CN109524075A - Drug expenditure risk of exceeding criterion control method and device based on data processing - Google Patents

Drug expenditure risk of exceeding criterion control method and device based on data processing Download PDF

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Publication number
CN109524075A
CN109524075A CN201811228496.2A CN201811228496A CN109524075A CN 109524075 A CN109524075 A CN 109524075A CN 201811228496 A CN201811228496 A CN 201811228496A CN 109524075 A CN109524075 A CN 109524075A
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drug
mentioned
expenditure
medical institutions
monitored
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CN201811228496.2A
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Chinese (zh)
Inventor
袁刚
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Shenzhen Ping An Medical Health Technology Service Co Ltd
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Ping An Medical and Healthcare Management Co Ltd
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Priority to CN201811228496.2A priority Critical patent/CN109524075A/en
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    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00—Administration; Management
    • G06Q10/06—Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
    • G06Q10/063—Operations research, analysis or management
    • G06Q10/0635—Risk analysis of enterprise or organisation activities
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/20—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

The embodiment of the present application discloses a kind of drug expenditure risk of exceeding criterion control method and device based on data processing, this method comprises: obtaining with effective prescription and with the medicine information included by effective prescription, and determines average daily drug expenditure according to medicine information；According to the sufferer quantity corresponding to the determining effective prescription of sufferer information for including in effective prescription, the day for human beings equal drug expenditure is determined according to medicine information and sufferer quantity；It is determined according to the medicine information of each similar drug included in medicine information with the target medicine in effective prescription and determines target medicine with the target medicine ratio in effective prescription；It is whether exceeded according to average daily drug expenditure, the day for human beings equal drug expenditure and target medicine ratio-dependent drug expenditure；If drug expenditure is exceeded, the exceeded risk control of drug expenditure is carried out based on average daily drug expenditure, the day for human beings equal drug expenditure and target medicine ratio.Using the embodiment of the present application, the accuracy of medication monitoring can be improved, improve the effective rate of utilization of medical resource.

Description

Drug expenditure risk of exceeding criterion control method and device based on data processing
Technical field
This application involves field of medical technology more particularly to a kind of drug expenditure risk of exceeding criterion controls based on data processing Method and device.
Background technique
Currently for the medication standard of each medical institutions of specification, evade big prescribing behaviour, to avoid the abuse of drug And waste, the purpose rationally treated is played, miscellaneous medication monitoring mechanism comes into being.Miscellaneous medication monitoring equipment System is for carrying out medication monitoring, including but not limited to each hospital, the department of each hospital, each clinic to each medical institutions Or even the medical institutions such as each doctor (or representative of medical institutions) carry out medication monitoring.
In the prior art, time equal prescription standard is mainly used for the evaluation of the medication standard of each medical institutions, Medication evaluation criterion exactly by the prescription average cost calculated every time (referred to as time equal prescription expenditure) as each medical institutions. Wherein, the medication evaluation criterion of above-mentioned time prescription expenditure is calculated in such a way that prescription total value is divided by prescription number It arrives.The prior art using time prescription expenditure as the medication evaluation criterion of each medical institutions cause each medical institutions in order to Evade big prescribing behaviour to be examined, it will usually lower time equal prescription expenditure using reduction prescription number of days, or by decomposition The biggish big prescription of single prescription total value is decomposed into the modes such as multiple lesser small prescriptions of single prescription total value by the mode of side Time equal prescription expenditure is reduced, to evade the monitoring of big prescription.The implementation of the prior art makes the use of each medical institutions The loophole of medicine monitoring is larger, low to the medication monitoring accuracy rate of each medical institutions, poor for applicability.
Summary of the invention
The embodiment of the present application provides a kind of drug expenditure risk of exceeding criterion control method and device based on data processing, operation Simply, the accuracy that the medication monitoring to medical institutions can be improved improves the reliability of the medication monitoring to medical institutions, improves The effective rate of utilization of medical resource, applicability are stronger.
In a first aspect, the embodiment of the present application provides a kind of drug expenditure risk of exceeding criterion controlling party based on data processing Method, this method comprises:
Obtain medical institutions to be monitored uses effective prescription；
Above-mentioned medicine information included in effective prescription is obtained, and above-mentioned doctor to be monitored is determined according to above-mentioned medicine information Treat the average daily drug expenditure of unit；
The above-mentioned sufferer quantity corresponding to effective prescription is determined with the sufferer information for including in effective prescription according to above-mentioned, according to Above-mentioned medicine information and above-mentioned sufferer quantity determine the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored；
The above-mentioned mesh in effective prescription is determined according to the medicine information of each similar drug included in above-mentioned medicine information Drug is marked, and determines above-mentioned target medicine in the above-mentioned target medicine in effective prescription according to the medicine information of above-mentioned each similar drug Ratio；
According to above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio, determine above-mentioned Whether the drug expenditure of medical institutions to be monitored is exceeded；
It is equal based on above-mentioned average daily drug expenditure, the above-mentioned day for human beings if the drug expenditure of above-mentioned medical institutions to be monitored is exceeded Drug expenditure and above-mentioned target medicine ratio carry out above-mentioned medical institutions to be monitored exceeded with the drug expenditure of effective prescription Risk control.
With reference to first aspect, in a kind of possible embodiment, above-mentioned acquisition medical institutions to be monitored use effective prescription Include:
The data system access qualification of above-mentioned medical institutions to be monitored is obtained, based on above-mentioned data system access qualification from upper State obtain above-mentioned medical institutions to be monitored in the data system of medical institutions to be monitored use effective prescription；And/or
The medical treatment Claims Resolution data that above-mentioned medical institutions to be monitored provide are obtained, are obtained from above-mentioned medical treatment Claims Resolution data above-mentioned Medical institutions to be monitored use effective prescription；
Wherein, above-mentioned medical institutions to be monitored includes above-mentioned medical institutions to be monitored in the individually examination period with effective prescription It is interior it is all use effective prescription, the above-mentioned single examination period includes odd-numbered day or more days.
With reference to first aspect, in a kind of possible embodiment, above-mentioned medical institutions to be monitored include with effective prescription All within the odd-numbered day of above-mentioned medical institutions to be monitored use effective prescription；
The above-mentioned medicine information included in effective prescription of above-mentioned acquisition, and determined according to above-mentioned medicine information above-mentioned wait supervise Control medical institutions average daily drug expenditure include:
Above-mentioned all medicine informations with each drug included in effective prescription are obtained, are included at least in above-mentioned medicine information Sales Volumes and drug use number of days；
Determine that the drug of above-mentioned all drugs all included by effective prescription is total according to the Sales Volumes of above-mentioned each drug Volume, and determine that above-mentioned all drugs with effective prescription use total number of days using number of days according to the drug of above-mentioned each drug；
The average daily drug of above-mentioned medical institutions to be monitored is determined using total number of days according to above-mentioned drug total value and above-mentioned drug Expense.
With reference to first aspect, in a kind of possible embodiment, above-mentioned medical institutions to be monitored include with effective prescription All within more days single examination periods of above-mentioned medical institutions to be monitored use effective prescription；
The above-mentioned medicine information included in effective prescription of above-mentioned acquisition, and determined according to above-mentioned medicine information above-mentioned wait supervise Control medical institutions average daily drug expenditure include:
Any day in the above-mentioned single examination period any odd-numbered day effective prescription is obtained, and obtains any of the above-described odd-numbered day medication The medicine information of included each drug in prescription includes at least Sales Volumes in above-mentioned medicine information and drug uses number of days；
It is determined according to the Sales Volumes of each drug included by any of the above-described odd-numbered day effective prescription and drug using number of days State the odd-numbered day average daily drug expenditure of medical institutions to be monitored；
According to above-mentioned medical institutions to be monitored in the above-mentioned single odd-numbered day average daily drug expenditure and medicine for examining period Nei Ge Product determine the average daily drug expenditure of above-mentioned medical institutions to be monitored using total number of days；
Wherein, any day drug is the medicine of each drug included in any of the above-described odd-numbered day effective prescription using total number of days Product use the summation of number of days.
With reference to first aspect, in a kind of possible embodiment, it is above-mentioned according to above-mentioned medical institutions to be monitored above-mentioned The odd-numbered day average daily drug expenditure and drug of single examination period Nei Ge determines above-mentioned medical institutions to be monitored using total number of days Daily drug expenditure includes:
The list in above-mentioned single examination period is determined according to the odd-numbered day average daily drug expenditure of above-mentioned single examination period Nei Ge Day average daily drug expenditure accumulated value is determined using total number of days according to the drug of above-mentioned single examination period Nei Ge and above-mentioned is individually examined Drug in nuclear cycle uses total number of days accumulated value；
It is determined according to average daily drug expenditure accumulated value of above-mentioned odd-numbered day and above-mentioned drug using total number of days accumulated value above-mentioned wait supervise Control the average daily drug expenditure of medical institutions.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=odd-numbered day average daily drug expenditure accumulated value/drug uses total number of days accumulated value.
Optionally, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=period drug total value/period drug uses total number of days；
Wherein, it can be the drug of all drugs of all prescriptions in the single examination period in above-mentioned period drug total value The total amount of the cumulative obtained all drugs of the amount of money, above-mentioned period drug can be the institute in the single examination period using total number of days There is the drug of each drug in drug to use the accumulated value of number of days.
With reference to first aspect, in a kind of possible embodiment, it is above-mentioned according to above-mentioned with the sufferer for including in effective prescription Information determines that the above-mentioned sufferer quantity corresponding to effective prescription includes:
It obtains above-mentioned sufferer information included in effective prescription, and is determined according to above-mentioned sufferer information and above-mentioned use effective prescription Targeted sufferer person-time, wherein one is directed to a sufferer person-time with effective prescription；
Above-mentioned sufferer person-time is determined as the above-mentioned sufferer quantity corresponding to effective prescription.
With reference to first aspect, above-mentioned according to above-mentioned medicine information and above-mentioned sufferer number in a kind of possible embodiment Amount determines that the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored includes:
It is determined according to above-mentioned medicine information above-mentioned single with drug sum included in effective prescription and above-mentioned medical treatment to be monitored The average daily drug expenditure of position；
Above-mentioned medical institutions to be monitored are determined according to above-mentioned average daily drug expenditure, above-mentioned sufferer quantity and above-mentioned drug sum The day for human beings equal drug expenditure.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=drug total value/drug uses total number of days.
The day for human beings of above-mentioned medical institutions to be monitored, equal drug expenditure met:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
With reference to first aspect, above-mentioned each included by above-mentioned medicine information in a kind of possible embodiment The medicine information of similar drug determines that the above-mentioned target medicine in effective prescription includes:
The above-mentioned medicine information with each similar drug included in effective prescription is determined according to above-mentioned medicine information, it is above-mentioned each Number of days is used including at least the Sales Volumes of each similar drug and drug in the medicine information of similar drug；
According to the medicine information of above-mentioned each similar drug determine the above-mentioned drug total value with similar drug any in effective prescription with And the drug of any of the above-described similar drug uses total number of days；
It is determined according to the drug of the drug total value of any of the above-described similar drug and any of the above-described similar drug using total number of days above-mentioned The average daily drug expenditure of single medicine of any similar drug is to obtain the average daily drug expenditure of single medicine of above-mentioned each similar drug；
The above-mentioned average daily medicine of the corresponding single medicine of effective prescription is determined according to the average daily drug expenditure of single medicine of above-mentioned each similar drug Product cost threshold, and the average daily drug expenditure of medicine single in above-mentioned each similar drug is more than or equal to the average daily drug expenditure of above-mentioned single medicine The drug of threshold value is determined as the above-mentioned target medicine in effective prescription.
Wherein, the average daily drug expenditure of single medicine of any of the above-described similar drug meets:
Drug total value/any similar drug drug of the single average daily drug expenditure of medicine=any similar drug uses total number of days.
With reference to first aspect, in a kind of possible embodiment, the above-mentioned medicine information according to above-mentioned each similar drug is true Above-mentioned target medicine is made above-mentioned includes: with the target medicine ratio of effective prescription
The above-mentioned drug total value with drugs all in effective prescription is determined according to the medicine information of above-mentioned each similar drug, and The above-mentioned target medicine total value with above-mentioned target medicine included in effective prescription；
The above-mentioned target with effective prescription is determined according to the drug total value of above-mentioned all drugs and above-mentioned target medicine total value Drugs proportion；
Wherein, above-mentioned target medicine ratio meets:
Target medicine ratio=target medicine total value/all drugs drug total value.
With reference to first aspect, above-mentioned according to above-mentioned average daily drug expenditure, the above-mentioned day for human beings in a kind of possible embodiment Equal drug expenditure and above-mentioned target medicine ratio, determining whether the drug expenditure of above-mentioned medical institutions to be monitored is exceeded includes:
The average daily drug of above-mentioned medical institutions to be monitored is determined according to the unit attribute information of above-mentioned medical institutions to be monitored Cost threshold, the day for human beings equal drug expenditure threshold value and target medicine proportion threshold value；
If above-mentioned average daily drug expenditure is greater than above-mentioned average daily drug expenditure threshold value, above-mentioned average daily drug expenditure is determined as Exceeded Drug utilization index parameter；And/or
If the above-mentioned day for human beings equal drug expenditure is greater than equal drug expenditure threshold value of the above-mentioned day for human beings, by equal drug expenditure of the above-mentioned day for human beings It is determined as exceeded Drug utilization index parameter；And/or
If above-mentioned target medicine ratio is greater than above-mentioned target medicine proportion threshold value, it is by above-mentioned target medicine ratio-dependent Exceeded Drug utilization index parameter；
According to the exceeded use in above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio Medicine index parameter determines whether the drug expenditure of above-mentioned medical institutions to be monitored is exceeded；
Wherein, the unit attribute information of above-mentioned medical institutions to be monitored includes flat type, region, unit institute locating for unit Locate one of city, unit drugs supply channel and unit sufferer person-time or a variety of.
With reference to first aspect, above-mentioned according to above-mentioned average daily drug expenditure, the above-mentioned day for human beings in a kind of possible embodiment Exceeded Drug utilization index parameter in equal drug expenditure and above-mentioned target medicine ratio determines the medicine of above-mentioned medical institutions to be monitored Whether product expense is exceeded to include:
If in above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio include one or The multinomial exceeded Drug utilization index parameter of person, it is determined that the drug expenditure of above-mentioned medical institutions to be monitored is exceeded；
If above-mentioned average daily drug expenditure is less than or equal to above-mentioned average daily drug expenditure threshold value, equal drug expenditure of the above-mentioned day for human beings Less than or equal to equal drug expenditure threshold value of the above-mentioned day for human beings and above-mentioned target medicine ratio is less than or equal to above-mentioned target medicine Proportion threshold value, it is determined that the drug expenditure of above-mentioned medical institutions to be monitored is not exceeded.
With reference to first aspect, above-mentioned to be based on above-mentioned average daily drug expenditure, the above-mentioned day for human beings in a kind of possible embodiment Equal drug expenditure and above-mentioned target medicine ratio carry out above-mentioned medical institutions to be monitored exceeded with the drug expenditure of effective prescription Risk control include:
By the exceeded medication in above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio Index parameter carries out publicity, the use of the above-mentioned medical institutions' control evolution to be monitored of the exceeded Drug utilization index parameter prompts based on publicity Medicine, with the exceeded risk control of the drug expenditure of realization effective prescription；And/or
Above-mentioned exceeded Drug utilization index parameter is exceeded into the corresponding Drug utilization index parameter threshold of above-mentioned exceeded Drug utilization index parameter Difference carry out publicity, the above-mentioned difference based on publicity prompts the medication of above-mentioned medical institutions to be monitored control evolution, to realize With the exceeded risk control of the drug expenditure of effective prescription；And/or
When receiving above-mentioned exceeded Drug utilization index parameter and/or the corresponding drug expenditure reimbursement of above-mentioned difference is requested, refuse Drug expenditure reimbursement request above-mentioned absolutely is to realize the risk control for using the drug expenditure of effective prescription exceeded.
