Within the
English National Health Service
The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the ...
(NHS), a Healthcare Resource Group (HRG) is a grouping consisting of patient events that have been judged to consume a similar level of resource. For example, there are a number of different knee-related procedures that all require similar levels of resource; they may all be assigned to one HRG.
The current revision of Healthcare Resource Groups in use is the fourth, and is known as HRG4. HRG4 is updated annually to enhance the system, reflect changes in clinical practice and to include changes to policy.
HRG4 is maintained by the National Casemix Office, part of
NHS Digital
NHS Digital was the trading name from 2016 of the Health and Social Care Information Centre, which was the national provider of information, data and IT systems for commissioners, analysts and clinicians in health and social care in England, p ...
.
The HRG system is used by
Payment by Results, an activity based payment system rolled out in the NHS in England (but not Wales) from 2004 and used to determine the income hospitals in England get for given hospital stays and procedures.
The 2013/14 Local Payment Grouper
- The NHS HSCIC website
HRGs can be derived for the following areas:
:* Admitted Patient Care
:* Non-Admitted Consultations
:* Emergency Medicine
:* Adult Critical Care
:* Paediatric Critical Care
:* Neonatal Critical Care
:* Renal
Patient data are assigned HRG codes using a software application known as a Grouper.
An HRG code consists of five characters: two letters followed by two numbers and a final letter. The first letter refers the Chapter, the second being the Sub-Chapter; these correspond to body areas or body systems identifying the area of clinical care that the HRG falls within. The final letter is known as the 'split' and is used, for example, to indicate the level of complications and comorbidities associated with the HRG (e.g. Minor, Intermediate and Major), for different lengths of stay, ages or a combination of factors.
Admitted Patient Care
In Admitted Patient Care, an HRG is derived for each Consultant Episode (a period of care under one consultant) and Provider Hospital Spell (a period of care from admission to discharge) using clinical coding (ICD-10
ICD-10 is the 10th revision of the International Classification of Diseases (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social cir ...
and OPCS-4
OPCS-4, or more formally OPCS Classification of Interventions and Procedures version 4, is the procedural classification used by clinical coders within National Health Service (NHS) hospitals of NHS England, NHS Scotland, NHS Wales and Health ...
) and administrative codes about patient events.
Non-Admitted Consultations
Non-admitted consultations includes outpatients and ward attenders. An HRG is derived for each attendance record using clinical coding and the 'First Attendance' data item.
Emergency Medicine
Emergency Medicine (A&E) data are grouped based on investigation and treatment codes.
Adult Critical Care
Adult Critical Care HRGs are allocated per Critical Care Period using a count of organ systems supported.
Paediatric Critical Care
Paediatric Critical Care HRGs are allocated on a per-day basis largely using Critical Care Activity Codes.
Neonatal Critical Care
Neonatal Critical Care HRGs are allocated on a per-day basis largely using Critical Care Activity Codes.
Renal
Renal HRGs are allocated based on the National Renal Dataset
See also
* Diagnosis Related Group
References
{{reflist
External links
NHS Digital
National Casemix Office
National Health Service (England)