CN109493937A - Drug expenditure based on data processing exceeded risk control method and device - Google Patents
Drug expenditure based on data processing exceeded risk control method and device Download PDFInfo
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- 239000003814 drug Substances 0.000 title claims abstract description 1002
- 229940079593 drug Drugs 0.000 title claims abstract description 909
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- 238000002483 medication Methods 0.000 description 6
- 230000008569 process Effects 0.000 description 6
- 239000002699 waste material Substances 0.000 description 5
- 241001269238 Data Species 0.000 description 4
- -1 Sales Volumes Substances 0.000 description 3
- 230000006399 behavior Effects 0.000 description 3
- 201000010099 disease Diseases 0.000 description 3
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 3
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- 239000000203 mixture Substances 0.000 description 1
- 238000012806 monitoring device Methods 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 239000000955 prescription drug Substances 0.000 description 1
- 229940126532 prescription medicine Drugs 0.000 description 1
- 238000003672 processing method Methods 0.000 description 1
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- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
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Abstract
The embodiment of the present application discloses a kind of risk control method and device that the drug expenditure based on data processing is exceeded, this method comprises: obtain medical institutions to be monitored uses effective prescription；The above-mentioned sufferer information for including in effective prescription is obtained, and the above-mentioned sufferer quantity corresponding to effective prescription is determined according to sufferer information；Above-mentioned medicine information included in effective prescription is obtained, and determines the day for human beings equal drug expenditure of medical institutions to be monitored according to medicine information and sufferer quantity；According to the day for human beings equal drug expenditure and the medical institutions to be monitored corresponding day for human beings equal drug expenditure threshold value, determine whether the medication of medical institutions to be monitored is exceeded.If the medication of medical institutions to be monitored is exceeded, medical institutions to be monitored controlled with the drug expenditure risk of exceeding criterion of effective prescription based on the day for human beings equal drug expenditure.Using the embodiment of the present application, the accuracy of the medication monitoring to medical institutions can be improved, enhance the reliability of the medication monitoring to medical institutions, improve the effective rate of utilization of medical resource.
Description
Technical field
This application involves field of medical technology more particularly to a kind of risk controls that the drug expenditure based on data processing is exceeded
Method and device processed.
Background technique
Currently for the medication standard of each medical institutions of specification, evade big prescribing behaviour, to avoid the abuse of drug
And waste, the purpose rationally treated is played, miscellaneous medication monitoring mechanism comes into being.Miscellaneous medication monitoring equipment
System is for carrying out medication monitoring, including but not limited to each hospital, the department of each hospital, each clinic to each medical institutions
Or even the medical institutions such as each doctor (or representative of medical institutions) carry out medication monitoring.
In the prior art, time equal prescription standard is mainly used for the evaluation of the medication standard of each medical institutions,
Medication evaluation criterion exactly by the prescription average cost calculated every time (referred to as time equal prescription expenditure) as each medical institutions.
Wherein, the medication evaluation criterion of above-mentioned time prescription expenditure is calculated in such a way that prescription total value is divided by prescription number
It arrives.The prior art using time prescription expenditure as the medication evaluation criterion of each medical institutions cause each medical institutions in order to
Evade big prescribing behaviour to be examined, it will usually lower time equal prescription expenditure using reduction prescription number of days, or by decomposition
The biggish big prescription of single prescription total value is decomposed into the modes such as multiple lesser small prescriptions of single prescription total value by the mode of side
Time equal prescription expenditure is reduced, to evade the monitoring of big prescription.The implementation of the prior art makes the use of each medical institutions
The loophole of medicine monitoring is larger, low to the medication monitoring accuracy rate of each medical institutions, poor for applicability.Also not base in the prior art
The drug risk control of medical institutions is carried out in the medicining condition of medical institutions, the waste of medical resource is serious.
Summary of the invention
The embodiment of the present application provides a kind of risk control method and device that the drug expenditure based on data processing is exceeded, behaviour
The accuracy for making simply to can be improved the medication monitoring to medical institutions enhances the reliability of the medication monitoring to medical institutions, mentions
The effective rate of utilization of high medical resource, applicability are stronger.
In a first aspect, the embodiment of the present application provides a kind of risk control side exceeded based on the drug expenditure of data processing
Method, this method comprises:
Obtain medical institutions to be monitored uses effective prescription；
The above-mentioned sufferer information for including in effective prescription is obtained, and above-mentioned effective prescription institute is determined according to above-mentioned sufferer information
Corresponding sufferer quantity；
Above-mentioned medicine information included in effective prescription is obtained, and true according to above-mentioned medicine information and above-mentioned sufferer quantity
The day for human beings equal drug expenditure of fixed above-mentioned medical institutions to be monitored；
According to equal drug expenditure of the above-mentioned day for human beings and equal drug expenditure threshold value of the above-mentioned medical institutions to be monitored corresponding day for human beings, really
Whether the medication of fixed above-mentioned medical institutions to be monitored is exceeded；
If the medication of above-mentioned medical institutions to be monitored is exceeded, based on equal drug expenditure of the above-mentioned day for human beings to above-mentioned doctor to be monitored
It treats unit and carries out the risk control exceeded with the drug expenditure of effective prescription.
With reference to first aspect, in a kind of possible embodiment, above-mentioned acquisition medical institutions to be monitored use effective prescription
Include:
The data system access qualification of above-mentioned medical institutions to be monitored is obtained, based on above-mentioned data system access qualification from upper
State obtain above-mentioned medical institutions to be monitored in the data system of medical institutions to be monitored use effective prescription；And/or
The medical treatment Claims Resolution data that above-mentioned medical institutions to be monitored provide are obtained, are obtained from above-mentioned medical treatment Claims Resolution data above-mentioned
Medical institutions to be monitored use effective prescription；
Wherein, above-mentioned medical institutions to be monitored includes above-mentioned medical institutions to be monitored in the individually examination period with effective prescription
It is interior it is all use effective prescription, the cycle duration in above-mentioned single examination period includes odd-numbered day or more days.
With reference to first aspect, in a kind of possible embodiment, the above-mentioned sufferer for including in effective prescription of above-mentioned acquisition
Information, and determine that the above-mentioned sufferer quantity corresponding to effective prescription includes: according to above-mentioned sufferer information
It obtains above-mentioned sufferer information included in effective prescription, and is determined according to above-mentioned sufferer information and above-mentioned use effective prescription
Targeted sufferer person-time, wherein one is directed to a sufferer person-time with effective prescription；
Above-mentioned sufferer person-time is determined as the above-mentioned sufferer quantity corresponding to effective prescription.
With reference to first aspect, in a kind of possible embodiment, above-mentioned medical institutions to be monitored include with effective prescription
All within the single examination period in odd-numbered day of above-mentioned medical institutions to be monitored use effective prescription；
The above-mentioned medicine information included in effective prescription of above-mentioned acquisition, and according to above-mentioned medicine information and above-mentioned sufferer number
Amount determines that the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored includes:
Obtain above-mentioned all medicine informations with drug sum and each drug included in effective prescription, above-mentioned medicine information
In include at least Sales Volumes and drug and use number of days；
Determine that the drug of above-mentioned all drugs all included by effective prescription is total according to the Sales Volumes of above-mentioned each drug
Volume, and determine that above-mentioned all drugs with effective prescription use total number of days using number of days according to the drug of above-mentioned each drug；
The average daily drug of above-mentioned medical institutions to be monitored is determined using total number of days according to above-mentioned drug total value and above-mentioned drug
Expense determines above-mentioned medical institutions to be monitored according to above-mentioned average daily drug expenditure, above-mentioned sufferer quantity and above-mentioned drug sum
The day for human beings equal drug expenditure.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=drug total value/drug uses total number of days.
The day for human beings of above-mentioned medical institutions to be monitored, equal drug expenditure met:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
With reference to first aspect, in a kind of possible embodiment, above-mentioned medical institutions to be monitored include with effective prescription
All within more days single examination periods of above-mentioned medical institutions to be monitored use effective prescription；
The above-mentioned medicine information included in effective prescription of above-mentioned acquisition, and according to above-mentioned medicine information and above-mentioned sufferer number
Amount determines that the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored includes:
Any day in the above-mentioned single examination period any odd-numbered day effective prescription is obtained, and obtains any of the above-described odd-numbered day medication
The medicine information of included each drug in prescription includes at least Sales Volumes in above-mentioned medicine information and drug uses number of days；
It is determined according to the Sales Volumes of each drug included by any of the above-described odd-numbered day effective prescription and drug using number of days
State the odd-numbered day average daily drug expenditure of medical institutions to be monitored；
According to above-mentioned medical institutions to be monitored in the above-mentioned single odd-numbered day average daily drug expenditure and medicine for examining period Nei Ge
Product determine that the average daily drug expenditure of above-mentioned medical institutions to be monitored, any day drug are above-mentioned using total number of days using total number of days
The drug of included each drug uses the summation of number of days in any odd-numbered day effective prescription；
It is determined according to above-mentioned average daily drug expenditure, above-mentioned all drug sums in effective prescription and above-mentioned sufferer quantity
State the day for human beings equal drug expenditure of medical institutions to be monitored.
Wherein, the day for human beings of above-mentioned medical institutions to be monitored equal drug expenditure meets:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
With reference to first aspect, in a kind of possible embodiment, it is above-mentioned according to above-mentioned medical institutions to be monitored above-mentioned
The odd-numbered day average daily drug expenditure and drug of single examination period Nei Ge determines above-mentioned medical institutions to be monitored using total number of days
Daily drug expenditure includes:
The list in above-mentioned single examination period is determined according to the odd-numbered day average daily drug expenditure of above-mentioned single examination period Nei Ge
Day average daily drug expenditure accumulated value is determined using total number of days according to the drug of above-mentioned single examination period Nei Ge and above-mentioned is individually examined
Drug in nuclear cycle uses total number of days accumulated value；
It is determined according to average daily drug expenditure accumulated value of above-mentioned odd-numbered day and above-mentioned drug using total number of days accumulated value above-mentioned wait supervise
Control the average daily drug expenditure of medical institutions.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=odd-numbered day average daily drug expenditure accumulated value/drug uses total number of days accumulated value.
Optionally, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=period drug total value/period drug uses total number of days；
Wherein, it can be the drug of all drugs of all prescriptions in the single examination period in above-mentioned period drug total value
The total amount of the cumulative obtained all drugs of the amount of money, above-mentioned period drug can be the institute in the single examination period using total number of days
There is the drug of each drug in drug to use the accumulated value of number of days.
With reference to first aspect, in a kind of possible embodiment, the corresponding day for human beings equal medicine of above-mentioned medical institutions to be monitored
Product cost threshold includes the equal drug expenditure upper limit of the above-mentioned medical institutions to be monitored corresponding day for human beings；
It is above-mentioned according to equal drug expenditure of the above-mentioned day for human beings and equal drug expenditure threshold of the above-mentioned medical institutions to be monitored corresponding day for human beings
Value, determining whether the medication of above-mentioned medical institutions to be monitored is exceeded includes:
The day for human beings equal medicine of above-mentioned medical institutions to be monitored is determined according to the unit attribute information of above-mentioned medical institutions to be monitored
The product expense upper limit；
If the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored is less than or equal on equal drug expenditure of the above-mentioned day for human beings
Limit, it is determined that the medication of above-mentioned medical institutions to be monitored is not exceeded；
If the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored is greater than the equal drug expenditure upper limit of the above-mentioned day for human beings, it is determined that
The medication of above-mentioned medical institutions to be monitored is exceeded；
Wherein, the unit attribute information of above-mentioned medical institutions to be monitored includes flat type, region, unit institute locating for unit
Locate one of city, unit drugs supply channel and unit sufferer person-time or a variety of.
