CN110033311A - A kind of disease score value payment methods and system - Google Patents
A kind of disease score value payment methods and system Download PDFInfo
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- CN110033311A CN110033311A CN201910186814.1A CN201910186814A CN110033311A CN 110033311 A CN110033311 A CN 110033311A CN 201910186814 A CN201910186814 A CN 201910186814A CN 110033311 A CN110033311 A CN 110033311A
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Abstract
The present invention relates to a kind of disease score value payment methods and systems, comprising the following steps: S01: determining the type of disease;S02: the default score value of the disease is determined according to the type of the disease;S03: the equivalent coefficient of different brackets medical institutions is determined;S04: the default score value is adjusted according to the type of the disease, the equivalent coefficient, determines the adjustment score value of the disease;S05: according to the adjustment score value, the medical expense quota of the disease is determined.The beneficial effects of the present invention are: being used cooperatively by that will reasonably select disease, disease price and medical expense, compatible compound receipts way of paying can be effectively controlled medical expense, reduce the risk of disbursement from fund.
Description
Technical field
The present invention relates to Cost of Medical Treatment technical field more particularly to a kind of disease score value payment methods and system.
Background technique
By the factors such as diagnosis of disease complexity and uncertainty restrict, the reform of medical insurance Payment system and improve all the time
It is all a difficult project.Theoretically, practice, which should be asked, can control fund expenditure, constrain unreasonable medical services row
For;Also energy compensating medical reasonable cost and expense are required, guarantees medical service quality and enthusiasm;The medical people are also paid close attention to simultaneously
It is raw, patients ' interest is ensured, to obtain the common support and approval that doctors and patients protect tripartite.But the receipt and payment expense of existing each medical institutions
Mode is numerous and disorderly different, is easy to appear that payment imbalance, medical insurance fund service efficiency be high, medical insurance increases unreasonable etc. ask
Topic.
Summary of the invention
The technical problem to be solved by the present invention is in view of the drawbacks of the prior art, provide a kind of disease score value payment methods
And system.
The technical scheme to solve the above technical problems is that
According to one aspect of the present invention, a kind of disease score value payment methods are provided, comprising the following steps:
S01: the type of disease is determined;
S02: the default score value of the disease is determined according to the type of the disease;
S03: the equivalent coefficient of different brackets medical institutions is determined;
S04: the default score value is adjusted according to the type of the disease, the equivalent coefficient, determines the tune of the disease
Whole score value;
S05: according to the adjustment score value, the medical expense quota of the disease is determined.
The beneficial effects of the present invention are: be used cooperatively by the way that disease, disease price and medical expense will be reasonably selected, it is compatible
Compound receipts way of paying, can be effectively controlled medical expense, reduce the risk of disbursement from fund;Disease score value is combined with DRG,
Developed from extensive style to fining, and realize the intelligent monitoring of medical institutions' receipt and payment expense, improves the efficiency and output of medical institutions,
Medical institutions are promoted to reinforce cost management;In addition, the satisfaction of insured patient can also be improved, improve doctor-patient relationship.
Based on the above technical solution, the present invention can also be improved as follows.
Further, the mode for determining the type of disease includes the type for determining disease according to Single diseases, according to common disease factor
The type of disease is determined with multiple etiology, type that disease is determined according to medical expense, true according to Main Diagnosis and therapeutic modality
Determine the type of disease.
The beneficial effect of above-mentioned further scheme is: various ways determine the type of disease, and disease type can be improved
Accuracy.
Further, determine the default score value of the disease specifically includes the following steps:
S02.1: according to the type of the disease, the distribution situation of the type of the disease and corresponding disease in investigation 3 years
Type medical expense situation;
S02.2: the type of common disease is filtered out according to investigation result;
S02.3: according to the medical expense situation of the type of the disease of screening, the initial value of the disease is determined;
S02.4: after expert rectifies a deviation, correcting the initial value, determines default score value;
S02.5: integrative feedback opinion determines and announces the default score value.
