CN114496184A - DRG intelligent supervision and analysis evaluation system - Google Patents
DRG intelligent supervision and analysis evaluation system Download PDFInfo
- Publication number
- CN114496184A CN114496184A CN202111581895.9A CN202111581895A CN114496184A CN 114496184 A CN114496184 A CN 114496184A CN 202111581895 A CN202111581895 A CN 202111581895A CN 114496184 A CN114496184 A CN 114496184A
- Authority
- CN
- China
- Prior art keywords
- credit
- statistical
- violation
- generating
- nurses
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
- 238000011156 evaluation Methods 0.000 title claims abstract description 13
- 238000007619 statistical method Methods 0.000 claims abstract description 15
- 241000208340 Araliaceae Species 0.000 description 6
- 235000005035 Panax pseudoginseng ssp. pseudoginseng Nutrition 0.000 description 6
- 235000003140 Panax quinquefolius Nutrition 0.000 description 6
- 235000008434 ginseng Nutrition 0.000 description 6
- 238000010586 diagram Methods 0.000 description 4
- 230000004075 alteration Effects 0.000 description 1
- 230000006399 behavior Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000005457 optimization Methods 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
Images
Classifications
-
- 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
-
- 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
- G06Q10/0639—Performance analysis of employees; Performance analysis of enterprise or organisation operations
- G06Q10/06393—Score-carding, benchmarking or key performance indicator [KPI] analysis
-
- 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
- G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
- G06Q40/08—Insurance
Landscapes
- Business, Economics & Management (AREA)
- Engineering & Computer Science (AREA)
- Human Resources & Organizations (AREA)
- General Business, Economics & Management (AREA)
- Strategic Management (AREA)
- Economics (AREA)
- Development Economics (AREA)
- Physics & Mathematics (AREA)
- Marketing (AREA)
- Finance (AREA)
- Accounting & Taxation (AREA)
- Theoretical Computer Science (AREA)
- Educational Administration (AREA)
- General Physics & Mathematics (AREA)
- Entrepreneurship & Innovation (AREA)
- Health & Medical Sciences (AREA)
- Epidemiology (AREA)
- Biomedical Technology (AREA)
- Operations Research (AREA)
- Quality & Reliability (AREA)
- Tourism & Hospitality (AREA)
- Game Theory and Decision Science (AREA)
- Primary Health Care (AREA)
- General Health & Medical Sciences (AREA)
- Medical Informatics (AREA)
- Public Health (AREA)
- Technology Law (AREA)
- Medical Treatment And Welfare Office Work (AREA)
Abstract
The invention relates to a DRG intelligent supervision and analysis evaluation system, which comprises: the login module is used for carrying out authentication login; and the credit data statistical analysis module is used for carrying out data statistics and displaying the credit values of the medical institutions, the doctors, the nurses, the participators, the medical institution, the doctors, the nurses, the participators, the violation indexes of the medical institutions, the violation indexes of the doctors, the violation indexes of the nurses and the participators according to the statistical data. The credit values of medical institutions, doctors, nurses, the credit values of the insured persons, the credit levels of the medical institutions, the doctors, the nurses, the credit levels of the insured persons, the violation indexes of the medical institutions, the violation indexes of the doctors, the violation indexes of the nurses and the violation indexes of the insured persons are monitored in all directions so as to be processed in time, and therefore the benign development of the insured persons is effectively guaranteed.
Description
Technical Field
The invention relates to the field of medical management, in particular to a DRG intelligent supervision and analysis evaluation system.
Background
Medical insurance generally refers to basic medical insurance, and is a social insurance system established to compensate economic losses of workers due to disease risks. In the medical insurance social system, due to lack of effective supervision measures, there may be illegal behaviors, such as prescription of a ginseng insurance person without illness, overdose prescription of a doctor, etc., which seriously affect the balance of the medical insurance fund and infringe the benefits of other ginseng insurance persons.
Disclosure of Invention
The invention aims to provide a DRG intelligent supervision and analysis evaluation system to overcome the defects in the prior art.