Second aspect, the embodiment of the present application provide a kind of drug expenditure risk of exceeding criterion control dress based on data processing It sets, which includes:
Data capture unit for obtaining the use effective prescription of medical institutions to be monitored, and obtains above-mentioned institute in effective prescription Including medicine information；
Medicine information processing unit, the above-mentioned medicine information for being obtained according to above-mentioned data capture unit determine it is above-mentioned to Monitor the average daily drug expenditure of medical institutions；
Medicine information processing unit, be also used to above-mentioned include in effective prescription according to what above-mentioned data capture unit obtained Sufferer information determines the above-mentioned sufferer quantity corresponding to effective prescription, is determined according to above-mentioned medicine information and above-mentioned sufferer quantity State the day for human beings equal drug expenditure of medical institutions to be monitored；
Medicine information processing unit is also used to true according to the medicine information of each similar drug included in above-mentioned medicine information The above-mentioned target medicine in effective prescription is made, and determines above-mentioned target medicine upper according to the medicine information of above-mentioned each similar drug It states with the target medicine ratio in effective prescription；
Medication monitoring unit, the above-mentioned average daily drug expenditure, above-mentioned for being determined according to above-mentioned medicine information processing unit The day for human beings equal drug expenditure and above-mentioned target medicine ratio determine whether the drug expenditure of above-mentioned medical institutions to be monitored is exceeded；
Drug risk control unit, for determining the drug expense of above-mentioned medical institutions to be monitored in above-mentioned medication monitoring unit With it is exceeded when, based on above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio to it is above-mentioned to Monitoring medical institutions carry out the risk control exceeded with the drug expenditure of effective prescription.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned data capture unit is used for:
The data system access qualification of above-mentioned medical institutions to be monitored is obtained, based on above-mentioned data system access qualification from upper State obtain above-mentioned medical institutions to be monitored in the data system of medical institutions to be monitored use effective prescription；And/or
The medical treatment Claims Resolution data that above-mentioned medical institutions to be monitored provide are obtained, are obtained from above-mentioned medical treatment Claims Resolution data above-mentioned Medical institutions to be monitored use effective prescription；
Wherein, above-mentioned medical institutions to be monitored includes above-mentioned medical institutions to be monitored in the individually examination period with effective prescription It is interior it is all use effective prescription, the above-mentioned single examination period includes odd-numbered day or more days.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medical institutions to be monitored include with effective prescription All within the odd-numbered day of above-mentioned medical institutions to be monitored use effective prescription；
Above-mentioned medicine information processing unit is used for:
Above-mentioned all medicine informations with each drug included in effective prescription are obtained, are included at least in above-mentioned medicine information Sales Volumes and drug use number of days；
Determine that the drug of above-mentioned all drugs all included by effective prescription is total according to the Sales Volumes of above-mentioned each drug Volume, and determine that above-mentioned all drugs with effective prescription use total number of days using number of days according to the drug of above-mentioned each drug；
The average daily drug of above-mentioned medical institutions to be monitored is determined using total number of days according to above-mentioned drug total value and above-mentioned drug Expense.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medical institutions to be monitored include with effective prescription All within more days single examination periods of above-mentioned medical institutions to be monitored use effective prescription；
Above-mentioned medicine information processing unit is used for:
Any day in the above-mentioned single examination period any odd-numbered day effective prescription is obtained, and obtains any of the above-described odd-numbered day medication The medicine information of included each drug in prescription includes at least Sales Volumes in above-mentioned medicine information and drug uses number of days；
It is determined according to the Sales Volumes of each drug included by any of the above-described odd-numbered day effective prescription and drug using number of days State the odd-numbered day average daily drug expenditure of medical institutions to be monitored；
According to above-mentioned medical institutions to be monitored in the above-mentioned single odd-numbered day average daily drug expenditure and medicine for examining period Nei Ge Product determine the average daily drug expenditure of above-mentioned medical institutions to be monitored using total number of days；
Wherein, any day drug is the medicine of each drug included in any of the above-described odd-numbered day effective prescription using total number of days Product use the summation of number of days.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medicine information processing unit is used for:
The list in above-mentioned single examination period is determined according to the odd-numbered day average daily drug expenditure of above-mentioned single examination period Nei Ge Day average daily drug expenditure accumulated value is determined using total number of days according to the drug of above-mentioned single examination period Nei Ge and above-mentioned is individually examined Drug in nuclear cycle uses total number of days accumulated value；
It is determined according to average daily drug expenditure accumulated value of above-mentioned odd-numbered day and above-mentioned drug using total number of days accumulated value above-mentioned wait supervise Control the average daily drug expenditure of medical institutions.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=odd-numbered day average daily drug expenditure accumulated value/drug uses total number of days accumulated value.
Optionally, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=period drug total value/period drug uses total number of days；
Wherein, it can be the drug of all drugs of all prescriptions in the single examination period in above-mentioned period drug total value The total amount of the cumulative obtained all drugs of the amount of money, above-mentioned period drug can be the institute in the single examination period using total number of days There is the drug of each drug in drug to use the accumulated value of number of days.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medicine information processing unit is used for:
It obtains above-mentioned sufferer information included in effective prescription, and is determined according to above-mentioned sufferer information and above-mentioned use effective prescription Targeted sufferer person-time, wherein one is directed to a sufferer person-time with effective prescription；
Above-mentioned sufferer person-time is determined as the above-mentioned sufferer quantity corresponding to effective prescription.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medicine information processing unit is used for:
It is determined according to above-mentioned medicine information above-mentioned single with drug sum included in effective prescription and above-mentioned medical treatment to be monitored The average daily drug expenditure of position；
Above-mentioned medical institutions to be monitored are determined according to above-mentioned average daily drug expenditure, above-mentioned sufferer quantity and above-mentioned drug sum The day for human beings equal drug expenditure.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=drug total value/drug uses total number of days；
The day for human beings of above-mentioned medical institutions to be monitored, equal drug expenditure met:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medicine information processing unit is used for:
The above-mentioned medicine information with each similar drug included in effective prescription is determined according to above-mentioned medicine information, it is above-mentioned each Number of days is used including at least the Sales Volumes of each similar drug and drug in the medicine information of similar drug；
According to the medicine information of above-mentioned each similar drug determine the above-mentioned drug total value with similar drug any in effective prescription with And the drug of any of the above-described similar drug uses total number of days；
It is determined according to the drug of the drug total value of any of the above-described similar drug and any of the above-described similar drug using total number of days above-mentioned The average daily drug expenditure of single medicine of any similar drug is to obtain the average daily drug expenditure of single medicine of above-mentioned each similar drug；
The above-mentioned average daily medicine of the corresponding single medicine of effective prescription is determined according to the average daily drug expenditure of single medicine of above-mentioned each similar drug Product cost threshold, and the average daily drug expenditure of medicine single in above-mentioned each similar drug is more than or equal to the average daily drug expenditure of above-mentioned single medicine The drug of threshold value is determined as the above-mentioned target medicine in effective prescription.
Wherein, the average daily drug expenditure of single medicine of any of the above-described similar drug meets:
Drug total value/any similar drug drug of the single average daily drug expenditure of medicine=any similar drug uses total number of days.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medicine information processing unit is used for:
The above-mentioned drug total value with drugs all in effective prescription is determined according to the medicine information of above-mentioned each similar drug, and The above-mentioned target medicine total value with above-mentioned target medicine included in effective prescription；
The above-mentioned target with effective prescription is determined according to the drug total value of above-mentioned all drugs and above-mentioned target medicine total value Drugs proportion；
Wherein, above-mentioned target medicine ratio meets:
Target medicine ratio=target medicine total value/all drugs drug total value.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medication monitoring unit is used for:
The average daily drug of above-mentioned medical institutions to be monitored is determined according to the unit attribute information of above-mentioned medical institutions to be monitored Cost threshold, the day for human beings equal drug expenditure threshold value and target medicine proportion threshold value；
If above-mentioned average daily drug expenditure is greater than above-mentioned average daily drug expenditure threshold value, above-mentioned average daily drug expenditure is determined as Exceeded Drug utilization index parameter；And/or
If the above-mentioned day for human beings equal drug expenditure is greater than equal drug expenditure threshold value of the above-mentioned day for human beings, by equal drug expenditure of the above-mentioned day for human beings It is determined as exceeded Drug utilization index parameter；And/or
If above-mentioned target medicine ratio is greater than above-mentioned target medicine proportion threshold value, it is by above-mentioned target medicine ratio-dependent Exceeded Drug utilization index parameter；
According to the exceeded use in above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio Medicine index parameter determines whether the drug expenditure of above-mentioned medical institutions to be monitored is exceeded；
Wherein, the unit attribute information of above-mentioned medical institutions to be monitored includes flat type, region, unit institute locating for unit Locate one of city, unit drugs supply channel and unit sufferer person-time or a variety of.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medication monitoring unit is used for:
In above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio include one or When the multinomial exceeded Drug utilization index parameter of person, determine that the drug expenditure of above-mentioned medical institutions to be monitored is exceeded；
It is less than or equal to above-mentioned average daily drug expenditure threshold value, equal drug expenditure of the above-mentioned day for human beings in above-mentioned average daily drug expenditure Less than or equal to equal drug expenditure threshold value of the above-mentioned day for human beings and above-mentioned target medicine ratio is less than or equal to above-mentioned target medicine When proportion threshold value, determine that the drug expenditure of above-mentioned medical institutions to be monitored is not exceeded.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned drug risk control unit is used for:
By the exceeded medication in above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio Index parameter carries out publicity, the use of the above-mentioned medical institutions' control evolution to be monitored of the exceeded Drug utilization index parameter prompts based on publicity Medicine, with the exceeded risk control of the drug expenditure of realization effective prescription；And/or
Above-mentioned exceeded Drug utilization index parameter is exceeded into the corresponding Drug utilization index parameter threshold of above-mentioned exceeded Drug utilization index parameter Difference carry out publicity, the above-mentioned difference based on publicity prompts the medication of above-mentioned medical institutions to be monitored control evolution, to realize With the exceeded risk control of the drug expenditure of effective prescription；And/or
When receiving above-mentioned exceeded Drug utilization index parameter and/or the corresponding drug expenditure reimbursement of above-mentioned difference is requested, refuse Drug expenditure reimbursement request above-mentioned absolutely is to realize the risk control for using the drug expenditure of effective prescription exceeded.
The third aspect, the embodiment of the present application provide a kind of terminal device, which includes processor and memory, The processor and memory are connected with each other.The memory for store support the terminal device execute above-mentioned first aspect and/or The computer program for the method that any possible implementation of first aspect provides, which includes program instruction, The processor is configured for calling above procedure instruction, executes above-mentioned first aspect and/or first aspect is any possible Method provided by embodiment.
Fourth aspect, the embodiment of the present application provide a kind of computer readable storage medium, the computer-readable storage medium Matter is stored with computer program, which includes program instruction, which makes at this when being executed by a processor It manages device and executes method provided by above-mentioned first aspect and/or any possible embodiment of first aspect.
The embodiment of the present application being believed with medicine information and sufferer included in effective prescription based on medical institutions to be monitored Breath, determines the average daily drug expenditure and the day for human beings equal drug expenditure of medical institutions to be monitored, can be according to included in effective prescription The medicine information of each similar drug determines with the target medicine ratio in effective prescription, and then can be based on the day of medical institutions to be monitored Equal drug expenditure, the day for human beings equal drug expenditure and target medicine ratio judge whether the drug expenditure of medical institutions to be monitored is exceeded, Realize the evaluation to the Drug utilization index parameter of medical institutions to be monitored, it is easy to operate.If multiple medications of medical institutions to be monitored Have in index parameter one or more Drug utilization index parameter it is exceeded when, then can be taken based on the average daily drug of medical institutions to be monitored Medical institutions to be monitored are carried out with effective prescription with the one or more in, the day for human beings equal drug expenditure and target medicine ratio The exceeded risk control of drug expenditure.It can be based on multiple Drug utilization index parameters (this day based on method provided by the embodiments of the present application Equal drug expenditure, the day for human beings equal drug expenditure and target medicine ratio) realize it is simple to the medication policer operation of each medical institutions, can The accuracy for improving the medication monitoring to medical institutions improves the reliability of the medication monitoring to medical institutions, improves medical treatment money The effective rate of utilization in source, applicability are stronger.
Detailed description of the invention
Technical solution in ord to more clearly illustrate embodiments of the present application, below will be to needed in embodiment description Attached drawing is briefly described, it should be apparent that, the accompanying drawings in the following description is some embodiments of the present application, general for this field For logical technical staff, without creative efforts, it is also possible to obtain other drawings based on these drawings.
Fig. 1 is a process of the drug expenditure risk of exceeding criterion control method provided by the embodiments of the present application based on data processing Schematic diagram；
Fig. 2 is another stream of the drug expenditure risk of exceeding criterion control method provided by the embodiments of the present application based on data processing Journey schematic diagram；
Fig. 3 is the embodiment of the drug expenditure risk of exceeding criterion control device provided by the embodiments of the present application based on data processing Structural schematic diagram；
Fig. 4 is the example structure schematic diagram of terminal device provided by the embodiments of the present application.
Specific embodiment
Below in conjunction with the attached drawing in the embodiment of the present application, technical solutions in the embodiments of the present application carries out clear, complete Site preparation description, it is clear that described embodiment is some embodiments of the present application, instead of all the embodiments.Based on this Shen Please in embodiment, every other implementation obtained by those of ordinary skill in the art without making creative efforts Example, shall fall in the protection scope of this application.
The embodiment of the present application provides a kind of drug expenditure risk of exceeding criterion control method based on data processing, can be based on each The medical institutions such as a hospital, the department of each hospital, each clinic or even each doctor (or medical institutions representative (or Team)) average daily drug expenditure, the day for human beings equal drug expenditure and target medicine ratio come evaluate each medical institutions (including hospital, Department, clinic or doctor) drug expenditure it is whether exceeded (or whether rationally).If multiple medications of medical institutions to be monitored Have in index parameter one or more Drug utilization index parameter it is exceeded when, then can be taken based on the average daily drug of medical institutions to be monitored Medical institutions to be monitored are carried out with effective prescription with the one or more in, the day for human beings equal drug expenditure and target medicine ratio The exceeded risk control of drug expenditure, including but not limited to by above-mentioned average daily drug expenditure, the day for human beings equal drug expenditure and target medicine The exceeded Drug utilization index parameter progress publicity of one or more in product ratio, and/or the above-mentioned one or more of refusal are exceeded Corresponding drug expenditure reimbursement of Drug utilization index parameter etc., realizes the exceeded risk of the drug expenditure with effective prescription to medical institutions Control, to avoid the waste of medical resource.Here, the day for human beings equal drug expenditure refers to the average daily drug expenditure of an average people, under Face will be illustrated in conjunction with average daily drug expenditure.For convenience of description, above-mentioned each hospital, the department of each hospital, each clinic Or even examination dimension represented by the representative of each doctor etc. medical institutions or medical institutions by with medical institutions this It is illustrated for examination dimension, repeats no more below.
Currently, the determination of the costly medicine in each area be by minimum package unit (such as one bottle, one packet, a box or One bag etc.) monovalent drug be more than some threshold value drug be determined as costly medicine.However, this method determines costly medicine Do not account for the monovalent drug of minimum package unit uses number of days problem, it is thus possible to there are the drawbacks of be the identical medicine of unit price Product or some low price drug or some high price drug lead to the monovalent higher but odd-numbered day of drug due to using number of days different The lower projecting situation of average price.For example certain drug list box price is 300 yuan, according to the costly medicine decision procedure of current each department It is determined as costly medicine；One box of costly medicine can be used 30 days, that is, the odd-numbered day average price of the drug is 10 yuan/day.In addition One drug list box price is 120 yuan, is determined as non-precious drug according to the costly medicine decision procedure of current each department；The medicine One box of product can be used 3 days, that is, the odd-numbered day average price of the drug is 40 yuan/day.It can be seen that according to the valuable of current each department The odd-numbered day average price for the non-precious drug that the decision procedure of drug determines has exceeded the odd-numbered day average price of costly medicine, it is therefore apparent that should Decision procedure is low to the assessment accuracy rate of costly medicine, so that the examination loophole of costly medicine is larger.
In some possible embodiments, target medicine provided by the embodiments of the present application can be costly medicine, expensive here The method of determination of weight drug is different from the method for determination of costly medicine of above-mentioned current each department.Here, costly medicine can be use The average daily drug expenditure of single medicine in effective prescription in included each similar drug is higher and in all kinds of medicines included by effective prescription Sort forward drug in the average daily drug expenditure of single medicine of product.It will be mentioned by taking costly medicine as an example in conjunction with the embodiment of the present application below The exceeded method for early warning of the drug expenditure based on data processing supplied is described.Corresponding, target medicine ratio can be with valuable medicine It is illustrated for product ratio, repeats no more below.
