CN110246046A

CN110246046A - Health informs case maintemance system, method and device

Info

Publication number: CN110246046A
Application number: CN201910336015.8A
Authority: CN
Inventors: 魏庆成; 徐旭
Original assignee: Alibaba Group Holding Ltd
Current assignee: Advanced New Technologies Co Ltd; Advantageous New Technologies Co Ltd
Priority date: 2019-04-24
Filing date: 2019-04-24
Publication date: 2019-09-17
Anticipated expiration: 2039-04-24
Also published as: CN110246046B

Abstract

The application provides health and informs case maintemance system, method and device, wherein the health informs that case maintemance system includes: to store user to apply for that the health executed during fitness programme, which is added, informs that the health of link informs case；First maintenance platform is configured as analyzing according to history Claims Resolution data of first maintenance period to healthy reference data and the fitness programme, and the new health that analysis is obtained informs that case update to the health is informed in database；Second maintenance platform, including case obtain module, parameter determination module, case generation module and case update module.The health informs case maintemance system, new health, which is obtained, by analysis informs that case informs that database is updated maintenance to health, health, which informs that the maintenance of case is more perfect, in database is informed to health, it improves health and informs the validity of case maintemance, while it is more comprehensive also to inform the health carried out on the basis of health informs case.

Description

Health informs case maintemance system, method and device

Technical field

This application involves technical field of data processing, in particular to a kind of health informs case maintemance system.The application is same When be related to a kind of health and inform case maintemance method and device, a kind of calculating equipment and a kind of computer-readable storage medium Matter.

Background technique

With the rapid development of Internet technology, the sale of insurance, after sale, Claims Resolution etc. conversational traffics can be more convenient Ground on-line operation, meanwhile, as degree of concern of the user to own health is higher and higher, the healthy insurance kind such as weight disease, life insurance is more next It, need to be by insurance company during insurer buys the healthy insurance kind such as serious illness insurance, life insurance on line more by the favor of user Receive insurer insure apply when, it is desirable that the confirmation of insurer's health status is illustrated, i.e., health is informed, insurance company one Denier is accepted insurance, and healthy informing content will become a component part of insurance contract.

Currently, the health during internet taking out insurances informs link, health usually is provided by insurance company and is informed Text, insurer combine own situation to confirm according to content of text to health informing, if insurer is in healthy inform Appearance is not understood, or can not judge own situation whether belong to health informing informing range when, it will usually occur telephone counseling, Abandon situations such as insuring or directly insuring, meanwhile, healthy informing content can also the Claims Resolution cost to insurance coverage have an impact.

Summary of the invention

In view of this, the embodiment of the present application provides a kind of health informing case maintemance system, to solve in the prior art Existing technological deficiency.The embodiment of the present application provides a kind of health informing case maintemance method, a kind of health informing case simultaneously Example maintenance device, a kind of calculating equipment and a kind of computer readable storage medium.

The embodiment of the present application discloses a kind of health informing case maintemance system, comprising:

Health informs database, the first maintenance platform and the second maintenance platform；

The health informs database, is configured as storage user and applies for that the health executed during fitness programme, which is added, accuses Know that the health of link informs case；

First maintenance platform, is configured as according to the first maintenance period to healthy reference data and the fitness programme History Claims Resolution data analyzed, will analysis obtain it is new health inform case update to it is described health inform database in；

Second maintenance platform, including case obtain module, parameter determination module, case generation module and case update Module；

Wherein, the case obtains module, is configured as obtaining the history of the fitness programme according to the second maintenance period The case details for case of settling a claim；The duration of second maintenance period is less than the duration of first maintenance period；

The parameter determination module, the case for being configured as in the case details for extracting the history Claims Resolution case including are paid for It pays type and case compensates information, and information is compensated based on the case and determines that each case compensates the case compensation parameter of type；

The case generation module is configured as compensating the case compensation that parameter meets default case compensation condition based on case It pays type and generates new health informing case；

The case update module, the new health for being configured as to generate inform that case update to the health informs data In library.

Optionally, further include Claims Resolution case database, be configured as storing the case details of the history Claims Resolution case；

Correspondingly, the case obtains module, it is specifically configured to according to second maintenance period from the Claims Resolution case The case details of the history Claims Resolution case are read in part database.

Optionally, first maintenance platform, is specifically configured to:

The case of the history Claims Resolution case generated in first maintenance period is read from the Claims Resolution case database Details；

The case for extracting the history Claims Resolution case recorded in the case details compensates type；

Based on the illness rate for each kinds of Diseases for including in the healthy reference data, the trouble of each kinds of Diseases is calculated Sick rate changing value；

It counts case and compensates the history Claims Resolution case that type is the kinds of Diseases that illness rate changing value is greater than default change threshold The number of cases of part；

If the number of cases for the history Claims Resolution case that the statistics obtains is greater than number of cases threshold value, generate described in carrying The health of kinds of Diseases informs that case informs case as the new health；

The new health of the generation is informed that case update to the health is informed in database.

Optionally, the parameter determination module, is specifically configured to:

It extracts the case for including in the case details of the history Claims Resolution case and compensates type, and extract the case details In include case compensate the amount of money as the case compensate information；

Type is compensated according to the case to cluster history Claims Resolution case, and it is corresponding to obtain each case compensation type Claims Resolution case collection；

Compensating the corresponding Claims Resolution case of type according to each case concentrates the case of history Claims Resolution case to compensate the amount of money, calculates each Case compensates the practical compensation amount of money of the corresponding Claims Resolution case collection of type；The practical amount of money of compensating refers to that each case compensates type Corresponding Claims Resolution case concentrates the case of history Claims Resolution case to compensate the sum of amount of money；

The corresponding practical compensation amount of money of type is compensated according to each case, each case compensates the corresponding case Claims Resolution number of type With program member's sum of the fitness programme, the practical loss ratio that each case compensates type is calculated, is compensated as the case Parameter.

Optionally, the case generation module, is specifically configured to:

Judge that each case compensates the compensation ratio of the practical loss ratio of type and the risk incidence of each case compensation type Whether it is greater than and compensates threshold value；

There is the payout ratio value to be greater than the health that each case for compensating threshold value compensates type if so, generating record respectively Inform that case informs case as the new health.

