Short Info: GHM (France)

The "Groupes homogènes de malades" (GHM) were developed within the framework of the "Programme de médicalisation des systèmes d'information" (PMSI) and originally stem from the third HCFA-DRG version; they have been enhanced in their 1997 version with elements from APDRG.

The diagnoses are codified according to the ICD-10, while the procedures are encoded using the French catalogue of services "Catalogue des actes médicaux" (CdAM), and its successor, the "Classification Commune des Actes Médicaux" (CCAM), respectively.

For 2008, a fundamental revision of the system to address the introduction of a GHM-based reimbursement system is currently in process.1 A fourth CC level will be introduced. For hospital stays under two days, three main categories (CMD 25 – 27) are defined.

Instead of DRGs, France has GHMs (Groupes homogènes de malades). Since 1996, the GHM system is being used to calculate the budgets of public hospitals.

Since 2004 (with a transition time until 2012), the GHM system is used for reimbursement.2 This project is named "Tarification à l'activité" (T2A). For that end, "Groupes homogènes de séjours" (GHS) where defined by the insurance providers: For each GHM, there is one, sometimes more than one GHS. For each GHS, several cost weights are defined. They depend upon the type of the financing of the hospital. To calculate GHS lump sums, cost surveys were made in public and private not-for-profit hospitals. The lump sums for the remaining private hospitals were calculated on the basis of their bills.

Exceptions with a remuneration of more than one GHS lump sum are e. g. palliative stays, radiotherapies, or dialyses.

In addition to the stay related lums sums, department type dependant daily lump sums are payed for treatment on specialised departments in reanimation, intensive care, monitoring, and neonatology.