DRG grouping by machine learning: from expert-oriented to data-based method.

Journal: BMC medical informatics and decision making
Published Date: Nov 9, 2021

Abstract

BACKGROUND: Diagnosis-related groups (DRGs) are a payment system that could effectively solve the problem of excessive increases in healthcare costs which are applied as a principal measure in the healthcare reform in China. However, expert-oriented DRG grouping is a black box with the drawbacks of upcoding and high cost.

Authors

  • Xiaoting Liu
    School of Public Affairs, Zhejiang University, Zijingang Campus, Hangzhou, 310058, Zhejiang Province, China.
  • Chenhao Fang
    College of Control Science and Engineering, Zhejiang University, Hangzhou, China.
  • Chao Wu
  • Jianxing Yu
    School of Public Affairs, Zhejiang University, Zijingang Campus, Hangzhou, 310058, Zhejiang Province, China. yujianxing@zju.edu.cn.
  • Qi Zhao

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