Diagnosis-Related Groups: Experience in Three High Complexity Hospitals in Colombia

Introduction: The health care process concentrates most of the resources of the Colombian health system. To measure the health care outcome (hospital product) is essential for clinical, administrative and financial management. There are different ways to achieve this, such as Diagnosis Related Groups (DRGs). Objectives: To evaluate the data quality from the individual health care records (RIPS) reported during 2011 and 2012 by three high complexity hospitals to establish the possibility of implementing DRGs in Colombia. Methods: A descriptive study using data from three high complexity hospitals obtained from RIPS. DRGs of the three hospitals were calculated, using IAmetrics Data software, version MS-DRG 28.0. Results: The quality of the data found was low: 15.3% episodes could not be grouped, 99.3% had a single diagnosis, and only 0.7% had a secondary diagnosis. For the casuistry, the first 15 GRD accumulated 25% of episodes of hospitalization. Conclusions: DRGs obtained with RIPS were incomplete, although it is possible to obtain them. Thus, the RIPS itself can be a tool for grouping the health care data in the country.