Short Info: AP-DRG (3M/USA)

The APDRG system is an extension of the spectrum of patients represented in the HCFA-DRG aimed to include "all patients" (= "AP"). This extension includes in particular: HIV infections, consideration of birth weight in newborns, differentiated consideration of diseases in children, and – in later versions – multiple trauma (in patients with at least two significant injuries). These extensions have been carried over in part into the 8th version of the HCFA-DRG system.

[Table 1] The APDRG system is a DRG system that contains 641 DRGs (version 12.0). It includes three CC levels:

• major co-morbidities or complications (MCCs = Major CCs)
• significant co-morbidities or complications (CCs)
• no significant co-morbidities or complications

By settling the MCCs on the level of Major Diagnostic Categories (and not on the level of the base DRGs, as in the RDRG project), the number of DRGs could be kept relatively low.

Basically, the APDRG system is revised annually. The last adjustments made in Europe however date back to version 12.0 from 1995. According to system developer 3M, the system can today be considered stable to a large extent. It is only being adjusted to the changes in the encoding systems which in the US are undertaken annually, too.

The first European version that was not based on American encoding systems was created for Wales, where the ICD-10 was used to encode diagnoses. This version has also been applied by the Swiss APDRG Association.