Evaluating performance of local case-mix system by international comparison: a case study in Beijing, China.
BACKGROUND
Case-mix is an important tool for health planning and management in many countries. As a major developing country, China is considering the introduction of the case-mix system in the health reform. Beijing, the capital of China, developed a local case-mix version whose performance needs to be evaluated before utilization.


OBJECTIVE
The objective of this study was to evaluate the performance of the case-mix system developed in Beijing by comparing it with those used in Australia and the U.S.A.


METHODS
A total of 1.3 million inpatient records from 154 hospitals in Beijing in 2008 were grouped respectively using three case-mix systems: (i) Beijing Diagnosis Related Groups (BJ-DRGs); (ii) US-based All Patient DRGs; and (iii) Australian Refined DRGs. Coefficient of variation (CV) and reduction in variance (RIV) were used to measure the performance of DRGs system.


RESULTS
The BJ-DRGs produced the best CV and RIV results for expenditure. However, at the level of Major Diagnostic Category (MDC), three MDCs of BJ-DRGs gave the poorest RIVs for both expenditure and length of stay.


CONCLUSIONS
Although the performance of BJ-DRGs was acceptable, further revision and improvement is needed. Comparisons with other mature DRGs versions can assist in identifying the improvement priorities of the local version.
Department of Health Policy and Management, School of Public Health, Health Science Center, Peking University, 38# Xueyuan Road, Haidian District, Beijing, China. jianweiyan@bjmu.edu.cn
Wei-Yan
WY
Jian
Ming
M
Lu
Tao
T
Cui
Mu
M
Hu
D001315:Australia; D002681:China; D003695:Delivery of Health Care; D003953:Diagnosis-Related Groups; D005260:Female; D018166:Health Care Reform; D006285:Health Planning / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008485:Medical Audit; D014481:United States