The provided effective prescription of the embodiment of the present application may include each doctor of each medical institutions for each sufferer The prescription issued of illness or the prescription issued for the illness of each sufferer of each doctor or prescription etc., This is with no restrictions.For convenience of description, will be illustrated by taking prescription as an example below.Generally, each doctor of each medical institutions It may include but be not limited to prescription in the prescription that teacher is issued and issue time, prescription number, department's number, sufferer information (including disease Suffer from personal information), drug details and doctor signature, specifically can according to practical application scene determine, herein with no restrictions.Change sentence It talks about, the either single biggish big prescription of prescription total value, or the lesser small prescription of single prescription total value or other are more The prescription of the form of expression has the drug details that medical institutions issue, including but not limited to nomenclature of drug, medicine in each prescription The product amount of money, drug usage mode and drug use number of days etc..It can determine that based on drug details included in each prescription Single average daily drug expenditure of medicine is higher and the forward drug of sequence is as costly medicine, so can the expense based on costly medicine in institute There is the ratio (i.e. costly medicine ratio) of the drug total cost in prescription to determine whether medication is reasonable.Therefore either big prescription Or small prescription or other, too busy to get away drug details.Costly medicine ratio based on each medical institutions is realized to each Each similar drug corresponding average daily drug expenditure (i.e. single medicine average daily drug expense is utilized when the evaluation of the medication standard of medical institutions With), allow also for the expense accounting situation of each similar drug, it is easy to operate and can cover preferably, more fully hereinafter Medication monitoring to each prescription of medical institutions.Therefore, based on the average daily drug expenditure of each medical institutions, the day for human beings equal drug Multiple Drug utilization index parameters such as expense and costly medicine ratio realize the evaluation to the medication standard of each medical institutions to reality Existing various dimensions the medication of each medical institutions is monitored, it is easy to operate and can cover preferably, more fully hereinafter to doctor Treat the medication monitoring of each prescription of unit.Average daily drug expenditure based on medical institutions, the day for human beings equal drug expenditure and expensive simultaneously Weight Drugs proportion realize to the medications of each medical institutions monitoring more it is accurate in place, to can be improved to each medical institutions The accuracy rate of medication monitoring.Further, the medicining condition based on each medical institutions can be improved to the use of each medical institutions The exceeded medication of one or more that effective prescription carries out in average daily drug expenditure, the day for human beings equal drug expenditure and target medicine ratio refers to Publicity of parameter, and/or the corresponding drug expenditure reimbursement of the above-mentioned exceeded Drug utilization index parameter of one or more of refusal etc. is marked to use The reliability of the drug expenditure risk of exceeding criterion control of effective prescription, can be improved the medication controllability of medical institutions' evolution, so as to The effective rate of utilization of medical resource is improved, applicability is higher.
In some possible embodiments, the average daily drug expenditure based on medical institutions, the day for human beings equal drug expenditure and expensive Weight Drugs proportion can daily be monitored the medicining condition of medical institutions when carrying out medication monitoring to medical institutions, and then can be every Its clearing medical institutions with the average daily drug expenditure of effective prescription, the day for human beings equal drug expenditure and costly medicine ratio, based on daily Average daily drug expenditure, the day for human beings equal drug expenditure and costly medicine ratio the medicining condition of medical institutions is monitored.It is optional , medication monitoring is carried out to medical institutions based on daily average daily drug expenditure, the day for human beings equal drug expenditure and costly medicine ratio While, it may be based on the overall merit etc. that the medication for adding up more days monitoring situation carries out medicining condition to medical institutions, such as It can specifically be determined according to practical application scene, herein with no restrictions in one week, one month, a season or 1 year etc..For Facilitate description, it below will be by the average daily drug expenditure of any day (will be illustrated by taking the odd-numbered day as an example below for convenience of description), people The calculating of average daily drug expenditure and costly medicine ratio and based on daily average daily drug expenditure, the day for human beings equal drug expenditure and expensive For weight Drugs proportion is monitored and/or evaluates to the medicining condition of medical institutions, it is based on to provided by the embodiments of the present application The drug expenditure risk of exceeding criterion control method of data processing is described.
Drug expenditure risk of exceeding criterion control method provided by the embodiments of the present application based on data processing can be by drug surveilance Management board, board of health, health and terminal associated by the medications monitoring unit such as the healthy committee and medical treatment Claims Resolution unit Equipment executes, such as above-mentioned medication monitoring unit is used to carry out each medical institutions the client of medication monitoring and/or man-machine Interactive device etc., herein with no restrictions.For convenience of description, will be illustrated by taking terminal device as an example below.
Embodiment one:
It is the drug expenditure risk of exceeding criterion control method provided by the embodiments of the present application based on data processing referring to Fig. 1, Fig. 1 A flow diagram.Drug expenditure risk of exceeding criterion control method provided by the embodiments of the present application based on data processing, can lead to Following steps S11 implementation provided by each step into S16 is crossed to be illustrated.
S11, obtain medical institutions to be monitored uses effective prescription.
In some possible embodiments, above-mentioned medical institutions to be monitored can monitor any that unit monitors by medication Medical institutions can specifically determine, herein with no restrictions according to practical application scene.In other words, any medical institutions all may By medication monitoring unit as monitored object, therefore selected monitored object then can be medical institutions to be monitored.It retouches for convenience It states, will be illustrated by taking medical institutions to be monitored as an example below.
In some possible embodiments, above-mentioned medical institutions may include medical institutions to be monitored in list with effective prescription It is all caused by a few days to use effective prescription.For convenience of description, generated institute within the odd-numbered day, above-mentioned medical institutions to be monitored is useful Effective prescription can be illustrated by taking odd-numbered day prescription as an example.The odd-numbered day prescription of above-mentioned medical institutions can refer to any day of medical institutions All prescriptions issued, all prescriptions, the list that all doctors of all departments of hospital are issued including but not limited in the odd-numbered day All prescriptions that in a few days all doctors of some department of hospital are issued or in the odd-numbered day some department of hospital certain Any situation in all prescriptions that one doctor is issued.Wherein, concrete condition represented by above-mentioned odd-numbered day prescription according to In practical application scene to medical institutions carry out medication monitoring examination dimension (such as medical institutions carry out medication monitoring, Some doctor of medication monitoring or some department for medical institutions is carried out for some department of medical institutions Carry out medication monitoring etc.) it determines, herein with no restrictions.For convenience of description, will own below with all departments of hospital in the odd-numbered day It is illustrated for all prescriptions that doctor is issued, hereinafter referred to as odd-numbered day prescription.As an example it is assumed that medical institutions is all The doctor one day all prescriptions issued add up to S (such as 80) prescription, wherein a prescription is directed to one in this 80 prescriptions Sufferer person-time, therefore this corresponding sufferer quantity of 80 prescriptions is 80.In other words, there may be multiple prescriptions pair in 80 prescriptions The same sufferer is answered, however this corresponding sufferer of multiple prescriptions is still calculated with sufferer person-time, therefore prescription total (80) is then Sufferer quantity, repeats no more below corresponding to all prescriptions.It is assumed that drug included by each prescription in above-mentioned 80 prescriptions The accumulative K (such as drug sum is 200) that adds up to of quantity is a, then can be calculated based on each drug details in this 200 drugs Average daily drug expenditure.Further, based on 200 drugs included by 80 prescriptions (corresponding sufferer quantity is 80), in conjunction with upper The day for human beings equal drug expenditure of the medical institutions can be calculated by stating average daily drug expenditure then.Based on included in above-mentioned 80 prescriptions 200 drugs in each similar drug drug details, can determine costly medicine and costly medicine from above-mentioned 200 drugs Ratio, so as to the medicining condition based on average daily drug expenditure, the day for human beings equal drug expenditure and costly medicine ratio to medical institutions It is monitored.
In some possible embodiments, terminal device can be docked with the data system of medical institutions to be monitored, be obtained The data system access qualification of medical institutions to be monitored, so can the data system access qualification based on medical institutions to be monitored from It is obtained in the data system of medical institutions to be monitored at the prescription of medical institutions to be monitored, such as the odd-numbered day of medical institutions to be monitored Side etc..Optionally, terminal device may be based on medical institutions to be monitored and provide medical treatment Claims Resolution data, from medical treatment Claims Resolution data Middle screening obtains the prescription datas such as the odd-numbered day prescription of medical institutions.Optionally, terminal device may be based on big data analysis, from each Screening obtains prescription datas such as the odd-numbered day prescription of medical institutions to be monitored, etc. in the sufferer diagnosis records of a medical institutions.Eventually End equipment can acquire the list of medical institutions to be monitored based on any data to acquisite approachs except above-mentioned data acquiring mode Day prescription can specifically determine, herein with no restrictions according to practical application scene.
It is opened in the prescription it is appreciated that may each comprise on any prescription in the odd-numbered day prescription of medical institutions to be monitored here The drug details of drug, including but not limited to nomenclature of drug, Sales Volumes, drug usage mode (or drug takes mode etc.) And drug uses number of days, can specifically be determined according to practical application scene, herein with no restrictions.
S12 obtains above-mentioned medicine information included in effective prescription, and is determined according to above-mentioned medicine information above-mentioned wait supervise Control the average daily drug expenditure of medical institutions.
In some possible embodiments, medical treatment to be monitored can be determined based on the odd-numbered day prescription of medical institutions to be monitored The medicine information of each drug included by all prescriptions in the odd-numbered day prescription of unit, wherein include in the medicine information of any drug But it is not limited to Sales Volumes and drug and uses number of days.All prescriptions are wrapped in odd-numbered day prescription based on above-mentioned medical institutions to be monitored The medicine information of each drug included can determine drug sum included in the odd-numbered day prescription of medical institutions to be monitored, drug total value And drug uses total number of days etc..Wherein, the Sales Volumes of any of the above-described drug are that the unit price of any drug is multiplied with quantity Obtain the price of single drug.After above-mentioned drug sum indicates that drug used in all prescriptions is cumulative in odd-numbered day prescription Drug sum.Above-mentioned drug total value is that the unit price based on each drug included in odd-numbered day prescription is multiplied to obtain individually with quantity The Sales Volumes of drug and then the Sales Volumes of all drugs included in odd-numbered day prescription are added up to obtain all medicines The drug total price (i.e. drug total value) of product.Above-mentioned drug is the medicine of each drug in all drugs in odd-numbered day prescription using total number of days Product use the accumulated value of number of days.The average daily drug expenditure of the odd-numbered day prescription of medical institutions to be monitored indicates that medical institutions to be monitored are single The average cost of included all drugs in day prescription, here can average daily drug expenditure be illustrated.Wherein, above-mentioned wait supervise The average daily drug expenditure for controlling the odd-numbered day prescription of medical institutions can be calculated based on following formula:
Average daily drug expenditure=drug total value/drug uses total number of days (1)
Wherein, the Sales Volumes of all drugs are cumulative in drug total value, that is, odd-numbered day prescription in above-mentioned formula (1) obtains The total price of all drugs, above-mentioned drug use number of days using the drug of each drug in all drugs in total number of days, that is, odd-numbered day prescription Accumulated value.
S13 determines the above-mentioned sufferer quantity corresponding to effective prescription with the sufferer information for including in effective prescription according to above-mentioned, The day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored is determined according to above-mentioned medicine information and above-mentioned sufferer quantity.
In some possible embodiments, above-mentioned with the sufferer information for including may include sufferer name, disease in effective prescription Suffer from the sufferers personal information such as identification card number, sufferer age and sufferer gender, can specifically be determined according to practical application scene, herein With no restrictions.Wherein, above-mentioned to be directed to a sufferer person-time with effective prescription with one in effective prescription, therefore according to above-mentioned in effective prescription Included sufferer information can determine the sufferer quantity corresponding to effective prescription.Here, sufferer quantity is equal to the place with effective prescription Side's sum, for details, reference can be made to implementations described in above-mentioned steps S11, and details are not described herein.
In some possible embodiments, it is calculated based on drug details included by each prescription in above-mentioned odd-numbered day prescription It, can also be based on above-mentioned sufferer quantity (i.e. with the prescription of effective prescription sum, such as S=80) and above-mentioned to after average daily drug expenditure It is single that the medical treatment can be then calculated in conjunction with above-mentioned average daily drug expenditure in the sum of drug included by 80 prescriptions (such as K=200) The day for human beings equal drug expenditure of position.Wherein, the calculating of equal drug expenditure of the above-mentioned day for human beings can meet following formula:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity * (2)
Wherein, such as above-mentioned formula (2) it is found that the drug sum included by the above-mentioned odd-numbered day prescription is K (such as 200 It is a), when sufferer quantity corresponding to above-mentioned odd-numbered day prescription is S (such as S=80, i.e. the prescription sum of odd-numbered day prescription are 80), The above-mentioned day for human beings equal drug expenditure can meet following formula:
The day for human beings equal average daily drug expenditure of drug expenditure=S/K*
The average daily drug expenditure of=200/80* (3)
In some possible embodiments, simply carrying out medication monitoring to medical institutions using average daily drug expenditure may Medical institutions be will lead in the way of increasing ethical goods type etc. to evade and be based on so that the average daily drug expenditure of single medicine is up to standard The medication monitoring of average daily drug expenditure, but the day for human beings equal drug expenditure or exceeded.Therefore, average daily drug expenditure, meter are based on Calculating the day for human beings equal drug expenditure can be increased and be monitored based on the drug expenditure in dimension per capita on the basis of average daily drug expenditure, from And preferably the medication of medical institutions can be monitored, operation is more flexible, and applicability is stronger.
S14 is determined above-mentioned in effective prescription according to the medicine information of each similar drug included in above-mentioned medicine information Target medicine, and determine above-mentioned target medicine in the above-mentioned target in effective prescription according to the medicine information of above-mentioned each similar drug Drugs proportion.
In some possible embodiments, the calculation of the average daily drug expenditure based on above-mentioned medical institutions is identical The average daily drug expenditure of every similar drug in the odd-numbered day prescription of medical institutions can be also calculated in principle, terminal device.Wherein, any It can be illustrated for the average daily drug expenditure of single medicine below the average daily drug expenditure of similar drug.It is single based on above-mentioned medical treatment to be monitored The odd-numbered day prescription of position, can obtain all medicine informations with each similar drug included in effective prescription, in above-mentioned medicine information extremely It less include that Sales Volumes and drug use number of days.Above-mentioned list is determined according to the medicine information of each similar drug in above-mentioned odd-numbered day prescription The drug of the drug total value of any similar drug and any of the above-described similar drug uses total number of days in day prescription, according to any of the above-described class The drug total value of drug and the drug of any of the above-described similar drug determine the average daily medicine of single medicine of any of the above-described similar drug using total number of days Product expense is to obtain the average daily drug expenditure of single medicine of above-mentioned each similar drug.Wherein, the average daily drug of single medicine of any of the above-described similar drug The calculating of expense can meet following formula:
Drug total value/any similar drug drug of the single average daily drug expenditure of medicine=any similar drug uses total number of days (4)
Wherein, in above-mentioned formula (4) some type in all drugs of any similar drug total value, that is, odd-numbered day prescription (for Facilitate description to be described with any sort) drug the cumulative obtained single medicine drug total price of price, any of the above-described similar drug makes With the accumulated value using number of days of this kind of similar drug drug in all drugs of total number of days, that is, odd-numbered day prescription.
It is included each in the odd-numbered day prescription in conjunction with unit to be monitored based on implementation provided by above-mentioned formula (4) The medicine information of similar drug can determine the average daily drug expenditure of single medicine of each similar drug in the odd-numbered day prescription of medical institutions to be monitored, into And the costly medicine in odd-numbered day prescription can be determined based on the average daily drug expenditure of single medicine of above-mentioned each similar drug.