Optionally, the parameter determination module, is specifically configured to:

It extracts the case for including in the case details of the history Claims Resolution case and compensates type, and extract the case details In include program member's gender as the case compensate information；

It calculates each case and compensates the property that the corresponding Claims Resolution case of type concentrates the included program member of projects member's gender Other accounting compensates parameter as the case.

Optionally, the case generation module, is specifically configured to:

Calculate the gender accounting difference of male program member accounting and women program member accounting in the gender accounting；

In the case where the gender accounting difference is greater than the first accounting threshold value, generating record has the gender accounting difference The health for compensating type and male gender greater than the case of the first accounting threshold value informs that case is informed as the new health Case；

In the case where the gender accounting difference is less than the second accounting threshold value, generating record has the gender accounting difference The health for compensating type and female gender less than the case of the second accounting threshold value informs that case is informed as the new health Case.

Optionally, the parameter determination module, is specifically configured to:

It extracts the case for including in the case details of the history Claims Resolution case and compensates type, and extract the case details In include case compensate the amount of money and program member's age as the case and compensate information；

The corresponding practical compensation amount of money of type is compensated according to each case, each case compensates the corresponding case Claims Resolution number of type With program member's sum of the fitness programme, the practical loss ratio that each case compensates type is calculated；

Calculate the compensation ratio that each case compensates the practical loss ratio of type and the risk incidence of each case compensation type；

Judge whether the compensation ratio is greater than compensation threshold value；

If so, calculating the ratio of compensating is greater than the corresponding Claims Resolution case collection of each case compensation type for compensating threshold value The dispersion degree at program member's age of middle history Claims Resolution charge sheet, compensates parameter as the case.

Optionally, the case generation module, is specifically configured to:

In the case where the dispersion degree is low dispersion degree, determine that the Claims Resolution case concentration of the low dispersion degree is gone through The low discrete age range at program member's age of history Claims Resolution charge sheet；The starting age of the low discrete age range and/ Or the termination age concentrates the accounting of each age group program member to determine according to the Claims Resolution case of the low dispersion degree；

Generate the health informing that record has the case of the low dispersion degree to compensate type and the low discrete age range Case informs case as the new health.

Optionally, the parameter determination module, is specifically configured to:

It extracts the case for including in the case details of the history Claims Resolution case and compensates type, and extract the case details In include case compensate the amount of money, program member's occupational information and program member's gender as the case and compensate information；

Type and program member's gender are compensated according to the case to cluster history Claims Resolution case, are obtained At least one Claims Resolution case collection；

It concentrates the case of history Claims Resolution case to compensate the amount of money according to each Claims Resolution case, calculates the practical compensation of each Claims Resolution case collection Pay the amount of money；The practical amount of money of compensating refers to that each Claims Resolution case concentrates the case of history Claims Resolution case to compensate the sum of amount of money；

According to the corresponding practical compensation amount of money of each Claims Resolution case collection, the corresponding case Claims Resolution number of each Claims Resolution case collection and institute The program member's sum for stating fitness programme, calculates the corresponding practical loss ratio of each Claims Resolution case collection, compensates and join as the case Number.

Optionally, the case generation module, is specifically configured to:

Calculate the compensation of the corresponding practical loss ratio of each Claims Resolution case collection risk incidence corresponding with each Claims Resolution case collection Ratio；

If so, the calculating ratio of compensating is greater than each Claims Resolution case concentration history Claims Resolution charge sheet for compensating threshold value Program member's occupational information dispersion degree；

In the case where the dispersion degree is low dispersion degree, it is each to determine that the Claims Resolution case of the low dispersion degree is concentrated The low discrete items member occupation set of program member's occupational information；The items that the low discrete items member occupation set includes Mesh member occupational information is determined according to the accounting that affiliated Claims Resolution case concentrates projects member's occupational information to correspond to program member；

Generating record has the case of the low dispersion degree to compensate type, program member's gender and the low discrete items The health of mesh member's occupation set informs that case informs case as the new health.

The application also provides a kind of health informing case maintemance method, comprising:

The case details of the history Claims Resolution case of fitness programme are obtained according to the second maintenance period；

It extracts the case for including in the case details of the history Claims Resolution case and compensates type and case compensation information, and base Information, which is compensated, in the case determines that each case compensates the case compensation parameter of type；

Type, which is compensated, based on the case that case compensates the default case compensation condition of parameter satisfaction generates newly health informing case；

The new health of generation is informed that case update to health is informed in database.

Optionally, the case details of the history Claims Resolution case that fitness programme is obtained according to the second maintenance period, comprising:

According to second maintenance period from the Claims Resolution case database for the case details for storing history Claims Resolution case The middle case details for reading the history Claims Resolution case.

Optionally, the case for including in the case details for extracting the history Claims Resolution case compensates type and case is paid for Information is paid, and information is compensated based on the case and determines that each case compensates the case compensation parameter of type, comprising:

Optionally, the case compensation type for compensating the default case compensation condition of parameter satisfaction based on case generates newly strong Health informs case, comprising:

The application also provides a kind of health informing case maintemance device, comprising:

Case acquiring unit is configured as obtaining the case of the history Claims Resolution case of fitness programme according to the second maintenance period Details；

Parameter determination unit, the case for being configured as in the case details for extracting the history Claims Resolution case including compensate kind Class and case compensate information, and compensate information based on the case and determine that each case compensates the case compensation parameter of type；

Case generation unit is configured as compensating the case compensation kind that parameter meets default case compensation condition based on case Class generates new health and informs case；

Case update unit, the new health for being configured as to generate inform that case update to health is informed in database.

The application also provides a kind of calculating equipment, comprising:

Memory and processor；

For the memory for storing computer executable instructions, the processor is executable for executing the computer Instruction:

The application also provides a kind of computer readable storage medium, is stored with computer instruction, and the instruction is by processor The step of health informs case maintemance method is realized when execution.

