CN109119143A - Medical service quality control method and quality management plateform system, electronic device - Google Patents

Medical service quality control method and quality management plateform system, electronic device Download PDF

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CN109119143A
CN109119143A CN201810298753.3A CN201810298753A CN109119143A CN 109119143 A CN109119143 A CN 109119143A CN 201810298753 A CN201810298753 A CN 201810298753A CN 109119143 A CN109119143 A CN 109119143A
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刘振民
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    • G06Q10/06395Quality analysis or management

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Abstract

The present invention discloses a kind of medical service quality control method, a kind of the quality management of medical service plateform system and a kind of electronic device, this method includes the quality of medical services being divided into multiple value grades, and establish medical service prices system according to value grade;Setting value grade evaluation parameter and record Medical service information;According to the historical record of Medical service information and value grade evaluation parameter, the current value grade of each evaluation object is generated;According to the current value grade of each evaluation object, the current medical service price of each evaluation object is generated.It uses objective indicator to dynamically distribute value grade and service price for user, it can achieve the effect that medical worker and medical institutions' progress character surveillance, improve medical level, reduce patient charge list use and shorten the disease treatment time, be of great importance to the social medical level of promotion.

Description

Medical service quality control method and quality management plateform system, electronic device
Technical field
The present invention relates to field of medical service more particularly to a kind of medical service quality control method and a kind of medical services Quality management plateform system and a kind of electronic device.
Background technique
The concept of medical service quality is so far still without unified definition.There is more to Health Service Quality by domestic and foreign scholars The explanation of sample, American Medical Association is the study found that have as many as 100 kinds (Friedman, 1995) to the explanation of Health Service Quality. Wherein, it is widely recognized that Donabedian was proposed in 1988: " medical service quality, which refers to, utilizes reasonable method Realize the ability of expectation target (restore patient's physical and mental health and satisfactory) ".In addition, American National medical association is to Health Services The definition of quality also has certain representativeness: " medical service quality is that medical services increase individual and group expectation health produces Possibility degree out is the degree that is consistent of medical services with level of expertise ".Although the two explain that statement is different, all Reflect two important medical service quality theories, it may be assumed that medical services are from " supplier's guiding " (Provide Orientation) the transformation to " patient's guiding " (Patient Orientation): medical service quality is exactly medical services The degree achieved in terms of restoring patient's physical and mental health and enabling patient satisfaction.With the continuous development of hygiene industry and perfect, Robert H.Brook etc. summarize to the definition of Health Service Quality and illustrated again, he thinks all Health Service Quality bases This is comprising there are two basic constituent elements: technical quality, service quality.Technical quality refers mainly to the inherence of medical and health services Quality, such as the main content related with medical and health services provider of safety, validity and efficiency;Service quality is then main Comprising fairness, the related external quality of demander (patient) of accessibility etc. and medical services, the two collectively forms one completely Health Service Quality system.
For a long time, it is a kind of meet market mechanism and can allow both sides of supply and demand approve medical service quality method of controlling not It sets up.And existing medical service prices cannot fully consider both sides of supply and demand by being then based on cost calculation price Demand, because due to cannot solve the conflict between doctors and patients to become increasingly conspicuous, or even deepened conflict between doctors and patients.
Therefore it provides a kind of can be approved by both sides of supply and demand, can solve being simple and efficient for the conflict between doctors and patients to become increasingly conspicuous again Medical service quality method of controlling, it has also become urgent need in the industry.
Summary of the invention
A kind of medical service quality control method is provided based on the above discovery and research, the present invention, it can be to medical services Quality is judged, to exercise supervision and control to medical service quality, is facilitated by evaluating and supervising raising medical services Horizontal and effective solution conflict between doctors and patients.Medical service quality control method provided in an embodiment of the present invention, comprising:
The quality of medical services is divided into multiple value grades;
Setting value grade evaluation parameter and record Medical service information;
According to the historical record of Medical service information and value grade evaluation parameter, the current value etc. of evaluation object is generated Grade.
Thus, it is possible to record according to the real work of medical worker, its technical level and service quality are evaluated, and according to it Technical level and service quality carry out value evaluation for it, help to improve social medical service quality.
In some embodiments, this method further includes distributing priority for the value grade evaluation parameter of setting, in root According to the historical record and value grade evaluation parameter of Medical service information, when generating the current value grade of the evaluation object, choosing The value grade evaluation parameter taken is determined according to the priority of value grade evaluation parameter.Wherein, priority can be set to wrap Social average priority, diagnosis and treatment science extension programme priority and system priority are included, social average priority is higher than diagnostics Art extension programme priority, diagnosis and treatment science extension programme priority are higher than system priority.It can thus configure according to demand Multiple and different value grade evaluation parameter and be that it distributes corresponding priority, to select suitable value etc. according to priority Grade evaluation parameter carries out the evaluation of value grade, and the parameter by distribution priority adjustment for evaluation can more tally with the actual situation And social demand.
In some embodiments, when the value grade evaluation parameter chosen according to priority is cost of medical service, according to With value grade evaluation parameter, the current value grade for generating each evaluation object includes: the historical record of Medical service information
It is obtained from medical record of service information according to the grade evaluation parameter of cost of medical service including evaluation object ID, treatment Disease, service charge, diagnosis and treatment expense and other expense, the diagnosis and therapy recording information of behavior should occur;
The treatment disease to be evaluated for obtaining evaluation object is currently commented according to evaluation object ID and treatment disease to be evaluated acquisition It is certain to calculate this according to the service charge of acquisition, diagnosis and treatment expense for service charge, the diagnosis and treatment expense of same disease in the regular period of valence object The average value of the cost of medical service of same disease in period;
System same period cost of medical service average value corresponding with treatment disease to be evaluated is obtained, according to the calculated regular period The average value and system same period cost of medical service average value of the cost of medical service of interior same disease generate the current value etc. of evaluation object Grade generates the current value grade of the evaluation object.
A kind of disease according to the principle of accurate medical treatment, clinical path be it is certain, therapeutic scheme is also certain , doctor is in diagnosis and treatment process, though there is deviation, by the meticulous judgement of doctor and technology, is infinitely close to true value.This Inventive embodiments do baseline with social average value, and the medical treatment that the dynamic evaluation competition by being worth grade provides medical worker takes The cost of medical service of business is infinitely close to true value, facilitates the raising of the technical level and service quality of doctor, so as to smart Heart diagnosis and science propose therapeutic scheme, so as to so that the treatment cost of patient constantly declines, while accurately having measured medical treatment The quality of service, and this quality scale determines the price of medical services, closes than executing medical service prices project specification Reason is effective more.Wherein, cost of medical service has included at least diagnosis expense and drug therapy expense, controls diagnosis expense, then makes to face Bed path is shorter, advantageously accounts for over-treatment;And the control of drug therapy expense, then it advantageously accounts for drug abuse and does not conform to The problem of managing medication.
In some embodiments, according to the average value of the cost of medical service of the same disease in the calculated regular period and it is The current value grade that system same period cost of medical service average value generates evaluation object generates the current value grade packet of the evaluation object It includes:
The value grade for obtaining the evaluation object judged,
When the value grade of the evaluation object is the maximum value grade lower than setting and the same disease in the regular period The average value of cost of medical service continuous certain time is lower than the certain percentage of system same period cost of medical service average value, by the evaluation pair The value grade of elephant rises m grades and is used as current value grade;
When the value grade of the evaluation object is the minimum value grade higher than setting and the same disease in the regular period The average value of cost of medical service continuous certain time exceeds the certain percentage of system same period cost of medical service average value, by the evaluation pair The value grade of elephant drops m grades and is used as current value grade;
Wherein, 1≤m and m are less than the value grade quantity of division.
It is this by doing baseline in medical services with the average value of the whole cost of medical service of evaluation object and social average value, It is all to be lower than certain value, then the technical level of evaluation object and the accuracy of service quality are reflected, and be higher than certain value, then reflect Evaluation object level and service quality are to be improved, and with the value grade of this dynamic generation evaluation object and corresponding service Price, by this dynamic service price system, the quality for controlling medical services is continuously improved, and has reached patient or society The Quality Control purpose and effect that medical burden decline, evaluation object technical level are continuously improved.
In some embodiments, when the value grade evaluation parameter chosen according to priority is treatment cycle, according to With value grade evaluation parameter, the current value grade for generating the evaluation object includes: the historical record of Medical service information
It is obtained from medical record of service information according to the grade evaluation parameter for the treatment of cycle including evaluation object ID, treatment The diagnosis and therapy recording information of the cost of medical service and treatment cycle of disease and corresponding treatment disease,
Treatment disease to be evaluated is obtained, is obtained according to evaluation object ID and treatment disease to be evaluated corresponding with the evaluation object Regular period in identical treatment disease treatment cycle, the treatment cycle calculated in the regular period with treatment disease is average Value;
System concurrent treatment period average corresponding with treatment disease to be evaluated is obtained, according to the calculated regular period Interior treatment cycle average value and system concurrent treatment period average with treatment disease is judged, is generated according to judging result The current value grade of the evaluation object.
In the control process of medical service quality, should also it give one's full attention to because medical insufficient, caused treatment cycle is prolonged Long and over-treatment.By setting grade evaluation parameter for treatment cycle, medical worker can be rationally controlled to treatment disease Treatment cycle shorten treatment cycle to reach, keep away so as to seek and select more effective therapeutic scheme and drug Exempt from the purpose of over-treatment and drug abuse.