The beneficial effect of above-mentioned further scheme is: by determining default score value, the reality for complying with corresponding disease is answered
With and treatment condition.
Further, the medical expense situation of the type of corresponding disease includes the actual average payment for medical care of the type of the disease
With.
The beneficial effect of above-mentioned further scheme is: facilitating calculating initial value.
Further, determining that the mode of the equivalent coefficient of different brackets medical institutions includes consulting on method, average data pair
Than method, constrained optimization method and managerial decision method.
The beneficial effect of above-mentioned further scheme is: equivalent coefficient is as agreement different brackets medical institutions disease score value
Weight coefficient reflects the proportionate relationship of average hospitalization expenses needed for treating identical disease between different brackets medical institutions, no
Equivalent coefficient between ad eundem medical institutions determines whether that whether rationally, it is fair to be related to distribution, is determined using various ways
Equivalent coefficient, it is ensured that equivalent coefficient it is fair and reasonable.
Further, determining that the medical expense quota of the disease includes the medical expense total value and determination of the determining disease
The funds payment of medical insurance volume of the disease, wherein the funds payment of medical insurance volume of the disease is to determine the disease
It is determined after the medical expense total value of kind.
Further, further including determining that each hierarchical healthcare mechanism can divide before the medical expense total value for determining the disease
The medical insurance risk-pooling fund total amount matched.
The beneficial effect of above-mentioned further scheme is: determine the assignable medical insurance risk-pooling fund total amount of medical institutions,
As the medical expense total value Con trolling index for paying the medical institutions.
According to another aspect of the invention, a kind of disease score value charging system is provided, including
Disease type determining module, determines the type of disease;
Default score value determining module, the default score value of the disease is determined according to the type of the disease;
Equivalent coefficient determining module determines the equivalent coefficient of different brackets medical institutions;
Score value adjusts module, adjusts the default score value according to the type of the disease, the equivalent coefficient, determine described in
The adjustment score value of disease;
Medical expense quota module determines the medical expense quota of the disease according to the adjustment score value.
Further, the mode for determining the type of disease includes the type for determining disease according to Single diseases, according to common disease factor
The type of disease is determined with multiple etiology, type that disease is determined according to medical expense, true according to Main Diagnosis and therapeutic modality
Determine the type of disease.
Further, determining that the mode of the equivalent coefficient of different brackets medical institutions includes consulting on method, average data pair
Than method, constrained optimization method and managerial decision method.
Detailed description of the invention
Fig. 1 is a kind of flow chart of disease score value payment methods of the present invention.
Specific embodiment
The principle and features of the present invention will be described below with reference to the accompanying drawings, and the given examples are served only to explain the present invention, and
It is non-to be used to limit the scope of the invention.
As shown in Figure 1, a kind of disease score value payment methods comprising following steps:
S01: the type of disease is determined;
S02: the default score value of the disease is determined according to the type of the disease;
S03: the equivalent coefficient of different brackets medical institutions is determined;
S04: the default score value is adjusted according to the type of the disease, the equivalent coefficient, determines the tune of the disease
Whole score value;
S05: according to the adjustment score value, the medical expense quota of the disease is determined.
Specifically, determining that the mode of the type of disease includes determining the kind of disease according to Single diseases in the step S01
Class, the type that disease is determined according to common disease factor and multiple etiology, the type for determining according to medical expense disease, according to mainly examining
The disconnected type that disease is determined with therapeutic modality.
The specific embodiment of the mode of the type of above-mentioned four kinds determining diseases is as described below:
First, the type of disease is determined according to Single diseases, by filtering out the pure disease in disease in hospital, by the list
Object of the pure venereal disease kind as DRGs-based payment system, to reduce medical insurance way of paying management difficulty and improve its operability.
Second, the type of disease is determined according to common disease factor and multiple etiology, it is common in disease in hospital by filtering out
Disease, frequently-occurring disease disease, as the main object of DRGs-based payment system mode, to improve the covering effect of medical insurance way of paying
It answers.