With reference to first aspect, in a kind of possible embodiment, the above-mentioned equal drug expenditure of the above-mentioned day for human beings that is based on is to above-mentioned
Medical institutions to be monitored carry out
Equal drug expenditure of the above-mentioned day for human beings and/or equal drug expenditure of the above-mentioned day for human beings are exceeded into equal drug expenditure threshold value of the above-mentioned day for human beings
Difference carry out publicity, equal drug expenditure of the above-mentioned day for human beings based on publicity and/or the above-mentioned medical treatment to be monitored of above-mentioned difference prompt are single
The medication of position control evolution, with the exceeded risk control of the drug expenditure of realization effective prescription；And/or
When receiving equal drug expenditure of the above-mentioned day for human beings and/or the corresponding drug expenditure reimbursement of above-mentioned difference is requested, refusal
Above-mentioned drug expenditure reimbursement request is to realize the risk control for using the drug expenditure of effective prescription exceeded.
Second aspect, the embodiment of the present application provide a kind of risk control that the drug expenditure based on data processing is exceeded dress
It sets, which includes:
Data capture unit uses effective prescription for obtain medical institutions to be monitored；
Above-mentioned data capture unit is also used to obtain the above-mentioned sufferer information for including in effective prescription, and according to above-mentioned disease
Suffer from information and determines the above-mentioned sufferer quantity corresponding to effective prescription；
Medicine information processing unit, it is above-mentioned with included in effective prescription for obtain that above-mentioned data capture unit obtains
Medicine information, and determine according to above-mentioned medicine information and above-mentioned sufferer quantity the day for human beings equal drug expense of above-mentioned medical institutions to be monitored
With；
Medication monitoring unit, for according to above-mentioned medicine information processing unit determine equal drug expenditure of the above-mentioned day for human beings and
The medical institutions to be monitored corresponding day for human beings equal drug expenditure threshold value is stated, determines whether the medication of above-mentioned medical institutions to be monitored surpasses
Mark；
Drug risk control unit, the medication for determining above-mentioned medical institutions to be monitored in above-mentioned medication monitoring unit are super
When mark, above-mentioned medical institutions to be monitored are carried out based on the equal drug expenditure of the above-mentioned day for human beings that above-mentioned medicine information processing unit determines
It is controlled with the drug expenditure risk of exceeding criterion of effective prescription.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned data capture unit is used for:
The data system access qualification of above-mentioned medical institutions to be monitored is obtained, based on above-mentioned data system access qualification from upper
State obtain above-mentioned medical institutions to be monitored in the data system of medical institutions to be monitored use effective prescription；And/or
The medical treatment Claims Resolution data that above-mentioned medical institutions to be monitored provide are obtained, are obtained from above-mentioned medical treatment Claims Resolution data above-mentioned
Medical institutions to be monitored use effective prescription；
Wherein, above-mentioned medical institutions to be monitored includes above-mentioned medical institutions to be monitored in the individually examination period with effective prescription
It is interior it is all use effective prescription, the cycle duration in above-mentioned single examination period includes odd-numbered day or more days.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned data capture unit is used for:
It obtains above-mentioned sufferer information included in effective prescription, and is determined according to above-mentioned sufferer information and above-mentioned use effective prescription
Targeted sufferer person-time, wherein one is directed to a sufferer person-time with effective prescription；
Above-mentioned sufferer person-time is determined as the above-mentioned sufferer quantity corresponding to effective prescription.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medical institutions to be monitored include with effective prescription
All within the single examination period in odd-numbered day of above-mentioned medical institutions to be monitored use effective prescription；
Above-mentioned medicine information processing unit is used for:
Obtain above-mentioned all medicine informations with drug sum and each drug included in effective prescription, above-mentioned medicine information
In include at least Sales Volumes and drug and use number of days；
Determine that the drug of above-mentioned all drugs all included by effective prescription is total according to the Sales Volumes of above-mentioned each drug
Volume, and determine that above-mentioned all drugs with effective prescription use total number of days using number of days according to the drug of above-mentioned each drug；
The average daily drug of above-mentioned medical institutions to be monitored is determined using total number of days according to above-mentioned drug total value and above-mentioned drug
Expense determines above-mentioned medical institutions to be monitored according to above-mentioned average daily drug expenditure, above-mentioned sufferer quantity and above-mentioned drug sum
The day for human beings equal drug expenditure.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=drug total value/drug uses total number of days.
The day for human beings of above-mentioned medical institutions to be monitored, equal drug expenditure met:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medical institutions to be monitored include with effective prescription
All within more days single examination periods of above-mentioned medical institutions to be monitored use effective prescription；
Above-mentioned medicine information processing unit is used for:
Any day in the above-mentioned single examination period any odd-numbered day effective prescription is obtained, and obtains any of the above-described odd-numbered day medication
The medicine information of included each drug in prescription includes at least Sales Volumes in above-mentioned medicine information and drug uses number of days；
It is determined according to the Sales Volumes of each drug included by any of the above-described odd-numbered day effective prescription and drug using number of days
State the odd-numbered day average daily drug expenditure of medical institutions to be monitored；
According to above-mentioned medical institutions to be monitored in the above-mentioned single odd-numbered day average daily drug expenditure and medicine for examining period Nei Ge
Product determine that the average daily drug expenditure of above-mentioned medical institutions to be monitored, any day drug are above-mentioned using total number of days using total number of days
The drug of included each drug uses the summation of number of days in any odd-numbered day effective prescription；
It is determined according to above-mentioned average daily drug expenditure, above-mentioned all drug sums in effective prescription and above-mentioned sufferer quantity
State the day for human beings equal drug expenditure of medical institutions to be monitored.
Wherein, the day for human beings of above-mentioned medical institutions to be monitored equal drug expenditure meets:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned medicine information processing unit is used for:
The list in above-mentioned single examination period is determined according to the odd-numbered day average daily drug expenditure of above-mentioned single examination period Nei Ge
Day average daily drug expenditure accumulated value is determined using total number of days according to the drug of above-mentioned single examination period Nei Ge and above-mentioned is individually examined
Drug in nuclear cycle uses total number of days accumulated value；
It is determined according to average daily drug expenditure accumulated value of above-mentioned odd-numbered day and above-mentioned drug using total number of days accumulated value above-mentioned wait supervise
Control the average daily drug expenditure of medical institutions；
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=odd-numbered day average daily drug expenditure accumulated value/drug uses total number of days accumulated value.
In conjunction with second aspect, in a kind of possible embodiment, the corresponding day for human beings equal medicine of above-mentioned medical institutions to be monitored
Product cost threshold includes the equal drug expenditure upper limit of the above-mentioned medical institutions to be monitored corresponding day for human beings；
Above-mentioned medication monitoring unit is used for:
The day for human beings equal medicine of above-mentioned medical institutions to be monitored is determined according to the unit attribute information of above-mentioned medical institutions to be monitored
The product expense upper limit；
If the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored is less than or equal on equal drug expenditure of the above-mentioned day for human beings
Limit, it is determined that the medication of above-mentioned medical institutions to be monitored is not exceeded；
If the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored is greater than the equal drug expenditure upper limit of the above-mentioned day for human beings, it is determined that
The medication of above-mentioned medical institutions to be monitored is exceeded；
Wherein, the unit attribute information of above-mentioned medical institutions to be monitored includes flat type, region, unit institute locating for unit
Locate one of city, unit drugs supply channel and unit sufferer person-time or a variety of.
In conjunction with second aspect, in a kind of possible embodiment, above-mentioned drug risk control unit is used for:
Equal drug expenditure of the above-mentioned day for human beings and/or equal drug expenditure of the above-mentioned day for human beings are exceeded to the difference of the day for human beings equal drug expenditure threshold value
Value carries out publicity, and equal drug expenditure of the above-mentioned day for human beings and/or above-mentioned difference based on publicity prompt above-mentioned medical institutions to be monitored
Doctor controls the medication of evolution, with the exceeded risk control of the drug expenditure of realization effective prescription；And/or
When receiving equal drug expenditure of the above-mentioned day for human beings and/or the corresponding drug expenditure reimbursement of above-mentioned difference is requested, refusal
Above-mentioned drug expenditure reimbursement request is to realize the risk control for using the drug expenditure of effective prescription exceeded.
The third aspect, the embodiment of the present application provide a kind of terminal device, which includes processor and memory,
The processor and memory are connected with each other.The memory for store support the terminal device execute above-mentioned first aspect and/or
The computer program for the method that any possible implementation of first aspect provides, which includes program instruction,
The processor is configured for calling above procedure instruction, executes above-mentioned first aspect and/or first aspect is any possible
Method provided by embodiment.
Fourth aspect, the embodiment of the present application provide a kind of computer readable storage medium, which deposits
Computer program is contained, which includes program instruction, which makes the processor when being executed by a processor
Execute method provided by above-mentioned first aspect and/or any possible embodiment of first aspect.
The embodiment of the present application being believed with medicine information and sufferer included in effective prescription based on medical institutions to be monitored
Breath, determines the day for human beings of medical institutions to be monitored equal drug expenditure, so can the day for human beings equal drug based on medical institutions to be monitored take
It is whether exceeded with the medication for judging medical institutions to be monitored, realize the evaluation to the Drug utilization index of medical institutions to be monitored, operation
Simply.It, then can be based on the day for human beings of the medical institutions to be monitored when the day for human beings of the medical institutions to be monitored, equal drug expenditure was exceeded
Equal drug expenditure carries out the risk control exceeded with the drug expenditure of effective prescription to the medical institutions to be monitored.Based on the application reality
The method realization for applying example offer is simple to the medication policer operation of each medical institutions, and the medication monitoring to medical institutions can be improved
Accuracy improves the reliability of the medication monitoring to medical institutions, improves the effective rate of utilization of medical resource, applicability is stronger.
Detailed description of the invention
Technical solution in ord to more clearly illustrate embodiments of the present application, below will be to needed in embodiment description
Attached drawing is briefly described, it should be apparent that, the accompanying drawings in the following description is some embodiments of the present application, general for this field
For logical technical staff, without creative efforts, it is also possible to obtain other drawings based on these drawings.
Fig. 1 is the one stream of the exceeded risk control method of the drug expenditure provided by the embodiments of the present application based on data processing
Journey schematic diagram；
Fig. 2 is the another of the exceeded risk control method of the drug expenditure provided by the embodiments of the present application based on data processing
Flow diagram；
Fig. 3 is the implementation of the exceeded risk control device of the drug expenditure provided by the embodiments of the present application based on data processing
Example structural schematic diagram；
Fig. 4 is the example structure schematic diagram of terminal device provided by the embodiments of the present application.
Specific embodiment
Below in conjunction with the attached drawing in the embodiment of the present application, technical solutions in the embodiments of the present application carries out clear, complete
Site preparation description, it is clear that described embodiment is some embodiments of the present application, instead of all the embodiments.Based on this Shen
Please in embodiment, every other implementation obtained by those of ordinary skill in the art without making creative efforts
Example, shall fall in the protection scope of this application.
The embodiment of the present application provides a kind of risk control method that the drug expenditure based on data processing is exceeded, can be based on
The medical institutions such as each hospital, the department of each hospital, each clinic or even each doctor (or medical institutions representative (or
Claim team)) the day for human beings equal drug expenditure evaluate the medication of each medical institutions (including hospital, department, clinic or doctor)
Whether exceeded (or unreasonable), and can the medicining condition based on medical institutions the day for human beings equal drug is carried out to the prescriptions of medical institutions
The exceeded publicity of expense, and/or the exceeded corresponding drug expenditure reimbursement of the refusal day for human beings equal drug expenditure etc., are realized to medical institutions
The exceeded risk control of the drug expenditure with effective prescription, to avoid the waste of medical resource.Here, the day for human beings equal drug expenditure is
The average daily drug expenditure for referring to an average people, is illustrated below in conjunction with average daily drug expenditure.It is above-mentioned each for convenience of description
Represented by the representative of hospital, the department of each hospital, each clinic or even each doctor etc. medical institutions or medical institutions
Examination dimension will by medical institutions this examination dimension for be illustrated, repeat no more below.
