Table 1.
DRG | DIP | |
---|---|---|
Patient classification rules | Develop 26 major diagnostic categories (MDCs)→divide each MDC into medical and surgical categories based on principal diagnosis or surgical procedure codes→define DRGs by considering patient characteristics, complications and comorbidities | Combinations of principal diagnosis ICD-10 codes and procedure ICD-9 CM codesb. Demographic factors not considered. |
Number of groups | Hundreds (<1000) | ≈13 000 |
Number of principal diagnoses in a group | Multiple | One for most groups |
Data quality requirements | Higher than DIP | Lower than DRG |
Payment modality | Payment rate for each case determined ex ante; total amount of payment capped by regional global budget. | Each group assigned with a certain number of ‘points’ reflecting its relative usage of resources; monetary value of each point determined ex post by regional global budget and city-wide point sum. |
DIP practice varies across localities. The information presented in this table is mainly based on the practice of Guangzhou, one of the pioneer cities of the DIP innovation.
ICD-10: International Classification of Diseases (10th edition). ICD-9 CM3: International Classification of Diseases (9th edition) Clinical Modifications.