CN109165968A - A kind of medical expense information processing method, system, device and storage medium - Google Patents
A kind of medical expense information processing method, system, device and storage medium Download PDFInfo
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Abstract
The invention discloses a kind of medical expense information processing method, system, device and storage mediums.The method includes obtaining patient generates in the current statistic period actual medical expense and be compared actual medical expense with reference medical expense；The system comprises actual medical cost model, with reference to medical expense module and medical expense progress module；Described device includes memory and processor.By the invention it is possible to calculate medical expense progress in real time, hospital is allow to grasp patient in real time as the influence of hospital's bring.Medical expense progress is feedback quantity of the hospital in current statistic period business policy, and hospital is not necessarily to until patient discharge or terminates the course for the treatment of, directly can adjust business policy according to real-time medical expense progress.By the method for the invention, expenses management in thing may be implemented in hospital, so that the benefit of hospital and patient.The present invention is widely used in medical information technical field.
Description
Technical field
The present invention relates to medical information technical field, especially a kind of medical expense information processing method, system, device and
Storage medium.
Background technique
Hospital during operation, need to be grasped its received patient medical expense information to carry out expenses management,
To be planned as a whole in terms of purchase of goods and materials, medical insurance subsidy and project, better management plan is formulated.But at present
Hospital can only accomplish subsequent expenses management, that is, only completing the entire course for the treatment of in patient and leave could be to the disease after hospital
Medical expense information caused by people is summarized, to evaluate in the entire therapeutic process of the patient to the profit and loss of hospital's bring
It influences, in this way, the expenses management work of hospital just has serious hysteresis quality.Due to that can not accomplish expenses management in thing, hospital
Patient can not be grasped in real time during Case treatment as the influence of hospital's bring, also can not just adjust management plan in time, this makes
The interests of hospital and patient can not maximize or even the interests of hospital and patient are damaged.
Summary of the invention
In order to solve the above-mentioned technical problem, the purpose of the present invention is to provide a kind of medical expense information processing method, be
System, device and storage medium.
First technical solution adopted by the present invention is:
A kind of medical expense information processing method, needed for obtaining hospital for the medical expense information processing according to patient
Expense progress msg, comprising the following steps:
Obtain the actual medical expense that patient generates in the current statistic period；
Actual medical expense is compared with reference to medical expense, to obtain medical expense progress；The reference doctor
Treatment expense is determined by the first diagnostic result, diagnosis and treatment mode and with previous equal expense；First diagnostic result is doctor to patient
The diagnostic result of institute's illness kind；The diagnosis and treatment mode is the treatment method for disease corresponding to the first diagnostic result；It is described with
Previous equal expense is everyone the average each required cost in previous measurement period of disease corresponding to the first diagnostic result.
Further, described to be obtained with reference to medical expense by following steps:
By medical insurance directory, the first diagnostic result is converted into clearing disease diagnosis；The medical insurance directory is from public data
It is obtained in library, the clearing disease diagnoses corresponding disease disease corresponding with the first diagnostic result with corresponding relationship；
Clearing disease is retrieved from diagnostic data base diagnoses corresponding diagnosis and treatment mode；The diagnostic data base is stored with more
Group clearing disease diagnosis-diagnosis and treatment mode corresponding relationship；
According to the diagnosis of clearing disease and diagnosis and treatment mode, searches and obtained accordingly with previous equal expense from public database；
By the reference medical expense using previous equal expense as required acquisition.
Further, the medical expense progress is calculated by the following formula to obtain:
Medical expense progress=actual medical expense/refer to medical expense × 100%.
Further, the method for the present invention is further comprising the steps of:
According to the numerical value of medical expense progress, profit and loss state of the hospital relative to the patient is determined.
Further, the profit and loss state of the numerical value of the medical expense progress and hospital has following corresponding relationship:
Less than 50% --- break even state；
More than or equal to 50% and less than 100% --- profit state；
More than or equal to 100% and less than 200% --- lossing state；
Greater than 200% --- defective value steady state.
Further, the method for the present invention is further comprising the steps of:
Medical expense progress is converted into corresponding progress bar and shows progress bar.
Further, the progress bar has variable color, and the color of the progress bar and the profit and loss state of hospital have
There is following corresponding relationship:
White --- break even state；
Green --- profit state；
It is red --- lossing state；
Black --- defective value steady state.
