Valuation relation
The valuation ratio (synonym costs weight , cost weight (CW), severity or relative weight) is a key figure in medical-economic classification systems such. B. DRG systems for billing medical services in hospitals. You will be assigned a group of patient cases (DRG) and gives the economic severity of a medical case and with that in conjunction with the base rate (Engl. Base rate) the proceeds of a case on.
The aim is to identify and define the economic effort required to treat / diagnose such a group of patient cases (in the DRG system: a specific DRG).
practice
Practical application: A theoretical average case of a patient is assigned a weighting ratio of 1.0. Cases that are more complex than the average get a weighting ratio of more than 1.0. Cases that are less complex than the average receive a weighting ratio of less than 1.0.
If you multiply the valuation ratio by the so-called base case value or base rate, you get the amount that a health insurance company has to pay to a hospital for such a treatment case .
Example: valuation ratio 0.86, base case value € 3000. 0.860 × 3000 € = 2580 € are to be paid to the hospital for this treatment case.
detection
The cost weight is determined for the currently valid DRG catalogs. The data according to §301 SGB V such as B. Main diagnosis (ICD-10 code), secondary diagnosis , therapy (OPS code), age, gender, ventilation duration, intake weight (only for children who are younger than one year of age). The basis for determining the evaluation ratio is cost data from hospitals participating in a nationwide calculation.
Development of the G-DRGs
| 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| G-DRG main departments | 664 | 824 | 878 | 954 | 1082 | 1137 | 1192 | 1200 | 1194 | 1193 | 1187 | 1196 | 1200 | 1220 | 1255 | 1292 | 1318 |
| G-DRG document departments | 806 | 762 | 748 | 771 | 933 | 882 | 873 | 857 | 844 | 835 | 824 | 815 | 799 | 814 | 824 | 825 | |
| Minimum valuation ratio | 0.122 | 0.113 | 0.118 | 0.117 | 0.106 | 0.111 | 0.119 | 0.130 | 0.140 | 0.141 | 0.145 | 0.135 | 0.123 | 0.141 | 0.151 | 0.205 | 0.210 |
| Maximum valuation ratio | 29,709 | 48.272 | 57.633 | 65,700 | 64.899 | 68.986 | 78.474 | 73.763 | 72.926 | 65.338 | 62,477 | 64.137 | 65.943 | 68.208 | 61.787 | 71.528 | 71,598 |
| span | 29,587 | 48.159 | 57.515 | 65,583 | 64.793 | 68.875 | 78.355 | 73.633 | 72.786 | 65.197 | 62,332 | 64.002 | 65.820 | 68,067 | 61.636 | 71,323 | 71.388 |