Refined DRGs (RDRGs)

Refined DRGs (RDRGs) was developed at Yale University to revise the use of complications and comorbidities in the Medicare DRGs . Health Care Financing Administration funded this project during 1980s. Yale University modified the original medicare DRGs and expanded the numbers of DRGs to 1263. The DRG system developed by the Yale project is referred to as Refined DRGs or RDRGs.

Before the Yale project there as no concept of CCs and MCCs. In the medicare DRG system DRGs were assigned depending upon the primary and secondary diagnosis, but now Yale project created 136 secondary DRG for CCs. So now if a patient has a CC then instead of assigning the next DRG there was a DRG code with CC in the same DRG group. For surgical patients each secondary diagnosis group was assigned to one of four CC complexity levels, (non CC, moderate CC, major CC, and catastrophic CC). For medical patients each secondary diagnosis group was assigned to one of three CC complexity levels (non-CC, moderate or major CC and catastrophic CC).

RDRGs were basically designed for Medicare purpose only where all the patient population were in elderly ages. This DRG system was not adequate to handle a patient population of all ages especially neonates and patients with Human Immunodeficiency Virus (HIV) infections as there were no DRGs for these patients. This deficiency led to the development of other DRG systems that can cater to the needs of patients of all ages.