In some embodiments, value grade includes successively from low to high A, B, C, D, E Pyatyi, according to calculated one Treatment cycle average value and system concurrent treatment period average in the timing phase with treatment disease are judged, are tied according to judgement The current value grade that fruit generates the evaluation object includes:
When the treatment cycle average value continuous certain time in the regular period with treatment disease is lower than system concurrent treatment week Phase average value and its deviation from average are -100%, then set E grades for the current value grade of the evaluation object;
When the treatment cycle average value continuous certain time in the regular period with treatment disease is lower than system concurrent treatment week Phase average value and its deviation from average are -50%, set D grades for the current value grade of the evaluation object;
It is equal to system concurrent treatment week when the treatment cycle average value continuous certain time in the regular period with treatment disease Phase average value and its deviation from average are ± 50%, set C grades for the current value grade of the evaluation object;
It is higher than system concurrent treatment week when the treatment cycle average value continuous certain time in the regular period with treatment disease Phase average value and its deviation from average are 50%, set B grades for the current value grade of the evaluation object;
It is higher than system concurrent treatment week when the treatment cycle average value continuous certain time in the regular period with treatment disease Phase average value and its deviation from average are 100%, set A grades for the current value grade of the evaluation object.
It is this by doing baseline in medical services with the average value in the whole medical treatment period of solo practitioner and social average value, It is all to be lower than certain value, then the diagnosis and treatment scheme of doctor and the validity of medication are reflected, and be higher than certain value, then reflect medical matters people The diagnosis and treatment scheme of member and the irrationality of medication, and valence is serviced with the value grade of this dynamic generation medical worker and accordingly Lattice control the continuous improvement of medical service level by this dynamic service price system, have reached shortening patient treatment Period and the Quality Control purpose and effect for avoiding over-treatment and drug abuse.
It in some embodiments, is diagnosis and treatment science extension programme in the value grade evaluation parameter chosen according to priority When adopting rate, according to the historical record of Medical service information and value grade evaluation parameter, generate the current of the evaluation object It is worth grade further include:
It is obtained from medical record of service information according to the value grade evaluation parameter for adopting rate of diagnosis and treatment science extension programme The record information of the diagnosis and treatment science extension programme ID including evaluation object ID He the evaluation object is taken,
The ID for obtaining diagnosis and treatment science extension programme to be evaluated counts phase according to diagnosis and treatment science extension programme ID to be evaluated The diagnosis and treatment science extension programme answered adopts rate;
Obtain the value grade for issuing the evaluation object of the diagnosis and treatment science extension programme to be evaluated, according to adopt rate into Row judges, and the current value grade of the evaluation object is arranged according to judging result.
One more accurate clinical path and therapeutic scheme, it will allow millions upon millions of patients to be benefited, by examining science Extension programme is treated as evaluation index, the research and innovation enthusiasm of medical worker can be improved, improve the practicability of learning value, Help to improve social medical level.
In some embodiments, this method further includes the steps that calculating value of services for evaluation object, which includes:
Weighted index is distributed according to demand for the grade evaluation parameter of setting;
The medical services value of evaluation object is generated according to the grade evaluation parameter of setting and the weighted index of distribution, In, the grade evaluation parameter of setting include at least the treatment cycle to same disease, diagnosis and treatment science extension programme adopt rate and Cost of medical service.
Value of services amount of the rate by medical worker is adopted by treatment cycle, cost of medical service and diagnosis and treatment science extension programme Change, the value of embodiment medical worker that can be more simple and clear, and comprehensively considers three important fingers for influencing patient's overall condition Mark is quantified, and obtained value of services has more reference value, simplifies social whole medical treatment service quality control measure, letter It is single efficient.
In some embodiments, the method for medical service quality control is carried out further include: doctor is established according to value grade Treat service price system;And the current value grade according to evaluation object, generate the current medical service price of evaluation object. Medical service prices are formed based on medical service quality sufficiently to examine so that medical service prices match with medical service quality The demand of both sides of supply and demand is considered, i.e., demand and party in request (such as patient) of the medical supplier (such as medical worker) to value return are right The demand of expense and treatment cycle guarantees rationally effective medical service level, reduces social medical service cost.And according to It is worth evaluation result dynamic generation service price, has fully considered the demand of medical supplier and medical demand side, active balance Doctor-patient relationship.
In some embodiments, evaluation object includes medical worker, medical institutions and Medical Group, the medical services Price includes the service charge of medical worker, the charging standard of medical institutions or doctor group, the receipts of medical institutions or doctor group Take the medical insurance reimbursement ratio of grade and medical institutions or doctor group.Be not only able to as a result, to medical worker itself it is horizontal into Row evaluation and supervision, moreover it is possible to medical institutions and group be evaluated and be supervised, so that its service level and its toll level phase Hook, the community service for promoting entire medical service organ on the whole are horizontal.
The embodiment of the invention also provides a kind of the quality management of medical service plateform systems, including registration module, storage mould Block, value grade control module and service price output module, wherein registration module is configured to reception input information and is examined Core, and after the approval, information initializing and output auditing result are carried out to the medical worker currently registered, wherein information Initialization includes distribution initial value grade;Memory module is for storing value grade evaluation parameter, medical worker's information, medical treatment Information on services, value class information, medical service prices information corresponding with value grade and social public information;Value etc. Grade control module is configured to according to value grade evaluation parameter, medical worker's information, Medical service information and social public information Generate the current value grade of each medical worker;Service price output module is configured to the current value etc. according to each medical worker Grade, value class information and medical service prices information corresponding with value grade generate the current service valence of each medical worker Lattice.
The system provided through the embodiment of the present invention, medical worker can obtain reasonable valence by its service level and quality Value and affirmative, and patient can obtain according to demand and meet the good service that its value is paid, and effectively solve conflict between doctors and patients, improve Social medical service level reduces medical services burden, shortens the medical services period, avoid over-treatment and drug abuse.
In some embodiments, which further includes value of services computing module, is configured to the evaluation of value -capture grade Parameter and its weighted index, according to value grade evaluation parameter, weighted index and medical worker's information and Medical service information Export the medical services value of each medical worker.
By can more intuitively embody the technical level and Service Quality of medical worker for the Leakage in Value of medical worker Amount, is simple and efficient.
The embodiment of the invention also provides a kind of electronic devices comprising storage medium, execution unit and display unit are deposited The computer program for realizing preceding method or system above-mentioned is recorded on storage media, execution unit is for executing computer Program, display unit are used to receive peripheral operation and show the implementing result of execution unit.
Compared to the grade for determining medical service quality according to the academic title of the evaluations such as the time limit, paper, and according to curing Rate of rotation, prescription qualification rate, first class medical record rate, diagnosis rate on the 3rd, enters discharge diagnosis coincidence rate, outpatient service and discharge and examines salvage success rate Disconnected coincidence rate, preoperative and postoperative diagnostic accordance rate, average length of hospitalization, Bed utilization rate, bed rotation rate etc. quality control index, this hair The quality controling mode of medical quality control method and the quality management of medical service plateform system that bright embodiment provides can be more Add the practical treatment level and service quality for objectively reflecting medical worker, also can more fully consider the common need of doctor and patient It asks, more rationally effectively, helps to improve social medical level and reduce social medical burden.
Detailed description of the invention
Fig. 1 is the method flow diagram of the medical service quality control method of one embodiment of the present invention;
When Fig. 2 is that value grade evaluation parameter is set as cost of medical service, in medical service quality control method shown in FIG. 1 Generate the processing flow schematic diagram of the current value grade of each medical worker;
When Fig. 3 is that value grade evaluation parameter is set as treatment cycle, in medical service quality control method shown in FIG. 1 Generate the processing flow schematic diagram of the current value grade of each medical worker;
When Fig. 4 is that value grade evaluation parameter is set as simultaneously including cost of medical service and treatment cycle, medical treatment shown in FIG. 1 The processing flow schematic diagram of the current value grade of each medical worker is generated in method for controlling quality of service;
Fig. 5 is the medical service quality shown in FIG. 1 when value grade evaluation parameter is set as diagnosis and treatment science extension programme The processing flow schematic diagram of the current value grade of each medical worker is generated in control method;
Fig. 6 is the method flow diagram of the medical service quality control method of another embodiment of the present invention;
Fig. 7 is the circuit theory schematic diagram of the medical services plateform system of one embodiment of the present invention;
Fig. 8 is the circuit theory schematic diagram of the medical services plateform system of another embodiment of the present invention.
Specific embodiment
The invention will now be described in further detail with reference to the accompanying drawings.
Fig. 1 to Fig. 6 shows medical service quality control method of the invention.Fig. 1 schematically shows medical services The method flow of method of quality control, as shown in Figure 1, method includes the following steps:
Step S101: the quality of medical services is divided into multiple value grades, and medical treatment clothes are established according to value grade Business pricing system.
Value grade classification is carried out to the quality of medical services according to demand, goes mark evaluation pair with different value grades The technological service level and medical service quality of elephant.Later, according to the value grade of division, correspondence establishment and different value grades The medical service prices to match, to form medical service prices system according to value grade.In this manner it is possible to by real-time The value grade of evaluation evaluation object obtains the service price being consistent with value grade, so as to improve the medical treatment clothes under market mechanism Business price does not fully demonstrate the deficiency of evaluation object medical service quality.Wherein, it should be noted that in the embodiment of the present invention Evaluation object can be medical worker, be also possible to medical institutions, can also be Medical Group or other need to its medical treatment Technical level exercises supervision the object of evaluation, and the embodiment of the present invention is limited not to this.