In some possible embodiments, the average daily drug of single medicine of each similar drug determined according to above-mentioned implementation takes With, it may be determined that go out the average daily drug expenditure threshold value of the corresponding single medicine of odd-numbered day prescription of unit to be monitored, and will be in above-mentioned each similar drug It is single that the drug that single average daily drug expenditure of medicine is more than or equal to the average daily drug expenditure threshold value of above-mentioned single medicine is determined as medical treatment to be monitored Costly medicine in the odd-numbered day prescription of position.Here, costly medicine refers to the average daily drug expenditure of single medicine in all medicines of odd-numbered day prescription Costly and single average daily drug expenditure of medicine is more than or equal to the average daily drug expenditure of single medicine in the average daily drug expenditure of single medicine of product The drug of threshold value.In other words, the average daily drug expenditure of single medicine based on each similar drug in odd-numbered day prescription can be by the list of each similar drug The average daily drug expenditure of medicine is ranked up according to sequence from high to low, and then forward one that can sort from the average daily drug expenditure of single medicine One that partially the average daily drug expenditure of single medicine is minimum in (such as 20%) drug is determined as the average daily drug expenditure threshold value of single medicine, at this time The average daily drug expenditure of single medicine of each drug is all larger than or is equal to the average daily drug expenditure of single medicine in the drug of this part (i.e. 20%) Threshold value, and then the drug of this part (i.e. 20%) can be determined as costly medicine.For example, in all drugs of odd-numbered day prescription, Determine that single average daily drug expenditure of medicine is x member/day (i.e. average daily drug expenditure of single medicine according to the average daily drug expenditure of single medicine of each similar drug Threshold value), such as the drug of 11 yuan/day is then costly medicine.In other words, as institute in the odd-numbered day prescription of medical institutions to be monitored Including all drugs in have 20% drug be the average daily drug expenditure of single medicine be more than or equal to 11 yuan/day drug, this portion Drug dispensing product are then costly medicine.
In some possible embodiments, it can determine that according to the medicine information of above-mentioned each similar drug and above-mentioned use effective prescription In all drugs drug total value and the above-mentioned costly medicine total value with above-mentioned costly medicine included in effective prescription.Root It can determine that in the odd-numbered day prescription of medical institutions to be monitored according to the drug total value and above-mentioned costly medicine total value of above-mentioned all drugs Costly medicine ratio.Here, costly medicine ratio can be the drug total value of costly medicine in odd-numbered day prescription in odd-numbered day prescription All drugs drug total price in ratio, that is to say, that costly medicine ratio meet:
Costly medicine ratio=costly medicine total value/all drugs drug total value (5)
In above-mentioned formula (5), costly medicine total value is the price-aggregate value of all kinds of costly medicines in odd-numbered day prescription, In, the price of every class costly medicine is the product of the quantity of such costly medicine and the unit price of such costly medicine.It is above-mentioned all The drug total value of drug is the price accumulated value of each similar drug in odd-numbered day prescription.
S15 is determined according to above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio Whether the drug expenditure of above-mentioned medical institutions to be monitored is exceeded.
In some possible embodiments, it when carrying out medication monitoring for different medical unit, can preset each The medication Standard of Monitoring of medical institutions and/or the performance assessment criteria threshold value of medication evaluation criterion, such as average daily drug expenditure threshold value, i.e., Upper limit up to standard (or average daily drug expenditure upper limit) of average daily drug expenditure etc..For example, being used for medical institutions to be monitored It, can the information settings doctor to be monitored such as history medication record based on medical institutions to be monitored or drug Distursement when medicine monitors The corresponding average daily drug expenditure threshold value of unit is treated, and then can be taken based on the average daily drug of the medical institutions to be monitored of above-mentioned determination With, in conjunction with the corresponding average daily drug expenditure threshold value of medical institutions to be monitored can determine the medical institutions average daily drug expenditure whether It is up to standard.In other words, as whether the average daily drug expenditure of medical institutions to be monitored is less than or equal to its corresponding average daily medicine Product cost threshold.If the average daily drug expenditure of medical institutions to be monitored is less than or equal to its corresponding average daily drug expenditure threshold Value, then can determine that the average daily drug expenditure of medical institutions to be monitored is up to standard.If the average daily drug of medical institutions to be monitored takes Be greater than its corresponding average daily drug expenditure threshold value, then can determine the average daily drug expenditure of medical institutions to be monitored be it is exceeded, At this point, above-mentioned average daily drug expenditure can be one of the exceeded Drug utilization index parameter of medical institutions to be monitored.
In some possible embodiments, it when carrying out medication monitoring for different medical unit, can also preset each The medication Standard of Monitoring of a medical institutions and/or the performance assessment criteria threshold value of medication evaluation criterion, such as the day for human beings equal drug expenditure threshold Value, the i.e. upper limit up to standard (or the day for human beings equal drug expenditure upper limit) etc. of the day for human beings equal drug expenditure.For example, single for medical treatment to be monitored It, can the information settings such as history medication record based on medical institutions to be monitored or drug Distursement when position carries out medication monitoring The corresponding day for human beings equal drug expenditure threshold value of medical institutions to be monitored, and then can be based on the people of the medical institutions to be monitored of above-mentioned determination Average daily drug expenditure determines that the day for human beings of the medical institutions is equal in conjunction with the medical institutions to be monitored corresponding day for human beings equal drug expenditure threshold value Whether drug expenditure is up to standard.In other words, as whether the day for human beings of medical institutions to be monitored equal drug expenditure is less than or equal to Its corresponding day for human beings equal drug expenditure threshold value.If the day for human beings of medical institutions to be monitored equal drug expenditure is less than or equal to its correspondence The day for human beings equal drug expenditure threshold value, then can determine that the day for human beings of medical institutions to be monitored equal drug expenditure is up to standard.If to be monitored The day for human beings of medical institutions equal drug expenditure is greater than its corresponding day for human beings equal drug expenditure threshold value, then can determine medical institutions to be monitored The day for human beings equal drug expenditure be it is exceeded, at this point, equal drug expenditure of the above-mentioned day for human beings can be medical institutions to be monitored exceeded medication One of index parameter.
In some possible embodiments, it when carrying out medication monitoring for different medical unit, can preset each The medication Standard of Monitoring of medical institutions and/or the performance assessment criteria threshold value of medication evaluation criterion, such as costly medicine proportion threshold value, i.e., Upper limit up to standard (or costly medicine ratio upper limit) of costly medicine ratio etc..For example, being used for medical institutions to be monitored It, can the information settings doctor to be monitored such as history medication record based on medical institutions to be monitored or drug Distursement when medicine monitors The corresponding costly medicine proportion threshold value of unit is treated, and then can be based on the costly medicine ratio of the medical institutions to be monitored of above-mentioned determination Example, determines whether the costly medicine ratio of the medical institutions reaches in conjunction with the corresponding costly medicine proportion threshold value of medical institutions to be monitored Mark.In other words, as whether the costly medicine ratio of medical institutions to be monitored is less than or equal to its corresponding costly medicine Proportion threshold value.If the costly medicine ratio of medical institutions to be monitored is less than or equal to its corresponding costly medicine proportion threshold value, It then can determine that the costly medicine ratio of medical institutions to be monitored is up to standard.If the costly medicine ratio of medical institutions to be monitored is big In its corresponding costly medicine proportion threshold value, then it can determine that the costly medicine ratio of medical institutions to be monitored is exceeded, at this point, Above-mentioned costly medicine ratio can be one of the exceeded Drug utilization index parameter of medical institutions to be monitored.
Optionally, in some possible embodiments, to medical institutions to be monitored carry out medication monitoring when, can based on to Monitor multiple Drug utilization index parameters such as average daily drug expenditure, the day for human beings equal drug expenditure and costly medicine ratio of medical institutions into Row overall merit.If the average daily drug expenditure of above-mentioned medical institutions to be monitored, the day for human beings equal drug expenditure and costly medicine ratio It is up to standard etc. multiple Drug utilization index parameters, then it can determine that the drug expenditure of medical institutions to be monitored is not exceeded.If above-mentioned to be monitored Have one in multiple Drug utilization index parameters such as the average daily drug expenditure of medical institutions, the day for human beings equal drug expenditure and costly medicine ratio It is a and more than one is exceeded, then it can determine that the drug expenditure of medical institutions to be monitored is exceeded.For example, if above-mentioned average daily drug takes It is less than or equal to equal medicine of the above-mentioned day for human beings with less than or equal to above-mentioned average daily drug expenditure threshold value, equal drug expenditure of the above-mentioned day for human beings Product cost threshold, and above-mentioned costly medicine ratio is less than or equal to above-mentioned costly medicine proportion threshold value, it is determined that it is above-mentioned wait supervise The drug expenditure for controlling medical institutions is not exceeded.Alternatively, if above-mentioned average daily drug expenditure is less than or equal to above-mentioned average daily drug and takes It is less than or equal to equal drug expenditure threshold value of the above-mentioned day for human beings and above-mentioned costly medicine ratio with threshold value, equal drug expenditure of the above-mentioned day for human beings Example, which is less than or equal in above-mentioned costly medicine proportion threshold value, one or more establishment, it is determined that above-mentioned medical treatment to be monitored is single The drug expenditure of position is exceeded.
S16 is based on above-mentioned average daily drug expenditure, above-mentioned people if the drug expenditure of above-mentioned medical institutions to be monitored is exceeded Average daily drug expenditure and above-mentioned target medicine ratio carry out above-mentioned medical institutions to be monitored super with the drug expenditure of effective prescription Target risk control.
It in some possible embodiments, can will be above-mentioned when the drug expenditure of above-mentioned medical institutions to be monitored is exceeded Exceeded Drug utilization index parameter in average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio carries out public Show, the medication of the above-mentioned medical institutions' control evolution to be monitored of the exceeded Drug utilization index parameter prompts based on publicity, to realize medication The exceeded risk control of the drug expenditure of prescription.Optionally, when the drug expenditure of above-mentioned medical institutions to be monitored is exceeded, may be used also Difference by above-mentioned exceeded Drug utilization index parameter beyond the corresponding Drug utilization index parameter threshold of above-mentioned exceeded Drug utilization index parameter into Row publicity, the above-mentioned difference based on publicity prompts the medication of above-mentioned medical institutions' control evolution to be monitored, with realization effective prescription The exceeded risk control of drug expenditure.For example, will be below exceeded Drug utilization index ginseng with average daily drug expenditure for convenience of describing It is illustrated for number.For example, when the average daily drug expenditure of medical institutions to be monitored is greater than average daily drug expenditure threshold value, it can be true The average daily drug expenditure beyond average daily drug expenditure threshold portion is poor in the average daily drug expenditure of fixed above-mentioned medical institutions to be monitored Value.Above-mentioned average daily drug expenditure and/or above-mentioned average daily drug expenditure difference can be carried out based on above-mentioned average daily drug expenditure difference Publicity, average daily drug expenditure and/or average daily drug expenditure difference based on publicity prompt the doctor of medical institutions to be monitored to control The medication of evolution avoids the doctor of medical institutions to be monitored random medication during evolution from causing the wave of the medical resources such as drug Take, realizes and the drug expenditure risk of exceeding criterion with effective prescription of medical institutions to be monitored is controlled.Optionally, it is based on above-mentioned average daily medicine Product expense and/or average daily drug expenditure difference can announce interface (such as unit hall in the unit hall of medical institutions to be monitored Message announce display screen) on carry out publicity or monitor in the medical institutions' medication that goes out of medication supervision unit to carry out on daily paper Publicity, to control the medication of medical institutions to be monitored and its each doctor's evolution, avoid medical institutions to be monitored uses effective prescription Average daily drug expenditure continue the waste of exceeded bring medical resource, realize to the exceeded wind of the drug expenditure of medical institutions to be monitored Danger control.It optionally, can also be in medical institutions to be monitored based on above-mentioned average daily drug expenditure and/or average daily drug expenditure difference Carry out publicity on the information bulletin interface of each department, and/or the evolution tool of each doctor in medical institutions to be monitored Publicity etc. is carried out in homepage, can specifically be determined according to practical application scene, herein with no restrictions.
The embodiment of the present application can be determined based on medical institutions to be monitored medicine information included in effective prescription wait supervise The average daily drug expenditure of medical institutions is controlled, it can also be based on drug included in sufferer quantity corresponding to odd-numbered day prescription and prescription The information such as sum determine the day for human beings equal drug expenditure of the medical institutions in conjunction with average daily drug expenditure.Based in above-mentioned odd-numbered day prescription The medicine information of included each similar drug can determine that single medicine of all kinds of medications is average daily in conjunction with the calculation of average daily drug expenditure Drug expenditure, to can determine that the costly medicine and costly medicine ratio in odd-numbered day prescription.Based on medical institutions to be monitored Multiple Drug utilization index parameters such as average daily drug expenditure, the day for human beings equal drug expenditure and costly medicine ratio it is single to medical treatment to be monitored The medication of position carries out overall merit, determines whether the drug expenditure of medical institutions to be monitored is exceeded, realizes single to medical treatment to be monitored The evaluation of the Drug utilization index of position, it is easy to operate.Multiple Drug utilization index parameters can be based on based on method provided by the embodiments of the present application It realizes the medication overall merit to medical institutions to be monitored, realizes, medication prison simple to the medication policer operation of each medical institutions More comprehensively, and then the accuracy of the medication monitoring to medical institutions can be improved in the examination dimension of control, improves the use to medical institutions The reliability of medicine monitoring.The prescription of each medical institutions is surpassed to which the medicining condition based on each medical institutions can be improved The reliability that the drug expenditure risk of exceeding criterion of the effective prescription such as publicity of Drug utilization index parameter controls is marked, the medical institutions is improved and opens The medication controllability of side, so that the effective rate of utilization of medical resource can be improved, applicability is stronger.
Embodiment two:
Referring to fig. 2, Fig. 2 is the drug expenditure risk of exceeding criterion control method provided by the embodiments of the present application based on data processing Another flow diagram.Drug expenditure risk of exceeding criterion control method provided by the embodiments of the present application based on data processing can be real Now medicining condition of the medical institutions to be monitored within more days single examination periods is monitored, this method can be by walking as follows Rapid S21 implementation provided by each step into S27 is illustrated.
S21, obtain medical institutions to be monitored uses effective prescription.
In some possible embodiments, the implementation with effective prescription of above-mentioned acquisition medical institutions to be monitored can join See implementation provided by step S11 in above-described embodiment, details are not described herein.
Optionally, in some possible embodiments, above-mentioned medical institutions with effective prescription may also include doctor to be monitored That treats that unit generated within more days single examination periods all uses effective prescription.In other words, the above-mentioned single examination period is greater than One day, such as a week, one month, a season or 1 year etc., herein with no restrictions.It is above-mentioned wait supervise for convenience of description Control medical institutions within more days single examination periods it is generated it is all can singly examine period prescription with effective prescription for into Row explanation.
Optionally, single examination period prescription of above-mentioned medical institutions can refer to institute in any examination period of medical institutions All prescriptions issued, all places that including but not limited to individually all doctors of all departments of hospital are issued in the examination period All prescriptions that all doctors of some department of hospital are issued in side, single examination period, or single examination period Any situation in all prescriptions that some doctor of some department of interior hospital is issued.Wherein, above-mentioned single examination Concrete condition represented by period prescription is according to the examination dimension (example that in practical application scene medical institutions are carried out with medication monitoring Such as medication monitoring is carried out, for some department progress medication monitoring of medical institutions or for medical single for medical institutions Some doctor of some department of position carries out medication monitoring etc.) it determines, herein with no restrictions.For convenience of description, below will It is illustrated by taking all prescriptions for individually examining all doctors of all departments of hospital in the period to be issued as an example, hereinafter referred to as singly Examine period prescription.
It is appreciated that can be wrapped on any prescription included in single examination period prescription of medical institutions to be monitored here Include the drug details of write a prescription product in the prescription, including but not limited to nomenclature of drug, Sales Volumes, drug usage mode and medicine Product use number of days, can specifically be determined according to practical application scene, herein with no restrictions.
S22 obtains above-mentioned medicine information included in effective prescription, and determining described wait supervise according to above-mentioned medicine information Control the average daily drug expenditure of medical institutions.
In some possible embodiments, the above-mentioned letter of the drug included by effective prescription based on medical institutions to be monitored Breath determines that the specific implementation of the average daily drug expenditure of medical institutions to be monitored can be found in step S12 in above-described embodiment and be mentioned The implementation of confession, details are not described herein.
Optionally, in some possible embodiments, average daily with effective prescription based on above-mentioned medical institutions to be monitored Drug expenditure can also handle to obtain the average daily drug expenditure of medical institutions to be monitored in designated time period, for example, a week, one A month, the average daily drug expenditure etc. in a season or 1 year.For convenience of description, can be examined below using a week as one Period is illustrated by taking the average daily drug expenditure in a week as an example, the average daily drug expenditure of referred to as single examination period prescription.
Optionally, the average daily drug expenditure of Dan Kaohe period prescription can meet following formula:
Average daily drug expenditure=period drug total value/period drug uses total number of days (6)
Wherein, period drug total value can be and be wrapped in all prescriptions in the single examination period in above-mentioned formula (6) The total amount of the cumulative obtained all drugs of the Sales Volumes of all drugs included, above-mentioned period drug can be using total number of days The drug of each drug uses the accumulated value of number of days in all drugs included by single examination period prescription.
