Healthcare Resource Groups

Healthcare Resource Groups (HRGs) are clinically meaningful groupings of patient activity, derived primarily from procedure (OPCS Classification of Interventions and Procedures Version 4.9) and diagnosis (International Statistical Classification of Diseases and Related Health Problems 10th Edition 5th Revision) codes within patient records. They are used, amongst other things, as a means of determining fair and equitable reimbursement for healthcare services by providing consistent 'units of currency' to support standardised commissioning across the NHS, at a local, regional and national level.

An awareness of the rigour employed by the National Casemix Office (NCO) in the development of our HRG classifications can help our users to:

• understand how HRGs can be used to benchmark healthcare services, within and between providers, and highlight differences in clinical practice, and patient outcomes
• appreciate how HRGs represents healthcare activity, supporting the development of new patient pathways, accompanied by a clear and quantifiable measure of the resources required for change
• recognise that HRGs can be used to establish baselines for future performance measurement, which is key to redesigning healthcare services for the future

From the first Reference Costs collection and the first national tariff, which used the HRG version 3 designs, to the expansion of coverage and concepts in HRG4, the HRG Casemix Classification has evolved in order to continue to reflect clinical practice, innovation and changes in care delivery protocols. Our HRGs are also updated for changes in the underlying primary classifications such as OPCS and IICD 10, which are currently updated on a specified three-year cycle.

The HRG4+ Casemix Classification is the most current version of our HRG design. It evolved from the HRG4 classification, retaining the same scope, but developed to better reflect healthcare activities, especially in the world of multiples (complications, comorbidities, procedures), innovation (devices and technology) and complexity (infants, interventions and interdependencies).