Third, determining the type of disease according to medical expense, anteposition is arranged by filtering out medical expense in disease in hospital
Disease improve medical insurance way of paying to the management effect of control medical expense as the object of DRGs-based payment system.
Fourth, determine the type of disease according to Main Diagnosis and therapeutic modality, by the Main Diagnosis of the disease that will be hospitalized with
Therapeutic modality combines, and filters out related disease of being hospitalized and carries out DRGs-based payment system, rationally to handle same disease because of therapeutic modality
It is different and caused by expense variance.
The mode of the type of above-mentioned four kinds determining diseases can determine the type of disease using one way in which, can also be with
Combine to determine the type of disease using at least two mode therein.
Specifically, in the step S02, determine the default score value of the disease specifically includes the following steps:
S02.1: according to the type of the disease, the distribution situation of the type of the disease and corresponding disease in investigation 3 years
Type medical expense situation;
S02.2: the type of common disease is filtered out according to investigation result;
S02.3: according to the medical expense situation of the type of the disease of screening, the initial value of the disease is determined;
S02.4: after expert rectifies a deviation, correcting the initial value, determines default score value;
S02.5: integrative feedback opinion determines and announces the default score value.
Preferably, the calculation method of the score value of the disease is score value=(average hospitalization charge/benchmark of the disease
The average hospitalization charge of disease) * benchmark disease score value.
Wherein, the benchmark disease be clinical path is clear, complication and complication are few, Clinics are mature, quality can
Control and the stable disease of medical expense.
The medical expense situation of the type of corresponding disease includes the actual average medical expense of the type of the disease.
The expert refers to the technical specialist well known to disease score value payment technical field;The feedback opinion refer to through
The feedback opinion that at least two technical specialists obtain after rectifying a deviation, that is, the default score value finally determined is comprehensive at least two
It is determined after the feedback opinion of technical specialist, ensures the reasonability of the default score value to the greatest extent.
Specifically, determining that the mode of the equivalent coefficient of different brackets medical institutions includes consulting in the step S03
Method, average data method of comparison, constrained optimization method and managerial decision method.
The specific implementation method of the mode of above-mentioned four kinds determining equivalent coefficients is as described below:
Method is consulted on, the view and medical institutions master that investigation different brackets medical institutions In Grade coefficient determines
It is horizontal to see the equivalent coefficient assert;
Average data method of comparison calculates the proportionate relationship between the types of different diseases, different brackets medical institutions, weighting
Obtain corresponding equivalent coefficient;
Constrained optimization method sets objective function and minimizes as the quadratic sum of each hierarchical healthcare mechanism rate of surplus, and variable is
The equivalent coefficient of each hierarchical healthcare mechanism, the range of equivalent coefficient obtain grade system between 0 to 1, through statistical software operation
Number is as a result, and do simulation clearing with resulting equivalent coefficient;
Managerial decision method invites human resources social security bureau, health bureau, the Bureau of Finance, pricing bureau and fund Ju Deng department
Equivalent coefficient is decided through discussion, determination and variation and each township medical technology from leadership's angle macroscopic view consideration equivalent coefficient
The guiding of development.
Weight coefficient of the equivalent coefficient as agreement different brackets medical institutions disease score value reflects different brackets medical treatment
The proportionate relationship of average hospitalization expenses needed for treating identical disease between mechanism, the equivalent coefficient between different brackets medical institutions
Determine whether that whether rationally, it is fair to be related to distribution, can such as be determined as the equivalent coefficient of the first-class designated medical organization of three-level
1, the equivalent coefficient of other three-level designated medical organizations is determined as 0.9, and the equivalent coefficient of second level designated medical organization is determined as
0.8, the equivalent coefficient of level-one designated medical organization (community medical service center) is determined as 0.6, the grade system of health clinics in towns and townships
Number is determined as 0.45.
