Diagnosegrupper

Diagnosegrupper, often referred to in English as diagnosis-related groups (DRGs), are standardized categories that group patient cases according to their principal diagnosis, secondary diagnoses, procedures performed and other factors. The aim is to classify hospital activity with similar clinical characteristics and similar resource use.

These groups underpin financing, planning and performance measurement in many healthcare systems. By assigning each patient to a single diagnosegruppe and applying a relative weight, hospitals can estimate expected costs for a case and receive payments that reflect resource consumption rather than length of stay alone.

Data used include diagnostic codes (such as ICD-10) and procedure codes recorded at discharge, plus factors like age and gender. A software grouper automatically assigns a case into a diagnosegruppe. Payments and budgets may be adjusted for severity, comorbidity, and regional price levels.

Originating in the United States in the 20th century, DRG-based systems spread worldwide and have been adapted to local coding and financing rules. In Sweden and several other Nordic countries the term diagnosegrupper is used to describe these groupings within the national financing and statistics framework, supporting hospital planning and comparability across institutions.

Critics note that the system can incentivize coding changes or shorter stays, and that it may not capture all aspects of patient complexity or social determinants of health. Ongoing refinement aims to improve accuracy, reduce gaming, and better reflect clinical reality.