Compared with prior art, the application has the advantages that

The application provide it is a kind of health inform case maintemance system, comprising: health inform database, the first maintenance platform and Second maintenance platform；It is described health inform database, be configured as storage user apply be added fitness programme during execute Health informs that the health of link informs case；First maintenance platform, is configured as according to the first maintenance period to healthy base Quasi- data and the history of fitness programme Claims Resolution data are analyzed, and the new health that analysis is obtained informs case update to institute Health is stated to inform in database；Second maintenance platform, including case obtain module, parameter determination module, case and generate mould Block and case update module；Wherein, the case obtains module, is configured as obtaining the healthy item according to the second maintenance period The case details of purpose history Claims Resolution case；The duration of second maintenance period is less than the duration of first maintenance period； The parameter determination module, be configured as extracting the case in the case details of the history Claims Resolution case included compensate type and Case compensates information, and compensates information based on the case and determine that each case compensates the case compensation parameter of type；The case Generation module, the case compensation type for being configured as compensating the default case compensation condition of parameter satisfaction based on case generate newly health Inform case；The case update module, the new health for being configured as to generate inform that case update to the health informs number According in library.

Health provided by the present application informs case maintemance system, flat by first maintenance platform and second maintenance Platform cooperation between the two informs case and right analyzing new health in longer maintenance period using first maintenance platform While the health informs that database is updated maintenance, to make the fitness programme timely respond to new healthy informing case Example is compensated type in each case of the shorter maintenance period to the fitness programme using second maintenance platform and is divided Analysis informs case to described strong to will compensate the case that cost changes greatly in shorter time period and compensate type as new health Health informs that database is updated maintenance, informs that health informs that the maintenance of case is more perfect in database, mentions to the health The healthy validity for informing case maintemance has been risen, while also having been made on the basis of the health informs that health informs case in database The health of progress is informed more comprehensive.

Detailed description of the invention

Fig. 1 is the structural block diagram that a kind of health provided by the embodiments of the present application informs case maintemance system；

Fig. 2 is that a kind of health provided by the embodiments of the present application informs case maintemance method process flow diagram；

Fig. 3 is the schematic diagram that a kind of health provided by the embodiments of the present application informs case maintemance device；

Fig. 4 is a kind of structural block diagram for calculating equipment provided by the embodiments of the present application.

Specific embodiment

Many details are explained in the following description in order to fully understand the application.But the application can be with Much it is different from other way described herein to implement, those skilled in the art can be without prejudice to the application intension the case where Under do similar popularization, therefore the application is not limited by following public specific implementation.

The term used in this specification one or more embodiment be only merely for for the purpose of describing particular embodiments, It is not intended to be limiting this specification one or more embodiment.In this specification one or more embodiment and appended claims The "an" of singular used in book, " described " and "the" are also intended to including most forms, unless context is clearly Indicate other meanings.It is also understood that term "and/or" used in this specification one or more embodiment refers to and includes One or more associated any or all of project listed may combine.

It will be appreciated that though may be retouched using term first, second etc. in this specification one or more embodiment Various information are stated, but these information should not necessarily be limited by these terms.These terms are only used to for same type of information being distinguished from each other It opens.For example, first can also be referred to as second, class in the case where not departing from this specification one or more scope of embodiments As, second can also be referred to as first.Depending on context, word as used in this " if " can be construed to " ... when " or " when ... " or " in response to determination ".

The application provides a kind of health informing case maintemance system, and the application also provides a kind of health informing case maintemance side Method, a kind of health informing case maintemance device, a kind of calculating equipment and a kind of computer readable storage medium.Individually below It is described in detail one by one in conjunction with the attached drawing of embodiment provided by the present application.

A kind of health provided by the present application informs that case maintemance system embodiment is as follows:

Referring to attached drawing 1, it illustrates a kind of structural block diagrams of health informing case maintemance system provided in this embodiment.

The health informs case maintemance system, comprising: health informs database 110, the first maintenance platform 120 and second Maintenance platform 130；

Wherein, the health informs database 110, is configured as storage user and applies executing during addition fitness programme Health inform link health inform case；

First maintenance platform 120, is configured as according to the first maintenance period to healthy reference data and the health The history Claims Resolution data of project are analyzed, and the new health that analysis is obtained informs that case update to the health informs database In 110；

Second maintenance platform 130, including case obtain module 132, parameter determination module 134, case generation module 136 and case update module 138；

Wherein, the case obtains module 132, is configured as obtaining going through for the fitness programme according to the second maintenance period The case details of history Claims Resolution case；The duration of second maintenance period is less than the duration of first maintenance period；

The parameter determination module 134 is configured as the case in the case details for extracting the history Claims Resolution case included Part compensates type and case compensates information, and compensates information based on the case and determine that each case compensates the case compensation ginseng of type Number；

The case generation module 136 is configured as compensating the case that parameter meets default case compensation condition based on case Part compensates type and generates new health informing case；

The case update module 138, the new health for being configured as to generate inform that case update to the health is informed In database 110.

Fitness programme described in the embodiment of the present application refers to serious illness insurance, medical insurance, the nursing health such as danger and personal accidental death and injury insurance The insurance coverage of insurance kind, it is to be particularly noted that the fitness programme can also be the fitness programme of mutual assistance mutual aid formula, this implementation Example is illustrated the fitness programme by taking health insurance project as an example, in addition, the fitness programme can also be other and health Relevant project, such as health and fitness information the checking item etc., do not limit this.

Serious illness insurance, medical insurance, the process of the healthy insurance kind in nursing danger and personal accidental death and injury insurance etc. are bought in practical application, on line In, insurance company need to protect link in core and carry out confirmation announcement to the health status for the insurer (user) that health insurance project is added in application Know, after user completes the confirmation that health is informed, core guarantor is carried out on the basis of health is informed, if core guarantor successfully passes, by insuring Company accepts insurance, and the content that user health is informed will become a component part of health insurance declaration form；As it can be seen that as health insurance The important component of declaration form, health, which is informed, becomes the most important thing that core protects link.

It should be noted that the premise for carrying out healthy informing is that user initiates health informing application, tool during purchasing danger Body refers to after the health for receiving user informs application, informs link into health.Wherein, the health informs that application can To be that the health that my artificial purchase is nearly initiated of insuring informs application, can also be insure it is artificial other people purchase the health initiated when danger and accuse Know application, for example the artificial household that insures buys the health initiated when health insurance and informs application；Correspondingly, if insurer is for this The health that people's purchase is nearly initiated informs application, then carries out health and inform it is that the health status based on insurer itself carries out；If thrown Guarantor is to purchase healthy inform nearly initiated for other people to apply, then carrying out health informing is the health status progress also based on other people.