Optionally, in some possible embodiments, institute in single examination period prescription based on medical institutions to be monitored Including medicine information, any day in the single examination period any odd-numbered day effective prescription can be obtained, and obtain any odd-numbered day to use The medicine information of included each drug in effective prescription wherein includes but is not limited to that Sales Volumes and drug use in medicine information Number of days.Medical treatment to be monitored is determined using number of days according to the Sales Volumes of each drug included by effective prescription of any odd-numbered day and drug Any day odd-numbered day of unit average daily drug expenditure.Wherein, the odd-numbered day average daily drug of any day of above-mentioned medical institutions to be monitored takes With can be found in the corresponding implementation of formula in above-described embodiment (1), details are not described herein.In addition, single based on medical treatment to be monitored The drug of position each drug included in daily prescription within the individually examination period can determine the medicine in daily prescription using number of days Product use total number of days, and then can determine that the single of medical institutions to be monitored examines the period using total number of days based on the drug of daily prescription The drug of included all drugs uses total number of days in prescription.Wherein, medical institutions to be monitored are within the individually examination period Any day drug uses the summation of number of days using the drug that total number of days is each drug included in any odd-numbered day prescription.According to Above-mentioned medical institutions to be monitored use total number of days can be true in individually the odd-numbered day average daily drug expenditure of examination period Nei Ge and drug Average daily drug expenditure of the fixed medical institutions to be monitored within the individually examination period.
It in some possible embodiments, can according to the odd-numbered day average daily drug expenditure of above-mentioned single examination period Nei Ge Determine that medical institutions to be monitored, can be referred to as single for convenience of description in the accumulated value of the individually odd-numbered day average daily drug expenditure in examination period Day average daily drug expenditure accumulated value.It can determine doctor to be monitored using total number of days according to the drug of above-mentioned single examination period Nei Ge Treat unit individually examination the period in drug use total number of days accumulated value, for convenience of description can abbreviation drug use total number of days Accumulated value.Medical treatment to be monitored is determined using total number of days accumulated value according to average daily drug expenditure accumulated value of above-mentioned odd-numbered day and above-mentioned drug The average daily drug expenditure of unit.
Here, (medical institutions i.e. to be monitored are within the individually examination period for the average daily drug expenditure of medical institutions to be monitored Average daily drug expenditure) following formula can be met:
Average daily drug expenditure=odd-numbered day average daily drug expenditure accumulated value/drug uses total number of days accumulated value (7)
It is assumed that individually the examination period is a week here, then the odd-numbered day average daily drug expenditure in above-mentioned formula (7) is tired The accumulated value of the average daily drug expenditure of each odd-numbered day prescription, above-mentioned public affairs in the value added 7 odd-numbered day prescriptions that can be in a week Drug in formula (7) can be the medicine of each odd-numbered day prescription in 7 odd-numbered day prescriptions in a week using total number of days accumulated value Product use the accumulated value of total number of days.
S23 determines above-mentioned medical treatment to be monitored according to above-mentioned average daily drug expenditure, above-mentioned sufferer quantity and above-mentioned drug sum The day for human beings of unit equal drug expenditure.
In some possible embodiments, the above-mentioned letter of the sufferer included by effective prescription based on medical institutions to be monitored The implementation of sufferer quantity corresponding to determining effective prescription is ceased, and based on the above-mentioned medicine information included by effective prescription Determine that the specific implementation of the day for human beings of medical institutions to be monitored equal drug expenditure can be found in step S13 in above-described embodiment and be mentioned The implementation of confession, details are not described herein.
Optionally, in some possible embodiments, above-mentioned all drug sums in effective prescription are above-mentioned more days The single examination period in each day the accumulated value with drug included in effective prescription, it is total to may be simply referred to as drug for convenience of description Number.Above-mentioned sufferer quantity all prescription sums with effective prescription equal in above-mentioned more days single examination periods.Based on above-mentioned true Fixed average daily drug expenditure, above-mentioned sufferer quantity (i.e. with the prescription sum of effective prescription, such as S=80) and above-mentioned 80 prescriptions institute Including drug total (such as K=200) the day for human beings equal drug expenditures of the medical institutions can then be calculated.Wherein, above-mentioned people The calculating of average daily drug expenditure can meet following formula:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity * (8)
Wherein, as known to above-mentioned formula (8), it is assumed that above-mentioned more days all drug sums included by effective prescription are K A (such as 200), above-mentioned more days all sufferer quantity corresponding to effective prescription are S (such as S=80, i.e. prescription sum It is 80) when, the above-mentioned day for human beings equal drug expenditure can meet following formula:
The day for human beings equal average daily drug expenditure of drug expenditure=S/K*
The average daily drug expenditure of=200/80* (9)
Wherein, the calculating of equal drug expenditure of the above-mentioned day for human beings can be found in realization side provided by step S13 in above-described embodiment Formula, details are not described herein.
S24 is determined above-mentioned in effective prescription according to the medicine information of each similar drug included in above-mentioned medicine information Target medicine, and determine above-mentioned target medicine in the above-mentioned target in effective prescription according to the medicine information of above-mentioned each similar drug Drugs proportion.
In some possible embodiments, the above-mentioned letter of the drug included by effective prescription based on medical institutions to be monitored Breath determines that the specific implementation of the average daily drug expenditure of single medicine of each similar drug of medical institutions to be monitored can be found in above-mentioned implementation Implementation provided by step S14 in example, details are not described herein.
Further, in some possible embodiments, the calculating of the average daily drug expenditure based on above-mentioned medical institutions The identical principle of mode, terminal device can also be calculated in all prescriptions in the single examination period of more days of medical institutions The average daily drug expenditure of single medicine of every similar drug.All prescriptions in the single examination period based on above-mentioned medical institutions to be monitored, The medicine information of each similar drug included in all prescriptions can be obtained, includes at least Sales Volumes and medicine in above-mentioned medicine information Product use number of days.It is determined according to the medicine information of each similar drug in all prescriptions in the above-mentioned single examination period above-mentioned single The drug of the drug total value of any similar drug and any of the above-described similar drug in all prescriptions in the period is examined to use total number of days, Any of the above-described class medicine is determined using total number of days according to the drug of the drug total value of any of the above-described similar drug and any of the above-described similar drug The average daily drug expenditure of single medicine of product is to obtain the average daily drug expenditure of single medicine of above-mentioned each similar drug.Wherein, any of the above-described similar drug The calculating of the average daily drug expenditure of single medicine can meet following formula:
Single average daily drug expenditure of medicine=the drug total value of any similar drug in the single examination period/is appointed in the single examination period The drug of one similar drug uses total number of days (10)
Wherein, any similar drug total value is the single all medicines for examining all prescriptions in the period in above-mentioned formula (10) The cumulative obtained single medicine drug total price of price of the drug of some type (being described for convenience of description with any sort) in product, Any similar drug is in the single all drugs for examining all prescriptions in the period using total number of days in the above-mentioned single examination period The accumulated value using number of days of this kind of similar drug drug.
Based on implementation provided by above-mentioned formula (10), in conjunction with unit to be monitored the single examination period in it is all The medicine information of included each similar drug can determine all places in the single examination period of medical institutions to be monitored in prescription The average daily drug expenditure of single medicine of each similar drug in side, and then can be determined based on the average daily drug expenditure of single medicine of above-mentioned each similar drug The costly medicine in all prescriptions in the single examination period.
Here, the drug total value that costly medicine ratio can be costly medicine in all prescriptions in the single examination period exists Ratio in the drug total price of all drugs of all prescriptions in the single examination period, that is to say, that costly medicine ratio is full Foot:
Costly medicine ratio=costly medicine total value/all drugs drug total value (11)
In above-mentioned formula (11), costly medicine total value is individually to examine all kinds of costly medicines in all prescriptions in the period Price-aggregate value, wherein the price of every class costly medicine be such costly medicine quantity and such costly medicine unit price Product.The drug total value of above-mentioned all drugs is that the single price for examining each similar drug in all prescriptions in the period is cumulative Value.
S25 determines the average daily of the medical institutions to be monitored according to the unit attribute information of the medical institutions to be monitored Drug expenditure threshold value, the day for human beings equal drug expenditure threshold value and target medicine proportion threshold value.
S26, according to above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio, in conjunction with Above-mentioned average daily drug expenditure threshold value, the day for human beings equal drug expenditure threshold value and the target medicine proportion threshold value, determine above-mentioned wait supervise Whether the drug expenditure for controlling medical institutions is exceeded.
In some possible embodiments, the above-mentioned average daily drug expenditure according to medical institutions to be monitored, the above-mentioned day for human beings The whether exceeded specific implementation of drug expenditure and the drug expenditure of above-mentioned target medicine ratio-dependent medical institutions to be monitored Mode can be found in implementation provided by step S15 in above-described embodiment, and details are not described herein.
Optionally, in some possible embodiments, it when carrying out medication monitoring for different medical unit, can also be based on The unit attribute information of each medical institutions determines the medication Standard of Monitoring of each medical institutions and/or examining for medication evaluation criterion Core metrics-thresholds, above-mentioned performance assessment criteria threshold value may include average daily drug expenditure threshold value, the day for human beings equal drug expenditure threshold value and valuable Upper limit up to standard of multiple Drug utilization indexes such as Drugs proportion threshold value, such as the upper limit up to standard of average daily drug expenditure etc..For convenience of description, The upper limit up to standard of above-mentioned multiple Drug utilization indexes will be illustrated by taking the upper limit up to standard of average daily drug expenditure as an example, i.e., average daily drug takes Use threshold value.Wherein, the unit attribute information of above-mentioned medical institutions to be monitored includes flat type, region, unit institute locating for unit Locate one of city, unit drugs supply channel and unit sufferer person-time or a variety of, it specifically can be according to practical application scene It determines, herein with no restrictions.For example, based on different geographical, different cities, different drugs supply channels or different sufferer flowings The performance assessment criteria threshold value of different medical unit associated by the parameters such as amount, medication monitoring can be not quite similar, i.e. different medical unit Corresponding average daily drug expenditure threshold value can be not quite similar.For example, medical institutions associated by city higher for price or The higher associated medical institutions of cost of drugs valence brought by drugs supply channel, then can be by the up to standard of its average daily drug expenditure The upper limit is somewhat higherly settable, i.e., its corresponding average daily drug expenditure threshold value then may be set to higher threshold value etc..For object The lower associated doctor of cost of drugs valence brought by medical institutions associated by the lower city of valence or drugs supply channel Treatment unit, then can be more lowerly settable by the upper limit up to standard of its average daily drug expenditure, i.e. its corresponding average daily drug expenditure Threshold value then may be set to lower threshold value etc..It can specifically be determined according to practical application scene, herein with no restrictions.Similarly, corresponding The setting of the day for human beings of medical institutions to be monitored equal drug expenditure threshold value and costly medicine proportion threshold value can also be used and average daily medicine The setting means of product cost threshold can specifically determine, herein with no restrictions according to practical application scene.
In some possible embodiments, when carrying out medication monitoring to medical institutions to be monitored, doctor to be monitored can be based on Multiple Drug utilization index parameters such as average daily drug expenditure, the day for human beings equal drug expenditure and the costly medicine ratio of unit are treated to be integrated Evaluation.If the average daily drug expenditure of above-mentioned medical institutions to be monitored, the day for human beings equal drug expenditure and costly medicine ratio these three There is one in Drug utilization index parameter and more than one is exceeded, then can determine that the drug expenditure of medical institutions to be monitored is exceeded, it is no Then determine that the drug expenditure of medical institutions to be monitored is not exceeded.For details, reference can be made to real provided by step S15 in above-described embodiment Existing mode, details are not described herein.
Optionally, in some possible embodiments, if above-mentioned average daily drug expenditure, the day for human beings equal drug expenditure and expensive There are two in multiple Drug utilization index parameters such as weight Drugs proportion or more than two Drug utilization index parameters are exceeded, then can be based on big Data analysis, which is found, obtains the reason for Exceeding of each Drug utilization index parameter.For example, determining each medical treatment using big data analysis The corresponding drug details of exceeded item Drug utilization index parameter in the Drug utilization index parameter of unit, and then can be based on each medical institutions The drug details of exceeded item Drug utilization index parameter determine the reason for Exceeding of every Drug utilization index parameter, to be referred to according to every medication The reason for Exceeding for marking parameter carries out drug expenditure control.In addition, in above-mentioned average daily drug expenditure, the day for human beings equal drug expenditure and expensive When there are two in multiple Drug utilization index parameters such as weight Drugs proportion or more than two exceeded, it can join from above-mentioned multiple Drug utilization indexes The maximum maximum Drug utilization index parameter of Drug utilization index parameter value is determined in number.For example, if the average daily medicine of medical institutions to be monitored It is there are two in multiple Drug utilization index parameters such as product expense, the day for human beings equal drug expenditure and costly medicine ratio or more than two Drug utilization index parameter is exceeded, at this time average daily drug expenditure be X1 member, the day for human beings equal drug expenditure be X2 member, costly medicine ratio it is exceeded Corresponding costly medicine expense is X3 member.Wherein, if above-mentioned X1 is greater than X2, X2 is greater than X3, then average daily drug above-mentioned at this time takes Maximum with Drug utilization index parameter in three Drug utilization index parameters of the, day for human beings equal drug expenditure and costly medicine ratio is average daily medicine Product expense.
In some possible embodiments, in above-mentioned average daily drug expenditure, the day for human beings equal drug expenditure and costly medicine ratio Drug utilization index parameter is maximum when being average daily drug expenditure in three Drug utilization index parameters of example, true that can be based on big data analysis Make the exceeded reason of average daily drug expenditure, such as some drug (can be illustrated by taking exceeded drug as an example for convenience of description) Expense caused by it is exceeded etc., but and then the exceeded drug expense as medical institutions to be monitored drug expenditure control expense mark It is quasi-.At this point, can be using above-mentioned X1 member as the benchmark of the drug expenditure of medical institutions to be monitored, and then can will include in above-mentioned X2 member Above-mentioned exceeded drug associated by drug expenditure reject the day for human beings except the drug expenditure for not included above-mentioned exceeded drug Equal drug expenditure X2 '.Similarly, drug expenditure associated by the above-mentioned exceeded drug for including in above-mentioned X3 member can be rejected to obtain not The costly medicine expense X3 ' of drug expenditure including above-mentioned exceeded drug, and according to eliminate exceeded drug drug expenditure it Costly medicine expense afterwards determines the costly medicine ratio rejected after exceeded drug.Above-mentioned two or more than two medications After removing the maximum average daily drug expenditure of Drug utilization index parameter in index parameter, it can further judge to reject except exceeded drug The day for human beings equal drug expenditure perhaps whether the Drug utilization indexes such as costly medicine ratio parameter exceeded or the above-mentioned exceeded drug of rejecting The corresponding drug expenditure of multiple Drug utilization index parameters such as the day for human beings equal drug expenditure or costly medicine ratio except drug expenditure Whether cumulative calculation is exceeded.If the day for human beings equal drug expenditure or costly medicine except the drug expenditure of the above-mentioned exceeded drug of rejecting Multiple Drug utilization index parameters such as ratio still remain one or more than one Drug utilization index parameter is exceeded, that is, include average daily medicine It is exceeded that two or more Drug utilization index parameters are still including this maximum Drug utilization index parameter of product expense, Huo Zheshang State multiple Drug utilization index ginsengs such as the day for human beings equal drug expenditure or costly medicine ratio except the drug expenditure for rejecting exceeded drug The corresponding drug expenditure cumulative calculation of number is exceeded, then can determine that the drug expenditure of the medical institutions is exceeded.If above-mentioned rejecting Surpass in multiple Drug utilization index parameters such as the day for human beings equal drug expenditure or costly medicine ratio except the drug expenditure of exceeded drug Mark the day for human beings equal drug expenditure of the Drug utilization index parameter less than one or except the drug expenditure of the exceeded drug of above-mentioned rejecting or The corresponding drug expenditure cumulative calculation of multiple Drug utilization index parameters such as costly medicine ratio is not exceeded, then can determine the medical institutions Drug expenditure be up to standard.It can specifically be determined according to practical application scene, herein with no restrictions.
S27 is based on above-mentioned average daily drug expenditure, above-mentioned people if the drug expenditure of above-mentioned medical institutions to be monitored is exceeded Average daily drug expenditure and above-mentioned target medicine ratio carry out above-mentioned medical institutions to be monitored super with the drug expenditure of effective prescription Target risk control.