The provided effective prescription of the embodiment of the present application may include each doctor of each medical institutions for each sufferer
The prescription issued of illness or the prescription issued for the illness of each sufferer of each doctor or prescription etc.,
This is with no restrictions.For convenience of description, will be illustrated by taking prescription as an example below.Generally, each doctor of each medical institutions
It may include but be not limited to prescription in the prescription that teacher is issued and issue time, prescription number, department's number, sufferer personal information, medicine
Product details and doctor's signature, can specifically determine, herein with no restrictions according to practical application scene.In other words, either singly
A biggish big prescription of prescription total value, or the place of the single lesser small prescription of prescription total value or other more forms of expression
It is square, the drug details that medical institutions issue, including but not limited to nomenclature of drug, Sales Volumes, drug are had in each prescription
Usage mode and drug use number of days etc..Therefore either big prescription or small prescription or other, too busy to get away drug is detailed
Feelings.Therefore, day for human beings based on each medical institutions equal drug expenditure realize the evaluation to the medication standard of each medical institutions from
And realize and the medications of each medical institutions is monitored, it is easy to operate and can cover preferably, more fully hereinafter to medical single
The medication monitoring of each prescription of position.The day for human beings equal drug expenditure simultaneously based on medical institutions realizes the use to each medical institutions
Medicine monitoring more it is accurate in place, so that the accuracy rate of the monitoring of the medication to each medical institutions can be improved, and then can be improved and be based on
The medicining condition of each medical institutions to the prescriptions of each medical institutions carry out the exceeded publicity of the day for human beings equal drug expenditure, and/or
Refuse the reliable of the drug expenditure risk of exceeding criterion control of the effective prescription such as exceeded corresponding drug expenditure reimbursement of average daily drug expenditure
Property, the medication controllability of medical institutions' evolution can be improved, so that the effective rate of utilization of medical resource can be improved, applicability is more
It is high.
In some possible embodiments, the day for human beings equal drug expenditure based on medical institutions carries out medication to medical institutions
The medicining condition of medical supply unit can be monitored daily when monitoring, and then the day for human beings that medical institutions can be settled accounts daily equal drug expense
With being monitored based on the daily day for human beings equal drug expenditure to the medicining condition of medical institutions.Optionally, based on the daily day for human beings
While equal drug expenditure carries out medication monitoring to medical institutions, the medication for adding up more days monitoring situation may be based on to medical single
Position carries out the overall merit etc. of medicining condition, such as a week, one month, a season or 1 year etc., specifically can basis
Practical application scene is determining, herein with no restrictions.For convenience of description, below will with any day (for convenience of description below will be with list
Day for be illustrated) the day for human beings equal drug expenditure calculating and based on the daily day for human beings equal drug expenditure to medical institutions
It is exceeded to the drug expenditure provided by the embodiments of the present application based on data processing for medicining condition is monitored and/or evaluates
Risk control method be described.
The exceeded risk control method of drug expenditure provided by the embodiments of the present application based on data processing can be supervised by drug
Superintend and direct management board, board of health, health and end associated by the medications monitoring unit such as the healthy committee and medical treatment Claims Resolution unit
End equipment executes, such as above-mentioned medication monitoring unit is used to carry out each medical institutions client and/or the people of medication monitoring
Machine interactive device etc., herein with no restrictions.For convenience of description, will be illustrated by taking terminal device as an example below.
Embodiment one:
It is the risk control side exceeded based on the drug expenditure of data processing provided by the embodiments of the present application referring to Fig. 1, Fig. 1
One flow diagram of method.The exceeded risk control method of drug expenditure provided by the embodiments of the present application based on data processing,
It S11 implementation provided by each step into S15 can be illustrated as follows.
S11, obtain medical institutions to be monitored uses effective prescription.
In some possible embodiments, above-mentioned medical institutions to be monitored can monitor any that unit monitors by medication
Medical institutions can specifically determine, herein with no restrictions according to practical application scene.In other words, any medical institutions all may
By medication monitoring unit as monitored object, therefore selected monitored object then can be medical institutions to be monitored.It retouches for convenience
It states, will be illustrated by taking medical institutions to be monitored as an example below.
In some possible embodiments, above-mentioned medical institutions may include medical institutions to be monitored in list with effective prescription
It is all caused by a few days to use effective prescription.For convenience of description, generated institute within the odd-numbered day, above-mentioned medical institutions to be monitored is useful
Effective prescription can be illustrated by taking odd-numbered day prescription (i.e. odd-numbered day effective prescription) as an example.The odd-numbered day prescription of above-mentioned medical institutions can refer to
All prescriptions of medical institutions issued any day, all doctors of all departments of hospital are opened including but not limited in the odd-numbered day
All prescriptions, all prescriptions that all doctors of some department of hospital are issued in the odd-numbered day or the hospital in the odd-numbered day of tool
Some department all prescriptions for being issued of some doctor in any situation.Wherein, above-mentioned odd-numbered day prescription institute table
The concrete condition shown carries out the examination dimension of medication monitoring (such as medical single to medical institutions according in practical application scene
Position carries out medication monitoring, for some department progress medication monitoring of medical institutions or for some section of medical institutions
Some doctor of room carries out medication monitoring etc.) it determines, herein with no restrictions.It, below will be with hospital in the odd-numbered day for convenience of description
All prescriptions for being issued of all doctors of all departments for be illustrated, hereinafter referred to as odd-numbered day prescription.As an example it is assumed that
All doctors one day all prescriptions issued of medical institutions add up to S (such as 80) prescription, wherein in this 80 prescriptions
One prescription is directed to a sufferer person-time, therefore this corresponding sufferer quantity of 80 prescriptions is 80.It in other words, can in 80 prescriptions
There can be multiple prescriptions to correspond to the same sufferer, however this corresponding sufferer of multiple prescriptions is still calculated with sufferer person-time, because herein
Side's sum (80) is then sufferer quantity corresponding to all prescriptions, is repeated no more below.It is assumed that in above-mentioned 80 prescriptions at each
The accumulative K (such as drug sum is 200) that adds up to of Quantity of drugs included by side is a, then based on each drug in this 200 drugs
Average daily drug expenditure can be calculated in details.Further, based on 200 included by 80 prescriptions (corresponding sufferer quantity is 80)
The day for human beings equal drug expenditure of the medical institutions can then be calculated in conjunction with above-mentioned average daily drug expenditure for a drug.
In some possible embodiments, terminal device can be docked with the data system of medical institutions to be monitored, be obtained
The data system access qualification of medical institutions to be monitored, so can the data system access qualification based on medical institutions to be monitored from
It is obtained in the data system of medical institutions to be monitored at the prescription of medical institutions to be monitored, such as the odd-numbered day of medical institutions to be monitored
Side etc..Optionally, terminal device may be based on medical institutions to be monitored and provide medical treatment Claims Resolution data, from medical treatment Claims Resolution data
Middle screening obtains the prescription datas such as the odd-numbered day prescription of medical institutions.Optionally, terminal device may be based on big data analysis, from each
Screening obtains prescription datas such as the odd-numbered day prescription of medical institutions to be monitored, etc. in the sufferer diagnosis records of a medical institutions.Eventually
End equipment can acquire the list of medical institutions to be monitored based on any data to acquisite approachs except above-mentioned data acquiring mode
Day prescription can specifically determine, herein with no restrictions according to practical application scene.
It is opened in the prescription it is appreciated that may each comprise on any prescription in the odd-numbered day prescription of medical institutions to be monitored here
The drug details of drug, including but not limited to nomenclature of drug, Sales Volumes, drug usage mode (or drug takes mode etc.)
And drug uses number of days, can specifically be determined according to practical application scene, herein with no restrictions.
S12 obtains the above-mentioned sufferer information for including in effective prescription, and is determined at above-mentioned medication according to above-mentioned sufferer information
Sufferer quantity corresponding to side.
In some possible embodiments, above-mentioned with the sufferer information for including may include sufferer name, disease in effective prescription
Suffer from the sufferers personal information such as identification card number, sufferer age and sufferer gender, can specifically be determined according to practical application scene, herein
With no restrictions.Wherein, above-mentioned to be directed to a sufferer person-time with effective prescription with one in effective prescription, therefore according to above-mentioned in effective prescription
Included sufferer information can determine the sufferer quantity corresponding to effective prescription.Here, sufferer quantity is equal to the place with effective prescription
Side's sum, for details, reference can be made to implementations described in above-mentioned steps S11, and details are not described herein.
S13 obtains above-mentioned medicine information included in effective prescription, and according to above-mentioned medicine information and above-mentioned sufferer number
Amount determines the day for human beings equal drug expenditure of the medical institutions to be monitored.
In some possible embodiments, medical treatment to be monitored can be determined based on the odd-numbered day prescription of medical institutions to be monitored
The medicine information of each drug included by all prescriptions in the odd-numbered day prescription of unit, wherein include in the medicine information of any drug
But it is not limited to Sales Volumes and drug and uses number of days.All prescriptions are wrapped in odd-numbered day prescription based on above-mentioned medical institutions to be monitored
The medicine information of each drug included can determine drug sum included in the odd-numbered day prescription of medical institutions to be monitored, drug total value
And drug uses total number of days etc..Wherein, the Sales Volumes of any of the above-described drug are that the unit price of any drug is multiplied with quantity
Obtain the price of single drug.After above-mentioned drug sum indicates that drug used in all prescriptions is cumulative in odd-numbered day prescription
Drug sum.Above-mentioned drug total value is that the unit price based on each drug included in odd-numbered day prescription is multiplied to obtain individually with quantity
The Sales Volumes of drug and then the Sales Volumes of all drugs included in odd-numbered day prescription are added up to obtain all medicines
The drug total price (i.e. drug total value) of product.Above-mentioned drug is the medicine of each drug in all drugs in odd-numbered day prescription using total number of days
Product use the accumulated value of number of days.The average daily drug expenditure of the odd-numbered day prescription of medical institutions to be monitored indicates that medical institutions to be monitored are single
The average cost of included all drugs in day prescription, here can average daily drug expenditure be illustrated.Wherein, above-mentioned wait supervise
The average daily drug expenditure for controlling the odd-numbered day prescription of medical institutions can be calculated based on following formula:
Average daily drug expenditure=drug total value/drug uses total number of days (1)
Wherein, the Sales Volumes of all drugs are cumulative in drug total value, that is, odd-numbered day prescription in above-mentioned formula (1) obtains
The total price of all drugs, above-mentioned drug use number of days using the drug of each drug in all drugs in total number of days, that is, odd-numbered day prescription
Accumulated value.