It is informed in link in health, insurer needs the healthy notification needed for health informing (for example, health is informed Book) in choose whether with corresponding kinds of Diseases, thus clearly to divide insurer's being good for before purchase danger and after purchase danger Health responsibility and right, and the kinds of Diseases in healthy notification inform database 110 from the health, the health informs data All kinds of Diseases that the health insurance project is related to are stored in library 110, wherein the health is informed deposits in database 110 Each kinds of Diseases of storage are known as a health and inform case.

By taking the serious illness insurance in health insurance as an example, it is necessary first to the kinds of Diseases in clear serious illness insurance scope of insurance coverage, including Malignant tumour, acute myocardial infarction, cerebral apoplexy sequela, great transplant operation etc., health is informed to be stored in database 110 All kinds of Diseases in serious illness insurance scope of insurance coverage are stored with all health that serious illness insurance is related to and inform case: is pernicious swollen Tumor, acute myocardial infarction, cerebral apoplexy sequela, great transplant operation etc..

It should be noted that health described in the present embodiment informs that database 110 only refers to for storing the health insurance The health of project informs the database of case, and different health insurance projects should configure corresponding health and inform database 110, For example serious illness insurance project should configure corresponding serious illness insurance health and inform database, personal accidental death and injury insurance project should also configure corresponding heavy Disease danger health informs database, if different health insurance projects inform that link is overlapped or similar health informs case in health It is more, then during configuration health informs database, it can refer to the kinds of Diseases registration for including or similarity be higher Health inform database configured.

In practical application, for running the insurance company of health insurance project, in the health insurance item of insurance company's operation In a fairly large number of situation of purpose, the maintenance of database 110, which will be that insurance company faces, is informed to the health of health insurance project Huge challenge then may result in once the health of one or more health insurance project informs the maintenance of database 110 not in time It is a large amount of to compensate, huge loss is brought to insurance company.

Health provided by the present application informs case maintemance system, passes through first maintenance platform 120 and second dimension The cooperation between the two of platform 130 is protected, it is on the one hand longer and disease treatment technology innovation iteration compares according to the disease treatment period Slow feature, therefore the illness rate for counting kinds of Diseases takes a long time the period, is pressed using first maintenance platform 120 Case is informed according to the new health that longer maintenance period (half a year or 1 year) analysis needs to update, based on the new health analyzed Informing, case realizes the update that database 110 is informed the health；On the other hand, to keep the health insurance project timely Respond the variation that case compensates situation, using second maintenance platform 130 according to shorter maintenance period (1 week, 1 day even It is shorter) each case compensation type of the health insurance project is analyzed, so that cost variation will be compensated in shorter time period The new health that biggish case compensation type is included in the health insurance project is informed case and is realized to the health informing data The update in library 110.

In a kind of optional embodiment provided by the embodiments of the present application, first maintenance platform 120 is from history Claims Resolution case Part sets out, and is to analyze according to the compensation kinds of Diseases to history Claims Resolution case with medical data, to targetedly will It compensates within the scope of the abnormal concern for being included in health informing, realizes that more accurate and more targetedly health is informed.Described One maintenance platform 120 specifically realizes the update for informing the health database 110 in the following way:

1) case that the history Claims Resolution case generated in first maintenance period is read from Claims Resolution case database is detailed Feelings；

The Claims Resolution case database is configured as storing the case details of the history Claims Resolution case；The case is detailed The case compensation kind that not only record has user to inform all information and history Claims Resolution case of link in health in feelings Class, that is, the kinds of Diseases compensated, the also attribute information of record user itself and information relevant to health insurance project, than The payment period of such as user, pay charge way information；

2) case for extracting the history Claims Resolution case recorded in the case details compensates type；

3) illness rate based on each kinds of Diseases for including in the healthy reference data, calculates each kinds of Diseases Illness rate changing value；

The health reference data refers to the illness rate of disease A in medical data, such as past 1 year of statistics, if the past 1 1 times of the illness rate rising of disease A is even more in year, then needs to pay close attention to whether disease A needs to bring into health informing range It is interior；

4) statistics case compensates the history Claims Resolution that type is the kinds of Diseases that illness rate changing value is greater than default change threshold The number of cases of case；

If 5) number of cases for the history Claims Resolution case that the statistics obtains is greater than number of cases threshold value, generates and carry institute The health for stating kinds of Diseases informs that case informs case as the new health；

6) the new health of the generation is informed that case update to the health is informed in database.

For example, the first maintenance platform 120 informs that the maintenance period of database 110 is 1 year to health in health insurance project, root According to the Claims Resolution time of history Claims Resolution case in the health insurance project of Claims Resolution case database purchase, read from Claims Resolution case database Take over settled a claim in 1 year in health insurance project generation history Claims Resolution case case details；

The generation compensation of each history Claims Resolution case is extracted from the case details of each history Claims Resolution case respectively Kinds of Diseases；According to the illness rate for the disease A and disease B for including in medical data in the past 1 year got, disease is calculated separately The illness rate of sick A and disease B, if the illness rate of disease A changes greatly in 1 year in the past, illness rate rises to from 0.03% 0.07%, beyond default change threshold (0.025%), then need to pay close attention to whether disease A needs to bring into health informing range It is interior；The illness rate variation of disease B is smaller, and illness rate drops to 0.026% from 0.028%, without departing from default change threshold (0.025%), then disease B is informed in range without being included in health；

All history Claims Resolution case that the kinds of Diseases compensated are disease A is counted in the history Claims Resolution case of reading Number of cases；If the history that the kinds of Diseases that the generation counted on is compensated are disease A is settled a claim, the number of cases of case is greater than Number of cases threshold value, number of cases threshold value can be being averaged for the number of cases for the various diseases that history Claims Resolution case generation is compensated Disease A is then included in health and informs range by value, is generated new health and is informed case a1；The new health of generation is finally informed into case The health that a1 is updated to health insurance project is informed in database 110.

Second maintenance platform 130, including the case obtain the module 132, parameter determination module 134, described Case generation module 136 and the case update module 138 this four modules, specifically to by informing data to the health During health in library 110 informs that the mode that case is updated informs that database 110 is safeguarded to the health, lead to It crosses the case and obtains module 132, the parameter determination module 134, the case generation module 136 and the case update mould Mutual cooperation between this four modules of block 138, it is common to complete to inform that health informs case in database 110 to the health Update, following bases to it is described health inform database 110 in health inform case update during this four modules it is successive Operation order is successively illustrated this four modules according to vertical operation order.