Step S102: setting value grade evaluation parameter simultaneously stores.
In order to which effectively evaluating is evaluated the value grade of object such as medical worker, reasonable value grade in real time is obtained, Before being timed (such as evaluation cycle can be set to one month) evaluation to value grade, need to determine evaluation ginseng first Number.Those skilled in the art should be understood that when evaluating, the evaluation parameter of setting be the key that influence evaluation result because Therefore element can carry out the setting of evaluation parameter according to business demand and industry characteristic.The embodiment of the present invention is mainly applied to Medical service quality control, Real-Time Evaluation be the objects such as medical worker, medical institutions or Medical Group value grade, because This, will carry out the setting of value grade evaluation parameter according to doctor-patient relationship and doctors and patients' demand, that is, in the concrete realization, Ke Yigen It is worth grade evaluation parameter according to doctor-patient relationship and demand flexible setting, fully considers service provider and demand for services to reach Relationship and respective demand between side realize both balances contradiction, improve the purpose of social medical service level.Based on this hair Improving eyesight, in a particular embodiment, value grade evaluation parameter can be set according to different needs, such as social based on reducing The purpose of medical treatment cost, will value grade evaluation parameter be set as cost of medical service, later based on cost of medical service to evaluation object into The evaluation of row value grade, to achieve the purpose that reduce social medical treatment cost;It is for another example based on reducing treatment cycle and prevent The purpose of medical treatment is spent, treatment cycle can be set by value grade evaluation parameter, later according to treatment cycle to evaluation object The evaluation of value grade is carried out, to achieve the purpose that reduce treatment cycle;For another example based on improving social medical service level, Academic innovations or diagnosis and treatment science extension programme can be set to value grade evaluation parameter, with provide according to evaluation object Art innovation scheme or diagnosis and treatment science extension programme are worth grade to it and evaluate, to promote innovation and research and develop, and then improve Social medical service level etc..In addition, in a particular embodiment, can also be set to different evaluation objects according to its service feature Set different value grade evaluation parameters, thus reach the medical worker for really embodying different posies or different characteristic it is such as comprehensive or Specialized health mechanism or the value of Medical Group are horizontal, realize the purpose of precisely medical treatment control, such as to clinician by examining The two value grade evaluation parameters for the treatment of expense and treatment cycle are evaluated, and are commented by the value grade such as error rate docimaster Valence parameter is evaluated, and is adopted rate etc. by Irrational Use of Drugs recall rate and Pharmaceutical Service scheme to pharmacist and is worth grade evaluation ginseng Number is evaluated.The embodiment of the present invention does not limit the specific value grade evaluation parameter of setting, as long as in order to reach Corresponding medical services control purpose, and adaptable value evaluation parameter of equal value is arranged and is carried out with the value grade to evaluation object The scheme of Real-Time Evaluation is all considered as the specific implementation example based on present inventive concept, is regarded as falling into protection scope of the present invention.
Step S103: it obtains Medical service information and stores.
In order to which the value grade accurately to evaluation object carries out Real-Time Evaluation, evaluation result is made more to meet evaluation object Active service is horizontal, and the embodiment of the present invention will record the horizontal relevant medical treatment of the active service to evaluation object in the concrete realization Information on services is stored, so that the Appreciation gist by the Medical service information of record as value grade, reaches and more meet Actual conditions, evaluation result more accurately purpose.Wherein, believe to the horizontal relevant medical services of the active service of evaluation object Breath by taking evaluation object is medical worker as an example, such as may include medical worker's information, treatment information and social public information. And medical worker's information for example may include that medical worker ID, the value grade of the medical worker and the medical worker treat Treat Information ID;Treat information for example and may include treat Information ID, treatment disease information, the medical worker ID for treating the disease, Medication information corresponding with treatment disease information checks chemical examination information and treatment cycle information;Social public information includes each Price, the difference of the variety classes medical services such as drug, diagnosis and treatment and inspection chemical examination are treated the corresponding cost of medical service of disease and are controlled Treat the period.Wherein, the medical worker ID of medical worker's information and initial value grade carry out Initialize installation in registration, and are somebody's turn to do The treatment information of medical worker's treatment and the physical record for treating information then pass through medical worker during specific diagnosis and treatment It is recorded and stored in real time, social public information then can be both manually entered by administrative staff or be grabbed by the page It obtains, is mainly used for providing social average value based on big data.And when evaluation object is medical institutions or Medical Group, record Medical service information can also include medical institutions' information, for example including medical institutions ID, medical institutions' type and the doctor All medical worker ID etc. under mechanism are treated, it thus can be by commenting each medical worker synthesis under the medical institutions Valence, to evaluate the value grade of the medical institutions or Medical Group.And medical institutions' type can be training or synthesis, if it is When training, medical institutions are evaluated based on the training corresponding disease, and when to be comprehensive, then based on the doctor's under it General practice overall merit (i.e. to the synthesis of the evaluation information of all diseases) evaluates medical institutions.
Step S104: according to the historical record of Medical service information and value grade evaluation parameter, each evaluation object is generated Current value grade.
After having carried out above step, so that it may generate the current value grade of evaluation object in real time according to demand.Its In, timing is usually and generates current value grade January to can be and check and select the information of evaluation object in patient according to demand When, it is generated and is exported in real time according to the historical record of Medical service information and value grade evaluation parameter, it is fixed to be also possible to Shi Shengcheng and the current value grade (such as after daily working time) for updating each evaluation object, the embodiment of the present invention With no restriction to this.Wherein, current value etc. is generated according to the historical record of Medical service information and value grade evaluation parameter Grade, needs preferred value -capture grade evaluation parameter to be judged, determines relevant review number according to value grade evaluation parameter According to, and obtain from the historical record of Medical service information relevant evaluation data and (such as directly read, or pass through history and remember Record is calculated), and judged according to obtained relevant evaluation data, works as present value according to what judging result obtained evaluation object It is worth grade.Since the concrete processing procedure and value grade evaluation parameter that generate current value grade have important relationship, that is, work as valence Treatment process can change when value grade evaluation parameter difference, and therefore, the embodiment of the present invention is below in connection with specific value The setting example of grade evaluation parameter, is specifically addressed, however, those skilled in the art should understand that, due to value grade evaluation Parameter and Medical service information can be adjusted flexibly according to demand, and the embodiment of the present invention is impossible to exhaust, therefore, hereafter specific Embodiment is not construed as In Grade evaluation parameter and generates the limitation of the treatment process of current value grade.
Step S105: according to the current value grade of each evaluation object, the current medical service valence of each evaluation object is generated Lattice.
After the current value grade (i.e. value grade in real time) for obtaining evaluation object, so that it may according in step S101 The medical service prices system corresponding with value grade established obtains the current medical service valence for meeting evaluation object value Lattice.Such as current value grade it is relatively low when, according to the medical service prices system of foundation and value ratings match, the evaluation The current medical service price of object will be relatively low, and when current value grade is relatively high, the evaluation object it is current Medical service prices will be relatively high.Wherein, when evaluation object is medical worker, corresponding medical service prices can To be set as the service charge of medical worker, and when evaluation object is medical institutions or Medical Group, corresponding medical services Price then can be set to the mechanism or group charging standard toll level or medical insurance reimbursement ratio.
Pass through above step, so that it may which flexible setting is worth grade evaluation parameter according to demand, according to value grade evaluation Parameter and the actual medical record of service information of evaluation object carry out the evaluation of value grade in real time, to be worked as according to what is evaluated Preceding value grade generates its current medical service prices.Since in this way, the active service price of evaluation object is directly by its medical treatment Service level determines, according to its actual technical level and service quality, is worth grade and service price is all timing dynamic It generates, to achieve the purpose that the quality for controlling medical services, is more bonded the real work situation of evaluation object, effect is more It is good.Moreover, real standard based on evaluation object carries out price adjustment, can promote evaluation object promoted quality and level and It can guarantee that its real standard is consistent with real value, moreover it is possible to which the satisfaction for reaching patient (obtains phase by the consumption to match The service quality matched), integrally achieve the effect that balanced doctor-patient relationship, alleviate conflict between doctors and patients.It should be noted that actually answering In, according to demand, the evaluation of value grade, and the generation without service price, the embodiment of the present invention can also be only carried out Only optimum embodiment is described in detail, it will be appreciated by persons skilled in the art that being generated without service price In the case where, the evaluation that only design according to the present invention carries out value grade also should belong to protection scope of the present invention.
For Fig. 2 by taking evaluation object is medical worker as an example, grade evaluation parameter ought will be worth by, which showing, is set as cost of medical service, The concrete processing procedure of the current value grade of each medical worker is generated, as shown in Fig. 2, the treatment process includes:
Step S201: medical worker is obtained from Medical service information according to the value grade evaluation parameter of cost of medical service ID, treatment disease, doctor's service charge, diagnosis and treatment expense.
When value -capture grade evaluation parameter is judged, and judging result is cost of medical service, according to cost of medical service Evaluation parameter carries out respective handling, including acquisition medical worker's information, treatment information and society are public from Medical service information Information obtains its doctor's service charge according to the corresponding value grade of medical worker each in medical worker's information, and according to each medical matters The corresponding treatment acquisition of information of personnel medication information corresponding with treatment disease information checks that chemical examination information and treatment cycle are believed Then breath chemically examines the drug in information and social public information according to medication information and inspection and checks the relevant expense of chemical examination Medication information diagnosis and treatment expense corresponding with chemical examination information is checked is calculated, is thus obtained in the entire diagnosis and treatment history of each medical worker Diagnosis and treatment situation record, including medical worker ID, treatment disease, doctor's service charge, diagnosis and treatment expense.