Specifically, in the step S04, determine the adjustment score value of the disease specifically includes the following steps:
S04.1: the proposal on adjustments information for being directed to the default score value is collected;
S04.2: it arranges and feeds back the proposal on adjustments information;
S04.3: multiple experts, president have an informal discussion for the default score value and the proposal on adjustments information, determine institute
State the adjustment score value of disease;
S04.4: the adjustment score value finally determined is announced.
In the step S05, determine the disease medical expense quota include the determining disease medical expense it is total
Volume and the funds payment of medical insurance volume for determining the disease, wherein the funds payment of medical insurance volume of the disease is true
It is determined after the medical expense total value of the fixed disease.
Wherein it is determined that the specific embodiment of the medical expense total value of the disease is, medical insurance handling institution according to
The methods of historical data method of determining and calculating determines disease medical expense total value, and medical institutions are in the correlation for completing the disease to insured patient
After treatment, payment for medical care is paid to medical institutions according to pre-determined disease medical expense total value from medical insurance handling institution
With.
The specific embodiment for determining the funds payment of medical insurance volume (or individual burden volume) of the disease is, in determination
On the basis of the medical expense total value of the disease, it is averaged disbursement from fund ratio or individual burden ratio referring to the previous disease,
Determine the funds payment of medical insurance volume or individual burden volume, to effectively prevent medical item outside medical institutions' excessive use range,
Increase the individual burden of insured patient.
It further include determining each assignable medical treatment of hierarchical healthcare mechanism before the medical expense total value for determining the disease
Insure risk-pooling fund total amount.
The specific embodiment for determining the assignable medical insurance risk-pooling fund total amount of each hierarchical healthcare mechanism is, according to each
Hierarchical healthcare mechanism is hospitalized the payable amount of money of annual risk-pooling fund and its ratio in annual risk-pooling fund pay-off control total amount, really
The fixed assignable medical insurance risk-pooling fund total amount of the medical institutions, as the medical expense total value control for paying medical institutions
Index processed.Wherein, the Hospitalized costs of pooling funds of basic medical insurance payment should divide moon control to use.
This specification embodiment also provides a kind of disease score value charging system, including
Disease type determining module, determines the type of disease;
Default score value determining module, the default score value of the disease is determined according to the type of the disease;
Equivalent coefficient determining module determines the equivalent coefficient of different brackets medical institutions;
Score value adjusts module, adjusts the default score value according to the type of the disease, the equivalent coefficient, determine described in
The adjustment score value of disease;
Medical expense quota module determines the medical expense quota of the disease according to the adjustment score value.
The mode for determining the type of disease includes the type that disease is determined according to Single diseases, according to common disease factor and frequently-occurring disease
The type of disease is determined because of the type of determining disease, according to medical expense, determines disease according to Main Diagnosis and therapeutic modality
Type.
The mode for determining the equivalent coefficient of different brackets medical institutions includes the method that consults on, average data method of comparison, about
Beam optimization method and managerial decision method.
Disease score value charging system is used cooperatively by that will reasonably select disease, disease price and medical insurance fund, effect table
Present the following aspects:
1, medical expense is effectively controlled, the risk of disbursement from fund is reduced.The most prominent feature of DRGs-based payment system clearing form
It is " being settled accounts by disease person-time, over-expense is not mended, and surplus returns oneself ", medical institutions' aggressive ground canonical medical behavior can be promoted, prevented
Only over-treatment controls medical expense, achievees the purpose that reduce medical service cost, reduces unnecessary medical services, to subtract
Hypopathia people burden and the expenditure for reducing Medical Benefits Fund.
2, the efficiency and output of medical institutions are improved, medical institutions is promoted to reinforce cost management.Excitation medical institutions are to obtain
It obtains surplus and actively reduces cost, improve the service efficiency of health resources, increase healthcare practitioner's labour value, improve service
Quality.
