Adapting DRGs: the British, Canadian and Australian experiences

The DRG classification was developed in the United States, and has been widely used there for analytical and resource allocation purposes. Its utility has been recognised in other countries. Some have adopted US versions without change, and others have chosen to develop their own adaptations. This paper discusses the processes and outcomes of adaptation in Canada, Britain and Australia. An attempt is made to generalise the trends. It is concluded that there is a high degree of similarity of intent, although different solutions have been adopted in some cases. Where major differences remain, they are mostly a consequence of the lack of resources to pursue all opportunities for refinement at the same time. All three countries have correctly focused on involvement of their own clinician groups. However, they have tended to restrict their view to US experiences when looking overseas. It is argued that greater attention should be paid to sharing their ideas with countries with which they have a greater degree of similarity.