Second technical solution adopted by the present invention is:
A kind of medical expense information processing system, comprising:
Actual medical cost model, for obtaining the actual medical expense that patient generates in the current statistic period；
With reference to medical expense module, refer to medical expense for obtaining, it is described with reference to medical expense by the first diagnostic result,
It diagnosis and treatment mode and is determined with previous equal expense；
Medical expense progress module, for actual medical expense to be compared with reference to medical expense, to be cured
Treatment expense progress；It is described to be determined with reference to medical expense by the first diagnostic result, diagnosis and treatment mode and with previous equal expense；
The reference medical expense module includes following submodule:
First diagnostic result submodule, for obtaining the first diagnostic result, first diagnostic result is doctor to patient
The diagnostic result of institute's illness kind；
Diagnosis and treatment mode submodule, for obtaining diagnosis and treatment mode, the diagnosis and treatment mode is for corresponding to the first diagnostic result
The treatment method of disease；
It is described to be tied with previous equal expense for the first diagnosis for obtaining with previous equal expense with previous equal expense submodule
Everyone the average each required cost in previous measurement period of disease corresponding to fruit.
Third technical solution adopted by the present invention is:
A kind of medical expense information processing unit, including memory and processor, the memory is for storing at least one
A program, the processor is for loading at least one described program to execute first technical solution the method.
4th technical solution adopted by the present invention is:
A kind of storage medium, wherein be stored with the executable instruction of processor, the executable instruction of the processor by
For executing such as first technical solution the method when processor executes.
The beneficial effects of the present invention are: by the invention it is possible to calculate medical expense progress in real time, make hospital can be with
The gap of medical expense and the medical expense in the generation of previous measurement period that patient generated in the current statistic period is understood in real time,
So as to grasp patient in real time as the influence of hospital's bring.Medical expense progress is hospital in current statistic period business policy
Feedback quantity, hospital be not necessarily to until patient discharge or terminate the course for the treatment of, can directly according to real-time medical expense progress come
Adjust business policy.By the method for the invention, expenses management in thing may be implemented in hospital, so that the interests of hospital and patient
It maximizes.
Detailed description of the invention
Fig. 1 is the flow chart of 1 method of the embodiment of the present invention；
Fig. 2 is the structural block diagram of 2 system of the embodiment of the present invention；
Fig. 3 is the structural block diagram of 3 device of the embodiment of the present invention.
Specific embodiment
Embodiment 1
A kind of medical expense information processing method of the present invention, for obtaining hospital according to the medical expense information processing of patient
Required expense progress msg, referring to Fig.1, comprising the following steps:
Obtain the actual medical expense that patient generates in the current statistic period；
Actual medical expense is compared with reference to medical expense, to obtain medical expense progress；The reference doctor
Treatment expense is determined by the first diagnostic result, diagnosis and treatment mode and with previous equal expense；First diagnostic result is doctor to patient
The diagnostic result of institute's illness kind；The diagnosis and treatment mode is the treatment method for disease corresponding to the first diagnostic result；It is described with
Previous equal expense is everyone the average each required cost in previous measurement period of disease corresponding to the first diagnostic result.
Measurement period in the present embodiment is related with the management system of hospital, can be by hospital in operation the method for the present invention
It is set in computer system.Generally a measurement period is a calendar year, namely locating year now in current statistic period
Part, previous measurement period is exactly the former time, generally refers to the previous year in current statistic period.
" patient " in the method for the present invention refers to individual without referring to group.Of course, it is possible to be directed to each individual patient
The method of the present invention is executed respectively.
Case treatment especially hospitalization usually has a longer period, thus actual medical expense be usually one section compared with
Aggregate-value in long-time.The actual medical expense that patient generates in the current statistic period can be by hospital according to treatment recording gauge
It obtains.
It is determining according to the first diagnostic result, diagnosis and treatment mode and determined with previous equal expense one with reference to medical expense
Reference value.It wherein, is that averagely everyone is each in previous measurement period for disease corresponding to the first diagnostic result with previous equal expense
Required cost, previous measurement period can be any one measurement period before the current statistic period, generally, two neighboring system
Management environment and the policy etc. for counting the period will not all change a lot, therefore the above measurement period is as current statistic
Period can make have larger reference value with reference to medical expense.It is public by medical insurance office or health bureau etc. with previous equal expense
Mechanism statistics, can be by obtaining in the public database of these public organizations with previous equal expense.
It can be seen from the above, with reference to medical expense be it is static, actual medical expense is dynamic.Pass through actual medical expense
Compared with reference medical expense, the available expense progress msg of hospital, that is, medical expense in the present embodiment into
Degree.The thought of the method for the present invention is to think that the external environment influence of previous measurement period and the hospital in current statistic period is identical
, hospital in the current statistic period to patient treatment be actually previous measurement period reproduction, therefore medical expense into
Degree reflects in the identical situation of other conditions, medical expense that patient generated in the current statistic period and in previous measurement period
The gap of the medical expense of generation.