The technical scheme for solving the technical problems is as follows:
a DRG intelligent supervision and analysis evaluation system comprises:
the login module is used for carrying out authentication login;
and the credit data statistical analysis module is used for carrying out data statistics and displaying the credit values of the medical institutions, the doctors, the nurses, the participators, the medical institution, the doctors, the nurses, the participators, the violation indexes of the medical institutions, the violation indexes of the doctors, the violation indexes of the nurses and the participators according to the statistical data.
On the basis of the technical scheme, the invention can be further improved as follows.
Further, the credit value of the medical institution, the credit value of the doctor, the credit value of the nurse, the credit value of the insured person, the credit level of the medical institution, the credit level of the doctor, the credit level of the nurse, the credit level of the insured person, the violation index of the medical institution, the violation index of the doctor, the violation index of the nurse and the violation index of the insured person are respectively displayed in a chart form.
Further, the credit data statistical analysis module comprises:
the medical institution credit score statistical unit is used for generating a credit score statistical chart and a credit list of all medical institutions in the region;
the physician credit score counting unit is used for generating a statistical graph and a credit statement of the average credit scores of all physicians in the region, and a statistical graph and a credit statement of the credit scores of all physicians per month;
the nurse credit score counting unit is used for generating a statistical chart of the average credit scores of all nurses in each institution of the region and a credit detail table, and a statistical chart of the credit scores of each nurse in each month and the credit detail table;
and the credit score counting unit of the insured person is used for generating a monthly average credit score statistical chart and a credit detail table of all the insured persons in the region, and the monthly credit score statistical chart and the credit detail table of each insured person.
Further, the credit data statistical analysis module further comprises:
the medical institution credit grade statistical unit is used for generating a credit grade statistical chart and a credit grade list of all medical institutions in the area;
the physician credit rating statistical unit is used for generating a statistical map of all physician credit ratings in the area and a credit rating list;
a nurse credit rating statistical unit for generating a statistical chart of the credit rating of all nurses in each institution in the area and a credit rating list;
and the credit rating statistical unit is used for generating a credit rating statistical chart and a credit rating list of all the insured persons in the area.
Further, the credit data statistical analysis module further comprises:
the medical institution violation index statistical unit is used for generating a statistical graph and a statistical table of violation indexes of each institution in the region;
the doctor violation index statistical unit is used for generating a doctor violation index statistical graph and a violation index statistical table in the area;
the nurse violation index statistical unit is used for generating a violation index statistical chart and a violation index statistical table of the guard in the region;
and the parameter protection violation index statistical unit is used for generating a parameter protection violation index statistical graph and a violation index statistical table in the region.
The invention has the beneficial effects that: the credit values of medical institutions, doctors, nurses, the credit values of the insured persons, the credit levels of the medical institutions, the doctors, the nurses, the credit levels of the insured persons, the violation indexes of the medical institutions, the violation indexes of the doctors, the violation indexes of the nurses and the violation indexes of the insured persons are monitored in all directions so as to be processed in time, and therefore the benign development of the insured persons is effectively guaranteed.
Drawings
FIG. 1 is a structural diagram of the DRG intelligent supervision and analysis evaluation system of the invention;
FIG. 2 is a diagram of a portion of a credit data statistics module according to the present invention;
FIG. 3 is a partial block diagram of a credit data statistics analysis module according to the invention;
fig. 4 is a partial structural diagram of the credit data statistical analysis module according to the invention.
Detailed Description
The principles and features of this invention are described below in conjunction with the following drawings, the examples of which are set forth to illustrate the invention and are not intended to limit the scope of the invention.
Example 1
As shown in fig. 1, a DRG intelligent supervision and analysis evaluation system includes:
the login module is used for carrying out authentication login;
the credit data statistical analysis module is used for carrying out data statistics and displaying a credit value of a medical institution, a credit value of a doctor, a credit value of a nurse, a credit value of a insured person, a credit level of the medical institution, a credit level of the doctor, a credit level of the nurse, a credit level of the insured person, a violation index of the medical institution, a violation index of the doctor, a violation index of the nurse and a violation index of the insured person according to the statistical data;
the credit data statistical analysis module can be accessed by authenticating a login on the login module.