In some possible embodiments, it is calculated based on drug details included by each prescription in above-mentioned odd-numbered day prescription
It, can also be based on above-mentioned sufferer quantity (i.e. with the prescription of effective prescription sum, such as S=80) and above-mentioned to after average daily drug expenditure
It is single that the medical treatment can be then calculated in conjunction with above-mentioned average daily drug expenditure in the sum of drug included by 80 prescriptions (such as K=200)
The day for human beings equal drug expenditure of position.Wherein, the calculating of equal drug expenditure of the above-mentioned day for human beings can meet following formula:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity * (2)
Wherein, such as above-mentioned formula (2) it is found that the drug sum included by the above-mentioned odd-numbered day prescription is K (such as 200
It is a), when sufferer quantity corresponding to above-mentioned odd-numbered day prescription is S (such as S=80, i.e. the prescription sum of odd-numbered day prescription are 80),
The above-mentioned day for human beings equal drug expenditure can meet following formula:
The day for human beings equal average daily drug expenditure of drug expenditure=S/K*
The average daily drug expenditure of=200/80* (3)
In some possible embodiments, simply carrying out medication monitoring to medical institutions using average daily drug expenditure may
Medical institutions be will lead in the way of increasing ethical goods type etc. to evade and be based on so that the average daily drug expenditure of single medicine is up to standard
The medication monitoring of average daily drug expenditure, but the day for human beings equal drug expenditure or exceeded.Therefore, average daily drug expenditure, meter are based on
Calculating the day for human beings equal drug expenditure can be increased and be monitored based on the drug expenditure in dimension per capita on the basis of average daily drug expenditure, from
And preferably the medication of medical institutions can be monitored, operation is more flexible, and applicability is stronger.
S14, according to equal drug expenditure of the above-mentioned day for human beings and equal drug expenditure threshold of the above-mentioned medical institutions to be monitored corresponding day for human beings
Value, determines whether the medication of above-mentioned medical institutions to be monitored is exceeded.
In some possible embodiments, it when carrying out medication monitoring for different medical unit, can preset each
The medication Standard of Monitoring of medical institutions and/or the performance assessment criteria threshold value of medication evaluation criterion.Wherein, above-mentioned performance assessment criteria threshold value can
For the average daily drug expenditure threshold value of people, such as the upper limit up to standard or the day for human beings equal drug expenditure upper limit etc. of the day for human beings equal drug expenditure.Example
It such as, can be based on the history medication record or medicine of medical institutions to be monitored when carrying out medication monitoring for medical institutions to be monitored
The information settings such as the product Distursement medical institutions to be monitored corresponding day for human beings equal drug expenditure upper limit, and then can be based on above-mentioned determination
Medical institutions to be monitored the day for human beings equal drug expenditure, in conjunction with corresponding performance assessment criteria threshold value (the i.e. people of the medical institutions to be monitored
The average daily drug expenditure upper limit) determine whether the medication of the medical institutions is exceeded.In other words, as the medical institutions to be monitored
Whether the day for human beings equal drug expenditure is greater than its corresponding day for human beings equal drug expenditure upper limit.If the day for human beings of the medical institutions to be monitored equal medicine
Product expense is less than or equal to its corresponding day for human beings equal drug expenditure upper limit, then can determine that the medication of medical institutions to be monitored is to reach
The medication of target, i.e., medical institutions to be monitored is not exceeded.If the day for human beings of medical institutions to be monitored equal drug expenditure is greater than its correspondence
The day for human beings equal drug expenditure upper limit, then can determine medical institutions to be monitored medication be it is exceeded, i.e., medical institutions to be monitored
Drug cost is exceeded.
S15, if the medication of above-mentioned medical institutions to be monitored is exceeded, the day for human beings equal medicine based on above-mentioned medical institutions to be monitored
Product expense carries out the risk control exceeded with the drug expenditure of effective prescription to above-mentioned medical institutions to be monitored.
In some possible embodiments, when the medication of above-mentioned medical institutions to be monitored is exceeded, such as medical institutions
When the day for human beings equal drug expenditure is greater than the day for human beings equal drug expenditure threshold value, it may be determined that the day for human beings equal drug of above-mentioned medical institutions to be monitored takes
Exceed the day for human beings equal drug expenditure difference of the day for human beings equal drug expenditure threshold portion in.Based on equal drug expenditure difference of the above-mentioned day for human beings
Equal drug expenditure of the above-mentioned day for human beings and/or equal drug expenditure difference of the above-mentioned day for human beings can be subjected to publicity, the day for human beings equal medicine based on publicity
Product expense and/or the day for human beings equal drug expenditure difference prompt medical institutions to be monitored doctor control evolution medication, avoid this to
The doctor of monitoring medical institutions random medication during evolution causes the waste of the medical resources such as drug, realizes to doctor to be monitored
The drug expenditure risk of exceeding criterion with effective prescription for treating unit controls.Optionally, equal drug expenditure of the above-mentioned day for human beings and/or the day for human beings are based on
Equal drug expenditure difference can announce interface in the unit hall of the medical institutions to be monitored, and (such as the message bulletin in unit hall is aobvious
Display screen) on carry out publicity or medication supervision unit go out medical institutions' medication monitoring daily paper on carry out publicity, with control
The medication of medical institutions to be monitored and its each doctor's evolution avoids the equal drug of the day for human beings with effective prescription of medical institutions to be monitored
Expense continues exceeded bring medical resource waste, realizes and controls the medication risk of exceeding criterion of the medical institutions to be monitored.It is optional
, it can also be in each of the medical institutions to be monitored based on equal drug expenditure of the above-mentioned day for human beings and/or the day for human beings equal drug expenditure difference
Carry out publicity on the information bulletin interface of department, and/or the medical institutions to be monitored each doctor evolution tool head
Publicity etc. is carried out on page, can specifically be determined according to practical application scene, herein with no restrictions.
The embodiment of the present application can be determined based on medical institutions to be monitored medicine information included in effective prescription wait supervise
The average daily drug expenditure of medical institutions is controlled, it can also be based on drug included in sufferer quantity corresponding to odd-numbered day prescription and prescription
The information such as sum determine the day for human beings equal drug expenditure of the medical institutions in conjunction with average daily drug expenditure.Based on medical institutions to be monitored
The day for human beings equal drug expenditure judge whether the medication of medical institutions to be monitored up to standard, realization the medication of medical institutions to be monitored is referred to
Target evaluation, it is easy to operate.The medication policer operation letter to each medical institutions is realized based on method provided by the embodiments of the present application
It is single, the accuracy of the medication monitoring to medical institutions can be improved, improve the reliability of the medication monitoring to medical institutions.In turn,
The medicining condition based on each medical institutions can be improved, the exceeded public affairs of average daily drug expenditure are carried out to the prescription of each medical institutions
The reliability controlled with the drug expenditure risk of exceeding criterion of effective prescription such as show, improves the medication controllability of medical institutions' evolution, from
And the effective rate of utilization of medical resource can be improved, applicability is stronger.
Embodiment two:
Referring to fig. 2, Fig. 2 is the risk control side exceeded based on the drug expenditure of data processing provided by the embodiments of the present application
Another flow diagram of method.The exceeded risk control method of drug expenditure provided by the embodiments of the present application based on data processing
It can be achieved to be monitored medicining condition of the medical institutions to be monitored within the individually examination period, this method can be as follows
S21 implementation provided by each step into S27 is illustrated.
S21, obtain medical institutions to be monitored uses effective prescription.
S22 obtains the above-mentioned sufferer information for including in effective prescription, and is determined at above-mentioned medication according to above-mentioned sufferer information
Sufferer quantity corresponding to side.
In some possible embodiments, the use effective prescription of above-mentioned acquisition medical institutions to be monitored and determining sufferer number
The implementation of amount can be found in implementation provided by step S11 and S12 in above-described embodiment, and details are not described herein.
In some possible embodiments, the implementation with effective prescription of above-mentioned acquisition medical institutions to be monitored can join
See implementation provided by step S11 in above-described embodiment, details are not described herein.
Optionally, in some possible embodiments, above-mentioned medical institutions with effective prescription may also include doctor to be monitored
Treat unit generated within the individually examination period it is all with effective prescription, wherein the above-mentioned single examination period greater than one day, such as one
A week, one month, a season or 1 year etc., herein with no restrictions.For convenience of description, above-mentioned medical institutions to be monitored exist
Generated all can singly be examined for period prescription with effective prescription is illustrated in the single examination period.
Optionally, single examination period prescription of above-mentioned medical institutions can refer to institute in any examination period of medical institutions
All prescriptions issued, all places that including but not limited to individually all doctors of all departments of hospital are issued in the examination period
All prescriptions that all doctors of some department of hospital are issued in side, single examination period, or single examination period
Any situation in all prescriptions that some doctor of some department of interior hospital is issued.Wherein, above-mentioned single examination
Concrete condition represented by period prescription is according to the examination dimension (example that in practical application scene medical institutions are carried out with medication monitoring
Such as medication monitoring is carried out, for some department progress medication monitoring of medical institutions or for medical single for medical institutions
Some doctor of some department of position carries out medication monitoring etc.) it determines, herein with no restrictions.For convenience of description, below will
It is illustrated by taking all prescriptions for individually examining all doctors of all departments of hospital in the period to be issued as an example, hereinafter referred to as singly
Examine period prescription.
It is appreciated that can be wrapped on any prescription included in single examination period prescription of medical institutions to be monitored here
Include the drug details of write a prescription product in the prescription, including but not limited to nomenclature of drug, Sales Volumes, drug usage mode and medicine
Product use number of days, can specifically be determined according to practical application scene, herein with no restrictions.
S23 obtains above-mentioned medicine information included in effective prescription, and determining described wait supervise according to above-mentioned medicine information
Control the average daily drug expenditure of medical institutions.
In some possible embodiments, the above-mentioned letter of the drug included by effective prescription based on medical institutions to be monitored
Breath determines that the specific implementation of the average daily drug expenditure of medical institutions to be monitored can be found in step S13 in above-described embodiment and be mentioned
The implementation of confession, details are not described herein.
Optionally, in some possible embodiments, average daily with effective prescription based on above-mentioned medical institutions to be monitored
Drug expenditure can also handle to obtain the average daily drug expenditure of medical institutions to be monitored in designated time period, for example, a week, one
A month, the average daily drug expenditure etc. in a season or 1 year.For convenience of description, can be examined below using a week as one
Period is illustrated by taking the average daily drug expenditure in a week as an example, the average daily drug expenditure of referred to as single examination period prescription.
Optionally, the average daily drug expenditure of Dan Kaohe period prescription can meet following formula:
Average daily drug expenditure=period drug total value/period drug uses total number of days (4)
Wherein, period drug total value can be and be wrapped in all prescriptions in the single examination period in above-mentioned formula (4)
The total amount of the cumulative obtained all drugs of the Sales Volumes of all drugs included, above-mentioned period drug can be using total number of days
The drug of each drug uses the accumulated value of number of days in all drugs included by single examination period prescription.
Optionally, in some possible embodiments, institute in single examination period prescription based on medical institutions to be monitored
Including medicine information, can obtain any day in the single examination period use effective prescription (for convenience of description, below will be with any list
It is illustrated for daily effective prescription), and the medicine information of each drug included in any odd-numbered day effective prescription is obtained, wherein
It include but is not limited to that Sales Volumes and drug use number of days in medicine information.According to each medicine included by any odd-numbered day effective prescription
The Sales Volumes and drug of product using number of days determine any day average daily drug expenditure of medical institutions to be monitored (for convenience of describe,
It will be illustrated by taking odd-numbered day average daily drug expenditure as an example below).Wherein, any day odd-numbered day day of above-mentioned medical institutions to be monitored
Equal drug expenditure can be found in the corresponding implementation of formula in above-described embodiment (1), and details are not described herein.In addition, based on wait supervise
The drug of control medical institutions each drug included in daily prescription within the individually examination period can determine daily place using number of days
Drug in side uses total number of days, and then the list of medical institutions to be monitored can be determined using total number of days based on the drug of daily prescription
The drug of all drugs included in period prescription is examined to use total number of days.Wherein, medical institutions to be monitored are individually examining
Any day drug in period uses number of days using the drug that total number of days is each drug included in any odd-numbered day prescription
Summation.It is used always according to above-mentioned medical institutions to be monitored in individually the odd-numbered day average daily drug expenditure of examination period Nei Ge and drug
Number of days can determine average daily drug expenditure of the medical institutions to be monitored within the individually examination period.