3, the satisfaction of insured patient is improved, doctor-patient relationship is improved.DRGs-based payment system system is objectively limiting part
Medical worker opens " big prescription ", excessive imaging and over-treatment, proposes and is distinctly claimed to the service quality of medical worker, and cures
It is clear to treat mechanism paying price, charging program simplifies, and working efficiency improves, increase insured patient to the degree of belief of doctor, from
And can preferably improve doctor-patient relationship, insured patient satisfaction increases accordingly.
The foregoing is merely presently preferred embodiments of the present invention, is not intended to limit the invention, it is all in spirit of the invention and
Within principle, any modification, equivalent replacement, improvement and so on be should all be included in the protection scope of the present invention.
Claims (10)
1. a kind of disease score value payment methods, which comprises the following steps:
S01: the type of disease is determined;
S02: the default score value of the disease is determined according to the type of the disease;
S03: the equivalent coefficient of different brackets medical institutions is determined;
S04: the default score value is adjusted according to the type of the disease, the equivalent coefficient, determines the adjustment point of the disease
Value;
S05: according to the adjustment score value, the medical expense quota of the disease is determined.
2. a kind of disease score value payment methods according to claim 1, it is characterised in that: determine the mode packet of the type of disease
It includes and determines the type of disease according to Single diseases, determine the type of disease according to common disease factor and multiple etiology, according to medical expense
It determines the type of disease, determine the type of disease according to Main Diagnosis and therapeutic modality.
3. a kind of disease score value payment methods according to claim 1, which is characterized in that determine the default score value of the disease
Specifically includes the following steps:
S02.1: according to the type of the disease, the kind of the distribution situation of the type of the disease and corresponding disease in investigation 3 years
The medical expense situation of class;
S02.2: the type of common disease is filtered out according to investigation result;
S02.3: according to the medical expense situation of the type of the disease of screening, the initial value of the disease is determined;
S02.4: after expert rectifies a deviation, correcting the initial value, determines default score value;
S02.5: integrative feedback opinion determines and announces the default score value.
4. a kind of disease score value payment methods according to claim 3, it is characterised in that: the payment for medical care of the type of corresponding disease
It include the actual average medical expense of the type of the disease with situation.
5. a kind of disease score value payment methods according to claim 1, it is characterised in that: determine different brackets medical institutions
The mode of equivalent coefficient includes consulting on method, average data method of comparison, constrained optimization method and managerial decision method.
6. a kind of disease score value payment methods according to claim 1, it is characterised in that: determine the medical expense of the disease
Quota includes the medical expense total value for determining the disease and the funds payment of medical insurance volume for determining the disease, wherein institute
The funds payment of medical insurance volume for stating disease is determined after the medical expense total value for determining the disease.
7. a kind of disease score value payment methods according to claim 6, it is characterised in that: in the payment for medical care for determining the disease
It further include before determining the assignable medical insurance risk-pooling fund total amount of each hierarchical healthcare mechanism with total value.
8. a kind of disease score value charging system, which is characterized in that including
Disease type determining module, determines the type of disease;
Default score value determining module, the default score value of the disease is determined according to the type of the disease;
Equivalent coefficient determining module determines the equivalent coefficient of different brackets medical institutions;
Score value adjusts module, adjusts the default score value according to the type of the disease, the equivalent coefficient, determines the disease
Adjustment score value;
Medical expense quota module determines the medical expense quota of the disease according to the adjustment score value.
9. a kind of disease score value charging system according to claim 1, it is characterised in that: determine the mode packet of the type of disease
It includes and determines the type of disease according to Single diseases, determine the type of disease according to common disease factor and multiple etiology, according to medical expense
It determines the type of disease, determine the type of disease according to Main Diagnosis and therapeutic modality.
10. a kind of disease score value charging system according to claim 8, it is characterised in that: determine different brackets medical institutions
Equivalent coefficient mode include consult on method, average data method of comparison, constrained optimization method and managerial decision method.
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Cited By (1)
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CN114334112A (en) * | 2021-12-30 | 2022-04-12 | 上海柯林布瑞信息技术有限公司 | Medical insurance-based hospital refined resource management method and device |
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Application publication date: 20190719 |