By the method for the invention, medical expense progress can be calculated in real time, so that hospital is understood patient in real time and existed
The gap of the medical expense that the current statistic period generates and the medical expense generated in previous measurement period, so as to slap in real time
Patient is held as the influence of hospital's bring.Medical expense progress is feedback quantity of the hospital in current statistic period business policy, hospital
It is not necessary that directly business policy can be adjusted according to real-time medical expense progress until patient discharge or the end course for the treatment of.
By the method for the invention, expenses management in thing may be implemented in hospital, so that the benefit of hospital and patient.
It is further used as preferred embodiment, described to be obtained with reference to medical expense by following steps:
By medical insurance directory, the first diagnostic result is converted into clearing disease diagnosis；The medical insurance directory is from public data
It is obtained in library, the clearing disease diagnoses corresponding disease disease corresponding with the first diagnostic result with corresponding relationship；
Clearing disease is retrieved from diagnostic data base diagnoses corresponding diagnosis and treatment mode；The diagnostic data base is stored with more
Group clearing disease diagnosis-diagnosis and treatment mode corresponding relationship；
According to the diagnosis of clearing disease and diagnosis and treatment mode, searches and obtained accordingly with previous equal expense from public database；
By the reference medical expense using previous equal expense as required acquisition.
In the method for the present invention, medical expense progress is calculated by actual medical expense and with reference to medical expense,
Wherein actual medical expense statistics obtains, and without calculating, and the calculating with reference to medical expense is then given in the present embodiment
Method.
Firstly, the first diagnostic result is converted to clearing disease diagnosis.First diagnostic result is made by doctor in charge
Patient suffers from the judgement of some disease, but disease involved in this judgement is generally not standard.It is so-called " nonstandard " to refer to doctor
Identical disease cannot be found by protecting in catalogue, and the management tactics of hospital be usually with medical insurance policies have it is very big contact,
It therefore should be according to medical insurance directory come by the first diagnostic result " standardization ".Medical insurance directory can be from medical insurance Ju Deng public organizations
It is downloaded in public database, what is recorded in medical insurance directory is typically all the disease name that can enjoy medical insurance policies that medical insurance office recognizes
Claim.When first diagnostic result is converted to clearing disease diagnosis, it can first determine that the first diagnostic result is related to according to medical knowledge
Disease the first diagnostic result is then converted into this if describing the disease that the first diagnostic result is related in medical insurance directory
Otherwise the diagnosis of clearing disease corresponding to disease searches the documented disease being related to the first diagnostic result in medical insurance directory
Then first diagnostic result is converted into the diagnosis of clearing disease corresponding to this most close disease by most similar disease.
Secondly, retrieving clearing disease from diagnostic data base diagnoses corresponding diagnosis and treatment mode.Diagnostic data base is stored with
Multiple groups settle accounts disease diagnosis-diagnosis and treatment mode corresponding relationship, and medically a corresponding disease of clearing disease diagnosis may deposit
In a variety of suitable diagnosis and treatment modes, and documented by diagnostic data base it is the most suitable diagnosis and treatment mode of the disease.Perfect diagnosis
Database should be that all clearing diseases diagnosis to medical insurance directory all standing, that is, in medical insurance directory can be from diagnosis number
According to finding corresponding diagnosis and treatment mode in library.
Medical insurance Ju Deng public organizations have counted with previous equal expense and have published it by internet etc..With previous
Equal expense is related with the diagnosis of clearing disease and diagnosis and treatment mode, is determining the diagnosis of clearing disease and diagnosis and treatment mode through the above steps
Afterwards, it can be obtained from the public database of medical insurance Ju Deng public organizations accordingly with previous equal expense, i.e., required acquisition
With reference to medical expense.
It is further used as preferred embodiment, the medical expense progress is calculated by the following formula to obtain:
Medical expense progress=actual medical expense/refer to medical expense × 100%.
It is a percentage by actual medical expense and the medical expense progress calculated with reference to medical expense, this
Percentage can intuitively reflect actual medical expense and the gap with reference to medical expense, so that hospital can be preferably
Carry out expenses management in thing.
It is further used as preferred embodiment, the method for the present invention is further comprising the steps of:
According to the numerical value of medical expense progress, profit and loss state of the hospital relative to the patient is determined.
