HRG4+ 2012/13 Reference Costs Grouper and Documentation
HRG4+ 2012/13 Reference Costs Grouper
The Reference Costs 2012/13 collection is the first collection to use the new enhanced HRG4+ National Casemix Office design.
The enhancements offered as part of the HRG4+ Casemix classification have been developed in partnership with the clinical community, as represented and endorsed by the Royal Colleges Associations and Professional Bodies. The increased applicability of the Casemix classification to emerging policy requirements has been influenced by findings from the Department of Health's International Review of Classifications, as well as international casemix developments and best practice. The design concepts have also taken into consideration concerns raised by several key national stakeholder forums, including the UKCHA, Project Diamond and the Shelford Group, as well as a variety of publications on HRG and national tariff performance by international consultancy companies such as PWC, KPMG and Ernst & Young.
The recognition of multiples, of both interventions and underlying disease, is an increasingly important international factor in the ability to differentiate between levels of care complexity and the healthcare providers that can effectively deliver such care.
As a response, the key benefits of the changes introduced into the HRG4+ design are:
- Procedure and Diagnosis Hierarchy Modifications that allow for greater distinction between procedures (especially) at the lower end of the expected resource use continuum
- Extensions of Multiple Matrix Grid Logic for specific specialised, discrete, service areas to reflect expected resource use of patient care
- Amendments to Complication and Comorbidity (CC) lists to improve consistency and maintain clinical relevance
- The addition of Interactive CC Logic, where clinically feasible, to better reflect the service and resource use in treating multiply comorbid patients
- The creation of HRGs specific to Specialised Activity, such as those for Congenital Cardiac Surgery, and including the expansion of age splits beyond the traditional adult/child boundary, thereby reflecting the significant resource differentiation within the child population
- Quality Improvements including enhancements to support national standards.
HRG4+ facilitates the delivery of requirements outlined in the Health and Social Care Act 2012 by allowing for specialised services provided in tertiary centres and NHS Centres of Excellence to be distinctly identified and appropriately costed and funded. It offers the potential to improve local decision-making, enabling more effective planning and service redesign within all levels of the health economy.
The HRG4+ 2012/13 Reference Costs Grouper should be used to process data and produce HRG4+ output for the Reference Cost collection for the 2012/13 financial year.
The grouper is being issued with new episode and spell Trimpoints to be used for the 2012/13 Reference Costing exercise.
It should be used in conjunction with the 
Grouper Reference Manual [650kb] (Opens in a new window), which explains how data should be sorted and presented for processing by the grouper. This and other resource materials can be downloaded from the documentation downloads section below.
As a precursor to using the grouper, it is strongly advised that users read the Summary of Changes [182kb](Opens in a new window) document to become familiar with the changes made since the 2011/12 Reference Costs Grouper.
Further information regarding the Reference Costs collection for 2012/13 can be found in the 2012/13 Reference Costs Guidance published on the Department of Health website (external).
Users should note that they will need to process data for the 2012/13 financial year using the HRG4 2012/13 Local Payment Grouper, for reimbursement purposes for that financial period.
For the 2013/14 financial year users should process data for reimbursement calculations using the HRG4 2013/14 Local Payment Grouper.
For queries about HRG4+ or the grouper, please call the HSCIC Contact Centre on 0845 300 6016 or email enquiries@hscic.gov.uk
HRG4+ 2012/13 Reference Costs Grouper Documentation
Grouper Reference Manual [650kb] (Opens in a new window) Provides full instructions on how to prepare and group data using the HRG4 Grouper software application.
Summary of Changes [182kb] (Opens in a new window)Overview of changes between the current HRG4+ grouper design and its HRG4 predecessor.
HRG4+ RC12-13 Roots v1.0 [1Mb] (Opens in a new window) Details of new HRGs, deleted HRGs and changes to existing HRG Labels between designs, at the aggregate HRG level.
HRG4+ 2012/13 Reference Costs Grouper Code to Group [4Mb] (Opens in a new window)Details on all mappings between primary classification codes and HRGs and the logic required to generate HRGs.
HRG4+ 2012/13 Reference Costs Grouper Chapter Summaries [5Mb] (Opens in a new window) Updates on changes and an overview of the scope, composition and grouping logic of individual subchapters.
HRG4+ 2012/13 Reference Costs Grouper Trimpoints [145kb] (Opens in a new window) Details of Episode and Spell-level Trimpoints to be used for the 2012/13 Reference Costs collection
HRG4+ 2012/13 Reference Costs Specialised Service Identification Code Sets [471kb] (Opens in a new window) A workbook containing details regarding the flags and trigger codes introduced for the first time in the HRG4+ Reference Costs Grouper to aid identification of specific Specialised Service activity.
HRG4+Companion v1.1 [174kb] (Opens in a new window) The starting point and general reference for new and existing users, providing an introduction to Casemix, HRG4 and HRG4+ design concepts and grouping logic.
HRG4+ 2012/13 Reference Costs Grouper Known Issue
18/03/2013:
Users should note that the content of the following HRGs differs between Grouper releases. As a result, comparisons cannot be drawn between the sets of HRGs identified as the activity each HRG captures is different, irrespective of the fact that the HRG codes are the same.
- HRG4+ BZ24D (Non-Surgical Ophthalmology, with Interventions) in RC12/13 is not the same as the content of the HRG4 BZ24D (Non-Surgical Ophthalmology with length of stay 1 day or less and age 18 years and under) in RC07/08;
- HRG4+ HC29B (Inflammatory Spinal Conditions with CC Score 0-1) in RC12/13 is not the same as the content of the HRG4 HC29B (Inflammatory Spinal Conditions with CC) in RC10/11;
- HRG4+ LB19C (Ureteric or Bladder Disorders, with Interventions, with CC Score 4+) in RC12/13 is not the same as the content of the HRG4 LB19C (Ureteric / Bladder Disorders 18 years and under) in RC07/08;
- HRG4+ MB08A (Threatened or Spontaneous Miscarriage, with Interventions) in RC12/13 is not the same as the content of the HRG4 MB08A (Threatened or Spontaneous Miscarriage 19 years and over) in RC07/08;
- HRG4+ MB08B (Threatened or Spontaneous Miscarriage, without Interventions) in RC12/13 is not the same as the content of the HRG4 MB08B (Threatened or Spontaneous Miscarriage 18 years and under) in RC07/08.
09/04/2013:
When using the single spell grouper, if the Group button is missing and you are running under Windows 7, you will need to change a display setting as follows:
- Select Control Panel - Display - select 100%.
- Reboot after changing the setting.