1, the case obtains module 132.

When it is implemented, the case obtains module 132, it is specifically configured to according to second maintenance period from described The case details of the history Claims Resolution case are read in Claims Resolution case database.

As described above, first maintenance platform 120 needs more in longer maintenance period (half a year or 1 year) analysis New new health informs case, informs that case is realized based on the new health analyzed and informs database 110 more to the health Newly；Second maintenance platform 130 is in shorter maintenance period (1 week, 1 day even shorter) to each case of the health insurance project Part is compensated type and is analyzed, and is included in described be good for will compensate the case that cost changes greatly in shorter time period and compensate type The new health of health danger project informs case and realizes the update for informing the health database 110；As it can be seen that first maintenance Platform 120 and second maintenance platform 130 are informing that database 110 carries out the emphasis in maintenance process not to the health Together, it should be noted that the duration of the second maintenance period described in the present embodiment is less than the duration of first maintenance period.

In practical application, in the biggish situation of program member's number for participating in the health insurance project, such as millions In the case where program member, tens million of program members even hundred million grades of program members, propose that Claims Resolution application produces from program member daily The number of raw Claims Resolution case is also the number rank that can not ignore, the compensation amount of money compensated due to these Claims Resolution cases Number is more maintained at a certain amount of grade or more, therefore, to make each kinds of Diseases of response of the health insurance project much sooner The various compensation situations such as cost are compensated, according to shorter second maintenance period of duration (1 week, 1 day or even shorter) from described The case details that history Claims Resolution case is read in Claims Resolution case database, on the basis of the case details of reading into Row analysis.

2, the parameter determination module 134.

When it is implemented, the parameter determination module 134 is informing that health informs case in database 110 to the health During being updated, for above-mentioned case obtain module 132 read the history Claims Resolution case case details into Row extraction and analysis generates new health for the case generation module 136 and informs that case is prepared.The embodiment of the present application provides following 4 kinds of parameter determination modules 134 extract the optional of analysis to the case details of the history Claims Resolution case read Implementation:

1) the compensation cost that each case compensates type from the health insurance project carries out case Claims Resolution analysis, practical In, the health insurance project often to compensate cost it is very sensitive, therefore from compensate the progress of cost angle case Claims Resolution analysis can be realized more obvious and more targeted case Claims Resolution analysis in health insurance project.

Specifically, the parameter determination module 134 is from the case Claims Resolution analysis of cost angle progress is compensated using such as Under type is realized:

A, it extracts the case for including in the case details of the history Claims Resolution case and compensates type, and it is detailed to extract the case The case for including in feelings compensates the amount of money as the case and compensates information；

B, type is compensated according to the case to cluster history Claims Resolution case, obtain each case and compensate type pair The Claims Resolution case collection answered；

C, compensating the corresponding Claims Resolution case of type according to each case concentrates the case of history Claims Resolution case to compensate the amount of money, calculates Each case compensates the practical compensation amount of money of the corresponding Claims Resolution case collection of type；

Wherein, the practical amount of money of compensating refers to that each case compensates the corresponding Claims Resolution case of type and concentrates history Claims Resolution case Case compensate the sum of amount of money；

D, the corresponding practical compensation amount of money of type is compensated according to each case, each case compensates the corresponding case Claims Resolution number of type The program member of mesh and health insurance project sum calculates the practical loss ratio that each case compensates type, as the case Compensate parameter.

For example, 130 pairs of health of the second maintenance platform inform that health informs the second dimension that case is safeguarded in database 110 Protecting the period is 1 day, the case if history that program member's proposition Claims Resolution application generates in 1 the second maintenance period of past is settled a claim 100 in total, then the case details of this 100 history Claims Resolution cases are read in Claims Resolution case database, on this basis, into Row following analysis calculates:

(compensation is generated firstly, extracting the case for including in the case details of this 100 history Claims Resolution case respectively and compensating type The kinds of Diseases paid) and the case compensation amount of money；

Then, being settled a claim according to history, case is corresponding to generate the kinds of Diseases compensated, to this 100 history Claims Resolution cases Part is clustered, and cluster result is as follows: the history Claims Resolution case that kinds of Diseases are disease A is compensated in 100 history Claims Resolution cases There are 50, obtains the Claims Resolution case collection S1 being made of 50 history Claims Resolution case that compensation kinds of Diseases are disease A；100 are gone through The history Claims Resolution case that kinds of Diseases are disease B is compensated in history Claims Resolution case 20, and obtaining by compensation kinds of Diseases is disease B 20 history Claims Resolution case constitute Claims Resolution case collection S2；Compensating kinds of Diseases in 100 history Claims Resolution cases is disease C's History Claims Resolution case has 30, obtains the Claims Resolution case being made of 30 history Claims Resolution case that compensation kinds of Diseases are disease C Collect S3；

Kinds of Diseases are compensated secondly, calculating Claims Resolution case and integrating 50 that S1 includes as the reality of the history of disease A Claims Resolution case The amount of money is compensated on border, if compensating the history Claims Resolution case that the amount of money is 100,000 yuan in 50 history Claims Resolution cases has 40, compensates gold The history that volume is 300,000 yuan case of settling a claim has 10, then case of settling a claim integrates 50 compensation kinds of Diseases that S1 includes as disease A Practical ten thousand yuan of compensation amount of money M1=40*10+30*10=700 of history Claims Resolution case；

It calculates Claims Resolution case and integrates 20 compensation kinds of Diseases that S2 includes as the practical compensation of the history of disease B Claims Resolution case The amount of money, if compensating the history Claims Resolution case that the amount of money is 100,000 yuan in 20 history Claims Resolution cases has 15, compensating the amount of money is 300,000 The history Claims Resolution case of member has 5, then case of settling a claim integrates 20 compensation kinds of Diseases that S2 includes as the history Claims Resolution case of disease B Practical ten thousand yuan of compensation amount of money M2=15*10+5*30=200 of part；

