Frequently Asked Questions

What is a DRG?

Diagnosis-Related Group (DRG) is a system to classify hospital cases into one of approximately 500 groups, also referred to as DRGs, expected to have similar hospital resource use, developed for Medicare as part of the prospective payment system. DRGs are assigned by a "grouper" program based on ICD diagnoses, procedures, age, sex, and the presence of complications or comorbidities. DRGs have been used since 1983 to determine how much Medicare pays the hospital, since patients within each category are similar clinically and are expected to use the same level of hospital resources.

What is an APR-DRG?

All Patient Refined DRGs (APR-DRGs) are a clinical model that expands on the basic Diagnosis Related Group (DRG) structure to include the addition of four subclasses to each DRG. These subclasses serve to identify minor, moderate, major, or extreme severity of illness or risk of mortality. APR-DRGs classify patients with multiple comorbid conditions involving several organ systems as high severity of illness and risk of mortality. Patients with clinically similar characteristics and similar resource consumption are assigned to one descriptive subclass for both severity of illness and risk of mortality: minor, moderate, major, or extreme. For more information please visit the 3M Health Information Systems website

What do you mean by risk-adjusted?

Some hospitals treat more high-risk patients, and some patients arrive at hospitals sicker than others and often sicker patients are transferred to specialty hospitals. That makes comparing hospitals for patients with the same condition but different health status difficult. To compensate for this fact, each hospital's data is risk adjusted to reflect the score the hospital would have had if it had provided services to the average mix of sick, complicated patients utilizing All Patient Refined-Diagnosis Related Groups (APR-DRGs).

What is a Mortality Rate?

The mortality rate is the number of patients who die in the hospital after a particular procedure, divided by the total number of patients in that hospital who have that procedure.

Where does the data for this Report Card come from?

This Health Care Report Card uses data from many sources, including state, national and government agencies and publicly available reports, and combines them into one format that makes this data more user-friendly. For a list of all sources of data used in this report, visit the Data Sources page.

Can a person be identified from the data in this Report Card?

We only use deidentified patient data in this report card. No patient names are disclosed and it is not possible to identify a patient from the data displayed.

Is this report card developed by industry?

This report card is developed by the New York State Health Accountability Foundation, which is a public-private partnership dedicated to promoting transparency in the health care system and providing employers and consumers with reliable, independent information on health care cost and quality. For more information on NYS HAF, visit the About Us page.