Step S202: it is obtained according to medical worker ID and treatment disease same in the regular period corresponding with medical worker ID Doctor's service charge, the diagnosis and treatment expense of disease, and calculate according to doctor's service charge of acquisition, diagnosis and treatment expense the same disease in the regular period The monthly average value of the cost of medical service of kind.
After obtaining the corresponding diagnosis and treatment situation record of each medical worker by step S201, according to the disease currently to be evaluated Kind, obtained in the regular period from the diagnosis and treatment situation for the medical worker being evaluated record (such as three months, it can set according to demand Doctor's service charge, the diagnosis and treatment expense of same disease calmly) calculate a timing according to doctor's service charge of acquisition, diagnosis and treatment expense first The corresponding cost of medical service of each diagnosis and therapy recording in phase, wherein the corresponding cost of medical service of each diagnosis and therapy recording can pass through doctor The directly summation of service charge, diagnosis and treatment expense obtains, and can also according to demand be doctor's service charge, diagnosis and treatment expense distribution weighted index, pass through Weight read group total obtains, for example, evaluating doctor 001, realizing so that the treatment disease of Evaluation: Current is gastritis as an example Journey is to obtain medical worker that medical worker ID is 001 in July, 2016 in September, 2016 (assuming that current time is 2016 October 1) medical records for gastritis disease in these three months, and 100 have been calculated comprising the doctor for stomach Doctor's service charge, the diagnosis and treatment expense of inflammation, then can be by (can be doctor's service charge of every record, diagnosis and treatment expense including drug Etc. treatment costs with the diagnostic fees such as check) be directly added to obtain the cost of medical service of every record (i.e. each patient) treatment gastritis, Can according to demand (i.e. quality control target, such as the control target of the embodiment of the present invention is that preferential reduce such as checks at the diagnostic fees, It will then check etc. that diagnostic fees are set as that accounting weight maximum, treatment costs are taken second place, doctor's service charge is more taken second place for drug etc., this target can To be determined according to disease feature, i.e., the influence degree of cost of medical service is determined in disease according to these three expenses) be Weighted index λ is arranged in doctor's service charge1=0.2, weighted index λ is set for treatment costs such as drugs2=0.5 and for check etc. diagnosis Take setting weighted index λ3=0.3, pass through formula cost of medical service=λ later1* doctor's service charge+λ2* the treatment costs such as drug+λ3* It checks diagnostic fees, the corresponding cost of medical service of every diagnosis and therapy recording is calculated.Later, it calculates in the regular period such as these three moons Interior every month corresponding cost of medical service average value, in the hope of the monthly average of the cost of medical service of the same disease in the regular period Value, i.e. the monthly average value of the cost of medical service of gastritis cases in these three months.Wherein, the monthly average being calculated in this step There are two types of situations for value: first is that single monthly average value (example of every month (i.e. in the regular period) is calculated in this evaluation cycle The monthly average value in July, the monthly average value of the monthly average value of August and September in example as above), second is that this evaluation cycle is calculated Interior monthly average value (total monthly average value of the July to September in i.e. upper example) total (i.e. in the regular period).Carrying out current value It is to be compared using single monthly average value with the system same period average value when judgement of grade, current value grade is arranged, and it is total Monthly average value be then used to be compared the change of rank trend to judge evaluation object with system same period average value.
Step S203: system same period cost of medical service average value corresponding with the treatment disease is obtained.
Calculate the average value of the cost of medical service to same disease of each medical worker over a period to come and then from society Examining for the disease (such as gastritis) in the same period interior (such as being all in July, 2016 in September, 2016) is obtained in public information The big data for the treatment of expense records, and is recorded according to the big data obtained from social public information, calculates needle in contemporaneity To the social average value (i.e. system same period cost of medical service average value) of the cost of medical service of the disease.Since social public information is to mention It, therefore, can be according to the society that can be obtained to obtain the social average value of the cost of medical service of contemporaneity for big data basis The type of public information carries out the definition of data format, as long as the social average value of cost of medical service can be calculated.Moreover, It will be apparent to a skilled person that the basis as big data analysis, the data record of social public information is more, point Calculated result is analysed closer to true value.
Step S204: the monthly average value of the cost of medical service of the same disease in the calculated regular period is examined with the system same period Treatment expense average value is compared, and is judged according to comparison result, works as present value according to what judging result generated the medical worker It is worth grade.
By the monthly average value (i.e. one of the cost of medical service of the same disease over a period to come of calculated each medical worker Each month monthly average value in the timing phase) it is compared respectively with system same period cost of medical service average value, and pass through medical worker The corresponding value grade of each medical worker of acquisition of information is judged according to comparison result later, and is generated according to judging result The current value grade (i.e. newest value grade in real time) of the medical worker, judgment principle can be as follows:
When the value grade of the medical worker is the maximum value grade lower than setting and the same disease in the regular period The monthly average value continuous certain time of cost of medical service is lower than the certain percentage of system same period cost of medical service average value, by the medical matters The value grade of personnel rises m grades and is used as current value grade;
When the value grade of the medical worker is the minimum value grade higher than setting and the same disease in the regular period The monthly average value continuous certain time of cost of medical service exceeds the certain percentage of system same period cost of medical service average value, by the medical matters The value grade of personnel drops m grades and is used as current value grade;
Wherein, 1≤m, and m is less than the corresponding number of highest value grade (if the value grade divided has Pyatyi, then most 5) the corresponding number of high value grade is.In a particular embodiment, regular period (i.e. evaluation cycle), continuous certain time It can be set according to demand with the certain percentage (i.e. evaluation criterion) for being lower than or exceeding.For example, in embodiments of the present invention Medical service quality is divided into five value grades and is followed successively by A, B, C, D, E from low to high, as the reference of service price, builds Found service price system corresponding with this five value grades are as follows:
A:10 monetary unit
B:100 monetary unit
C:500 monetary unit
D:1000 monetary unit
E: agreed-upon price merit (more than 1000 monetary units)
Then in the embodiment, it is initial level that A, which can be set, and D is the upgrading upper limit, and E is agreed-upon price grade, and above-mentioned judgment principle can Be implemented as obtaining the value grade of certain medical worker and by the medical worker within half a year with the cost of medical service of disease Monthly average value be compared with system same period cost of medical service average value, medical matters people is judged and generated according to comparison result The new current value grade of member, for example, if the value grade of the medical worker obtained is A grades or more D grades hereinafter, and comparing Relatively result is the medical worker monthly average value of the cost of medical service of same disease (such as gastritis) and diagnosis and treatment of the system same period within half a year The difference (deviation from average) of expense average value is then to keep within positive and negative the 50% of system same period cost of medical service society average value The value grade of the medical worker is constant and is equivalent to value grade C;If the value grade of the medical worker obtained is A grades Above D grades hereinafter, and comparison result is that the medical worker is same with the monthly average value of the cost of medical service of disease and system within half a year Absolute value continuous three months of phase cost of medical service average value difference are lower than 50% (ratio of system same period cost of medical service average value Can according to need flexible setting with continuous months, that is, evaluation criterion), then the value grade of the medical worker is risen into level-one, such as B grades are raised to by A grades;If the value grade of the medical worker obtained is A, and comparison result is the medical worker within half a year The monthly average value of cost of medical service with disease was lower than with absolute value continuous six months of system same period cost of medical service average value difference The value grade of the medical worker is then risen second level, that is, is raised to C grades by the 100% of system same period cost of medical service average value.It needs to infuse Meaning if the value grade of the medical worker is D grades, upgrades to E, can negotiate a price with patient in this embodiment, into Row medical services.Therefore, when judge obtain the medical worker value grade be D grade when, then be made whether agreed-upon price or degradation Judgement, agreed-upon price judgement be, for example, obtain 3 years in the medical worker same disease cost of medical service monthly average value carry out Multilevel iudge, if comparison result is the monthly average value and system same period diagnosis and treatment expense of the cost of medical service of the same disease of the medical worker It was lower than the 50% of system same period cost of medical service average value with the absolute value of average value difference continuous 3 years, then is upgraded to E grades for D grades, Obtain agreed-upon price qualification, wherein refer within continuous 3 years that statistics months are continuously, to be higher than if existed during statistics 50% month, then continuously statistics stopped, and it is just effective to reach continuous criterion calculation, i.e., if certain month moon diagnosis and treatment expense in this 3 years It is higher than system same period cost of medical service average value with average value and the absolute value of the difference of system same period cost of medical service average value 50%, then to meet 50% month lower than system same period cost of medical service average value as continuous first month from next Start to recalculate;The moon that the judgement of agreed-upon price is also possible to obtain the cost of medical service of the same disease of the medical worker in 1 year is flat Mean value is compared judgement, if comparison result is same for the monthly average value and system of the cost of medical service of the same disease of the medical worker It is lower than the 50% of system same period cost of medical service average value within the absolute value of the difference of phase cost of medical service average value continuous 1 year, then can incites somebody to action D grades upgrade to E grades, i.e., the medical worker obtains agreed-upon price qualification, during which if there is (existing the average value moon beyond lower bound 50% Certain month cost of medical service average value and the absolute value of the difference of system same period cost of medical service average value are higher than system same period diagnosis and treatment expense The case where with the 50% of average value), then the continuous moon is recalculated from next month.And if the value grade of the medical worker obtained It is A grades or more, such as B grades, and comparison result is that the monthly average value of the cost of medical service with disease and system same period cost of medical service are averaged The absolute value of the difference of value continuous June exceeds the 50% of system same period cost of medical service average value, then by the value of the medical worker Level-one drops in grade, that is, is reduced to A grades;And if the value grade of the medical worker obtained is A grades or more, such as C grades, and compare knot Fruit is absolute value continuous 1 year of the monthly average value of the cost of medical service with disease and the difference of system same period cost of medical service average value And be more than the 100% of system same period cost of medical service average value, then the value grade of the medical worker is fallen 2 grades, that is, is reduced to A Grade.It should be noted that in embodiments of the present invention, if being raised to D grades, condition is tightened up if rising to E grades, and probation is more It is long, convenient for stablizing the stabilization of its service quality, but judged whether to degrade or whether be adjusted to agreed-upon price grade according to its comparison result, And no longer degrade if the value grade of medical worker has had been reduced to lowermost level i.e. A grades.Meanwhile may be used also in this embodiment To be implemented as, if the value grade of the medical worker obtained is any one in A~E grades, and comparison result is With the continuous three months height of absolute value of the difference of the monthly average value and system same period cost of medical service average value of the cost of medical service of disease In 50% or more of system same period cost of medical service average value, then sound a warning.It simultaneously can also be by the diagnosis and treatment expense in some cycles Total monthly average value is compared the change of rank trend to judge evaluation object with system same period cost of medical service average value, i.e., If the absolute value of the total monthly average value and the difference of system same period cost of medical service average value of the cost of medical service in some cycles is The standard for meeting upgrading, then judge that the level of the evaluation object is ascendant trend, if the absolute value of difference meets the mark to degrade Standard then judges that the level of the evaluation object is downward trend, and the trend is exported.
