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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Bibliographic Details
Published in:Inquiry (00469580) Vol. 62; pp. 1 - 10
Main Authors: Wang, Haitian, Luo, Li, Ma, Dongyuan, Xie, Zhecheng, Fang, Yuanchen
Format: equations & formulas research tables/charts Journal Article
Published: Sage Publications Inc. 11/5/2025
Online Access:View this record in EBSCOhost