It is a percentage by the medical expense progress that above-mentioned formula determines, it, can be with by the size of this percentage
Determine profit and loss state of the hospital relative to the patient, that is, hospital in the case where only considering the patient without considering other patients
Profit and loss state, such as can be judged by 1 corresponding relationship of table.
Table 1
It is further used as preferred embodiment, the method for the present invention is further comprising the steps of:
Medical expense progress is converted into corresponding progress bar and shows progress bar.
It is a percentage by the medical expense progress that above-mentioned formula determines, the form that can be converted progress bar carries out
Display can generate better suggesting effect for hospital to have more intuitive.Progress bar can have variable color,
Its color can change with the difference of the profit and loss state of hospital, such as carry out color conversion by 2 corresponding relationship of table.
Table 2
| The profit and loss state of hospital | Progress bar color |
| Break even state | White |
| Profit state | Green |
| Lossing state | It is red |
| Defective value steady state | Black |
The method of the present invention is illustrated with more specific embodiment.
Patient A was admitted to hospital on January 1st, 2018 receives treatment, and the disease that the first diagnostic result of doctor shows that it is suffered from is
Ecphyaditis.
Add up to generate 800 yuan of expenses on 2 1st, 2018, i.e. current statistic period (2018) interior patient A generates
Actual medical expense be 800 yuan.The newest medical insurance directory announced by medical insurance office can inquire this disease of ecphyaditis,
Therefore it is also ecphyaditis that clearing disease, which diagnoses corresponding disease,.The best of ecphyaditis this disease is inquired from diagnostic data base
Diagnosis and treatment mode is conservative therapy, and further inquires 2017 in public database and treated by conservative therapy therapy
Time expense of ecphyaditis is 4000 yuan, that is, with previous equal expense for 4000 yuan.Medical expense progress is calculated by formula
For 800/4000 × 100%=20%.By above-mentioned calculating it is found that by 2 1st, 2018 medical expense progress be 20%.
The medical expense progress on other dates in 2018 can be calculated by above method, to realize the reality of medical expense progress
Shi Gengxin.When showing on 2 1st, 2018 medical expense progress with progress strips, the progress of progress bar is 20%, and is sentenced
Disconnected hospital is currently in break even state, and the color of progress bar is white.Hospital terminates to treat without waiting for patient A,
Directly to judge present hospitals profit and loss state according to current medical expense progress, to consider whether to need to adjust to manage political affairs
Plan also can protect the interests of patient to improve the economic benefit of hospital.
The realization of the systems such as HIS can be used in the present embodiment method, can also be run by hospital's others by computer
Operation management system realize.In the case where being realized by computer system, data can fast and accurately be located
Reason, avoids mistake.
Embodiment 2
A kind of medical expense information processing system of the present invention, referring to Fig. 2, comprising:
Actual medical cost model, for obtaining the actual medical expense that patient generates in the current statistic period；
With reference to medical expense module, refer to medical expense for obtaining, it is described with reference to medical expense by the first diagnostic result,
It diagnosis and treatment mode and is determined with previous equal expense；
Medical expense progress module, for actual medical expense to be compared with reference to medical expense, to be cured
Treatment expense progress；It is described to be determined with reference to medical expense by the first diagnostic result, diagnosis and treatment mode and with previous equal expense；
The reference medical expense module includes following submodule:
First diagnostic result submodule, for obtaining the first diagnostic result, first diagnostic result is doctor to patient
The diagnostic result of institute's illness kind；
Diagnosis and treatment mode submodule, for obtaining diagnosis and treatment mode, the diagnosis and treatment mode is for corresponding to the first diagnostic result
The treatment method of disease；
It is described to be tied with previous equal expense for the first diagnosis for obtaining with previous equal expense with previous equal expense submodule
Everyone the average each required cost in previous measurement period of disease corresponding to fruit.
Each functional module can be the software module for realizing corresponding function, be also possible to have corresponding function
Hardware module.
Embodiment 3
Inventive network O&M failure solving device is used for referring to Fig. 3, including memory and processor, the memory
At least one program is stored, the processor is for loading at least one described program to execute 1 the method for embodiment.
Medical expense provided by embodiment of the present invention method can be performed in the medical expense information processing unit of the present embodiment
Information processing method, any combination implementation steps of executing method embodiment have the corresponding function of this method and beneficial to effect
Fruit.
Embodiment 4
A kind of storage medium of the present invention, wherein it is stored with the executable instruction of processor, the executable finger of the processor
It enables when executed by the processor for executing 1 the method for embodiment.Invention medium in the present embodiment can be used for implementing
3 described device of example.
