當保險介入醫療服務市場時，付費機制隨之改變，第三者付費機制以及傳統論量計酬（Fee-For-Service）的醫療保險給付方式，往往誘導醫療服務供給者提供更多或更昂貴的醫療服務與檢查項目，使得醫療費用上漲情況愈趨惡化。 為改善醫療費用急速成長之情況，國內外學者無不致力於相關研究，企圖發展出有效的醫療費用控制方法。而前瞻性付費制度，普遍被認為是較可明顯抑制醫療費用迅速成長之方法。其中又以1980年代實施於美國老人保險（Medicare）之診斷關係群（Diagnosis Related Group, DRG）最受矚目，備受各界討論。診斷關係群乃指藉由收集過去之醫院住院病患之相關醫療資源耗用與疾病資訊，且考量不同醫院間之服務量差異，依照病例分類，定義不同疾病之較適醫療資源耗用程度，並以此為支付基準，促進醫院對於此分類病患之醫療資源利用加以規劃與管理，倘若疾病之細項分類定義完善，則可達到前瞻性支付剛度之醫療資源規劃與控制之目的。本文說明比較目前OECD國家發展診斷關係群之演進與支付金額計算考量因素，以期能控制與績效提昇之責任，無論政策制訂者與醫療機構均責無旁貸。政府亦需參考國外之經驗，除了制訂相關監控與品質促進之措施外，更應納入更多考量因素，以發展出適合臺灣醫療環境與體系之診斷關係群支付制度。

While insurance, the third-party payer, was introduce din the health care market, not only the moral hazard from consumer side, but also the supply side induced demands might become a serious problems and result in increasing health care resource consumed and high health care costs. Diagnosis Related Group, DRG, was introduced in American Medicare in 1983 and was regarded as a mechanism, which may increase the efficiency in the health care market. DRG system combined with prospective payment may result in significant improvement on performance of cost control in a health care institution. However, from the past experiences in many OECD countries, the quality of health care may be affected. Applying DRG system may also result in patient dumping and DRG creep. Peer-group organization is suggested to be an efficient method to avoid such possible outcomes following by application of DRG systems. This study tends to compare DRG system in OECD countries and some developing countries and make a systematic overview on previous finding and outcomes of DRG systems.