Example 2
This example is a further optimization performed on the basis of example 1, and specifically includes the following:
the credit values of medical institutions are displayed in a chart form, the credit values of doctors are displayed in a chart form, the credit values of nurses are displayed in a chart form, the credit values of insured persons are displayed in a chart form, the credit levels of medical institutions are displayed in a chart form, the credit levels of doctors are displayed in a chart form, the credit levels of nurses are displayed in a chart form, the credit levels of insured persons are displayed in a chart form, the violation indicators of medical institutions are displayed in a chart form, the violation indicators of doctors are displayed in a chart form, the violation indicators of nurses are displayed in a chart form, and the violation indicators of insured persons are displayed in a chart form.
Example 3
As shown in fig. 2, this embodiment is further optimized based on embodiment 2, and the specific details thereof are as follows:
the credit data statistical analysis module comprises:
the credit score counting unit of the medical institution selects the year, the institution grade, the institution name and the institution code to generate a credit score counting chart and a credit detail table of the regional medical institution, the credit score detail of the medical institution can be checked through details, and in addition, the Excel credit score detail table can be derived from all information;
a physician credit score counting unit which selects the year to generate a statistical chart and a credit detail table of average credit scores of all physicians in the area, inputs the name of the physician to generate a statistical chart and a credit detail table of the credit score of the physician in each month, and can check the credit score detail of the physician according to the details, and in addition, each information can derive an Excel credit score detail table;
a nurse credit value counting unit for selecting the year and the medical institution to generate a statistical chart and a credit list of the average credit value of all nurses in the institution, and inputting the name or the code of a nurse to generate a statistical chart and a credit list of the credit value of each month of the nurse, wherein the credit value list of the nurse can be checked according to the details, and in addition, each information can be led out of an Excel credit value list;
the credit score counting unit of the insured person selects the year to generate an average credit score counting chart and a credit detail list of each month of all the insured persons in the area, the credit score counting chart and the credit detail list of each month of the insured person can be generated by inputting the name or the identity card of the insured person, the credit score detail of the insured person can be checked through details, and in addition, the Excel credit score detail list can be derived from all information.
Example 4
As shown in fig. 3, this embodiment is further optimized based on embodiment 2 or 3, and it is specifically as follows:
the credit data statistical analysis module further comprises:
the credit rating statistical unit of the medical institution selects the year to generate a credit rating statistical chart and a credit rating list of all the medical institutions in the area, selects the year and inputs the institution name to generate the credit rating statistical chart and the credit rating list of the medical institution, and the Excel rating list can be derived from the information;
the physician credit rating counting unit selects the year to generate all physician credit rating statistical graphs and credit rating lists in the area, selects the year and inputs the name of the physician to generate the physician credit rating statistical graphs and the credit rating lists, and the Excel rating lists can be derived from the information;
a nurse credit rating counting unit for generating a credit rating counting chart and a credit rating list of all nurses of each institution in the area by selecting the year, generating the credit rating counting chart and the credit rating list by selecting the year and inputting the name of a nurse, and deriving the Excel rating list by the information;
and the credit rating counting unit of the insured person selects the year to generate a credit rating counting chart and a credit rating detail table of all the insured persons in the area, selects the year and the area name or inputs the insured person name and the identity card number to generate the credit rating counting chart and the credit rating detail table of the insured person, and the Excel rating detail table can be derived from the information.