It calculates Claims Resolution case and integrates 30 compensation kinds of Diseases that S3 includes as the practical compensation of the history of disease C Claims Resolution case The amount of money, if compensating the history Claims Resolution case that the amount of money is 100,000 yuan in 30 history Claims Resolution cases has 24, compensating the amount of money is 30 Ten thousand yuan of history Claims Resolution case has 6, then case of settling a claim integrates 30 that S3 includes and compensates kinds of Diseases as the Claims Resolution of the history of disease C Practical ten thousand yuan of compensation amount of money M3=24*10+6*30=420 of case；

Finally, integrating 50 compensation kinds of Diseases that S1 includes according to Claims Resolution case as the reality of the history of disease A Claims Resolution case The project of case the Claims Resolution number 50 and health insurance project of the history Claims Resolution case that amount of money M1 is compensated on border, Claims Resolution case collection S1 includes Membership 100,000, and the practical compensation amount of money M1/ of practical loss ratio R1=for calculating this compensation kinds of Diseases of disease A is (practical to pay for Pay amount of money M1/ case Claims Resolution number * program member sum)=7,000,000/(7,000,000/50*100000)=0.05%；

Integrate 20 compensation kinds of Diseases that S2 includes according to Claims Resolution case as the practical compensation of the history of disease B Claims Resolution case The case Claims Resolution number 20 for the history Claims Resolution case that amount of money M2, Claims Resolution case collection S2 include and the program member of health insurance project are total Number 100,000, the practical compensation amount of money M2/ of practical loss ratio R2=for calculating this compensation kinds of Diseases of disease B are (practical to compensate the amount of money M2/ case Claims Resolution number * program member sum)=2,000,000/(2,000,000/20*100000)=0.02%；

Integrate 30 compensation kinds of Diseases that S3 includes according to Claims Resolution case as the practical compensation of the history of disease C Claims Resolution case The case Claims Resolution number 30 for the history Claims Resolution case that amount of money M3, Claims Resolution case collection S3 include and the program member of health insurance project are total Number 100,000, the practical compensation amount of money M3/ of practical loss ratio R3=for calculating this compensation kinds of Diseases of disease C are (practical to compensate the amount of money M3/ case Claims Resolution number * program member sum)=4,200,000/(4,200,000/30*100000)=0.03%.

2) program member's gender that each case compensates type from the health insurance project carries out case Claims Resolution analysis, In practical application, many kinds of Diseases are very sensitive to program member's gender, for example many diseases are in the illness rate of female group Much larger than the illness rate in male population, or even only can be in female group or male population illness, such as female there are many disease The gynecological disease of property group, the andrological diseases of male population, in response to this, from the angle progress of program member's gender Case Claims Resolution is analyzed, and can play more targeted effect in the health insurance project in actual scene.

Specifically, the parameter determination module 134 is adopted from the Claims Resolution analysis of the case of program member's gender angle progress It is realized with such as under type:

A, it extracts the case for including in the case details of the history Claims Resolution case and compensates type, and it is detailed to extract the case The program member's gender for including in feelings compensates information as the case；

C, it calculates the corresponding Claims Resolution case of each case compensation type and concentrates the included program member's of projects member's gender Gender accounting compensates parameter as the case.

(compensation is generated firstly, extracting the case for including in the case details of this 100 history Claims Resolution case respectively and compensating type The kinds of Diseases paid) and program member's gender；

Secondly, being settled a claim according to history, case is corresponding to generate the kinds of Diseases compensated, to this 100 history Claims Resolution cases Part is clustered, and cluster result is as follows: the history Claims Resolution case that kinds of Diseases are disease A is compensated in 100 history Claims Resolution cases There are 50, obtains the Claims Resolution case collection S1 being made of 50 history Claims Resolution case that compensation kinds of Diseases are disease A；100 are gone through The history Claims Resolution case that kinds of Diseases are disease B is compensated in history Claims Resolution case 20, and obtaining by compensation kinds of Diseases is disease B 20 history Claims Resolution case constitute Claims Resolution case collection S2；Compensating kinds of Diseases in 100 history Claims Resolution cases is disease C's History Claims Resolution case has 30, obtains the Claims Resolution case being made of 30 history Claims Resolution case that compensation kinds of Diseases are disease C Collect S3；

Finally, the number of male program member and the number of women program member in statistics Claims Resolution case collection S1, calculate Male's program member's accounting of this compensation kinds of Diseases of disease A is 75%, and women program member's accounting is 25%；Statistics Claims Resolution The number of the number of male program member and women program member in case collection S2 calculates this compensation kinds of Diseases of disease B Male's program member's accounting be 47%, women program member's accounting be 53%；Statistics Claims Resolution case collection S3 in male's project at The number of member and the number of women program member, the male's program member's accounting for calculating disease C this compensation kinds of Diseases are 51%, women program member's accounting is 49%.

3) each case compensates the compensation cost and program member's age carry out case of type from the health insurance project Part Claims Resolution is analyzed, and in practical application, many kinds of Diseases are more sensitive to program member's age, for example many diseases are in children group The illness rate of body is much larger than the illness rate in Adult group, and many diseases are much larger than in the illness rate of the elderly group for another example The illness rate of youth group, in response to this, on the basis of the case Claims Resolution analysis for compensating the progress of cost angle, into One step from age angle to compensate cost carry out case Claims Resolution analysis analysis result progress deeper into analysis, thus It determines the age bracket for leading to compensate cost occurrence variation, the analysis of health informing case is more deepened targetedly and more Enter.

