Development of Casemix-based Patient Classification for Patient-Level Costing in a Tertiary Hospital, Saudi Arabia

The current study was performed to develop a Diagnosis Related Group (DRG) based casemix classification for inpatients. We applied a crosssectional retrospective approach to categorize the inpatients based on their diagnosis and procedures at King Fahd Central Hospital (KFCH) Jazan, Saudi Arabia. Inpatient discharge data from 2018 was considered, and patients were categorized based on the casemix system. During the study period, 12,979 patients were discharged from the hospital. Of these, 38% of cases were related to surgical procedures, and 62% were treated under different medical specialties. The maximum number of procedures (19.8%) performed were under the Case-Mix Group (CMG) "O" (deliveries). The highest number (22.2%) of inpatient medical cases were observed in CMG "B" (pancreatic system). 269 DRGs from different severity levels were assigned to patient cases, and among these maximum number of patients (12.1%) were found under DRG "Other liver diseases-mild." We developed the DRG casemix system and categorized the patients according to their Casemix and services provided during their stay at the hospital. Patient identification and grouping based on the diagnosis and procedure is an essential part of resource estimation process and can bring transparency to the clinical practice. This study can potentially help public hospitals to implement a DRG system for patient classification.