It in some possible embodiments, can according to the odd-numbered day average daily drug expenditure of above-mentioned single examination period Nei Ge
Determine that medical institutions to be monitored, can be referred to as single for convenience of description in the accumulated value of the individually odd-numbered day average daily drug expenditure in examination period
Day average daily drug expenditure accumulated value.It can determine doctor to be monitored using total number of days according to the drug of above-mentioned single examination period Nei Ge
Treat unit individually examination the period in drug use total number of days accumulated value, for convenience of description can abbreviation drug use total number of days
Accumulated value.Medical treatment to be monitored is determined using total number of days accumulated value according to average daily drug expenditure accumulated value of above-mentioned odd-numbered day and above-mentioned drug
The average daily drug expenditure of unit.
Here, (medical institutions i.e. to be monitored are within the individually examination period for the average daily drug expenditure of medical institutions to be monitored
Average daily drug expenditure) following formula can be met:
Average daily drug expenditure=odd-numbered day average daily drug expenditure accumulated value/drug uses total number of days accumulated value (5)
It is assumed that individually the examination period is a week here, then the odd-numbered day average daily drug expenditure in above-mentioned formula (5) is tired
The accumulated value of the average daily drug expenditure of each odd-numbered day prescription, above-mentioned public affairs in the value added 7 odd-numbered day prescriptions that can be in a week
Drug in formula (5) can be the medicine of each odd-numbered day prescription in 7 odd-numbered day prescriptions in a week using total number of days accumulated value
Product use the accumulated value of total number of days.
S24, it is true according to above-mentioned average daily drug expenditure, above-mentioned all drug sums in effective prescription and above-mentioned sufferer quantity
The day for human beings equal drug expenditure of fixed above-mentioned medical institutions to be monitored.
In some possible embodiments, above-mentioned all drug sums in effective prescription be above-mentioned more days individually examine
The accumulated value with drug included in effective prescription of each day in nuclear cycle may be simply referred to as drug sum for convenience of description.Above-mentioned disease
It is total equal to all prescriptions with effective prescription in above-mentioned more days single examination periods to suffer from quantity.Based on the average daily medicine of above-mentioned determination
Drug included by product expense, above-mentioned sufferer quantity (i.e. with the prescription sum of effective prescription, such as S=80) and above-mentioned 80 prescriptions
The day for human beings equal drug expenditure of the medical institutions can be then calculated in total (such as K=200).Wherein, equal drug of the above-mentioned day for human beings takes
Calculating can meet following formula:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity * (6)
Wherein, as known to above-mentioned formula (6), it is assumed that above-mentioned more days all drug sums included by effective prescription are K
A (such as 200), above-mentioned more days all sufferer quantity corresponding to effective prescription are S (such as S=80, i.e. prescription sum
It is 80) when, the above-mentioned day for human beings equal drug expenditure can meet following formula:
The day for human beings equal average daily drug expenditure of drug expenditure=S/K*
The average daily drug expenditure of=200/80* (7)
Wherein, the calculating of equal drug expenditure of the above-mentioned day for human beings can be found in realization side provided by step S13 in above-described embodiment
Formula, details are not described herein.
S25 determines that above-mentioned medical institutions to be monitored are corresponding according to the unit attribute information of above-mentioned medical institutions to be monitored
The day for human beings equal drug expenditure upper limit.
S26, it is corresponding according to the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored and above-mentioned medical institutions to be monitored
The day for human beings equal drug expenditure upper limit determines whether the medication of medical institutions to be monitored is exceeded.
In some possible embodiments, equal drug expenditure of the above-mentioned day for human beings according to medical institutions to be monitored, and wait supervise
The corresponding day for human beings equal drug expenditure threshold value of control medical institutions determines the whether exceeded specific implementation of the medication of medical institutions to be monitored
Mode can be found in implementation provided by step S14 in above-described embodiment, and details are not described herein.
Optionally, in some possible embodiments, it when carrying out medication monitoring for different medical unit, can also be based on
The unit attribute information of each medical institutions determines the medication Standard of Monitoring of each medical institutions and/or examining for medication evaluation criterion
Core metrics-thresholds, the i.e. day for human beings equal drug expenditure threshold value, such as the upper limit up to standard of the day for human beings equal drug expenditure etc..Wherein, above-mentioned wait supervise
The unit attribute information of control medical institutions includes flat type, city, unit drugs supply canal locating for region, unit locating for unit
One of road and unit sufferer person-time are a variety of, can specifically be determined according to practical application scene, herein with no restrictions.Example
Such as, based on difference associated by the parameters such as different geographical, different cities, different drugs supply channels or different sufferer amount of flow
The performance assessment criteria threshold value of medical supply unit, medication monitoring can be not quite similar.For example, medical treatment associated by city higher for price
The higher associated medical supply unit of cost of drugs valence brought by unit or drugs supply channel, then can be by its day for human beings equal drug
The upper limit up to standard of expense is somewhat higherly settable, i.e. the performance assessment criteria threshold value of its corresponding medication Standard of Monitoring then may be set to
Higher performance assessment criteria etc..Medicine brought by medical institutions associated by city lower for price or drugs supply channel
The lower associated medical supply unit of product cost price, then can by the upper limit up to standard of its day for human beings equal drug expenditure it is settable lower one
A bit, i.e. the performance assessment criteria threshold value of its corresponding medication Standard of Monitoring then may be set to lower performance assessment criteria etc..It specifically can basis
Practical application scene is determining, herein with no restrictions.
In some possible embodiments, based on the day for human beings equal drug expenditure of the medical institutions to be monitored of above-mentioned determination,
The performance assessment criteria threshold value in conjunction with determined by the unit attribute information based on medical institutions to be monitored is (i.e. on the day for human beings equal drug expenditure
Limit) can determine whether the medication of the medical institutions is exceeded, in other words, as the day for human beings of medical institutions to be monitored equal drug expenditure
Whether its corresponding day for human beings equal drug expenditure upper limit is greater than.If equal drug expenditure was less than or waited the day for human beings of medical institutions to be monitored
In its corresponding day for human beings equal drug expenditure upper limit, then it can determine that the medication of medical institutions to be monitored is not exceeded, otherwise the medical treatment is single
The medication of position is then exceeded.
S27, if the medication of above-mentioned medical institutions to be monitored is exceeded, the day for human beings equal medicine based on above-mentioned medical institutions to be monitored
Product expense carries out the risk control exceeded with the drug expenditure of effective prescription to above-mentioned medical institutions to be monitored.
In some possible embodiments, based on the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored to it is above-mentioned to
The day for human beings equal drug expenditure difference for monitoring the exceeded part of medical institutions carries out publicity, to realize the medication to medical institutions to be monitored
The implementation for carrying out the exceeded risk control of drug expenditure can be found in realization side provided by step S15 in above-described embodiment
Formula, details are not described herein.
Optionally, in some possible embodiments, it is based on equal drug expenditure difference of the above-mentioned day for human beings, can also received
When drug expenditure reimbursement request or drug expenditure Claims Resolution request that the medical institutions to be monitored submit, refuse the medical treatment to be monitored
The drug expenditure reimbursement request or drug expenditure Claims Resolution request of unit, realize the day for human beings equal medicine for being directed to the medical institutions to be monitored
This exceeded appraisal standards of product expense are punished, the medical institutions are carried out with the risk control of drug expenditure.For example, working as
It, can be in the drug expense for receiving medical institutions and mentioning this day of report when the day for human beings of some day of the medical institutions equal drug expenditure is exceeded
When with reimbursement and/or request, the reimbursement failure of the drug expenditure of this day all prescriptions is fed back to the medical institutions.In other words,
When the day for human beings of some day of the medical institutions, equal drug expenditure was exceeded, terminal device receives this day that medical institutions mention report
When ethical goods expense reimbursement and/or Claims Resolution request, can the medical institutions be fed back with the ethical goods expense refusal reimbursement of this day
Or Claims Resolution, and then the medical institutions can be prompted to carry out self control to the day for human beings of daily prescription equal drug expenditure to realize to this
The exceeded prescription risk control of the drug expenditure of medical institutions.
Optionally, in some possible embodiments, when the medication standard of medical institutions to be monitored is exceeded, such as medical treatment
When the day for human beings equal drug expenditure of unit odd-numbered day prescription is greater than the day for human beings equal drug expenditure threshold value, terminal device can calculate medical treatment to be monitored
Difference between the day for human beings of unit equal drug expenditure and equal drug expenditure threshold value of the above-mentioned day for human beings.When terminal device receives this wait supervise
When controlling the drug expenditure reimbursement and/or Claims Resolution request of medical institutions, then the day for human beings equal drug of the medical institutions to be monitored can be directed to
Difference between expense and equal drug expenditure threshold value of the above-mentioned day for human beings, in the drug expenditure of medical institutions' odd-numbered day prescription to be monitored
The reimbursement of difference portion drug expenditure refusal is settled a claim to carry out the exceeded prescription risk control of drug cost to the medical institutions.
Optionally, in some possible embodiments, when terminal device determines some examination of medical institutions to be monitored
The medication of prescription in period (such as one day or a week etc.) is exceeded, such as in some examination period of medical institutions to be monitored
The day for human beings equal drug expenditure of prescription (such as odd-numbered day prescription) when being greater than the day for human beings equal drug expenditure threshold value, terminal device then can be at this
Examine next examination period after period (the exceeded day for human beings of odd-numbered day prescription equal drug expenditure is some day, such as Monday)
By the day for human beings in the examination period at the beginning of (second day of this exceeded day of the day for human beings of odd-numbered day prescription equal drug expenditure, such as Tuesday)
The equal exceeded report of drug expenditure sends the medical institutions to be monitored to.Wherein, the exceeded report of the average daily drug expenditure of the people is for mentioning
Show that the medical institutions to be monitored are exceeded in the examination period innerlich anwenden, and if the medical institutions to be monitored can be reminded to examine next
The day for human beings equal drug expenditure is still exceeded in nuclear cycle or continuous multiple examination periods in specified time, then will be to be monitored to this
Medical institutions carry out the exceeded punishment of the day for human beings equal drug expenditure.Wherein, above-mentioned punishment includes exceeded to the medical institutions to be monitored
Drug expenditure all refusal reimbursement perhaps settles a claim or to the exceeded portion of the day for human beings of the medical institutions to be monitored equal drug expenditure
Divide refusal reimbursement or Claims Resolution etc..The above-mentioned exceeded report of the day for human beings equal drug expenditure is for prompting the medical institutions to be monitored to the day for human beings
Equal drug expenditure carries out self control to realize the risk control exceeded to the drug expenditure of the medical institutions to be monitored
The embodiment of the present application can based on medical institutions to be monitored within the individually examination period with included in effective prescription
Medicine information determines average daily drug expenditure of the medical institutions to be monitored within the individually examination period, and individually the examination period wraps here
The odd-numbered day is included, also includes the examination period of any duration more than one day.According to average daily drug expenditure, all medicines in effective prescription
Product sum and sufferer quantity determine the day for human beings of medical institutions to be monitored equal drug expenditure.Based on medical institutions to be monitored in the examination
The day for human beings equal drug expenditure in period judges whether the medication of medical institutions to be monitored is up to standard, realizes to medical institutions to be monitored
The evaluation of Drug utilization index, mode of operation multiplicity.The medication to each medical institutions is realized based on method provided by the embodiments of the present application
The accuracy of the medication monitoring to medical institutions had both can be improved in policer operation mode multiplicity, improves the medication to medical institutions and supervises
The reliability of control, while the operating flexibility of the medication monitoring to medical institutions can also be enhanced, and then can be improved based on each doctor
The medicining condition for treating unit carries out the exceeded publicity of medication to the prescription of each medical institutions, and/or the refusal day for human beings equal drug takes
With the reliability of the exceeded risk controls of medications such as exceeded corresponding drug expenditure reimbursement and/or Claims Resolution request, the doctor can be improved
The medication controllability of unit evolution is treated, so that the effective rate of utilization of medical resource can be improved, applicability is stronger.