In some possible embodiments, based on the exceeded Drug utilization index parameter of above-mentioned medical institutions to be monitored to above-mentioned The drug expenditure difference of the exceeded part of medical institutions to be monitored carries out publicity, to realize that the medication to medical institutions to be monitored carries out The implementation of the exceeded risk control of drug expenditure can be found in implementation provided by step S16 in above-described embodiment, This is repeated no more.
Optionally, in some possible embodiments, it is based on the corresponding exceeded medication of above-mentioned exceeded Drug utilization index parameter Index parameter difference can also receive the drug expenditure reimbursement request or drug expenditure Claims Resolution that medical institutions to be monitored submit When request, refuses the drug expenditure reimbursement request or drug expenditure Claims Resolution request of medical institutions to be monitored, realize for wait supervise Control the exceeded progress of Drug utilization indexes parameter such as average daily drug expenditure, the day for human beings equal drug expenditure and the costly medicine ratio of medical institutions Punishment, the medical institutions are carried out with the risk control of drug expenditure.For example, the average daily drug of some day when the medical institutions It, can be when receiving the drug expenditure reimbursement and/or request of this day that medical institutions mention report, to the medical institutions when expense is exceeded Feed back the reimbursement failure of the drug expenditure of this day all prescriptions.In other words, when the average daily drug of some day of the medical institutions When expense is exceeded, when terminal device receives the ethical goods expense reimbursement and/or Claims Resolution request for this day that medical institutions mention report, The medical institutions can be fed back with the reimbursement of ethical goods expense refusal or Claims Resolution of this day, and then the medical institutions can be prompted to every The average daily drug expenditure of its prescription carries out self control to realize the prescription risk control exceeded to the drug expenditure of the medical institutions System.
Optionally, in some possible embodiments, when the drug expenditure of medical institutions to be monitored is exceeded, such as wait supervise When controlling the average daily drug expenditure of medical institutions' odd-numbered day prescription greater than average daily drug expenditure threshold value, terminal device can calculate doctor to be monitored Treat the difference between the average daily drug expenditure and above-mentioned average daily drug expenditure threshold value of unit.When terminal device receives doctor to be monitored Treat unit drug expenditure reimbursement and/or Claims Resolution request when, then can for medical institutions to be monitored average daily drug expenditure with it is upper The difference between average daily drug expenditure threshold value is stated, to difference portion drug in the drug expenditure of medical institutions' odd-numbered day prescription to be monitored The reimbursement of expense refusal is settled a claim to carry out the exceeded prescription risk control of drug cost to the medical institutions.
Optionally, in some possible embodiments, if terminal device determines some examination of medical institutions to be monitored The drug expenditure of prescription in period (such as one day or a week etc.) is exceeded, including but not limited to average daily drug expenditure, people One or more Drug utilization index parameter in average daily drug expenditure and costly medicine ratio is exceeded, such as medical treatment to be monitored is single The average daily drug expenditure of prescription (such as odd-numbered day prescription) in some examination period of position is greater than average daily drug expenditure threshold value, then can be Next examination period after the examination period (the exceeded average daily drug expenditure of odd-numbered day prescription is some day, such as Monday) The drug in the examination period is taken at the beginning of (second day of this exceeded day of average daily drug expenditure of odd-numbered day prescription, such as Tuesday) Medical institutions to be monitored are sent to exceeded report.Wherein, the exceeded report of the drug expenditure is for prompting medical institutions to be monitored Drug expenditure is exceeded within the examination period, and if can remind medical institutions to be monitored next examination period or it is specified when Average daily drug expenditure is still exceeded in interior continuous multiple examination periods, then will carry out drug expenditure to medical institutions to be monitored Exceeded punishment.Wherein, above-mentioned punishment includes that all refusal is submitted an expense account or managed to the drug expenditure that medical institutions to be monitored are exceeded It pays for, either to the refusal reimbursement of exceeded part or Claims Resolution of the average daily drug expenditure of medical institutions to be monitored etc..Above-mentioned average daily medicine The exceeded report of product expense is for prompting medical institutions to be monitored to carry out self control to average daily drug expenditure to realize to be monitored The exceeded risk control of the drug expenditure of medical institutions.
The embodiment of the present application can based on medical institutions to be monitored within the individually examination period with included in effective prescription Medicine information determines the day for human beings equal drug expenditure of the medical institutions to be monitored within the individually examination period, individually examines the period here It also include the examination period of any duration more than one day including the odd-numbered day.Based on all kinds of medicines included in above-mentioned odd-numbered day prescription The medicine information of product can determine the average daily drug expenditure of single medicine of all kinds of medications in conjunction with the calculation of average daily drug expenditure, thus It can determine that the costly medicine and costly medicine ratio in odd-numbered day prescription.Based on medical institutions to be monitored within the examination period Multiple Drug utilization index parameters such as average daily drug expenditure, the day for human beings equal drug expenditure and costly medicine ratio it is single to medical treatment to be monitored The medication of position carries out overall merit, determines whether the drug expenditure of medical institutions to be monitored is exceeded, realizes single to medical treatment to be monitored The evaluation of the Drug utilization index of position, mode of operation multiplicity.It is realized based on method provided by the embodiments of the present application to each medical institutions Medication policer operation mode multiplicity both can be improved the accuracy of the medication monitoring to medical institutions, and improve the use to medical institutions The reliability of medicine monitoring, while the operating flexibility of the medication monitoring to medical institutions can also be enhanced, and then can be improved based on each The medicining condition of a medical institutions carries out the exceeded publicity of drug expenditure, and/or refusal medication to the prescription of each medical institutions The reliability of the exceeded risk control of medications such as the exceeded corresponding drug expenditure reimbursement of index parameter and/or Claims Resolution request, can mention The medication controllability of high medical institutions' evolution, so that the effective rate of utilization of medical resource can be improved, applicability is stronger.
Embodiment three:
It is the drug expenditure risk of exceeding criterion control device provided by the embodiments of the present application based on data processing referring to Fig. 3, Fig. 3 Example structure schematic diagram.Drug expenditure risk of exceeding criterion control device packet provided by the embodiments of the present application based on data processing It includes:
Data capture unit 31 for obtaining the use effective prescription of medical institutions to be monitored, and obtains above-mentioned in effective prescription Included medicine information.
Medicine information processing unit 32, the above-mentioned medicine information for being obtained according to above-mentioned data capture unit 31 determine State the average daily drug expenditure of medical institutions to be monitored.
Medicine information processing unit 32 is also used to above-mentioned being wrapped in effective prescription according to the acquisition of above-mentioned data capture unit 31 The sufferer information included determines the above-mentioned sufferer quantity corresponding to effective prescription, true according to above-mentioned medicine information and above-mentioned sufferer quantity The day for human beings equal drug expenditure of fixed above-mentioned medical institutions to be monitored.
Medicine information processing unit 32 is also used to the medicine information according to each similar drug included in above-mentioned medicine information It determines the above-mentioned target medicine in effective prescription, and determines that above-mentioned target medicine exists according to the medicine information of above-mentioned each similar drug The above-mentioned target medicine ratio in effective prescription.
Medication monitoring unit 33, for according to above-mentioned medicine information processing unit 32 determine above-mentioned average daily drug expenditure, The above-mentioned day for human beings equal drug expenditure and above-mentioned target medicine ratio, determine whether the drug expenditure of above-mentioned medical institutions to be monitored surpasses Mark.
Drug risk control unit 34, for determining the medicine of above-mentioned medical institutions to be monitored in above-mentioned medication monitoring unit 32 When product expense is exceeded, based on above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio to upper It states medical institutions to be monitored and carries out the risk control exceeded with the drug expenditure of effective prescription.
In some possible embodiments, above-mentioned data capture unit 31 is used for:
The data system access qualification of above-mentioned medical institutions to be monitored is obtained, based on above-mentioned data system access qualification from upper State obtain above-mentioned medical institutions to be monitored in the data system of medical institutions to be monitored use effective prescription；And/or
The medical treatment Claims Resolution data that above-mentioned medical institutions to be monitored provide are obtained, are obtained from above-mentioned medical treatment Claims Resolution data above-mentioned Medical institutions to be monitored use effective prescription；
Wherein, above-mentioned medical institutions to be monitored includes above-mentioned medical institutions to be monitored in the individually examination period with effective prescription It is interior it is all use effective prescription, the above-mentioned single examination period includes odd-numbered day or more days.
In some possible embodiments, above-mentioned medical institutions to be monitored includes above-mentioned medical treatment to be monitored with effective prescription All within the odd-numbered day of unit use effective prescription；
Above-mentioned medicine information processing unit 32 is used for:
Above-mentioned all medicine informations with each drug included in effective prescription are obtained, are included at least in above-mentioned medicine information Sales Volumes and drug use number of days；
Determine that the drug of above-mentioned all drugs all included by effective prescription is total according to the Sales Volumes of above-mentioned each drug Volume, and determine that above-mentioned all drugs with effective prescription use total number of days using number of days according to the drug of above-mentioned each drug；
The average daily drug of above-mentioned medical institutions to be monitored is determined using total number of days according to above-mentioned drug total value and above-mentioned drug Expense.
In some possible embodiments, above-mentioned medical institutions to be monitored includes above-mentioned medical treatment to be monitored with effective prescription All within more days single examination periods of unit use effective prescription；
Above-mentioned medicine information processing unit 32 is used for:
Any day in the above-mentioned single examination period any odd-numbered day effective prescription is obtained, and obtains any of the above-described odd-numbered day medication The medicine information of included each drug in prescription includes at least Sales Volumes in above-mentioned medicine information and drug uses number of days；
It is determined according to the Sales Volumes of each drug included by any of the above-described odd-numbered day effective prescription and drug using number of days State the odd-numbered day average daily drug expenditure of medical institutions to be monitored；
According to above-mentioned medical institutions to be monitored in the above-mentioned single odd-numbered day average daily drug expenditure and medicine for examining period Nei Ge Product determine the average daily drug expenditure of above-mentioned medical institutions to be monitored using total number of days；
Wherein, any day drug is the medicine of each drug included in any of the above-described odd-numbered day effective prescription using total number of days Product use the summation of number of days.
In some possible embodiments, above-mentioned medicine information processing unit 32 is used for:
The list in above-mentioned single examination period is determined according to the odd-numbered day average daily drug expenditure of above-mentioned single examination period Nei Ge Day average daily drug expenditure accumulated value is determined using total number of days according to the drug of above-mentioned single examination period Nei Ge and above-mentioned is individually examined Drug in nuclear cycle uses total number of days accumulated value；
It is determined according to average daily drug expenditure accumulated value of above-mentioned odd-numbered day and above-mentioned drug using total number of days accumulated value above-mentioned wait supervise Control the average daily drug expenditure of medical institutions.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=odd-numbered day average daily drug expenditure accumulated value/drug uses total number of days accumulated value.
Optionally, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=period drug total value/period drug uses total number of days；
Wherein, it can be the drug of all drugs of all prescriptions in the single examination period in above-mentioned period drug total value The total amount of the cumulative obtained all drugs of the amount of money, above-mentioned period drug can be the institute in the single examination period using total number of days There is the drug of each drug in drug to use the accumulated value of number of days.
In some possible embodiments, above-mentioned medicine information processing unit 32 is used for:
It obtains above-mentioned sufferer information included in effective prescription, and is determined according to above-mentioned sufferer information and above-mentioned use effective prescription Targeted sufferer person-time, wherein one is directed to a sufferer person-time with effective prescription；
Above-mentioned sufferer person-time is determined as the above-mentioned sufferer quantity corresponding to effective prescription.
In some possible embodiments, above-mentioned medicine information processing unit 32 is used for:
It is determined according to above-mentioned medicine information above-mentioned single with drug sum included in effective prescription and above-mentioned medical treatment to be monitored The average daily drug expenditure of position；
Above-mentioned medical institutions to be monitored are determined according to above-mentioned average daily drug expenditure, above-mentioned sufferer quantity and above-mentioned drug sum The day for human beings equal drug expenditure.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=drug total value/drug uses total number of days；
The day for human beings of above-mentioned medical institutions to be monitored, equal drug expenditure met:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
In some possible embodiments, above-mentioned medicine information processing unit 32 is used for:
The above-mentioned medicine information with each similar drug included in effective prescription is determined according to above-mentioned medicine information, it is above-mentioned each Number of days is used including at least the Sales Volumes of each similar drug and drug in the medicine information of similar drug；
According to the medicine information of above-mentioned each similar drug determine the above-mentioned drug total value with similar drug any in effective prescription with And the drug of any of the above-described similar drug uses total number of days；
It is determined according to the drug of the drug total value of any of the above-described similar drug and any of the above-described similar drug using total number of days above-mentioned The average daily drug expenditure of single medicine of any similar drug is to obtain the average daily drug expenditure of single medicine of above-mentioned each similar drug；
The above-mentioned average daily medicine of the corresponding single medicine of effective prescription is determined according to the average daily drug expenditure of single medicine of above-mentioned each similar drug Product cost threshold, and the average daily drug expenditure of medicine single in above-mentioned each similar drug is more than or equal to the average daily drug expenditure of above-mentioned single medicine The drug of threshold value is determined as the above-mentioned target medicine in effective prescription.
Wherein, the average daily drug expenditure of single medicine of any of the above-described similar drug meets:
Drug total value/any similar drug drug of the single average daily drug expenditure of medicine=any similar drug uses total number of days.
In some possible embodiments, above-mentioned medicine information processing unit 32 is used for:
The above-mentioned drug total value with drugs all in effective prescription is determined according to the medicine information of above-mentioned each similar drug, and The above-mentioned target medicine total value with above-mentioned target medicine included in effective prescription；
The above-mentioned target with effective prescription is determined according to the drug total value of above-mentioned all drugs and above-mentioned target medicine total value Drugs proportion；
Wherein, above-mentioned target medicine ratio meets:
Target medicine ratio=target medicine total value/all drugs drug total value.
In some possible embodiments, above-mentioned medication monitoring unit 33 is used for:
The average daily drug of above-mentioned medical institutions to be monitored is determined according to the unit attribute information of above-mentioned medical institutions to be monitored Cost threshold, the day for human beings equal drug expenditure threshold value and target medicine proportion threshold value；
If above-mentioned average daily drug expenditure is greater than above-mentioned average daily drug expenditure threshold value, above-mentioned average daily drug expenditure is determined as Exceeded Drug utilization index parameter；And/or
If the above-mentioned day for human beings equal drug expenditure is greater than equal drug expenditure threshold value of the above-mentioned day for human beings, by equal drug expenditure of the above-mentioned day for human beings It is determined as exceeded Drug utilization index parameter；And/or
If above-mentioned target medicine ratio is greater than above-mentioned target medicine proportion threshold value, it is by above-mentioned target medicine ratio-dependent Exceeded Drug utilization index parameter；
According to the exceeded use in above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio Medicine index parameter determines whether the drug expenditure of above-mentioned medical institutions to be monitored is exceeded；
Wherein, the unit attribute information of above-mentioned medical institutions to be monitored includes flat type, region, unit institute locating for unit Locate one of city, unit drugs supply channel and unit sufferer person-time or a variety of.
In some possible embodiments, above-mentioned medication monitoring unit 33 is used for:
In above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio include one or When the multinomial exceeded Drug utilization index parameter of person, determine that the drug expenditure of above-mentioned medical institutions to be monitored is exceeded；
It is less than or equal to above-mentioned average daily drug expenditure threshold value, equal drug expenditure of the above-mentioned day for human beings in above-mentioned average daily drug expenditure Less than or equal to equal drug expenditure threshold value of the above-mentioned day for human beings and above-mentioned target medicine ratio is less than or equal to above-mentioned target medicine When proportion threshold value, determine that the drug expenditure of above-mentioned medical institutions to be monitored is not exceeded.
In some possible embodiments, above-mentioned drug risk control unit 34 is used for:
By the exceeded medication in above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio Index parameter carries out publicity, the use of the above-mentioned medical institutions' control evolution to be monitored of the exceeded Drug utilization index parameter prompts based on publicity Medicine, with the exceeded risk control of the drug expenditure of realization effective prescription；And/or
Above-mentioned exceeded Drug utilization index parameter is exceeded into the corresponding Drug utilization index parameter threshold of above-mentioned exceeded Drug utilization index parameter Difference carry out publicity, the above-mentioned difference based on publicity prompts the medication of above-mentioned medical institutions to be monitored control evolution, to realize With the exceeded risk control of the drug expenditure of effective prescription；And/or
When receiving above-mentioned exceeded Drug utilization index parameter and/or the corresponding drug expenditure reimbursement of above-mentioned difference is requested, refuse Drug expenditure reimbursement request above-mentioned absolutely is to realize the risk control for using the drug expenditure of effective prescription exceeded.
