performance of these categories was tested using variance reduction (RIV) data. Compared to the other three taxonomies, AR-DRG in Australia has the most taxonomic advantages and produces the best overall RIV results. A comparison of sections within each system shows that some systems in each system have RIV values that are higher than the RIV values of the same sections in other systems. Finding a better design change from the various versions of the HRG through a comparative study, and further revisions to the HRG should focus on those sections that have the greatest potential for improvement.