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Updated: Feb 23, 2026

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Markov Model of the Outpatient Classification System Morbidity Related Groups (MRG)
Timo Emcke1, Thomas Ostermann2, Reinhard Schuster3
1Association of SHI Physicians, Bad Segeberg, Germany.
Background:
Benchmarking and guidance of outpatient physicians in Germany are almost always based on one year data. This also holds true for morbidity related groups, a classification system applied in northern Germany since 2017. A study of the markov properties of prescription based grouping algorithms is reported here.
Results:
There is a strongly connected graph for almost all components and the resulting markov chain has a unique stationary solution.
Conclusions:
Target values based on the status quo of prescription behavior can provide stable guidelines for outpatient physicians. Every set of partitions converging like MRG should be considered for controlling measures.
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