Short Info: HRG (UK)

After some previous unsuccessful attempts with american DRG systems, the HRG system has been developed in the early 90s with the aim to define more homogenous patient categories compared to DRGs.1

The two most significant divergences from the construction principles of standard DRG systems were:

• Priority was given to the principal procedure over the principal diagnosis, as primary criterion for grouping of cases.
• Definition of not just one single CC list for all base DRGs, but of one CC list for each main category.

The first HRG version containing 522 patient categories was published in 1991. A fundamental recast has been carried out in 2007, baring the name "HRG4" and including 1404 patient categories. In this version, three severity grades are applied.

The HRG system has been applied for remuneration since 2006 within the framework of the "Payments by Results" program.

For some activities and cost elements, a number of 160 «unbundled» HRGs were created in the new HRG4 system.2 These can be attributed to treatment cases in addition to the usual HRGs.