In some possible embodiments, the above-mentioned drug expenditure risk of exceeding criterion control device based on data processing can lead to It crosses each functional module built in it and executes the implementation as provided by above-mentioned Fig. 1 each step into Fig. 2.Optionally, on Stating the drug expenditure risk of exceeding criterion control device based on data processing can be terminal device described in above-mentioned each embodiment, Herein with no restrictions.For example, above-mentioned data capture unit 31 can be used for executing medical institutions to be monitored in above-mentioned each step With the acquisition of effective prescription and medicine information, for details, reference can be made to implementations provided by above-mentioned each step, no longer superfluous herein It states.Above-mentioned medicine information processing unit 32 can be used for executing in above-mentioned each step institute in the use effective prescription of medical institutions to be monitored Including each drug Sales Volumes, with the average daily drug expenditure of effective prescription, odd-numbered day average daily drug expenditure, with the day for human beings of effective prescription Equal drug expenditure and the calculating of costly medicine ratio and other implementations, for details, reference can be made to realize provided by above-mentioned each step Mode, details are not described herein.Above-mentioned medication monitoring unit 33 can be used for executing single based on medical treatment to be monitored in above-mentioned each step The unit attribute information of position determines the average daily drug expenditure threshold value of medical institutions to be monitored, the day for human beings equal drug expenditure threshold value and expensive The performance assessment criteria threshold value (or Drug utilization index parameter threshold) of the medications monitoring such as weight Drugs proportion threshold value, and it is based on doctor to be monitored It treats the Drug utilization indexes parameters such as average daily drug expenditure, the day for human beings equal drug expenditure and the costly medicine ratio of unit and judges doctor to be monitored Whether the drug expenditure for treating unit is exceeded and other implementations, for details, reference can be made to implementation provided by above-mentioned each step, This is repeated no more.Above-mentioned drug risk control unit 34 is used to execute based on the above-mentioned of above-mentioned medicine information processing unit 32 determination The Drug utilization indexes parameters such as average daily drug expenditure, the day for human beings equal drug expenditure and costly medicine ratio carry out medical institutions to be monitored With the drug expenditure risk of exceeding criterion control and other implementations of effective prescription, for details, reference can be made to realization sides provided by above-mentioned each step Formula, details are not described herein.
In the embodiment of the present application, medication monitoring device can be based on use of the medical institutions to be monitored within the individually examination period Included medicine information in effective prescription determines the day for human beings equal drug expenditure of the medical institutions to be monitored within the individually examination period, Here individually the examination period includes the odd-numbered day, also includes the examination period of any duration more than one day.Medication monitoring device can base The medicine information of included each similar drug, can determine respectively in conjunction with the calculation of average daily drug expenditure in above-mentioned odd-numbered day prescription The average daily drug expenditure of single medicine of class medication, to can determine that the costly medicine and costly medicine ratio in odd-numbered day prescription.With Medicine monitoring device can based on average daily drug expenditure of the medical institutions to be monitored within the examination period, the day for human beings equal drug expenditure and Multiple Drug utilization index parameters such as costly medicine ratio carry out overall merit to the medication of medical institutions to be monitored, determine doctor to be monitored Whether the drug expenditure for treating unit is exceeded, realizes the evaluation to the Drug utilization index of medical institutions to be monitored, mode of operation multiplicity.Base The medication policer operation mode multiplicity to each medical institutions can be realized in medication monitoring device, and the use to medical institutions both can be improved The accuracy of medicine monitoring, improves the reliability of the medication monitoring to medical institutions, while can also enhance the medication to medical institutions The operating flexibility of monitoring, and then the medicining condition based on each medical institutions can be improved, the prescription of each medical institutions is carried out The exceeded publicity of drug expenditure, and/or the exceeded corresponding drug expenditure reimbursement of refusal Drug utilization index parameter and/or Claims Resolution request etc. The reliability of the exceeded risk control of medication, can be improved the medication controllability of medical institutions' evolution, so that medical money can be improved The effective rate of utilization in source, applicability are stronger.
Example IV:
Referring to fig. 4, Fig. 4 is a kind of example structure schematic diagram of terminal device provided by the embodiments of the present application.Such as Fig. 4 institute Show, the terminal device in the present embodiment may include: one or more processors 401 and memory 402.Above-mentioned processor 401 It is connected with memory 402 by bus 403.For memory 402 for storing computer program, which includes that program refers to It enables, processor 401 is used to execute the program instruction of the storage of memory 402.Wherein, above-mentioned processor 401 is configured for calling The program instruction performs the following operations:
Obtain medical institutions to be monitored uses effective prescription；
Above-mentioned medicine information included in effective prescription is obtained, and above-mentioned doctor to be monitored is determined according to above-mentioned medicine information Treat the average daily drug expenditure of unit；
The above-mentioned sufferer quantity corresponding to effective prescription is determined with the sufferer information for including in effective prescription according to above-mentioned, according to Above-mentioned medicine information and above-mentioned sufferer quantity determine the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored；
The above-mentioned mesh in effective prescription is determined according to the medicine information of each similar drug included in above-mentioned medicine information Drug is marked, and determines above-mentioned target medicine in the above-mentioned target medicine in effective prescription according to the medicine information of above-mentioned each similar drug Ratio；
According to above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio, determine above-mentioned Whether the drug expenditure of medical institutions to be monitored is exceeded；
It is equal based on above-mentioned average daily drug expenditure, the above-mentioned day for human beings if the drug expenditure of above-mentioned medical institutions to be monitored is exceeded Drug expenditure and above-mentioned target medicine ratio carry out above-mentioned medical institutions to be monitored exceeded with the drug expenditure of effective prescription Risk control.
In some possible embodiments, above-mentioned processor 401, is used for:
The data system access qualification of above-mentioned medical institutions to be monitored is obtained, based on above-mentioned data system access qualification from upper State obtain above-mentioned medical institutions to be monitored in the data system of medical institutions to be monitored use effective prescription；And/or
The medical treatment Claims Resolution data that above-mentioned medical institutions to be monitored provide are obtained, are obtained from above-mentioned medical treatment Claims Resolution data above-mentioned Medical institutions to be monitored use effective prescription；
Wherein, above-mentioned medical institutions to be monitored includes above-mentioned medical institutions to be monitored in the individually examination period with effective prescription It is interior it is all use effective prescription, the above-mentioned single examination period includes odd-numbered day or more days.
In some possible embodiments, above-mentioned medical institutions to be monitored includes above-mentioned medical treatment to be monitored with effective prescription All within the odd-numbered day of unit use effective prescription；
Above-mentioned processor 401, is used for:
Above-mentioned all medicine informations with each drug included in effective prescription are obtained, are included at least in above-mentioned medicine information Sales Volumes and drug use number of days；
Determine that the drug of above-mentioned all drugs all included by effective prescription is total according to the Sales Volumes of above-mentioned each drug Volume, and determine that above-mentioned all drugs with effective prescription use total number of days using number of days according to the drug of above-mentioned each drug；
The average daily drug of above-mentioned medical institutions to be monitored is determined using total number of days according to above-mentioned drug total value and above-mentioned drug Expense.
In some possible embodiments, above-mentioned medical institutions to be monitored includes above-mentioned medical treatment to be monitored with effective prescription All within more days single examination periods of unit use effective prescription；
Above-mentioned processor 401, is used for:
Any day in the above-mentioned single examination period any odd-numbered day effective prescription is obtained, and obtains any of the above-described odd-numbered day medication The medicine information of included each drug in prescription includes at least Sales Volumes in above-mentioned medicine information and drug uses number of days；
It is determined according to the Sales Volumes of each drug included by any of the above-described odd-numbered day effective prescription and drug using number of days State the odd-numbered day average daily drug expenditure of medical institutions to be monitored；
According to above-mentioned medical institutions to be monitored in the above-mentioned single odd-numbered day average daily drug expenditure and medicine for examining period Nei Ge Product determine the average daily drug expenditure of above-mentioned medical institutions to be monitored using total number of days；
Wherein, any day drug is the medicine of each drug included in any of the above-described odd-numbered day effective prescription using total number of days Product use the summation of number of days.
In some possible embodiments, above-mentioned processor 401, is used for:
The list in above-mentioned single examination period is determined according to the odd-numbered day average daily drug expenditure of above-mentioned single examination period Nei Ge Day average daily drug expenditure accumulated value is determined using total number of days according to the drug of above-mentioned single examination period Nei Ge and above-mentioned is individually examined Drug in nuclear cycle uses total number of days accumulated value；
It is determined according to average daily drug expenditure accumulated value of above-mentioned odd-numbered day and above-mentioned drug using total number of days accumulated value above-mentioned wait supervise Control the average daily drug expenditure of medical institutions.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=odd-numbered day average daily drug expenditure accumulated value/drug uses total number of days accumulated value.
Optionally, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=period drug total value/period drug uses total number of days；
Wherein, it can be the drug of all drugs of all prescriptions in the single examination period in above-mentioned period drug total value The total amount of the cumulative obtained all drugs of the amount of money, above-mentioned period drug can be the institute in the single examination period using total number of days There is the drug of each drug in drug to use the accumulated value of number of days.
In some possible embodiments, above-mentioned processor 401, is used for:
It obtains above-mentioned sufferer information included in effective prescription, and is determined according to above-mentioned sufferer information and above-mentioned use effective prescription Targeted sufferer person-time, wherein one is directed to a sufferer person-time with effective prescription；
Above-mentioned sufferer person-time is determined as the above-mentioned sufferer quantity corresponding to effective prescription.
In some possible embodiments, above-mentioned processor 401, is used for:
It is determined according to above-mentioned medicine information above-mentioned single with drug sum included in effective prescription and above-mentioned medical treatment to be monitored The average daily drug expenditure of position；
Above-mentioned medical institutions to be monitored are determined according to above-mentioned average daily drug expenditure, above-mentioned sufferer quantity and above-mentioned drug sum The day for human beings equal drug expenditure.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=drug total value/drug uses total number of days；
The day for human beings of above-mentioned medical institutions to be monitored, equal drug expenditure met:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
In some possible embodiments, above-mentioned processor 401, is used for:
The above-mentioned medicine information with each similar drug included in effective prescription is determined according to above-mentioned medicine information, it is above-mentioned each Number of days is used including at least the Sales Volumes of each similar drug and drug in the medicine information of similar drug；
According to the medicine information of above-mentioned each similar drug determine the above-mentioned drug total value with similar drug any in effective prescription with And the drug of any of the above-described similar drug uses total number of days；
It is determined according to the drug of the drug total value of any of the above-described similar drug and any of the above-described similar drug using total number of days above-mentioned The average daily drug expenditure of single medicine of any similar drug is to obtain the average daily drug expenditure of single medicine of above-mentioned each similar drug；
The above-mentioned average daily medicine of the corresponding single medicine of effective prescription is determined according to the average daily drug expenditure of single medicine of above-mentioned each similar drug Product cost threshold, and the average daily drug expenditure of medicine single in above-mentioned each similar drug is more than or equal to the average daily drug expenditure of above-mentioned single medicine The drug of threshold value is determined as the above-mentioned target medicine in effective prescription.
Wherein, the average daily drug expenditure of single medicine of any of the above-described similar drug meets:
Drug total value/any similar drug drug of the single average daily drug expenditure of medicine=any similar drug uses total number of days.
In some possible embodiments, above-mentioned processor 401, is used for:
The above-mentioned drug total value with drugs all in effective prescription is determined according to the medicine information of above-mentioned each similar drug, and The above-mentioned target medicine total value with above-mentioned target medicine included in effective prescription；
The above-mentioned target with effective prescription is determined according to the drug total value of above-mentioned all drugs and above-mentioned target medicine total value Drugs proportion；
Wherein, above-mentioned target medicine ratio meets:
Target medicine ratio=target medicine total value/all drugs drug total value.
In some possible embodiments, above-mentioned processor 401, is used for:
The average daily drug of above-mentioned medical institutions to be monitored is determined according to the unit attribute information of above-mentioned medical institutions to be monitored Cost threshold, the day for human beings equal drug expenditure threshold value and target medicine proportion threshold value；
If above-mentioned average daily drug expenditure is greater than above-mentioned average daily drug expenditure threshold value, above-mentioned average daily drug expenditure is determined as Exceeded Drug utilization index parameter；And/or
If the above-mentioned day for human beings equal drug expenditure is greater than equal drug expenditure threshold value of the above-mentioned day for human beings, by equal drug expenditure of the above-mentioned day for human beings It is determined as exceeded Drug utilization index parameter；And/or
If above-mentioned target medicine ratio is greater than above-mentioned target medicine proportion threshold value, it is by above-mentioned target medicine ratio-dependent Exceeded Drug utilization index parameter；
According to the exceeded use in above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio Medicine index parameter determines whether the drug expenditure of above-mentioned medical institutions to be monitored is exceeded；
Wherein, the unit attribute information of above-mentioned medical institutions to be monitored includes flat type, region, unit institute locating for unit Locate one of city, unit drugs supply channel and unit sufferer person-time or a variety of.
In some possible embodiments, above-mentioned processor 401, is used for:
In above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio include one or When the multinomial exceeded Drug utilization index parameter of person, determine that the drug expenditure of above-mentioned medical institutions to be monitored is exceeded；
It is less than or equal to above-mentioned average daily drug expenditure threshold value, equal drug expenditure of the above-mentioned day for human beings in above-mentioned average daily drug expenditure Less than or equal to equal drug expenditure threshold value of the above-mentioned day for human beings and above-mentioned target medicine ratio is less than or equal to above-mentioned target medicine When proportion threshold value, determine that the drug expenditure of above-mentioned medical institutions to be monitored is not exceeded.
In some possible embodiments, above-mentioned processor 401, is used for:
By the exceeded medication in above-mentioned average daily drug expenditure, equal drug expenditure of the above-mentioned day for human beings and above-mentioned target medicine ratio Index parameter carries out publicity, the use of the above-mentioned medical institutions' control evolution to be monitored of the exceeded Drug utilization index parameter prompts based on publicity Medicine, with the exceeded risk control of the drug expenditure of realization effective prescription；And/or
Above-mentioned exceeded Drug utilization index parameter is exceeded into the corresponding Drug utilization index parameter threshold of above-mentioned exceeded Drug utilization index parameter Difference carry out publicity, the above-mentioned difference based on publicity prompts the medication of above-mentioned medical institutions to be monitored control evolution, to realize With the exceeded risk control of the drug expenditure of effective prescription；And/or
When receiving above-mentioned exceeded Drug utilization index parameter and/or the corresponding drug expenditure reimbursement of above-mentioned difference is requested, refuse Drug expenditure reimbursement request above-mentioned absolutely is to realize the risk control for using the drug expenditure of effective prescription exceeded.
In some possible embodiments, above-mentioned processor 401 can be central processing unit (central Processing unit, CPU), which can also be other general processors, digital signal processor (digital Signal processor, DSP), specific integrated circuit (application specific integrated circuit, ASIC), ready-made programmable gate array (field-programmable gate array, FPGA) or other programmable logic Device, discrete gate or transistor logic, discrete hardware components etc..General processor can be microprocessor or this at Reason device is also possible to any conventional processor etc..
The memory 402 may include read-only memory and random access memory, and to processor 401 provide instruction and Data.The a part of of memory 402 can also include nonvolatile RAM.For example, memory 402 can also be deposited Store up the information of device type.
In some possible embodiments, above-mentioned terminal device can pass through each function mould of processor 401 built in it Block executes the implementation as provided by above-mentioned Fig. 1 each step into Fig. 2, and for details, reference can be made to provided by above-mentioned each step Implementation, details are not described herein.
