Interactive complexity and comorbidity splits in Health Resource Group 4+

Abstract

The development of Health Resource Group 4+ (HRG4+) marks a significant enhancement to its Health Resource Group 4 (HRG4) predecessor, reflecting a large number of changes, including greater granularity; procedure and diagnosis hierarchy changes; intervention splits; and most notably, the introduction of interactive complexity and comorbidity (CC) splits. This article concentrates on the interactive CC splits, initially by explaining the underlying logic on which they are constructed, prior to a series of high-level analytical investigations into both their structure and activity volumes and provider case-mix distributions. Comparisons are made between both HRG versions, outlining the impact of HRGs that exhibit CC splits. In addition, the range of CC splits are presented and specific examples used to further highlight the switch from HRG4 to HRG4+. By using reference cost spell activity data for 2013/14, providers case-mix are analysed and activity profiles produced, that highlight significant and noticeable differences across providers.