The mean lengths of stay and discharge rates per 10,000 patients were compared for Victoria, Australia, and the United States on a DRG-specific basis to explain variations in hospital bed utilization and costs. Results were presented for a number of high-volume DRGs where the differences between the two hospital systems were substantial. For several DRGs associated with chronically ill patients, the mean lengths of stay were much longer in Victoria, although most of the difference disappeared after the removal of outliers. The presence of many acute-care patients in Victoria in several DRGs associated with minor surgical procedures produced very low mean lengths of stay. In the United States, rates were markedly higher for providing several major elective surgical procedures and very high-volume medical DRGs. The results of this comparison indicate that greater control over admission and discharge practices could promote greater efficiency and higher quality care in both Australia and the United States.