Specifically, the parameter determination module 134 is from compensating cost angle and program member's age angle progress Case Claims Resolution analysis is realized in the following way:

A, it extracts the case for including in the case details of the history Claims Resolution case and compensates type, and it is detailed to extract the case The case for including in feelings compensates the amount of money and program member's age as the case and compensates information；

C, compensating the corresponding Claims Resolution case of type according to each case concentrates the case of history Claims Resolution case to compensate the amount of money, calculates Each case compensates the practical compensation amount of money of the corresponding Claims Resolution case collection of type；The practical amount of money of compensating refers to that each case compensates kind The corresponding Claims Resolution case of class concentrates the case of history Claims Resolution case to compensate the sum of amount of money；

D, the corresponding practical compensation amount of money of type is compensated according to each case, each case compensates the corresponding case Claims Resolution number of type The program member of mesh and health insurance project sum calculates the practical loss ratio that each case compensates type；

E, the payout ratio that each case compensates the practical loss ratio of type and the risk incidence of each case compensation type is calculated Value；

F, judge whether the compensation ratio is greater than compensation threshold value；

If so, showing that case compensates the practical loss ratio for the history Claims Resolution case that the corresponding Claims Resolution case collection of type includes It higher than the risk incidence that the case compensates type, needs to compensate the case type progress selective analysis, judges whether to incite somebody to action The case compensates type and is included in health informing range, executes following step g；

If it is not, then showing that case compensates the practical loss ratio for the history Claims Resolution case that the corresponding Claims Resolution case collection of type includes Below or equal to the risk incidence that the case compensates type, range is informed without being included in health, is not processed；

G, the ratio of compensating is calculated to concentrate greater than the corresponding Claims Resolution case of each case compensation type for compensating threshold value The dispersion degree at program member's age of history Claims Resolution charge sheet, compensates parameter as the case.

A, the case for including in the case details of this 100 history Claims Resolution cases is extracted respectively compensates type (generation compensation Kinds of Diseases), case compensate the amount of money and program member's age；

B, being settled a claim according to history, case is corresponding to generate the kinds of Diseases compensated, to this 100 history Claims Resolution cases Clustered, cluster result is as follows: the history Claims Resolution case that kinds of Diseases are disease A is compensated in 100 history Claims Resolution cases to be had 50, obtain the Claims Resolution case collection S1 being made of 50 history Claims Resolution case that compensation kinds of Diseases are disease A；100 history The history Claims Resolution case that kinds of Diseases are disease B is compensated in Claims Resolution case 20, and obtaining by compensation kinds of Diseases is disease B's The Claims Resolution case collection S2 that 20 history Claims Resolution cases are constituted；Compensating kinds of Diseases in 100 history Claims Resolution cases is going through for disease C History Claims Resolution case has 30, obtains the Claims Resolution case collection being made of 30 history Claims Resolution case that compensation kinds of Diseases are disease C S3；

C, it calculates Claims Resolution case and integrates 50 compensation kinds of Diseases that S1 includes as the practical compensation of the history of disease A Claims Resolution case The amount of money is paid, if compensating the history Claims Resolution case that the amount of money is 100,000 yuan in 50 history Claims Resolution cases there are 40, compensating the amount of money is 300000 yuan of history Claims Resolution case has 10, then case of settling a claim integrates 50 compensation kinds of Diseases that S1 includes as the history of disease A Practical ten thousand yuan of compensation amount of money M1=40*10+30*10=700 of case of settling a claim；

D, 50 compensation kinds of Diseases that S1 includes are integrated as the practical compensation of the history of disease A Claims Resolution case according to Claims Resolution case Pay amount of money M1, the program member of case the Claims Resolution number 50 and health insurance project of the history Claims Resolution case that Claims Resolution case collection S1 includes Sum 100,000, the practical compensation amount of money M1/ of practical loss ratio R1=for calculating this compensation kinds of Diseases of disease A are (practical to compensate gold Volume M1/ case Claims Resolution number * program member sum)=7,000,000/(7,000,000/50*100000)=0.05%；

Integrate 30 compensation kinds of Diseases that S3 includes according to Claims Resolution case as the practical compensation of the history of disease C Claims Resolution case The case Claims Resolution number 30 for the history Claims Resolution case that amount of money M3, Claims Resolution case collection S3 include and the program member of health insurance project are total Number 100,000, the practical compensation amount of money M3/ of practical loss ratio R3=for calculating this compensation kinds of Diseases of disease C are (practical to compensate the amount of money M3/ case Claims Resolution number * program member sum)=4,200,000/(4,200,000/30*100000)=0.03%；

E, the compensation ratio of the illness rate 0.03% of the practical loss ratio M1 and disease A of this compensation kinds of Diseases of disease A =practical loss ratio M1/ illness rate=0.05%/0.03%=1.67；

The compensation ratio of the illness rate 0.028% of the practical loss ratio M2 and disease B of this compensation kinds of Diseases of disease B= Practical loss ratio M2/ illness rate=0.02%/0.028%=0.71；

The compensation ratio of the illness rate 0.03% of the practical loss ratio M3 and disease C of this compensation kinds of Diseases of disease C= Practical loss ratio M3/ illness rate=0.03%/0.03%=1；

F, judging disease A, disease B and disease C, these three compensate whether the respective compensation ratio of kinds of Diseases is greater than compensation Threshold value 1.5, for disease B and disease C, the two compensation ratios for compensating kinds of Diseases are less than compensation threshold value 1.5 to judging result, then The two compensation kinds of Diseases of disease B and disease C inform range without being included in health；The compensation of this compensation kinds of Diseases of disease A It pays ratio 1.67 and is greater than compensation threshold value 1.5, then carry out the processing of following step seven；

G, 50 history Claims Resolution cases in the corresponding Claims Resolution case collection S1 of this compensation kinds of Diseases of disease A are calculated respectively to remember The variance at program member's age of record is settled a claim program member's age of corresponding 50 program members of cases as 50 history Dispersion degree.

4) from the health insurance project each case compensate compensation cost, program member's occupational information and the project of type at Member's gender, which is set out, carries out case Claims Resolution analysis, and in practical application, the health insurance project is often very sensitive to compensation cost, needle To such case, on the basis of the case Claims Resolution analysis for compensating the progress of cost angle, further from program member's occupation Information viewpoint and program member's gender angle are set out deeper to carrying out in the analysis result for compensating cost progress case Claims Resolution analysis The analysis entered informs health so that it is determined that leading to the program member's occupation and program member's gender of compensating cost occurrence variation The analysis of case is more targeted and more deep.

