Analysis and development of the GRDs in the National Health System

Year 2008

Methodological notes on weights and costs of the GRD in the NHS year 2008 (in Spanish)

AP v25 (All Patient version 25)

• Weights of the GRDs of the National Health System (PDF version)     (Excel version) (in Spanish)

AP v23 (All Patient version 23)

• Weights of the GRDs of the National Health System (PDF version)     (Excel version) (in Spanish)

+ 1990 - 2005 series data (documents in Spanish)

In the year 1997 the Ministry of Health and Consumer Affairs approved the transfer of the health management to the autonomous regions and the INSALUD, the project of “Analysis and development of the G.R.D in the National Health System”. To this project united, later and by request of its respective Health Advisers, the autonomous regions of Murcia and Madrid. In the present day, all the autonomous regions take part on this project. The goals they initially proposed were:

• Evaluate the G.R.D. grouping system for its adaptation, if needed, to the features of our environment, for its use as a funding or budgeting tool in the National Health System.
• Know the in-group variability of the G.R.D. obtained according to the encoding of the hospital discharges in the National Health System.
• Develop a general catalogue of processes, based on the measuring of the case-mix, for its use as a funding system.
• Develop a standardized methodology for the imputation of costs.
• Develop a methodology for the definition of the intermediate products.

One of the lines of work which nowadays the Ministry of Health, Social Policy and Equality develops in accordance with the goals of this project is the development of the Spanish state weighs of the G.R.D. and the homogenization of the imputations of costs systems.

The G.R.D. as a system for patient’s risk adjustment, incorporate a cost estimator for each kind of patient. The G.R.D. are one of the most used patients grouping system in terms of the procurement of the so-called case-mix, a measure of the average complexity of the dealt patients in hospitals, and the relative weights, or consumption level of resources attributable to each kind or group of patients.

The concept of weight is based on the playing down of the average cost of each one of the G.R.D. Every G.R.D carries with it a relative weight which represents the foreseeable cost of this kind of patients in accordance to the average cost of all the hospital admittance acute patients.

A weight of value 1 equals to the average cost of the hospitalized patient (standard). A weight above or below 1 means that its cost will be above or below respectively of the standard (cost of the average patient).

The concept is obtained from the integration of the hospital costs with the information contained in the CMBD of hospital admittance of acute patients in the framework of the project “Analysis and development of the G.R.D. in the National Health System”.

Complete text of the project and initial results (PDF format) (in Spanish)