Embodiment three:
It is the exceeded risk control dress of the drug expenditure provided by the embodiments of the present application based on data processing referring to Fig. 3, Fig. 3
The example structure schematic diagram set.The exceeded risk control dress of drug expenditure provided by the embodiments of the present application based on data processing
It sets and includes:
Data capture unit 31 uses effective prescription for obtain medical institutions to be monitored.
Above-mentioned data capture unit 31 is also used to obtain the above-mentioned sufferer information for including in effective prescription, and according to above-mentioned
Sufferer information determines the above-mentioned sufferer quantity corresponding to effective prescription.
Medicine information processing unit 32, for obtaining the above-mentioned with included in effective prescription of above-mentioned data capture unit acquisition
Medicine information, and determine according to above-mentioned medicine information and above-mentioned sufferer information the day for human beings equal drug of above-mentioned medical institutions to be monitored
Expense.
Medication monitoring unit 33, for according to above-mentioned medicine information processing unit determine equal drug expenditure of the above-mentioned day for human beings and
The corresponding day for human beings equal drug expenditure threshold value of above-mentioned medical institutions to be monitored, determines whether the medication of above-mentioned medical institutions to be monitored surpasses
Mark.
Drug risk control unit 34, for determining the medication of above-mentioned medical institutions to be monitored in above-mentioned medication monitoring unit
When exceeded, based on above-mentioned medicine information processing unit determine equal drug expenditure of the above-mentioned day for human beings to above-mentioned medical institutions to be monitored into
The drug expenditure risk of exceeding criterion of capable effective prescription controls.
In some possible embodiments, above-mentioned data capture unit 31 is used for:
The data system access qualification of above-mentioned medical institutions to be monitored is obtained, based on above-mentioned data system access qualification from upper
State obtain above-mentioned medical institutions to be monitored in the data system of medical institutions to be monitored use effective prescription；And/or
The medical treatment Claims Resolution data that above-mentioned medical institutions to be monitored provide are obtained, are obtained from above-mentioned medical treatment Claims Resolution data above-mentioned
Medical institutions to be monitored use effective prescription；
Wherein, above-mentioned medical institutions to be monitored includes above-mentioned medical institutions to be monitored in the individually examination period with effective prescription
It is interior it is all use effective prescription, the cycle duration in above-mentioned single examination period includes odd-numbered day or more days.
In some possible embodiments, above-mentioned data capture unit 31 is used for:
It obtains above-mentioned sufferer information included in effective prescription, and is determined according to above-mentioned sufferer information and above-mentioned use effective prescription
Targeted sufferer person-time, wherein one is directed to a sufferer person-time with effective prescription；
Above-mentioned sufferer person-time is determined as the above-mentioned sufferer quantity corresponding to effective prescription.
In some possible embodiments, above-mentioned medical institutions to be monitored includes above-mentioned medical treatment to be monitored with effective prescription
All within the single examination period in odd-numbered day of unit use effective prescription；
Above-mentioned medicine information processing unit 32 is used for:
Obtain above-mentioned all medicine informations with drug sum and each drug included in effective prescription, above-mentioned medicine information
In include at least Sales Volumes and drug and use number of days；
Determine that the drug of above-mentioned all drugs all included by effective prescription is total according to the Sales Volumes of above-mentioned each drug
Volume, and determine that above-mentioned all drugs with effective prescription use total number of days using number of days according to the drug of above-mentioned each drug；
The average daily drug of above-mentioned medical institutions to be monitored is determined using total number of days according to above-mentioned drug total value and above-mentioned drug
Expense determines above-mentioned medical institutions to be monitored according to above-mentioned average daily drug expenditure, above-mentioned sufferer quantity and above-mentioned drug sum
The day for human beings equal drug expenditure.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=drug total value/drug uses total number of days.
The day for human beings of above-mentioned medical institutions to be monitored, equal drug expenditure met:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
In some possible embodiments, above-mentioned medical institutions to be monitored includes above-mentioned medical treatment to be monitored with effective prescription
All within more days single examination periods of unit use effective prescription；
Above-mentioned medicine information processing unit 32 is used for:
Any day in the above-mentioned single examination period any odd-numbered day effective prescription is obtained, and obtains any of the above-described odd-numbered day medication
The medicine information of included each drug in prescription includes at least Sales Volumes in above-mentioned medicine information and drug uses number of days；
It is determined according to the Sales Volumes of each drug included by any of the above-described odd-numbered day effective prescription and drug using number of days
State the odd-numbered day average daily drug expenditure of medical institutions to be monitored；
According to above-mentioned medical institutions to be monitored in the above-mentioned single odd-numbered day average daily drug expenditure and medicine for examining period Nei Ge
Product determine that the average daily drug expenditure of above-mentioned medical institutions to be monitored, any day drug are above-mentioned using total number of days using total number of days
The drug of included each drug uses the summation of number of days in any odd-numbered day effective prescription；
It is determined according to above-mentioned average daily drug expenditure, above-mentioned all drug sums in effective prescription and above-mentioned sufferer quantity
State the day for human beings equal drug expenditure of medical institutions to be monitored.
Wherein, the day for human beings of above-mentioned medical institutions to be monitored equal drug expenditure meets:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
In some possible embodiments, above-mentioned medicine information processing unit 32 is used for:
The list in above-mentioned single examination period is determined according to the odd-numbered day average daily drug expenditure of above-mentioned single examination period Nei Ge
Day average daily drug expenditure accumulated value is determined using total number of days according to the drug of above-mentioned single examination period Nei Ge and above-mentioned is individually examined
Drug in nuclear cycle uses total number of days accumulated value；
It is determined according to average daily drug expenditure accumulated value of above-mentioned odd-numbered day and above-mentioned drug using total number of days accumulated value above-mentioned wait supervise
Control the average daily drug expenditure of medical institutions；
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=odd-numbered day average daily drug expenditure accumulated value/drug uses total number of days accumulated value.
Optionally, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=period drug total value/period drug uses total number of days；
Wherein, it can be the drug of all drugs of all prescriptions in the single examination period in above-mentioned period drug total value
The total amount of the cumulative obtained all drugs of the amount of money, above-mentioned period drug can be the institute in the single examination period using total number of days
There is the drug of each drug in drug to use the accumulated value of number of days.
In some possible embodiments, above-mentioned medical institutions to be monitored equal drug expenditure threshold value of the corresponding day for human beings includes
The corresponding day for human beings equal drug expenditure upper limit of above-mentioned medical institutions to be monitored；
Above-mentioned medication monitoring unit 33 is used for:
The day for human beings equal medicine of above-mentioned medical institutions to be monitored is determined according to the unit attribute information of above-mentioned medical institutions to be monitored
The product expense upper limit；
If the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored is less than or equal on equal drug expenditure of the above-mentioned day for human beings
Limit, it is determined that the medication of above-mentioned medical institutions to be monitored is not exceeded；
If the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored is greater than the equal drug expenditure upper limit of the above-mentioned day for human beings, it is determined that
The medication of above-mentioned medical institutions to be monitored is exceeded；
Wherein, the unit attribute information of above-mentioned medical institutions to be monitored includes flat type, region, unit institute locating for unit
Locate one of city, unit drugs supply channel and unit sufferer person-time or a variety of.
In some possible embodiments, above-mentioned drug risk control unit 34 is used for:
Equal drug expenditure of the above-mentioned day for human beings and/or equal drug expenditure of the above-mentioned day for human beings are exceeded to the difference of the day for human beings equal drug expenditure threshold value
Value carries out publicity, and equal drug expenditure of the above-mentioned day for human beings and/or above-mentioned difference based on publicity prompt above-mentioned medical institutions to be monitored
Doctor controls the medication of evolution, with the exceeded risk control of the drug expenditure of realization effective prescription；And/or
When receiving equal drug expenditure of the above-mentioned day for human beings and/or the corresponding drug expenditure reimbursement of above-mentioned difference is requested, refusal
Above-mentioned drug expenditure reimbursement request is to realize the risk control for using the drug expenditure of effective prescription exceeded.
In some possible embodiments, the exceeded risk control device of the above-mentioned drug expenditure based on data processing can
The implementation as provided by above-mentioned Fig. 1 each step into Fig. 2 is executed by each functional module built in it.Optionally,
The exceeded risk control device of the above-mentioned drug expenditure based on data processing can be terminal described in above-mentioned each embodiment
Equipment, herein with no restrictions.For example, above-mentioned data capture unit 31 can be used for executing medical treatment list to be monitored in above-mentioned each step
The acquisition with effective prescription of position, for details, reference can be made to implementations provided by above-mentioned each step, and details are not described herein.Above-mentioned medicine
Product information process unit 32 can be used for executing medical institutions to be monitored in above-mentioned each step with included each in effective prescription
The day for human beings equal drug expenditure of the Sales Volumes of drug, odd-numbered day average daily drug expenditure and/or medical institutions to be monitored and other implementations,
For details, reference can be made to implementations provided by above-mentioned each step, and details are not described herein.Above-mentioned medication monitoring unit 33 can be used for
It executes the unit attribute information in above-mentioned each step based on medical institutions to be monitored and determines that the day for human beings of medical institutions to be monitored is equal
The performance assessment criteria threshold value of the medications such as drug expenditure upper limit monitoring, and the day for human beings equal drug expenditure based on medical institutions to be monitored are sentenced
Break medical institutions to be monitored medication it is whether exceeded and other implementations, for details, reference can be made to realization sides provided by above-mentioned each step
Formula, details are not described herein.Above-mentioned drug risk control unit 34 is determined for executing based on above-mentioned medicine information processing unit 32
Equal drug expenditure of the above-mentioned day for human beings medical institutions to be monitored controlled with the drug expenditure risk of exceeding criterion of effective prescription etc. realize
Mode, for details, reference can be made to implementations provided by above-mentioned each step, and details are not described herein.
In the embodiment of the present application, above-mentioned medication monitoring device can be based on medical institutions to be monitored within the individually examination period
With medicine information included in effective prescription, determine average daily drug expense of the medical institutions to be monitored within the individually examination period
With individually the examination period includes the odd-numbered day here, also includes the examination period of any duration more than one day.Taken according to average daily drug
The day for human beings equal drug expenditure of medical institutions to be monitored is determined with, all drug sums and sufferer quantity in effective prescription.It is based on
The day for human beings equal drug expenditure of the medical institutions to be monitored within the examination period judges whether the medication of medical institutions to be monitored is up to standard,
Realize the evaluation to the Drug utilization index of medical institutions to be monitored, mode of operation multiplicity.Based on method provided by the embodiments of the present application
It realizes the medication policer operation mode multiplicity to each medical institutions, the accuracy of the medication monitoring to medical institutions both can be improved,
The reliability of the medication monitoring to medical institutions is improved, while the flexible operation of the medication monitoring to medical institutions can also be enhanced
Property, and then the medicining condition based on each medical institutions can be improved, the exceeded public affairs of medication are carried out to the prescription of each medical institutions
Show, and/or refuse the exceeded risks of medications such as the exceeded corresponding drug expenditure reimbursement of the day for human beings equal drug expenditure and/or Claims Resolution request
The reliability of control, can be improved the medication controllability of medical institutions' evolution, so that the effective rate of utilization of medical resource can be improved,
Applicability is stronger.