It should be noted that for continuously counting, but being led due to being unsatisfactory for condition by certain moon in other specific embodiments When cause is recalculated, remedial measure can also be added to recalculating, remedial measure for example can be to have added up months up to standard It has had reached half the time and has interrupted, then judged its (residue of the evaluation cycle after interrupting within the later half time In time) the average value of cost of medical service whether be not less than the average value of leading portion cost of medical service, if met in the later half time Interior cost of medical service is not less than the average value of leading portion cost of medical service, then is worth the value that grade is also equivalent to leading portion, i.e., not to working as Preceding evaluation object carries out downgrade processing.The remedial measure is also applied for the situation of other value grade evaluation parameters, such as Treatment cycle etc. hereafter.
Pass through embodiment shown in Fig. 2, so that it may the service quality of medical worker is controlled based on cost of medical service, Achieve the effect that compete by medical service quality and improves the treatment level of doctor, the medication for reducing patient and examination burden.
When Fig. 3 is that value grade evaluation parameter is set as treatment cycle, in medical service quality control method shown in FIG. 1 The processing flow schematic diagram for generating the current value grade of each evaluation object, by taking evaluation object is medical worker as an example, such as Fig. 3 institute Show, this method comprises:
Step S301: medical worker is obtained from Medical service information according to the value grade evaluation parameter of cost of medical service ID, the treatment cycle for treating disease and identical treatment disease.
When value -capture grade evaluation parameter is judged, and judging result is treatment cycle, according to treatment cycle Evaluation parameter carries out respective handling, including acquisition medical worker's information, treatment information and society are public from Medical service information Information, according to the corresponding treatment acquisition of information of each medical worker treatment cycle information corresponding with treatment disease information, thus It disease and is controlled to the diagnosis and treatment situation record in the entire diagnosis and treatment history of each medical worker, including medical worker ID, treatment for this Treat the treatment cycle of disease.
Step S302: the phase in the regular period corresponding with medical worker ID is obtained according to medical worker ID and treatment disease With the treatment cycle for the treatment of disease, calculate in the regular period with the treatment cycle average value for the treatment of disease.
After obtaining the corresponding diagnosis and treatment situation record of each medical worker by step S301, obtain first current to be evaluated Treat disease, for example, gastritis, obtained in the regular period according to treatment disease and current evaluation object later (such as 2016 July to these three moons of in September, 2016, can set according to demand) treatment cycle of the same disease of the evaluation object, later, meter Calculate in the regular period as in these three months every month the corresponding disease treatment cycle average value, it is certain in the hope of this The monthly average value of the treatment cycle of same disease in period, for example, the gastritis cases in these three months treatment cycle monthly average Value.Similarly, the monthly average value being calculated in this step is also there are two types of situation: i.e. every month single monthly average value (such as The monthly average value in July, the monthly average value of the monthly average value of August and September in upper example) and this evaluation cycle in (i.e. this one timing In phase) total monthly average value (total monthly average value of the July to September in i.e. upper example).When carrying out the judgement of current value grade, it is It is compared using single monthly average value with system same period average value, current value grade is arranged, and total monthly average value is then used In being compared the change of rank trend to judge evaluation object with system same period average value.
Step S303: system concurrent treatment period average corresponding with the treatment disease is obtained.
Calculate the monthly average value of the treatment cycle to same disease of each medical worker over a period to come and then from society The disease (such as gastritis) in the same period interior (such as being all in July, 2016 in September, 2016) can be obtained in public information The big data for the treatment of cycle records, and is recorded according to the big data obtained from social public information, calculates in contemporaneity For the social average value (i.e. system concurrent treatment period average) of the treatment cycle of the disease.
Step S304: calculated treatment cycle monthly average value is compared with system concurrent treatment period average, Judged according to comparison result, the current value grade of the medical worker is generated according to judging result.
After above-mentioned calculating, by calculated each medical worker for disease treatment cycle monthly average value with System concurrent treatment period average is compared, and the current value grade of the medical worker is arranged according to comparison result, such as It can be and judged according to comparison result, grade will be worth and be in turn divided into from low to high be including A, B, C, D, E Pyatyi Example, when judging result is in the regular period with the treatment cycle monthly average value continuous certain time for the treatment of disease (such as continuous 1 A month) lower than system concurrent treatment period average and its deviation from average is 100%, the current value grade of the medical worker is set It is set to E grades;When judging result be the regular period in treatment disease treatment cycle monthly average value continuous certain time (such as Continuous 3 months) lower than system concurrent treatment period average and its deviation from average is 50%, by the current value etc. of the medical worker Grade is set as D grades;When judging result is in the regular period with the treatment cycle monthly average value continuous certain time for the treatment of disease (such as continuous 6 months) are equal to system concurrent treatment period average and its deviation from average is ± 50%, by working as the medical worker Preceding value grade is set as C grades;If it is judged that for when the treatment cycle monthly average value for the treatment of disease same in the regular period Continuous certain time (such as continuous 12 months) is higher than system concurrent treatment period average and its deviation from average is 50%, by the doctor The current value grade of business personnel is set as B grades;When judging result is to be averaged in the regular period with the treatment cycle for treating disease It is worth continuous certain time higher than system concurrent treatment period average and its deviation from average is 100%, by the current of the evaluation object Value grade is set as A grades.Wherein, deviation from average is referred to the prior art and is calculated, and the value of generally medical services is got over Height, the treatment cycle average value in the regular period with treatment disease are got over than the deviation from average of system concurrent treatment period average It is small, that is, it is lower than.
And when establishing medical service prices system, then consultation fee valence can be correspondingly arranged according to the value grade of division Lattice, such as A grades of corresponding consultation fee prices are 5 yuan or 10 yuan, and with the promotion of value grade, consultation fee is also upgraded (i.e. consultation fee Price is accordingly promoted) etc..Doctor in this way works competition, declines the treatment cycle of patient, doctor in terms of medication more Add and precisely, more select reliable drug and diagnostic method for patient, the service of doctor can be improved in this way to avoid over-treatment Technical ability and quality.And total monthly average value of the treatment cycle in some cycles can also be put down with the system concurrent treatment period simultaneously Mean value is compared the change of rank trend to judge evaluation object, i.e., based on total monthly average of the treatment cycle in some cycles It is worth and judges on the basis of total monthly average value with the absolute value of the difference of system concurrent treatment period average, the evaluation object It is worth the variation tendency of grade, and is ascendant trend using the variation tendency as the horizontal variation tendency of the evaluation object, also It is downward trend, and the trend is exported.
In order to control simultaneously cost of medical service and treatment cycle, it can also set same for value grade evaluation parameter When include cost of medical service and treatment cycle, Fig. 4 is that value grade evaluation parameter is set as simultaneously including cost of medical service and treatment week When the phase, the process flow that the current value grade of each evaluation object is generated in medical service quality control method shown in FIG. 1 is shown It is intended to, by taking evaluation object is medical worker as an example, as shown in figure 4, this method comprises:
Step S401: it is obtained from Medical service information according to the value grade evaluation parameter of cost of medical service and treatment cycle Medical worker ID, the cost of medical service and treatment cycle for treating disease and identical treatment disease.
When value -capture grade evaluation parameter is judged, and judging result is simultaneously including cost of medical service and treatment cycle When, respective handling is carried out according to the evaluation parameter of cost of medical service, including obtain medical worker's information from Medical service information, control Information and social public information are treated, according to the medication corresponding with treatment disease information of the corresponding treatment acquisition of information of each medical worker Information checks chemical examination information and treatment cycle information, then public according to medication information and inspection chemical examination information and society Drug and inspection in information chemically examine relevant expense and calculate medication information diagnosis and treatment expense corresponding with chemical examination information is checked, thus Obtain the diagnosis and treatment situation record in the entire diagnosis and treatment history of each medical worker, including medical worker ID, treatment disease, cost of medical service And treatment cycle.