Example 5
As shown in fig. 4, this embodiment is further optimized based on embodiment 2, 3 or 4, and it specifically includes the following steps:
the credit data statistical analysis module further comprises:
the medical institution violation index statistical unit is used for selecting the year to generate various violation index statistical graphs and violation index statistical tables of the mechanism in the region, selecting the year, month and mechanism name to generate various violation index statistical graphs and violation index statistical tables of the mechanism, and the information can be used for deriving an Excel violation index detail table;
the physician violation index counting unit is used for generating a physician violation index statistical graph and a violation index statistical table in the area by selecting the year, the month and the physician name, and deriving an Excel violation index detail table according to the information;
the nurse violation index counting unit selects the year to generate a violation index counting chart and a violation index counting table of the security of the region, selects the year, the month and the name of the nurse to generate the violation index counting chart and the violation index counting table of the nurse, and the information can lead out an Excel violation index detail table;
and the ginseng insurance violation index statistical unit selects the year to generate a ginseng insurance violation index statistical graph and a violation index statistical table in the region, selects the year, the month and the name of the ginseng insurance to generate the ginseng insurance violation index statistical graph and the violation index statistical table, and the information can derive an Excel violation index detail table.
Although embodiments of the present invention have been shown and described above, it should be understood that the above embodiments are exemplary and not to be construed as limiting the invention, and that changes, modifications, substitutions and alterations can be made to the above embodiments by those of ordinary skill in the art within the scope of the invention.
Claims (5)
1. A DRG intelligent supervision and analysis evaluation system is characterized by comprising:
the login module is used for carrying out authentication login;
and the credit data statistical analysis module is used for carrying out data statistics and displaying the credit values of the medical institutions, the doctors, the nurses, the participators, the medical institution, the doctors, the nurses, the participators, the violation indexes of the medical institutions, the violation indexes of the doctors, the violation indexes of the nurses and the participators according to the statistical data.
2. The DRG intelligent supervision, analysis and evaluation system according to claim 1, wherein the medical institution credit score, physician credit score, nurse credit score, insured person credit score, medical institution credit rating, physician credit rating, nurse credit rating, insured person credit rating, medical institution violation index, physician violation index, nurse violation index, and insured person violation index are respectively displayed in a graph form.
3. The intelligent DRG supervision, analysis and evaluation system according to claim 1 or 2, wherein the credit data statistical analysis module comprises:
the medical institution credit score statistical unit is used for generating a credit score statistical chart and a credit list of all medical institutions in the region;
the physician credit score counting unit is used for generating a statistical graph and a credit statement of the average credit scores of all physicians in the region, and a statistical graph and a credit statement of the credit scores of all physicians per month;
the nurse credit score counting unit is used for generating a statistical chart of the average credit scores of all nurses in each institution of the region and a credit detail table, and a statistical chart of the credit scores of each nurse in each month and the credit detail table;
and the credit score counting unit of the insured person is used for generating a monthly average credit score statistical chart and a credit detail table of all the insured persons in the region, and the monthly credit score statistical chart and the credit detail table of each insured person.
4. The DRG intelligent supervision, analysis and evaluation system according to claim 1, 2 or 3, wherein the credit data statistical analysis module further comprises:
the medical institution credit grade statistical unit is used for generating a credit grade statistical chart and a credit grade list of all medical institutions in the area;
the physician credit rating statistical unit is used for generating a statistical map of all physician credit ratings in the area and a credit rating list;
a nurse credit rating statistical unit for generating a statistical chart of the credit rating of all nurses in each institution in the area and a credit rating list;
and the credit rating statistical unit is used for generating a credit rating statistical chart and a credit rating list of all the insured persons in the area.