In the embodiment of the present application, terminal device can be based on medical institutions to be monitored at the medication in the individually examination period Included medicine information in side determines the day for human beings equal drug expenditure of the medical institutions to be monitored within the individually examination period, here The single examination period includes the odd-numbered day, also includes the examination period of any duration more than one day.Terminal device can be based on above-mentioned list The medicine information of included each similar drug, can determine all kinds of medications in conjunction with the calculation of average daily drug expenditure in day prescription Single average daily drug expenditure of medicine, to can determine that the costly medicine and costly medicine ratio in odd-numbered day prescription.Terminal device can Average daily drug expenditure, the day for human beings equal drug expenditure and costly medicine ratio based on medical institutions to be monitored within the examination period Overall merit is carried out to the medication of medical institutions to be monitored etc. multiple Drug utilization index parameters, determines the drug of medical institutions to be monitored Whether expense is exceeded, realizes the evaluation to the Drug utilization index of medical institutions to be monitored, mode of operation multiplicity.Implemented based on the application The terminal device that example provides can realize the medication policer operation mode multiplicity to each medical institutions, both can be improved to medical institutions The accuracy of medication monitoring, improves the reliability of the medication monitoring to medical institutions, while can also enhance the use to medical institutions The operating flexibility of medicine monitoring, so can be improved the medicining condition based on each medical institutions to the prescriptions of each medical institutions into The exceeded publicity of row drug expenditure, and/or the exceeded corresponding drug expenditure reimbursement of refusal Drug utilization index parameter and/or Claims Resolution request The reliability of the exceeded risk control of equal medications, can be improved the medication controllability of medical institutions' evolution, so that medical treatment can be improved The effective rate of utilization of resource, applicability are stronger.
The embodiment of the present application also provides a kind of computer readable storage medium, which has meter Calculation machine program, the computer program include program instruction, which realizes that Fig. 1 is each into Fig. 2 when being executed by processor Drug expenditure risk of exceeding criterion control method based on data processing provided by step, for details, reference can be made to above-mentioned each steps to be mentioned The implementation of confession, details are not described herein.
Above-mentioned computer readable storage medium can be the drug expense based on data processing that aforementioned any embodiment provides With the hard disk or memory of risk of exceeding criterion control device or the internal storage unit of above-mentioned terminal device, such as electronic equipment.It should Computer readable storage medium is also possible to the grafting being equipped on the External memory equipment of the electronic equipment, such as the electronic equipment Formula hard disk, intelligent memory card (smart media card, SMC), secure digital (secure digital, SD) card, flash card (flash card) etc..Further, which can also both include the storage inside of the electronic equipment Unit also includes External memory equipment.The computer readable storage medium is for storing the computer program and the electronic equipment Other required programs and data.The computer readable storage medium, which can be also used for temporarily storing, have been exported or will The data of output.
Term " includes " and " having " and their any changes in following claims and specification and attached drawing Shape, it is intended that cover and non-exclusive include.Such as contain the process, method of a series of steps or units, system, product or Equipment is not limited to listed step or unit, but optionally further comprising the step of not listing or unit or optional Ground further includes the other step or units intrinsic for these process, methods, product or equipment.Referenced herein " embodiment " It is meant that a particular feature, structure, or characteristic described may be embodied at least one embodiment of the application in conjunction with the embodiments. Each position in the description shows that the phrase might not each mean identical embodiment, nor mutual with other embodiments The independent or alternative embodiment of reprimand.Those skilled in the art explicitly and implicitly understand, reality described herein Applying example can combine with other embodiments.The term "and/or" used in present specification and the appended claims Refer to any combination and all possible combinations of one or more of associated item listed, and including these combinations.
Those of ordinary skill in the art may be aware that list described in conjunction with the examples disclosed in the embodiments of the present disclosure Member and algorithm steps, can be realized with electronic hardware, computer software, or a combination of the two, in order to clearly demonstrate hardware With the interchangeability of software, each exemplary composition and step are generally described according to function in the above description.This A little functions are implemented in hardware or software actually, the specific application and design constraint depending on technical solution.Specially Industry technical staff can use different methods to achieve the described function each specific application, but this realization is not It is considered as beyond scope of the present application.Method provided by the embodiments of the present application and relevant apparatus are provided referring to the embodiment of the present application Method flow diagram and/or structural schematic diagram come what is described, can specifically be realized by computer program instructions method flow diagram and/or The combination of each flow and/or block of structural schematic diagram and process and/or box in flowchart and/or the block diagram.This A little computer program instructions can provide at general purpose computer, special purpose computer, Embedded Processor or other programmable datas The processor of equipment is managed to generate a machine, so that holding by the processor of computer or other programmable data processing devices Capable instruction generates for realizing in one box of one or more flows of the flowchart and/or structural schematic diagram or multiple sides The device for the function of being specified in frame.These computer program instructions, which may also be stored in, is able to guide computer or other programmable datas In processing equipment computer-readable memory operate in a specific manner, so that finger stored in the computer readable memory It enables and generates the manufacture including command device, which realizes in one or more flows of the flowchart and/or structure The function of being specified in schematic diagram one box or multiple boxes.These computer program instructions can also be loaded into computer or other In programmable data processing device, so that executing series of operation steps on a computer or other programmable device in terms of generating The processing that calculation machine is realized, so that instruction executed on a computer or other programmable device is provided for realizing in flow chart one The step of function of being specified in a process or multiple processes and/or structural representation one box or multiple boxes.

Claims (15)

1. a kind of drug expenditure risk of exceeding criterion control method based on data processing, which is characterized in that the described method includes:
Obtain medical institutions to be monitored uses effective prescription；
The medicine information included in effective prescription is obtained, and determines that the medical treatment to be monitored is single according to the medicine information The average daily drug expenditure of position；
The sufferer quantity corresponding to effective prescription is determined with the sufferer information for including in effective prescription according to described, according to described Medicine information and the sufferer quantity determine the day for human beings equal drug expenditure of the medical institutions to be monitored；
The target medicine in effective prescription is determined according to the medicine information of each similar drug included in the medicine information Product, and determine the target medicine in the target medicine ratio in effective prescription according to the medicine information of each similar drug Example；
According to the average daily drug expenditure, the day for human beings equal drug expenditure and the target medicine ratio, determine described wait supervise Whether the drug expenditure for controlling medical institutions is exceeded；
If the drug expenditure of the medical institutions to be monitored is exceeded, it is based on the average daily drug expenditure, the day for human beings equal drug Expense and the target medicine ratio carry out the risk exceeded with the drug expenditure of effective prescription to the medical institutions to be monitored Control.
2. the method according to claim 1, wherein it is described obtain medical institutions to be monitored with effective prescription packet It includes:
Obtain the data system access qualification of the medical institutions to be monitored, based on the data the qualification of system access from it is described to The medical institutions to be monitored are obtained in the data system of monitoring medical institutions uses effective prescription；And/or
The medical treatment Claims Resolution data that the medical institutions to be monitored provide are obtained, are obtained from the medical treatment Claims Resolution data described wait supervise Control medical institutions use effective prescription；
Wherein, the medical institutions to be monitored includes the medical institutions to be monitored within the individually examination period with effective prescription All to use effective prescription, the cycle duration in the single examination period includes odd-numbered day or more days.
3. method according to claim 1 or 2, which is characterized in that the medical institutions to be monitored include with effective prescription All within the odd-numbered day of the medical institutions to be monitored use effective prescription；
It is described to obtain the medicine information included in effective prescription, and the doctor to be monitored is determined according to the medicine information Treat unit average daily drug expenditure include:
All medicine informations with each drug included in effective prescription are obtained, include at least drug in the medicine information The amount of money and drug use number of days；
The drug total value of all drugs all included by effective prescription is determined according to the Sales Volumes of each drug, and Determine that all drugs with effective prescription use total number of days using number of days according to the drug of each drug；
The average daily drug expenditure of the medical institutions to be monitored is determined using total number of days according to the drug total value and the drug.
4. method according to claim 1 or 2, which is characterized in that the medical institutions to be monitored include with effective prescription All within more days single examination periods of the medical institutions to be monitored use effective prescription；
It is described to obtain the medicine information included in effective prescription, and the doctor to be monitored is determined according to the medicine information Treat unit average daily drug expenditure include:
Any day in the single examination period any odd-numbered day effective prescription is obtained, and obtains any odd-numbered day effective prescription In included each drug medicine information, include at least Sales Volumes in the medicine information and drug use number of days；
Described in being determined according to the Sales Volumes of each drug included by any odd-numbered day effective prescription and drug using number of days to Monitor the odd-numbered day average daily drug expenditure of medical institutions；
Made according to the medical institutions to be monitored in the odd-numbered day average daily drug expenditure and drug of the single examination period Nei Ge The average daily drug expenditure of the medical institutions to be monitored is determined with total number of days；
Wherein, any day drug is made using the drug that total number of days is each drug included in any odd-numbered day effective prescription With the summation of number of days.
5. according to the method described in claim 4, it is characterized in that, it is described according to the medical institutions to be monitored described single The odd-numbered day average daily drug expenditure and drug of examination period Nei Ge determines the average daily of the medical institutions to be monitored using total number of days Drug expenditure includes:
The odd-numbered day day in the single examination period is determined according to the odd-numbered day average daily drug expenditure of the single examination period Nei Ge Equal drug expenditure accumulated value determines the single examination week using total number of days according to the drug of the single examination period Nei Ge Drug in phase uses total number of days accumulated value；
The doctor to be monitored is determined using total number of days accumulated value according to the odd-numbered day average daily drug expenditure accumulated value and the drug Treat the average daily drug expenditure of unit.
6. the method according to claim 3 or 4, which is characterized in that it is described according to described with the sufferer for including in effective prescription Information determines that the sufferer quantity corresponding to effective prescription includes:
The sufferer information included in effective prescription is obtained, and the effective prescription institute needle is determined according to the sufferer information Pair sufferer person-time, wherein one with effective prescription be directed to a sufferer person-time；
The sufferer person-time is determined as the sufferer quantity corresponding to effective prescription.
7. according to the method described in claim 6, it is characterized in that, described true according to the medicine information and the sufferer quantity The day for human beings equal drug expenditure of the medical institutions to be monitored includes: calmly
It is determined according to the medicine information described with drug sum included in effective prescription and the medical institutions to be monitored Average daily drug expenditure；
The people of the medical institutions to be monitored is determined according to the average daily drug expenditure, the sufferer quantity and the drug sum Average daily drug expenditure.
8. method according to claim 1 or 2, which is characterized in that described each included by the medicine information The medicine information of similar drug determines that the target medicine in effective prescription includes:
The medicine information with each similar drug included in effective prescription, all kinds of medicines are determined according to the medicine information Number of days is used including at least the Sales Volumes of each similar drug and drug in the medicine information of product；
The drug total value with similar drug any in effective prescription and institute are determined according to the medicine information of each similar drug The drug for stating any similar drug uses total number of days；
It is determined according to the drug of the drug total value of any similar drug and any similar drug using total number of days described any The average daily drug expenditure of single medicine of similar drug is to obtain the average daily drug expenditure of single medicine of each similar drug；
The average daily drug expense of the corresponding single medicine of effective prescription is determined according to the average daily drug expenditure of single medicine of each similar drug It is more than or equal to the average daily drug expenditure threshold value of single medicine with threshold value, and by the average daily drug expenditure of medicine single in each similar drug Drug be determined as the target medicine in effective prescription.
9. according to the method described in claim 8, it is characterized in that, the medicine information according to each similar drug is determined The target medicine includes: with the target medicine ratio of effective prescription described
The drug total value with drugs all in effective prescription and described is determined according to the medicine information of each similar drug With the target medicine total value of the target medicine included in effective prescription；
The target medicine with effective prescription is determined according to the drug total value of all drugs and the target medicine total value Ratio；
Wherein, the target medicine ratio meets:
Target medicine ratio=target medicine total value/all drugs drug total value.
10. -9 described in any item methods according to claim 1, which is characterized in that described according to the average daily drug expenditure, institute The day for human beings equal drug expenditure and the target medicine ratio are stated, determines whether the drug expenditure of the medical institutions to be monitored is exceeded Include:
The average daily drug expenditure of the medical institutions to be monitored is determined according to the unit attribute information of the medical institutions to be monitored Threshold value, the day for human beings equal drug expenditure threshold value and target medicine proportion threshold value；
If the average daily drug expenditure is greater than the average daily drug expenditure threshold value, the average daily drug expenditure is determined as exceeded Drug utilization index parameter；And/or
If the day for human beings equal drug expenditure is greater than the day for human beings equal drug expenditure threshold value, the day for human beings equal drug expenditure is determined For exceeded Drug utilization index parameter；And/or
It is exceeded by the target medicine ratio-dependent if the target medicine ratio is greater than the target medicine proportion threshold value Drug utilization index parameter；
Referred to according to the exceeded medication in the average daily drug expenditure, the day for human beings equal drug expenditure and the target medicine ratio Mark parameter determines whether the drug expenditure of the medical institutions to be monitored is exceeded；
Wherein, the unit attribute information of the medical institutions to be monitored includes flat type, city locating for region, unit locating for unit One of city, unit drugs supply channel and unit sufferer person-time are a variety of.
11. according to the method described in claim 10, it is characterized in that, described according to the average daily drug expenditure, the day for human beings Exceeded Drug utilization index parameter in equal drug expenditure and the target medicine ratio determines the medicine of the medical institutions to be monitored Whether product expense is exceeded to include:
If including one or more in the average daily drug expenditure, the day for human beings equal drug expenditure and the target medicine ratio The exceeded Drug utilization index parameter of item, it is determined that the drug expenditure of the medical institutions to be monitored is exceeded；
If the average daily drug expenditure is less than or equal to the average daily drug expenditure threshold value, the day for human beings equal drug expenditure is less than Or it is equal to the day for human beings equal drug expenditure threshold value and the target medicine ratio and is less than or equal to the target medicine ratio Threshold value, it is determined that the drug expenditure of the medical institutions to be monitored is not exceeded.
12. according to the method described in claim 10, it is characterized in that, described be based on the average daily drug expenditure, the day for human beings Equal drug expenditure and the target medicine ratio carry out the medical institutions to be monitored exceeded with the drug expenditure of effective prescription Risk control include:
By the exceeded Drug utilization index in the average daily drug expenditure, the day for human beings equal drug expenditure and the target medicine ratio Parameter carries out publicity, the medication of medical institutions' control evolution to be monitored described in the exceeded Drug utilization index parameter prompts based on publicity, With the exceeded risk control of the drug expenditure of realization effective prescription；And/or
The exceeded Drug utilization index parameter is exceeded to the difference of the corresponding Drug utilization index parameter threshold of the exceeded Drug utilization index parameter Value carries out publicity, and the difference based on publicity prompts the medication of medical institutions' control evolution to be monitored, to realize medication The exceeded risk control of the drug expenditure of prescription；And/or
When receiving the exceeded Drug utilization index parameter and/or the corresponding drug expenditure reimbursement of the difference is requested, refuse institute Drug expenditure reimbursement request is stated to realize the risk control for using the drug expenditure of effective prescription exceeded.
13. a kind of drug expenditure risk of exceeding criterion control device based on data processing, which is characterized in that described device includes:
Data capture unit for obtaining the use effective prescription of medical institutions to be monitored, and obtains described with included in effective prescription Medicine information；
Medicine information processing unit, the medicine information for being obtained according to the data capture unit determine described to be monitored The average daily drug expenditure of medical institutions；
Medicine information processing unit is also used to be obtained according to the data capture unit described with the sufferer for including in effective prescription Information determines the sufferer quantity corresponding to effective prescription, according to the medicine information and the sufferer quantity determine it is described to Monitor the day for human beings equal drug expenditure of medical institutions；
Medicine information processing unit is also used to be determined according to the medicine information of each similar drug included in the medicine information The target medicine in effective prescription, and determine the target medicine in the use according to the medicine information of each similar drug Target medicine ratio in effective prescription；
Medication monitoring unit, the average daily drug expenditure, the day for human beings for being determined according to the medicine information processing unit Equal drug expenditure and the target medicine ratio, determine whether the drug expenditure of the medical institutions to be monitored is exceeded；
Drug risk control unit, the drug expenditure for determining the medical institutions to be monitored in the medication monitoring unit are super When mark, based on the average daily drug expenditure, the day for human beings equal drug expenditure and the target medicine ratio to described to be monitored Medical institutions carry out the risk control exceeded with the drug expenditure of effective prescription.
14. a kind of terminal device, which is characterized in that including processor and memory, the processor and memory are connected with each other, Wherein, the memory is for storing computer program, and the computer program includes program instruction, and the processor is configured For calling described program to instruct, such as the described in any item methods of claim 1-12 are executed.
15. a kind of computer readable storage medium, which is characterized in that be stored with computer in the computer readable storage medium Program, the computer program include program instruction, and described program instruction when being executed by a processor executes the processor Such as the described in any item methods of claim 1-12.
CN201811228496.2A 2018-10-22 2018-10-22 Drug expenditure risk of exceeding criterion control method and device based on data processing Pending CN109524075A (en)

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