weights assigned to the DRG. The Diagnostic Related Groups are
             determined by resource consumption and clinical patterns, and also incorporate other pertinent factors, such as: the principal diagnosis; up to eight additional (secondary) diagnoses; up to six procedures performed during the stay; and the age, gender, and discharge status of the patient. "A weight is calculated for each DRG which represents the average resources necessary to care for cases in that DRG relative to the average resources used to treat all cases in all other DRGs. Services provided to the patient during the course of treatment are not addressed specifically, but are included in the total charges, which are used as the measure of resource consumption. Each year, the relative weights assigned to DRGs are recalibrated based on the latest available discharge data for Medicare discharges" (Edwards, et al, 1994, pp. 45).
             Since the cost is based on the standardized amount multiplied by the weight of the DRG and not on each individual episode, resource expenditure or procedure; in some cases the
             cost will be less than the expenditure, while, in other cases, it will exceed the amount billed. Through the averaging process, and given the normal distribution, cost will be balanced, over time, with expenditures. "The initial set of DRG weights was published in the September 1, 1983 Federal Register (Besdine, 1998). The weights have since been updated in response to legislation mandating periodic recalibration. They were first recalibrated in 1986 as a result of Public Law 98-21, which required the weighting factors to be adjusted for discharges occurring in fiscal year
             1986 and at least every 4 years thereafter. Subsequently, Public Law 99-509 was passed, requiring the DRG weights to be adjusted annually beginning with fiscal year 1988" (Rogowski and Byrne, 1990, pp. 87). The recalibration in 1986 included the change from calculating...