Casemix systems have been used around the world for the purposes of hospital financing and measuring productivity and quality of care. The most noted implementation of a casemix system for hospital financing was that introduced by the USA Federal Government under the Medicare system in the 1980’s which used the Diagnosis Related Groups (DRG) system for classifying hospital activity.

The most well known system, the DRG seeks to classify hospital patients into over 500 groups or categories using the diagnoses and procedures assigned to patients, such that each DRG contains patient who are expected to use similar levels of resources.

Countries that have developed their own version of DRG include: Canada (Case Mix Groups [CMG]), Australia (Australian Refined [AR-DRG]), the Nordic Countries (Nord DRG), Japan (Diagnosis Procedure Combinations [DPC]), France (Groupes Homognes de Malades [GHM]), Germany (G-DRG), Holland (Diagnosis Behandeling Combinatie [DBC]), Austria (Leistungsorientierte Krankenanstaltenfinanzierung [LKF]) and the UK (Healthcare Resource Groups [HRG]). In addition, other countries use the DRGs within a payment system similar to the system used in the UK called “payment by results”. These countries include Portugal, Ireland, Italy, Singapore, Hungary and the Czech Republic.