Example IV:
Referring to fig. 4, Fig. 4 is a kind of example structure schematic diagram of terminal device provided by the embodiments of the present application.Such as Fig. 4 institute
Show, the terminal device in the present embodiment may include: one or more processors 401 and memory 402.Above-mentioned processor 401
It is connected with memory 402 by bus 403.For memory 402 for storing computer program, which includes that program refers to
It enables, processor 401 is used to execute the program instruction of the storage of memory 402.Wherein, above-mentioned processor 401 is configured for calling
The program instruction performs the following operations:
Obtain medical institutions to be monitored uses effective prescription；
The above-mentioned sufferer information for including in effective prescription is obtained, and above-mentioned effective prescription institute is determined according to above-mentioned sufferer information
Corresponding sufferer quantity；
Above-mentioned medicine information included in effective prescription is obtained, and true according to above-mentioned medicine information and above-mentioned sufferer quantity
The day for human beings equal drug expenditure of fixed above-mentioned medical institutions to be monitored；
According to equal drug expenditure of the above-mentioned day for human beings and equal drug expenditure threshold value of the above-mentioned medical institutions to be monitored corresponding day for human beings, really
Whether the medication of fixed above-mentioned medical institutions to be monitored is exceeded；
If the medication of above-mentioned medical institutions to be monitored is exceeded, based on equal drug expenditure of the above-mentioned day for human beings to above-mentioned doctor to be monitored
It treats unit and carries out the risk control exceeded with the drug expenditure of effective prescription.
In some possible embodiments, above-mentioned processor 401, is used for:
The data system access qualification of above-mentioned medical institutions to be monitored is obtained, based on above-mentioned data system access qualification from upper
State obtain above-mentioned medical institutions to be monitored in the data system of medical institutions to be monitored use effective prescription；And/or
The medical treatment Claims Resolution data that above-mentioned medical institutions to be monitored provide are obtained, are obtained from above-mentioned medical treatment Claims Resolution data above-mentioned
Medical institutions to be monitored use effective prescription；
Wherein, above-mentioned medical institutions to be monitored includes that above-mentioned medical institutions to be monitored are all within the odd-numbered day with effective prescription
It is all with effective prescription, above-mentioned single examination week within the individually examination period with effective prescription or above-mentioned medical institutions to be monitored
Phase is greater than one.
In some possible embodiments, above-mentioned processor 401, is used for:
It obtains above-mentioned sufferer information included in effective prescription, and is determined according to above-mentioned sufferer information and above-mentioned use effective prescription
Targeted sufferer person-time, wherein one is directed to a sufferer person-time with effective prescription；
Above-mentioned sufferer person-time is determined as the above-mentioned sufferer quantity corresponding to effective prescription.
In some possible embodiments, above-mentioned medical institutions to be monitored includes above-mentioned medical treatment to be monitored with effective prescription
All within the single examination period in odd-numbered day of unit use effective prescription；
Above-mentioned processor 401, is used for:
Obtain above-mentioned all medicine informations with drug sum and each drug included in effective prescription, above-mentioned medicine information
In include at least Sales Volumes and drug and use number of days；
Determine that the drug of above-mentioned all drugs all included by effective prescription is total according to the Sales Volumes of above-mentioned each drug
Volume, and determine that above-mentioned all drugs with effective prescription use total number of days using number of days according to the drug of above-mentioned each drug；
The average daily drug of above-mentioned medical institutions to be monitored is determined using total number of days according to above-mentioned drug total value and above-mentioned drug
Expense determines above-mentioned medical institutions to be monitored according to above-mentioned average daily drug expenditure, above-mentioned sufferer quantity and above-mentioned drug sum
The day for human beings equal drug expenditure.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=drug total value/drug uses total number of days.
The day for human beings of above-mentioned medical institutions to be monitored, equal drug expenditure met:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
In some possible embodiments, above-mentioned medical institutions to be monitored includes above-mentioned medical treatment to be monitored with effective prescription
All within more days single examination periods of unit use effective prescription；
Above-mentioned processor 401, is used for:
Any day in the above-mentioned single examination period any odd-numbered day effective prescription is obtained, and obtains any of the above-described odd-numbered day medication
The medicine information of included each drug in prescription includes at least Sales Volumes in above-mentioned medicine information and drug uses number of days；
It is determined according to the Sales Volumes of each drug included by any of the above-described odd-numbered day effective prescription and drug using number of days
State the odd-numbered day average daily drug expenditure of medical institutions to be monitored；
According to above-mentioned medical institutions to be monitored in the above-mentioned single odd-numbered day average daily drug expenditure and medicine for examining period Nei Ge
Product determine that the average daily drug expenditure of above-mentioned medical institutions to be monitored, any day drug are above-mentioned using total number of days using total number of days
The drug of included each drug uses the summation of number of days in any odd-numbered day effective prescription；
It is determined according to above-mentioned average daily drug expenditure, above-mentioned all drug sums in effective prescription and above-mentioned sufferer quantity
State the day for human beings equal drug expenditure of medical institutions to be monitored.
Wherein, the day for human beings of above-mentioned medical institutions to be monitored equal drug expenditure meets:
The day for human beings equal drug expenditure=drug sum/average daily drug expenditure of sufferer quantity *.
In some possible embodiments, above-mentioned processor 401, is used for:
The list in above-mentioned single examination period is determined according to the odd-numbered day average daily drug expenditure of above-mentioned single examination period Nei Ge
Day average daily drug expenditure accumulated value is determined using total number of days according to the drug of above-mentioned single examination period Nei Ge and above-mentioned is individually examined
Drug in nuclear cycle uses total number of days accumulated value；
It is determined according to average daily drug expenditure accumulated value of above-mentioned odd-numbered day and above-mentioned drug using total number of days accumulated value above-mentioned wait supervise
Control the average daily drug expenditure of medical institutions.
Wherein, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=odd-numbered day average daily drug expenditure accumulated value/drug uses total number of days accumulated value.Or
Optionally, the average daily drug expenditure of above-mentioned medical institutions to be monitored meets:
Average daily drug expenditure=period drug total value/period drug uses total number of days；
Wherein, it can be the drug of all drugs of all prescriptions in the single examination period in above-mentioned period drug total value
The total amount of the cumulative obtained all drugs of the amount of money, above-mentioned period drug can be the institute in the single examination period using total number of days
There is the drug of each drug in drug to use the accumulated value of number of days.
In some possible embodiments, the corresponding average daily drug expenditure threshold value of above-mentioned medical institutions to be monitored includes upper
State the medical institutions to be monitored corresponding day for human beings equal drug expenditure upper limit；
Above-mentioned processor 401, is used for:
The day for human beings equal medicine of above-mentioned medical institutions to be monitored is determined according to the unit attribute information of above-mentioned medical institutions to be monitored
The product expense upper limit；
If the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored is less than or equal on equal drug expenditure of the above-mentioned day for human beings
Limit, it is determined that the medication of above-mentioned medical institutions to be monitored is not exceeded；
If the day for human beings equal drug expenditure of above-mentioned medical institutions to be monitored is greater than the equal drug expenditure upper limit of the above-mentioned day for human beings, it is determined that
The medication of above-mentioned medical institutions to be monitored is exceeded；
Wherein, the unit attribute information of above-mentioned medical institutions to be monitored includes flat type, region, unit institute locating for unit
Locate one of city, unit drugs supply channel and unit sufferer person-time or a variety of.
In some possible embodiments, above-mentioned processor 401 is used for:
Equal drug expenditure of the above-mentioned day for human beings and/or equal drug expenditure of the above-mentioned day for human beings are exceeded to the difference of the day for human beings equal drug expenditure threshold value
Value carries out publicity, the above-mentioned medical institutions' control to be monitored of the equal drug expenditure of the above-mentioned day for human beings and/or the prompt of above-mentioned difference based on publicity
The medication of evolution processed, with the exceeded risk control of the drug expenditure of realization effective prescription；And/or
When receiving equal drug expenditure of the above-mentioned day for human beings and/or the corresponding drug expenditure reimbursement of above-mentioned difference is requested, refusal
Above-mentioned drug expenditure reimbursement request is to realize the risk control for using the drug expenditure of effective prescription exceeded.
In some possible embodiments, above-mentioned processor 401 can be central processing unit (central
Processing unit, CPU), which can also be other general processors, digital signal processor (digital
Signal processor, DSP), specific integrated circuit (application specific integrated circuit,
ASIC), ready-made programmable gate array (field-programmable gate array, FPGA) or other programmable logic
Device, discrete gate or transistor logic, discrete hardware components etc..General processor can be microprocessor or this at
Reason device is also possible to any conventional processor etc..
The memory 402 may include read-only memory and random access memory, and to processor 401 provide instruction and
Data.The a part of of memory 402 can also include nonvolatile RAM.For example, memory 402 can also be deposited
Store up the information of device type.
In some possible embodiments, above-mentioned terminal device can pass through each function mould of processor 401 built in it
Block executes the implementation as provided by above-mentioned Fig. 1 each step into Fig. 2, and for details, reference can be made to provided by above-mentioned each step
Implementation, details are not described herein.
In the embodiment of the present application, terminal device can be based on medical institutions to be monitored at the medication in the individually examination period
Included medicine information in side determines average daily drug expenditure of the medical institutions to be monitored within the individually examination period, single here
A examination period includes the odd-numbered day, also includes the examination period of any duration more than one day.It is useful according to average daily drug expenditure, institute
Drug sum and sufferer quantity in effective prescription determine the day for human beings of medical institutions to be monitored equal drug expenditure.Based on medical treatment to be monitored
The day for human beings equal drug expenditure of the unit within the examination period judges whether the medication of medical institutions to be monitored is up to standard, and prison is treated in realization
Control the evaluation of the Drug utilization index of medical institutions, mode of operation multiplicity.It is realized based on method provided by the embodiments of the present application to each doctor
The medication policer operation mode multiplicity for treating unit, both can be improved the accuracy of the medication monitoring to medical institutions, had improved to medical treatment
The reliability of the medication monitoring of unit, while the operating flexibility of the medication monitoring to medical institutions can also be enhanced, and then can mention
Medicining condition of the height based on each medical institutions carries out the exceeded publicity, and/or refusal of medication to the prescription of each medical institutions
The exceeded corresponding drug expenditure reimbursement of the day for human beings equal drug expenditure and/or the reliable of the exceeded risk controls of medications such as request of settling a claim
Property, the medication controllability of medical institutions' evolution can be improved, so that the effective rate of utilization of medical resource can be improved, applicability is more
By force.
The embodiment of the present application also provides a kind of computer readable storage medium, which has meter
Calculation machine program, the computer program include program instruction, which realizes that Fig. 1 is each into Fig. 2 when being executed by processor
The exceeded risk control method of drug expenditure based on data processing provided by step, for details, reference can be made to above-mentioned each step institutes
The implementation of offer, details are not described herein.
Above-mentioned computer readable storage medium can be the drug expense based on data processing that aforementioned any embodiment provides
With the internal storage unit of exceeded risk control device or above-mentioned terminal device, such as the hard disk or memory of electronic equipment.
What the computer readable storage medium was also possible to be equipped on the External memory equipment of the electronic equipment, such as the electronic equipment inserts
Connect formula hard disk, intelligent memory card (smart media card, SMC), secure digital (secure digital, SD) card, flash memory
Block (flash card) etc..Further, which can also both deposit the inside including the electronic equipment
Storage unit also includes External memory equipment.The computer readable storage medium is used to store the computer program and the electronics is set
Standby required other programs and data.The computer readable storage medium, which can be also used for temporarily storing, to have exported or has incited somebody to action
The data to be exported.