Step S402: the phase in the regular period corresponding with medical worker ID is obtained according to medical worker ID and treatment disease With the cost of medical service and treatment cycle for the treatment of disease, calculate in the regular period with the cost of medical service and treatment cycle for the treatment of disease Monthly average value.
After obtaining the corresponding diagnosis and treatment situation record of each medical worker by step S401, it is first determined treatment to be evaluated Disease, and according to treatment disease to be evaluated and it is evaluated in the object acquisition regular period that (such as in July, 2016 is in September, 2016 Can set according to demand these three moons) cost of medical service and treatment cycle of the same disease of the medical worker, later, calculating should In regular period as in these three months every month the corresponding disease cost of medical service and treatment cycle average value, in the hope of The cost of medical service of same disease in the regular period and the monthly average value for the treatment of cycle, such as gastritis cases in these three months The monthly average value of cost of medical service and treatment cycle.Wherein, cost of medical service be diagnosis and treatment expense direct and/or weight with, can refer to above The calculation of cost of medical service monthly average value, details are not described herein.
Step S403: system same period cost of medical service corresponding with the treatment disease and treatment cycle average value are obtained.
Calculate each medical worker over a period to come to the cost of medical service of same disease and the monthly average value for the treatment of cycle And then obtained from social public information the disease (such as gastritis) in the same period in (such as all in July, 2016 to In September, 2016) cost of medical service and treatment cycle big data record, and according to the big data obtained from social public information Record, calculates in contemporaneity that (i.e. the system same period examines for the social average value of the cost of medical service of the disease and treatment cycle Treatment expense average value and system concurrent treatment period average).
Step S404: calculated cost of medical service monthly average value and treatment cycle monthly average value are examined with the system same period respectively Treatment expense average value and system concurrent treatment period average are compared, and are judged according to comparison result, are tied according to judgement Fruit generates the current value grade of the medical worker.
After above-mentioned calculating, by calculated each medical worker for disease cost of medical service monthly average value and Treatment cycle monthly average value is compared with system same period cost of medical service average value and system concurrent treatment period average respectively, The current value grade of the medical worker is set according to comparison result, such as can be and judged according to comparison result, it will Value grade is in turn divided into from low to high including for A, B, C, D, E Pyatyi, when judging result is in the regular period with controlling The cost of medical service monthly average value and treatment cycle monthly average value and system same period cost of medical service average value and treatment cycle for the treatment of disease It is average higher than system concurrent treatment week expense that the absolute value of average value difference distinguishes continuous certain time (such as continuous 1 month) The 100% of value and system concurrent treatment period average, sets A grades for the current value grade of the medical worker;Work as judgement As a result it is examined for the cost of medical service monthly average value and treatment cycle monthly average value in the regular period with treatment disease with the system same period Treatment expense average value and the absolute value for the treatment of cycle average value difference are distinguished continuous certain time (such as continuous 3 months) and are higher than The 50% of system same period cost of medical service average value and system concurrent treatment period average, by the current value etc. of the medical worker Grade is set as B grades;When judging result is in the regular period with the cost of medical service monthly average value and the treatment cycle moon for the treatment of disease Average value and system same period cost of medical service average value and the absolute value for the treatment of cycle average value difference distinguish continuous certain time (such as continuous 6 months), will in ± the 50% of system same period cost of medical service average value and system concurrent treatment period average The current value grade of the medical worker is set as C grades;If it is judged that for when examining with treatment disease in the regular period Treatment expense monthly average value and treatment cycle monthly average value and system same period cost of medical service average value and treatment cycle average value difference Absolute value distinguish continuous certain time (such as continuous 12 months) lower than system same period cost of medical service average value and system it is same The current value grade of the medical worker is set D grades by the 50% of phase treatment cycle average value.Likewise it is possible to by should Doctor is judged with the total monthly average value of cost of medical service for the treatment of disease and the variation tendency of the total monthly average value for the treatment of cycle in regular period The horizontal variation tendency of business personnel specifically can refer to Trend judgement method above.
Doctor in this way, which works, to be competed, and simultaneously declines the cost of medical service of patient and treatment cycle, doctor is in medication Aspect is more accurate, the drug and diagnostic method of economic and reliable are more selected for patient, can avoid over-treatment simultaneously in this way And drug abuse, shorten patient's treatment cycle, reduces social medical treatment cost, improve the service technical ability and quality of doctor.
In other embodiments, diagnosis and treatment science extension programme can also be set by value grade evaluation parameter, so that doctor Business personnel can push medical treatment progress, promote social whole medical treatment service level by the research achievement of oneself.Fig. 5 is to work as valence It is generated when value grade evaluation parameter is set as diagnosis and treatment science extension programme, in medical service quality control method shown in FIG. 1 each The processing flow schematic diagram of the current value grade of medical worker,
Step S501: doctor is obtained from Medical service information according to the value grade evaluation parameter of diagnosis and treatment science extension programme Business personnel ID and diagnosis and treatment science extension programme ID.
When value -capture grade evaluation parameter is judged, and judging result is diagnosis and treatment science extension programme, from medical treatment Medical worker's information is obtained in information on services, and medical worker upload is obtained according to the corresponding medical worker ID of each medical worker Thus diagnosis and treatment science extension programme obtains the medical worker ID and diagnosis and treatment science extension programme id information of each medical worker.
Step S502: the type of diagnosis and treatment science extension programme is obtained according to diagnosis and treatment science extension programme ID, and according to diagnosis and treatment Academic promotion scheme type obtains the tissue characterization result that diagnosis and treatment science extension programme adopts rate or Academic innovations.
After obtaining the diagnosis and treatment science extension programme ID that each medical worker uploads by step S501, diagnosis and treatment Academic promotion is arrived In scheme information (can be the storage information record sheet automatically generated according to the diagnosis and treatment science extension programme that medical worker uploads) The type of the diagnosis and treatment science extension programme is obtained, if the type of diagnosis and treatment science extension programme is diagnosis and treatment science extension programme, It obtains it and adopts rate, if type is Academic innovations, the tissue characterization result for obtaining the Academic innovations is (special by system specified Family composition of personnel, Academic innovations are evaluated, and input tissue characterization result storage, storage content be can be value score If 0~10,0 indicates not to be worth, 10 indicate high value).
Step S503: diagnosis and treatment science extension programme adopts rate or the tissue characterization result of Academic innovations is judged, according to Judging result generates the current value grade of the medical worker.
It obtains after adopting rate or tissue characterization result, is judged according to the value for adopting rate or tissue characterization result, from And the current value grade of the medical worker is set according to comparison result, such as can be when judging result is that adopt rate be 5~9 Position medical worker adopts or tissue characterization result is 1~3, and the current value grade of the medical worker is risen level-one;When judgement is tied Fruit is that 10~30 medical workers adopt or tissue characterization result is 4~6 to adopt rate, by the current value etc. of the medical worker Grade rises 2 grades or is directly confirmed as B grades without rank;When judging result is that 31~50 medical workers adopt or organize mirror to adopt rate Determining result is 7~8, the current value grade of the medical worker is risen 3 grades, until D grades bind;If it is judged that being to adopt rate 51 or more medical workers adopt or tissue characterization result is 9~10, and the current value grade of the medical worker is risen 4 grades, can It is directly entered E grades or D grades of guarantor is preferential.
And when establishing medical service prices system, then consultation fee valence can be correspondingly arranged according to the value grade of division Lattice, such as A grades of corresponding consultation fee prices are 5 yuan or 10 yuan, and with the promotion of value grade, consultation fee, which is also upgraded, (examines Price of gold lattice are accordingly promoted) etc..One more accurate clinical path and therapeutic scheme, it will allow millions upon millions of patients to be benefited, because This, the enthusiasm of medical worker's research and innovation can be improved in method through the embodiment of the present invention, so that achievement is affirmed, pushes away The raising of dynamic entire society's medical level.
In a preferred embodiment, various value grade evaluation parameter can also be set, and pass through setting weight according to demand Index replacement difference is worth the specific gravity of grade evaluation parameter, to realize more control targets.Fig. 6 shows another embodiment Medical services control method by the way that multiple value grade evaluation parameters are arranged, and be in this embodiment each value grade Evaluation parameter distributes weight index, to calculate the service valence of medical worker by value grade evaluation parameter and weight index Value, the current value grade of medical worker is generated according to value of services, and accordingly generates its medical service prices, with the valence of setting For value grade evaluation parameter includes cost of medical service, treatment cycle, Academic innovations and other factors, as shown in fig. 6, this method packet It includes:
Step S601: the quality of medical services is divided into multiple value grades, and medical treatment clothes are established according to value grade Business pricing system.
The step and step S101 are essentially identical, the difference lies in that being the grade of direct setting value grade in step S101 Number is that will be worth grade to be correspondingly arranged with value of services and in the present embodiment, such as 0~0.20 counter value of value of services etc. Grade A, 0.21~0.40 counter value grade B of value of services, 0.41~0.60 counter value grade C of value of services, value of services 0.61~0.80 counter value grade D, 0.81~1 counter value grade E of value of services.
Step S602: setting value grade evaluation parameter simultaneously stores.
