Reducing the Risk of Upcoding in DRG Grouping Through a Two-Stage DRG Grouper Based on Machine Learning.

In the implementation of diagnosis-related groups (DRGs), hospitals respond to price changes by incorporating more patients into the more profitable DRGs, thereby providing evidence for upcoding. This study proposes a two-stage DRGs grouper (ML-DRG) to alleviate the risk of upcoding. The ML-DRG empl...

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Publicado en:Inquiry (00469580) Vol. 62; pp. 1 - 10
Autores principales: Wang, Haitian, Luo, Li, Ma, Dongyuan, Xie, Zhecheng, Fang, Yuanchen
Formato: equations & formulas research tables/charts Journal Article
Publicado: Sage Publications Inc. 11/5/2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 11/5/2025
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      pub: Sage Publications Inc.
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        atl: Reducing the Risk of Upcoding in DRG Grouping Through a Two-Stage DRG Grouper Based on Machine Learning.
      aug:
        au:
          Wang, Haitian
          Luo, Li
          Ma, Dongyuan
          Xie, Zhecheng
          Fang, Yuanchen
        affil: Business School, Sichuan University, Chengdu, China
      sug:
        subj:
          Diagnosis-Related Groups Economics
          Coding Standards
          Reimbursement Mechanisms
          Fraud Prevention and Control
          Machine Learning Methods
          Human
          Funding Source
          China
          Comparative Studies
          Descriptive Statistics
          Mann-Whitney U Test
          Kruskal-Wallis Test
          Prediction Models
          Health Care Costs
          Intracranial Hemorrhage Diagnosis
          Respiratory Tract Infections Diagnosis
          Inflammation Diagnosis
          Hospitals Economics
          Health Information Management
          Machine Learning Algorithms
      ab: In the implementation of diagnosis-related groups (DRGs), hospitals respond to price changes by incorporating more patients into the more profitable DRGs, thereby providing evidence for upcoding. This study proposes a two-stage DRGs grouper (ML-DRG) to alleviate the risk of upcoding. The ML-DRG employs machine learning methods to build a predictive model of patients' clinical resource consumption and assigns the model output as the resource consumption index, which comprehensively considers various patients characteristics and is challenging to modify. We utilize the data from the Chengdu Healthcare Security Administration of China, covering the period from 2011 to 2018, to compare the performance of the proposed method with the 3 mainstream approaches. Our findings indicate that the intracranial hemorrhagic disease (BR1) group and respiratory infection/inflammation disease (ES2) group of ADRG were divided into 4 DRGs, with the coefficient of variation of each group being less than.8. Among the 4 grouping methods, ML-DRG demonstrated the best performance. These findings suggest that the application of ML-DRG may reduce the risk of upcoding by helping hospitals avoid selecting incorrect DRG codes for higher reimbursement rates.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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