5. The intelligent DRG supervision, analysis and evaluation system according to claim 3, wherein the credit data statistical analysis module further comprises:
the medical institution violation index statistical unit is used for generating a statistical graph and a statistical table of violation indexes of each institution in the region;
the doctor violation index statistical unit is used for generating a doctor violation index statistical graph and a violation index statistical table in the area;
the nurse violation index statistical unit is used for generating a violation index statistical chart and a violation index statistical table of the guard in the region;
and the parameter protection violation index statistical unit is used for generating a parameter protection violation index statistical graph and a violation index statistical table in the region.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111581895.9A CN114496184A (en) | 2021-12-22 | 2021-12-22 | DRG intelligent supervision and analysis evaluation system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111581895.9A CN114496184A (en) | 2021-12-22 | 2021-12-22 | DRG intelligent supervision and analysis evaluation system |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN114496184A true CN114496184A (en) | 2022-05-13 |
Family
ID=81493861
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202111581895.9A Pending CN114496184A (en) | 2021-12-22 | 2021-12-22 | DRG intelligent supervision and analysis evaluation system |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN114496184A (en) |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110797115A (en) * | 2019-10-26 | 2020-02-14 | 曹庆恒 | Intelligent recommended medical examination and inspection method, system and equipment |
| CN112700873A (en) * | 2020-12-28 | 2021-04-23 | 西安科锐盛创新科技有限公司 | Intelligent nursing information interaction system |
| CN113743783A (en) * | 2021-09-03 | 2021-12-03 | 泰康保险集团股份有限公司 | Credit evaluation method and device for medical institution |
-
2021
- 2021-12-22 CN CN202111581895.9A patent/CN114496184A/en active Pending
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN110797115A (en) * | 2019-10-26 | 2020-02-14 | 曹庆恒 | Intelligent recommended medical examination and inspection method, system and equipment |
| CN112700873A (en) * | 2020-12-28 | 2021-04-23 | 西安科锐盛创新科技有限公司 | Intelligent nursing information interaction system |
| CN113743783A (en) * | 2021-09-03 | 2021-12-03 | 泰康保险集团股份有限公司 | Credit evaluation method and device for medical institution |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CN108492196B (en) | Wind control method for deducing medical insurance violation behavior through data analysis | |
| Gupta et al. | Burden of allergic disease in the UK: secondary analyses of national databases | |
| Jacob et al. | Economics of collaborative care for management of depressive disorders: a community guide systematic review | |
| Thomas et al. | Low costs of defensive medicine, small savings from tort reform | |
| World Health Organization | Global monitoring report on financial protection in health 2021 | |
| US11127498B2 (en) | Intelligent alert suppression | |
| CN104182824A (en) | Rule checking system and rule checking method for recognizing medical insurance reimbursement violations | |
| Grašič et al. | Paying for the quantity and quality of hospital care: the foundations and evolution of payment policy in England | |
| Arab-zozani | Health sector evolution in Iran; a short review | |
| Poghosyan et al. | The economic impact of the expansion of nurse practitioner scope of practice for Medicaid | |
| Azeez et al. | Towards universal health coverage: an analysis of the health insurance coverage in Nigeria | |
| CN114496184A (en) | DRG intelligent supervision and analysis evaluation system | |
| Yu | Studying the health care systems in seven East Asian countries by the cluster analysis | |
| CN111582879A (en) | Anti-fraud medical insurance identification method based on genetic algorithm | |
| Friebel et al. | Assessing The Dangers Of A Hospital Stay For Patients With Developmental Disability In England, 2017–19: Study examines the dangers for patients with developmental disability who stay in a National Health Service hospital in England. | |
| Rój | Improvement of Equality in the Distribution of Human Resources in Polish Healthcare | |
| Souetre et al. | Methodological approaches to pharmaco‐economics | |
| Oyem et al. | Recognizing the Sex Disparity in Surgeons Performing Total Knee Arthroplasty | |
| Nguyen-Feng et al. | Disparities in hospital services utilization among patients with mental health issues: A statewide example examining insurance status and race factors from 1999-2010 | |
| Du et al. | Application of Isolation Forest Algorithm in Fraud Detection of Medical Insurance Big Data | |
| Moore | The Philippines’ Universal Healthcare Policy (Kalusugan Pangkalahatan) and the Poor | |
| Kingshill | Finding Parity Through Preclusion: Novel Mental Health Parity Solutions at the State Level | |
| Wan et al. | Mining medical claims data with exploratory to confirmatory statistical methods | |
| Harper | Trust Me I'm a Doctor: The struggle over scope of practice and its effect on health care fraud and abuse | |
| Puteh et al. | The Common Types of Health Insurance Fraud among Insured and Healthcare Provider |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| RJ01 | Rejection of invention patent application after publication | ||
| RJ01 | Rejection of invention patent application after publication |
Application publication date: 20220513 |