Term " includes " and " having " and their any changes in following claims and specification and attached drawing
Shape, it is intended that cover and non-exclusive include.Such as contain the process, method of a series of steps or units, system, product or
Equipment is not limited to listed step or unit, but optionally further comprising the step of not listing or unit or optional
Ground further includes the other step or units intrinsic for these process, methods, product or equipment.Referenced herein " embodiment "
It is meant that a particular feature, structure, or characteristic described may be embodied at least one embodiment of the application in conjunction with the embodiments.
Each position in the description shows that the phrase might not each mean identical embodiment, nor mutual with other embodiments
The independent or alternative embodiment of reprimand.Those skilled in the art explicitly and implicitly understand, reality described herein
Applying example can combine with other embodiments.The term "and/or" used in present specification and the appended claims
Refer to any combination and all possible combinations of one or more of associated item listed, and including these combinations.
Those of ordinary skill in the art may be aware that list described in conjunction with the examples disclosed in the embodiments of the present disclosure
Member and algorithm steps, can be realized with electronic hardware, computer software, or a combination of the two, in order to clearly demonstrate hardware
With the interchangeability of software, each exemplary composition and step are generally described according to function in the above description.This
A little functions are implemented in hardware or software actually, the specific application and design constraint depending on technical solution.Specially
Industry technical staff can use different methods to achieve the described function each specific application, but this realization is not
It is considered as beyond scope of the present application.Method provided by the embodiments of the present application and relevant apparatus are provided referring to the embodiment of the present application
Method flow diagram and/or structural schematic diagram come what is described, can specifically be realized by computer program instructions method flow diagram and/or
The combination of each flow and/or block of structural schematic diagram and process and/or box in flowchart and/or the block diagram.This
A little computer program instructions can provide at general purpose computer, special purpose computer, Embedded Processor or other programmable datas
The processor of equipment is managed to generate a machine, so that holding by the processor of computer or other programmable data processing devices
Capable instruction generates for realizing in one box of one or more flows of the flowchart and/or structural schematic diagram or multiple sides
The device for the function of being specified in frame.These computer program instructions, which may also be stored in, is able to guide computer or other programmable datas
In processing equipment computer-readable memory operate in a specific manner, so that finger stored in the computer readable memory
It enables and generates the manufacture including command device, which realizes in one or more flows of the flowchart and/or structure
The function of being specified in schematic diagram one box or multiple boxes.These computer program instructions can also be loaded into computer or other
In programmable data processing device, so that executing series of operation steps on a computer or other programmable device in terms of generating
The processing that calculation machine is realized, so that instruction executed on a computer or other programmable device is provided for realizing in flow chart one
The step of function of being specified in a process or multiple processes and/or structural representation one box or multiple boxes.
Claims (10)
1. a kind of risk control method that the drug expenditure based on data processing is exceeded, which is characterized in that the described method includes:
Obtain medical institutions to be monitored uses effective prescription；
The sufferer information for including in effective prescription is obtained, and described use corresponding to effective prescription is determined according to the sufferer information
Sufferer quantity；
The medicine information included in effective prescription is obtained, and institute is determined according to the medicine information and the sufferer quantity
State the day for human beings equal drug expenditure of medical institutions to be monitored；
According to the day for human beings equal drug expenditure and the medical institutions to be monitored corresponding day for human beings equal drug expenditure threshold value, institute is determined
Whether the medication for stating medical institutions to be monitored is exceeded；
It is single to the medical treatment to be monitored based on the day for human beings equal drug expenditure if the medication of the medical institutions to be monitored is exceeded
Position carries out the risk control exceeded with the drug expenditure of effective prescription.
2. the method according to claim 1, wherein it is described obtain medical institutions to be monitored with effective prescription packet
It includes:
Obtain the data system access qualification of the medical institutions to be monitored, based on the data the qualification of system access from it is described to
The medical institutions to be monitored are obtained in the data system of monitoring medical institutions uses effective prescription；And/or
The medical treatment Claims Resolution data that the medical institutions to be monitored provide are obtained, are obtained from the medical treatment Claims Resolution data described wait supervise
Control medical institutions use effective prescription；
Wherein, the medical institutions to be monitored includes the medical institutions to be monitored within the individually examination period with effective prescription
All to use effective prescription, the cycle duration in the single examination period includes odd-numbered day or more days.
3. method according to claim 1 or 2, which is characterized in that described to obtain the sufferer for including in effective prescription
Information, and determine that the sufferer quantity corresponding to effective prescription includes: according to the sufferer information
The sufferer information included in effective prescription is obtained, and the effective prescription institute needle is determined according to the sufferer information
Pair sufferer person-time, wherein one with effective prescription be directed to a sufferer person-time；
The sufferer person-time is determined as the sufferer quantity corresponding to effective prescription.
4. according to the method described in claim 3, it is characterized in that, the medical institutions to be monitored include described with effective prescription
All within the single examination period in odd-numbered day of medical institutions to be monitored use effective prescription；
It is described to obtain the medicine information included in effective prescription and true according to the medicine information and the sufferer quantity
The day for human beings equal drug expenditure of the medical institutions to be monitored includes: calmly
Obtain all medicine informations with drug sum and each drug included in effective prescription, in the medicine information extremely
It less include that Sales Volumes and drug use number of days；
The drug total value of all drugs all included by effective prescription is determined according to the Sales Volumes of each drug, and
Determine that all drugs with effective prescription use total number of days using number of days according to the drug of each drug；
The average daily drug expenditure of the medical institutions to be monitored is determined using total number of days according to the drug total value and the drug,
Determine that the day for human beings of the medical institutions to be monitored is equal according to the average daily drug expenditure, the sufferer quantity and the drug sum
Drug expenditure.
5. according to the method described in claim 3, it is characterized in that, the medical institutions to be monitored include described with effective prescription
All within more days single examination periods of medical institutions to be monitored use effective prescription；
It is described to obtain the medicine information included in effective prescription and true according to the medicine information and the sufferer quantity
The day for human beings equal drug expenditure of the medical institutions to be monitored includes: calmly
Any day in the single examination period any odd-numbered day effective prescription is obtained, and obtains any odd-numbered day effective prescription
In included each drug medicine information, include at least Sales Volumes in the medicine information and drug use number of days；
Described in being determined according to the Sales Volumes of each drug included by any odd-numbered day effective prescription and drug using number of days to
Monitor the odd-numbered day average daily drug expenditure of medical institutions；
Made according to the medical institutions to be monitored in the odd-numbered day average daily drug expenditure and drug of the single examination period Nei Ge
Determine that the average daily drug expenditure of the medical institutions to be monitored, any day drug are described any using total number of days with total number of days
The drug of included each drug uses the summation of number of days in odd-numbered day effective prescription；
According to the average daily drug expenditure, all drug sums in effective prescription and the sufferer quantity determine it is described to
Monitor the day for human beings equal drug expenditure of medical institutions.
6. according to the method described in claim 5, it is characterized in that, it is described according to the medical institutions to be monitored described single
The odd-numbered day average daily drug expenditure and drug of examination period Nei Ge determines the average daily of the medical institutions to be monitored using total number of days
Drug expenditure includes:
The odd-numbered day day in the single examination period is determined according to the odd-numbered day average daily drug expenditure of the single examination period Nei Ge
Equal drug expenditure accumulated value determines the single examination week using total number of days according to the drug of the single examination period Nei Ge
Drug in phase uses total number of days accumulated value；
The doctor to be monitored is determined using total number of days accumulated value according to the odd-numbered day average daily drug expenditure accumulated value and the drug
Treat the average daily drug expenditure of unit.
7. method according to claim 4 or 5, which is characterized in that the corresponding day for human beings equal medicine of the medical institutions to be monitored
Product cost threshold includes the medical institutions to be monitored corresponding day for human beings equal drug expenditure upper limit；
It is described according to the day for human beings equal drug expenditure and the medical institutions to be monitored corresponding day for human beings equal drug expenditure threshold value, really
Whether the medication of the fixed medical institutions to be monitored is exceeded to include:
The day for human beings equal medicine of the medical institutions to be monitored is determined according to the unit attribute information of the medical institutions to be monitored
The product expense upper limit；
If the day for human beings equal drug expenditure of the medical institutions to be monitored is less than or equal to the day for human beings equal drug expenditure upper limit,
Determine that the medication of the medical institutions to be monitored is not exceeded；
If the day for human beings equal drug expenditure of the medical institutions to be monitored is greater than the day for human beings equal drug expenditure upper limit, it is determined that described
The medication of medical institutions to be monitored is exceeded；
Wherein, the unit attribute information of the medical institutions to be monitored includes flat type, city locating for region, unit locating for unit
One of city, unit drugs supply channel and unit sufferer person-time are a variety of.
8. method according to claim 1-7, which is characterized in that described to be based on the day for human beings equal drug expenditure pair
The medical institutions to be monitored carry out
The day for human beings equal drug expenditure and/or the day for human beings equal drug expenditure are exceeded to the difference of the day for human beings equal drug expenditure threshold value
Value carries out publicity, the medical institutions' control to be monitored of the day for human beings equal drug expenditure and/or difference prompt based on publicity
The medication of evolution processed, with the exceeded risk control of the drug expenditure of realization effective prescription；And/or
When receiving the day for human beings equal drug expenditure and/or the corresponding drug expenditure reimbursement of the difference is requested, described in refusal
Drug expenditure reimbursement request is to realize the risk control for using the drug expenditure of effective prescription exceeded.
9. a kind of risk control device that the drug expenditure based on data processing is exceeded, which is characterized in that described device includes:
Data capture unit uses effective prescription for obtain medical institutions to be monitored；
The data capture unit is also used to obtain the sufferer information for including in effective prescription, and is believed according to the sufferer
Breath determines the sufferer quantity corresponding to effective prescription；
Medicine information processing unit, for obtaining the described with drug included in effective prescription of the data capture unit acquisition
Information, and determine according to the medicine information and the sufferer quantity day for human beings equal drug expenditure of the medical institutions to be monitored；
Medication monitoring unit, for according to the medicine information processing unit determine the day for human beings equal drug expenditure and it is described to
The corresponding day for human beings equal drug expenditure threshold value of medical institutions is monitored, determines whether the medication of the medical institutions to be monitored is exceeded；
Drug risk control unit, for determining that the medication of the medical institutions to be monitored is exceeded in the medication monitoring unit
When, the day for human beings equal drug expenditure determined based on the medicine information processing unit uses the medical institutions to be monitored
The drug expenditure risk of exceeding criterion of effective prescription controls.
10. a kind of terminal device, which is characterized in that including processor and memory, the processor and the memory are mutual
Connection, wherein the memory is for storing computer program, and the computer program includes program instruction, the processor
It is configured for calling described program instruction, executes the method according to claim 1.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811233473.0A CN109493937A (en) | 2018-10-22 | 2018-10-22 | Drug expenditure based on data processing exceeded risk control method and device |
| PCT/CN2019/095003 WO2020082791A1 (en) | 2018-10-22 | 2019-07-08 | Drug cost over-standard risk control method and apparatus based on data processing |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811233473.0A CN109493937A (en) | 2018-10-22 | 2018-10-22 | Drug expenditure based on data processing exceeded risk control method and device |
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| CN109493937A true CN109493937A (en) | 2019-03-19 |
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| WO (1) | WO2020082791A1 (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
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| WO2020082791A1 (en) * | 2018-10-22 | 2020-04-30 | 平安医疗健康管理股份有限公司 | Drug cost over-standard risk control method and apparatus based on data processing |
| CN112289424A (en) * | 2020-12-30 | 2021-01-29 | 曜立科技(北京)有限公司 | Intelligent report automatic generation method and system based on operation fee control |
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