The design of this step is identical as step S102, sets four for value grade evaluation parameter in this embodiment, Including cost of medical service, treatment cycle, Academic innovations and other factors, wherein cost of medical service is indicated with C, treatment cycle is indicated with T, Academic innovations are indicated with P, other factors are indicated with O.
Step S603: weighted index is distributed for value grade evaluation parameter.
It is according to demand value grade evaluation parameter i.e. cost of medical service, treatment cycle, the science being arranged in step S602 Weighted index is respectively set in innovation and other factors, wherein the weighted index K of cost of medical service1It indicates, the weight for the treatment of cycle Index K2It indicates, the weighted index K of Academic innovations3It indicates, the weighted index K of other factors4It indicates.
Step S604: it obtains Medical service information and stores.
The realization of this step is identical as step S103, can refer to and describes above, and details are not described herein.
Step S605: it according to the historical record of Medical service information, value grade evaluation parameter and weighted index, generates each The value of services of medical worker.
In constituting medical service prices, some constant expenses is allowed to reach unanimity, by competition, allows the treatment cycle of patient Shorten, is the decline of patient's cost of medical service in aggregate performance, for the solo practitioner of medical services, services most worthy Be also to decline social medical treatment cost, therefore, the doctor for popularizing rate and most worthy of good diagnosis and treatment method (scheme) Treat one of service form, therefore, can the medical treatment of value grade evaluation parameter and weighted index and record based on setting take Business information calculates the value of services of each medical worker, i.e., quantifies its value of services, express each medical worker's with formula Medical services value is exactly:
EV=-K1*T(∑(T1+T2……Tn)/N-Ti)/Ti+K2*P(∑(P1+P2……PN))-K3*C(∑(C1+ C2……Cn)/N-Ci)/Ci-K4*O(∑(O1+O2……On)/N-Oi)/Oi
Ki is weight coefficient, is adjusted according to quality management policy.T (Time) is treatment number of days, this index can be effectively pre- Anti- insufficient therapy or reduction diagnose and mistaken diagnosis, the mistake of extended treatment time, and Ti is the social same period average value for the treatment of cycle;P (paper) be optimal diagnosis method, treatment method adopts rate, this is the evaluation index to the practicability of academic paper, the ginseng The visual disease of number distinguishes weight, and if highest weighting of the pathologist to oncotherapy can be to 50%, early detection is to treatment week Phase and expense reduction plays a decisive role, such pathologist do not see patient its value can according to other doctors adopt rate come Its value is improved, realizes its income, laboratory personnel judges its value of services by its accuracy rate or error rate;C(Charge) For cost of medical service, Ci is the social average value of the cost of medical service of the same period;O (Other) other Con trolling index, Oi are other of the same period The social average value of Con trolling index.Weight is the baton of quality policy, carries out appropriate adjustment according to the target of quality management, and It is adjusted by the formula according to weight, so that it may quantify the whole medical treatment value of services of evaluation object such as medical worker.
Step S606: according to the value of services of each medical worker, the current value grade of each medical worker is generated.
After the value of services for calculating each medical worker, so that it may judge value of services, and according to judging result With the value grade established in step S601, the current value grade of medical worker is obtained.Such as when value of services is 0.78, According to the matching relationship of the value of services of foundation and value grade, so that it may obtain the current value grade of the medical worker, example If 0.78 corresponding value grade is D.
Step S607: according to the current value grade of each medical worker, the current service price of each medical worker is generated.
The realization of this step is identical as step S105, can refer to and describes above, and details are not described herein.
Pass through embodiment shown in fig. 6, so that it may flexible setting value grade evaluation parameter and weight index according to demand, Medical service quality is controlled and adjusted by value grade evaluation parameter and weight index, can flexibly be adjusted according to demand Full price value grade evaluation parameter and its weight index, to realize regulation purpose.Moreover, by by the value of services of medical worker Quantization, the level and value for seeing medical worker that can be simple and clear facilitate carry out quality management.Also, its number quantified It is the diagnosis and therapy recording of each medical worker oneself according to source, data are true and reliable, and medical worker can be promoted to promote quality and water It is flat, and can guarantee that its real standard is consistent with real value, moreover it is possible to the satisfaction for reaching patient (is obtained by the consumption to match The service quality to match), integrally achieve the effect that balanced doctor-patient relationship, alleviate conflict between doctors and patients.
In other embodiments, according to demand value grade evaluation parameter can also be set as examining and checks fallout ratio, Such as when needing the medical worker to posies such as pathology, x-ray, clinical examinations teacher to carry out quality control.And in other embodiments In, can also Irrational Use of Drugs recall rate and/or great common bad anti-be set by value grade evaluation parameter according to demand Incidence is answered, such as when needing to control clinical pharmacist's quality of pharmaceutical service.
In a preferred embodiment, misdiagnosis rate can also be set by value grade evaluation parameter, valence is divided according to misdiagnosis rate Value grade and its current value grade is generated according to the misdiagnosis rate of medical worker, such as can be set to be higher than system when misdiagnosis rate When same period average value (i.e. according to the calculated public misdiagnosis rate of society of big data analysis), it will be worth grade to it and carry out at degradation Reason can also carry out conjugation iteration according to system and carry out preferentially.(it is arranged by the way that misdiagnosis rate reduction index is maintained at 2-3% The evaluation criterion of misdiagnosis rate parameter is 2%-3%), the misdiagnosis rate of entire medical worker can be made gradually to tend to 2%-3%;Pass through Multiple check system controls the error rate of system below hundred a ten thousandths.
Above embodiments are the detailed narrations carried out with evaluation object for medical worker's example, when evaluation object is medical institutions Or when Medical Group, statistical average can be carried out by the corresponding parametric values of all medical workers under administering to it, according to it The average value of the relevant parameter of included all medical workers judges that judgment principle is identical, and is worth corresponding to grade Medical service prices then can accordingly be adjusted to medical institutions charging standard toll level or medical insurance reimbursement ratio.And work as When evaluation object is other, it is also based on the calculating that same design carries out corresponding value grade according to its feature.
In addition, in the above-mentioned methods can also include the value grade evaluation parameter point for setting in a preferred embodiment The step of with priority, when generating the current value grade of evaluation object, first has in the realization example for being assigned with priority The value grade evaluation parameter selected is determined according to priority, and current value etc. is carried out according to the value grade evaluation parameter of selection The calculating of grade.Wherein, in practical applications, the priority of setting can be including social average priority, diagnosis and treatment Academic promotion Scheme priority and system priority, diagnosis and treatment science extension programme priority are only second to social average priority;All systems are excellent First grade obeys social average demands priority.Multiple value grade evaluation parameters thus can be set, when being evaluated, Current most suitable value grade evaluation parameter is selected to carry out current value grade according to the priority of value grade evaluation parameter Evaluation, more meet social demand.Such as the value grade evaluation parameter of setting can be including cost of medical service and treatment cycle, System priority is set for treatment cycle and cost of medical service, and the system priority of two parameters is set as in evaluation cycle Cost of medical service (average value of the cost of medical service in the i.e. calculated regular period) is average less than or equal to synchronization system cost of medical service When within 2 times of value, the priority for the treatment of cycle is higher than cost of medical service (i.e. at this time using treatment cycle as evaluation parameter using upper State the evaluation that method carries out current value grade and service price), and the treatment cycle (i.e. calculated one in evaluation cycle Treatment cycle average value in the timing phase) (nothing under artificial discharge turnover rate system when being less than the synchronization system mean treatment period Effect), the priority of cost of medical service is higher than treatment cycle and (is participated in the above method using cost of medical service mean value as evaluation parameter at this time Carry out the evaluation of current value grade and service price), 70% treatment cycle is pressed in other situations, 30% cost of medical service carries out Judged (as gone out medical services value by weighted average calculation, to carry out current value according to value of services after weighted average The evaluation of grade and service price), the corresponding mean value that can be obtained first in two parameters and evaluation cycle at this time is sentenced Disconnected, according to judging result, the parameter for selecting high priority generates current value grade and service price, or is weighted to the two Average value is worth according to medical services to obtain medical services value and generates current value grade and service price.It needs Bright, social average priority is the evaluation parameter put together after having collected social opinion, also embodies crew's matter The theory of buret reason, such as to some painful diseases or very painful critical illness, then with treatment phase, survival period, survival amount, Success rate is index;And the disease for the pain that some patients and family members can be born, due to individual requirement and it is experienced as more Kind multiplicity, then with social average value as judge index, since the priority represents most of requirements of society, It can be defined as social average priority.In the preferred embodiment of the present invention, when being evaluated, select society average excellent first Secondly the index of first grade selects the index of diagnosis and treatment science extension programme priority as evaluation parameter, finally as evaluation parameter Select the index of system priority as evaluation parameter.
Fig. 7~8 show the medical services plateform system of one embodiment of the present invention, the medical services as shown in Figure 7 Plateform system includes registration module 1, memory module 2, value grade control module 3 and service price output module 4.Wherein, it infuses Volume module 1 is configured to reception input information and is audited, and after the approval, carries out information to the medical worker currently registered Initialization and output auditing result, wherein information initializing includes distribution initial value grade.Memory module 2 is for storing valence It is worth grade evaluation parameter, Medical service information, value class information and medical service prices information corresponding with value grade, Wherein, Medical service information for example can be set to include medical worker's information (for example including medical worker ID, value grade and Its corresponding treatment disease ID), treatment disease information (medical worker ID for example including treatment, treatment disease ID, with treatment disease The corresponding medication information of kind of information checks chemical examination information and treatment cycle information etc.) and society's public information (for example including society Disease big data information, the pricing information of for example various drugs of various types of social price cost informations, inspection chemical examination can be treated Pricing information, the treatment cycle big data information of various diseases etc.).Value grade control module 3 is configured to according to value etc. Grade evaluation parameter and Medical service information generate the current value grade of each medical worker.Service price output module 4 is configured to It is raw according to the current value grade of each medical worker, value class information and medical service prices information corresponding with value grade At the current service price of each medical worker.