It is to be illustrated to preferable implementation of the invention, but the implementation is not limited to the invention above
Example, those skilled in the art can also make various equivalent variations on the premise of without prejudice to spirit of the invention or replace
It changes, these equivalent deformations or replacement are all included in the scope defined by the claims of the present application.
Claims (10)
1. a kind of medical expense information processing method, the expense needed for obtaining hospital for the medical expense information processing according to patient
With progress msg, which comprises the following steps:
Obtain the actual medical expense that patient generates in the current statistic period；
Actual medical expense is compared with reference to medical expense, to obtain medical expense progress；It is described to refer to payment for medical care
It is determined with by the first diagnostic result, diagnosis and treatment mode and with previous equal expense；First diagnostic result suffers from patient by doctor
The diagnostic result of disease；The diagnosis and treatment mode is the treatment method for disease corresponding to the first diagnostic result；It is described with previous
Equal expense is everyone the average each required cost in previous measurement period of disease corresponding to the first diagnostic result.
2. a kind of medical expense information processing method according to claim 1, which is characterized in that described to refer to medical expense
It is obtained by following steps:
By medical insurance directory, the first diagnostic result is converted into clearing disease diagnosis；The medical insurance directory is from public database
It obtains, the clearing disease diagnoses corresponding disease disease corresponding with the first diagnostic result with corresponding relationship；
Clearing disease is retrieved from diagnostic data base diagnoses corresponding diagnosis and treatment mode；The diagnostic data base is stored with multiple groups knot
Calculate disease diagnosis-diagnosis and treatment mode corresponding relationship；
According to the diagnosis of clearing disease and diagnosis and treatment mode, searches and obtained accordingly with previous equal expense from public database；
By the reference medical expense using previous equal expense as required acquisition.
3. a kind of medical expense information processing method according to claim 1, which is characterized in that the medical expense progress
It is calculated by the following formula to obtain:
Medical expense progress=actual medical expense/refer to medical expense × 100%.
4. a kind of medical expense information processing method according to claim 3, which is characterized in that further comprising the steps of:
According to the numerical value of medical expense progress, profit and loss state of the hospital relative to the patient is determined.
5. a kind of medical expense information processing method according to claim 4, which is characterized in that the medical expense progress
Numerical value and hospital profit and loss state have following corresponding relationship:
Less than 50% --- break even state；
More than or equal to 50% and less than 100% --- profit state；
More than or equal to 100% and less than 200% --- lossing state；
Greater than 200% --- defective value steady state.
6. a kind of medical expense information processing method according to claim 5, which is characterized in that further comprising the steps of:
Medical expense progress is converted into corresponding progress bar and shows progress bar.
7. a kind of medical expense information processing method according to claim 6, which is characterized in that the progress bar has can
The color of change, the color of the progress bar and the profit and loss state of hospital have following corresponding relationship:
White --- break even state；
Green --- profit state；
It is red --- lossing state；
Black --- defective value steady state.
8. a kind of medical expense information processing system characterized by comprising
Actual medical cost model, for obtaining the actual medical expense that patient generates in the current statistic period；
With reference to medical expense module, medical expense is referred to for obtaining, the reference medical expense is by the first diagnostic result, diagnosis and treatment
It mode and is determined with previous equal expense；
Medical expense progress module, for actual medical expense to be compared with reference to medical expense, to obtain payment for medical care
Use progress；It is described to be determined with reference to medical expense by the first diagnostic result, diagnosis and treatment mode and with previous equal expense；
The reference medical expense module includes following submodule:
First diagnostic result submodule, for obtaining the first diagnostic result, first diagnostic result suffers from patient by doctor
The diagnostic result of disease；
Diagnosis and treatment mode submodule, for obtaining diagnosis and treatment mode, the diagnosis and treatment mode is for disease corresponding to the first diagnostic result
Treatment method；
With previous equal expense submodule, for obtaining with previous equal expense, described with previous equal expense is the first diagnostic result institute
Corresponding disease everyone average each required cost in previous measurement period.
9. a kind of medical expense information processing unit, which is characterized in that including memory and processor, the memory is for depositing
At least one program is stored up, the processor is required described in any one of 1-7 for loading at least one described program with perform claim
Method.
10. a kind of storage medium, wherein being stored with the executable instruction of processor, which is characterized in that the processor is executable
Instruction be used to execute such as any one of claim 1-7 the method when executed by the processor.
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