As shown in figure 8, the system further includes value of services computing module 5, be configured to value -capture grade evaluation parameter and Its weighted index exports each according to value grade evaluation parameter, weighted index and medical worker's information and Medical service information The medical services of medical worker are worth.In the embodiment for including value of services computing module 5, value grade control module 3 is matched It is set to the current value grade that the value grade for being worth and corresponding to according to calculated medical services and divide generates medical worker.
Wherein, the specific implementation process of value grade control module 3 and service value calculation module 5, is referred to above Narration, is no longer repeated herein.
By the system, qualified medical worker (i.e. with the medical worker of corresponding qualification) can be by registering mould The corresponding User Page of block 1 is registered, and registration module 1 receives the information of accredited personnel's input and the qualification file of upload, is mentioned It hands over to system manager, is audited by system manager, when audit passes through, system manager is by registration module 1 to working as The medical worker of preceding registration carries out information initializing and auditing result is sent to accredited personnel.Later, the medical matters of registration are completed Personnel may log into the system and provide medical services, and the record of its medical services, such as treatment disease, doctor's overall to patient Business expense, medication information, inspection checking information, treatment cycle information etc. can be all recorded and stored by system into memory module 2.And Value grade control module 3 and service value calculation module 5 be exactly according to the actual medical service log of each medical worker with Analytical calculation is carried out according to the value class information of system setting, obtains the current value grade of each medical worker.And it services Price output module 4 is then the medical service prices system corresponding with value grade according to foundation, is generated and each medical matters people The medical technology of member and horizontal adaptable medical service prices are medical matters to realize the purpose of medical service quality control Personnel and patient's offer are rationally efficient, can embody the service platform of medical worker's value and patient demand.
In embodiments of the present invention, value grade evaluation parameter, which can be, is stored in advance in memory module 2, and at it In his preferred embodiment, value grade evaluation parameter setup module can also be set in systems, for receiving external input, root Value grade evaluation parameter is set according to external input, to reach according to control purpose, value grade evaluation parameter is adjusted flexibly Purpose.In other preferred embodiments, weight index distribution module can also be set accordingly, for receiving external input, root It is that weighted index is arranged in different value grade evaluation parameters according to external input, to adjust different values etc. according to control purpose The weighted value of grade evaluation parameter, realizes the purpose regulated and controled on demand.And in some preferred embodiments, then it can be preferential by being arranged Grade distribution module and evaluation parameter choose module with for value grade evaluation parameter setting priority and based on priority choose into The evaluation parameter of row evaluation, the judgement of current value grade and service price is carried out according to the evaluation parameter of selection.
Wherein, the method and system of the embodiment of the present invention can be realized by way of computer program, and computer journey Sequence can store in the electronic device for including storage medium, such as in smart machine (mobile phone, wrist-watch, tablet computer etc.).This Sample, so that it may realize the smart machine of the above method or system by recording and provide corresponding service for user.
Above-described is only some embodiments of the present invention.For those of ordinary skill in the art, not Under the premise of being detached from the invention design, various modifications and improvements can be made, these belong to protection model of the invention It encloses.

Claims (12)

1. medical service quality control method characterized by comprising
The quality of medical services is divided into multiple value grades;
Setting value grade evaluation parameter and record Medical service information;
According to the historical record of Medical service information and value grade evaluation parameter, the current value grade of evaluation object is generated.
2. the method according to claim 1, wherein further include for setting value grade evaluation parameter distribution it is excellent First grade generates the current value of the evaluation object in the historical record and value grade evaluation parameter according to Medical service information When grade, the value grade evaluation parameter of selection is determined according to the priority of value grade evaluation parameter.
3. according to the method described in claim 2, it is characterized in that, the value grade evaluation parameter chosen according to priority is to examine When treatment expense, the historical record according to Medical service information and value grade evaluation parameter generate the current of evaluation object Being worth grade includes:
It is obtained from medical record of service information according to the value grade evaluation parameter of cost of medical service including evaluation object ID, treatment Disease, service charge, diagnosis and treatment expense and other expense, the diagnosis and therapy recording information of behavior should occur;
The treatment disease to be evaluated for obtaining evaluation object obtains Evaluation: Current pair according to evaluation object ID and treatment disease to be evaluated Service charge, the diagnosis and treatment expense of same disease in the regular period of elephant calculate the regular period according to the service charge of acquisition, diagnosis and treatment expense The average value of the cost of medical service of interior same disease;
System same period cost of medical service average value corresponding with treatment disease to be evaluated is obtained, according to the calculated regular period The average value and system same period cost of medical service average value of the cost of medical service of interior same disease generate the current value of the evaluation object Grade.
4. according to the method described in claim 2, it is characterized in that, being arranged according to the value grade evaluation parameter that priority is chosen When for treatment cycle, the historical record according to Medical service information and value grade evaluation parameter generate evaluation object Current value grade includes:
It is obtained from medical record of service information according to the value grade evaluation parameter for the treatment of cycle including evaluation object ID, treatment The diagnosis and therapy recording information of the cost of medical service and treatment cycle of disease and corresponding treatment disease,
Treatment disease to be evaluated is obtained, obtains corresponding with the evaluation object one according to evaluation object ID and treatment disease to be evaluated The treatment cycle of identical treatment disease in the timing phase calculates in the regular period with the treatment cycle average value for the treatment of disease;
Obtain system concurrent treatment period average corresponding with the treatment disease to be evaluated, according to it is described it is calculated centainly Judged in period with the treatment cycle average value for the treatment of disease and the system concurrent treatment period average, according to judgement As a result the current value grade of the evaluation object is generated.
5. according to the method described in claim 2, it is characterized in that, the value grade evaluation parameter chosen according to priority It is diagnosis and treatment science extension programme when adopting rate, the historical record according to Medical service information and value grade evaluation ginseng Number, the current value grade for generating the evaluation object include:
Packet is obtained from medical record of service information according to the value grade evaluation parameter for adopting rate of diagnosis and treatment science extension programme The record information of evaluation object ID and the diagnosis and treatment science extension programme ID of the evaluation object are included,
The ID for obtaining diagnosis and treatment science extension programme to be evaluated counts corresponding according to diagnosis and treatment science extension programme ID to be evaluated Diagnosis and treatment science extension programme adopts rate;
The value grade for issuing the evaluation object of the diagnosis and treatment science extension programme to be evaluated is obtained, is sentenced according to rate is adopted Break, and the current value grade of the evaluation object is set according to judging result.
6. method according to any one of claims 2 to 5, wherein the priority includes social average priority, diagnosis and treatment Academic promotion scheme priority and system priority, it is preferential that society's average priority is higher than the diagnosis and treatment science extension programme Grade, the diagnosis and treatment science extension programme priority are higher than the system priority.
7. method according to any one of claims 1 to 5, which is characterized in that further include calculating service valence for evaluation object The step of value, the step include:
Weighted index is distributed according to demand for the value grade evaluation parameter of setting;
The medical services value of evaluation object is generated according to the value grade evaluation parameter of setting and the weighted index of distribution, In, the value grade evaluation parameter of the setting includes at least treatment cycle to same disease, diagnosis and treatment science extension programme Adopt rate and cost of medical service.
8. method according to any one of claims 1 to 5, which is characterized in that the method also includes:
Medical service prices system is established according to value grade;And
According to the current value grade of evaluation object, the current medical service price of evaluation object is generated.
9. according to the method described in claim 8, wherein, the evaluation object includes medical worker, medical institutions and medical treatment collection Group, the medical service prices include the service charge of medical worker, the charging standard of medical institutions or doctor group, medical institutions Or ratio is submitted an expense account in the toll level of doctor group and the medical insurance of medical institutions or doctor group.
10. the quality management of medical service plateform system, including registration module, memory module, value grade control module and service Price output module,
The registration module, which is configured to receive input information, to be audited, and the evaluation pair after the approval, to currently registering As carrying out information initializing and output auditing result, wherein the information initializing includes distribution initial value grade;
The memory module is for storing value grade evaluation parameter, evaluation object information, Medical service information, value grade letter Breath, medical service prices information corresponding with value grade and social public information;
The value grade control module is configured to according to value grade evaluation parameter, evaluation object information, Medical service information The current value grade of each evaluation object is generated with social public information;
The service price output module is configured to the current value grade according to each evaluation object, value class information and and valence The corresponding medical service prices information of value grade generates the current service price of each evaluation object.
11. system according to claim 10 further includes value of services computing module, it is configured to the evaluation of value -capture grade Parameter and its weighted index, according to value grade evaluation parameter, weighted index and evaluation object information and Medical service information Export the medical services value of each evaluation object.
12. a kind of electronic device comprising storage medium, execution unit and display unit record on storage medium for real The computer program of existing preceding method or system above-mentioned, execution unit is for executing computer program, and display unit is for connecing It receives peripheral operation and shows the implementing result of execution unit.
CN201810298753.3A 2017-04-06 2018-04-04 Medical service quality control method and quality management plateform system, electronic device Pending CN109119143A (en)

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