Specifically, the parameter determination module 134 is settled a claim from the case for compensating cost angle and age angle progress Analysis is realized in the following way:

A, it extracts the case for including in the case details of the history Claims Resolution case and compensates type, and it is detailed to extract the case The case for including in feelings compensates the amount of money, program member's occupational information and program member's gender as the case and compensates information；

B, type and program member's gender are compensated according to the case to cluster history Claims Resolution case, is obtained Obtain at least one Claims Resolution case collection；

C, it concentrates the case of history Claims Resolution case to compensate the amount of money according to each Claims Resolution case, calculates the reality of each Claims Resolution case collection Compensate the amount of money；The practical amount of money of compensating refers to that each Claims Resolution case concentrates the case of history Claims Resolution case to compensate the sum of amount of money；

D, according to each Claims Resolution case collection it is corresponding it is practical compensate the amount of money, the corresponding case Claims Resolution number of each Claims Resolution case collection and Program member's sum of the health insurance project, calculates the corresponding practical loss ratio of each Claims Resolution case collection, pays for as the case Pay parameter.

3, the case generation module 136.

When it is implemented, the parameter determination module 134 is informing that health informs case in database 110 to the health During being updated, for above-mentioned case obtain module 132 read the history Claims Resolution case case details into Row extraction and analysis generates new health for the case generation module 136 and informs that case is prepared.

With the parameter determination module 134 of above-mentioned offer to the case details of the history Claims Resolution case read into 4 kinds of implementations of row extraction and analysis correspond, and it is right that the embodiment of the present application provides following 4 kinds of case generation modules 136 The case details of the history Claims Resolution case read extract the implementation of analysis:

1) the compensation cost angle that each case compensates type in the health insurance project carries out the base of case Claims Resolution analysis New health informing case is generated on plinth, and the new health generated is made to inform that case is more accurate and more targeted.

Specifically, above-mentioned parameter determining module 134 from compensate the progress of cost angle case Claims Resolution analysis can On the basis of selecting mode to realize, the case generation module 136 informs case from the new health for compensating the progress of cost angle It generates and realizes in the following way:

If so, showing that case compensates the practical loss ratio height for the history Claims Resolution case that the corresponding Claims Resolution case collection of type includes The risk incidence of type is compensated in the case, which should be compensated to type and be included in health informing range, generate record respectively The health for having the payout ratio value to be greater than each case compensation type for compensating threshold value informs that case is accused as the new health Know case；

If it is not, showing that the practical loss ratio for the history Claims Resolution case that the corresponding Claims Resolution case collection of case compensation type includes is low In or equal to the case compensate type risk incidence, without be included in health inform range, be not processed.

It uses the example above, the compensation of the illness rate 0.03% of the practical loss ratio M1 and disease A of this compensation kinds of Diseases of disease A Pay ratio=practical loss ratio M1/ illness rate=0.05%/0.03%=1.67；The reality of this compensation kinds of Diseases of disease B Compensation ratio=practical loss ratio M2/ illness rate=0.02%/0.028% of the illness rate 0.028% of loss ratio M2 and disease B =0.71；Compensation ratio=reality of the illness rate 0.03% of the practical loss ratio M3 and disease C of this compensation kinds of Diseases of disease C Border loss ratio M3/ illness rate=0.03%/0.03%=1；

Judging disease A, disease B and disease C, these three compensate whether the respective compensation ratio of kinds of Diseases is greater than compensation threshold Value 1.5, for disease B and disease C, the two compensation ratios for compensating kinds of Diseases are less than compensation threshold value 1.5 to judging result, then disease The two compensate kinds of Diseases without being included in health informing range to sick B and disease C, show to inform that link is not necessarily to for disease in health Sick B or disease C are informed；The compensation ratio 1.67 of this compensation kinds of Diseases of disease A be greater than compensate threshold value 1.5, need by Disease A is included in health and informs range, and the kinds of Diseases that disease A is also informed as health informing link generate disease The corresponding new health of sick A informs case, shows to inform that link needs to be informed for disease A in health.

2) program member's gender angle that each case compensates type in the health insurance project carries out case Claims Resolution analysis On the basis of generate new health and inform that case, the new health of generation inform case equally more targetedly.

It is analyzed specifically, settling a claim in above-mentioned parameter determining module 134 from the case of program member's gender angle progress Optional way realize on the basis of, new health of the case generation module 136 from program member's gender angle progress It informs that case generates to realize in the following way:

A, the gender accounting difference of male program member accounting and women program member accounting in the gender accounting is calculated；

B, in the case where the gender accounting difference is greater than the first accounting threshold value, generating record has the gender accounting poor The case that value is greater than the first accounting threshold value compensates type and the health of male gender informs that case is accused as the new health Know case；

C, in the case where the gender accounting difference is less than the second accounting threshold value, generating record has the gender accounting poor The case that value is less than the second accounting threshold value compensates type and the health of female gender informs that case is accused as the new health Know case.

For example, according to the above-mentioned male calculated in the corresponding Claims Resolution case collection S1 of disease A this compensation kinds of Diseases Mesh member's accounting is 75%, and women program member's accounting is 25%, calculates male program member accounting and accounts for women program member The gender accounting difference of ratio is 75%-25%=50%；

According to the above-mentioned male program member calculated in the corresponding Claims Resolution case collection S2 of disease B this compensation kinds of Diseases Accounting is 47%, and women program member's accounting is 53%, calculates the property of male program member accounting and women program member accounting Other accounting difference is 47%-53%=-6%；

According to the above-mentioned male program member calculated in the corresponding Claims Resolution case collection S3 of disease C this compensation kinds of Diseases Accounting is 51%, and women program member's accounting is 49%, calculates the property of male program member accounting and women program member accounting Other accounting difference is 51%-49%=2%；

The corresponding gender accounting difference of this compensation kinds of Diseases of disease A is 50% greater than the first accounting threshold value 30%, can See that male program member is greater than the illness rate that women program member is directed to disease A for the illness rate of disease A, it is therefore desirable to will be male Property program member inform range for this case that disease A being included in health, generate the new health that record has disease A and male gender It informs case, shows that male program member informs that link needs to carry out the informing of disease A in health.

The corresponding gender accounting difference of this compensation kinds of Diseases of disease B is -6% less than the first accounting threshold value 30%, and And be greater than the first accounting threshold value -30%, show male program member and women program member for disease B illness rate difference compared with It is small, without informing that link carries out the informing of disease B in health particular for male program member or women program member；

The corresponding gender accounting difference of this compensation kinds of Diseases of disease C is 2% less than the first accounting threshold value 30%, and Greater than the first accounting threshold value -30%, show male program member and women program member for disease C illness rate difference compared with It is small, it is same without informing that link carries out the informing of disease C in health particular for male program member or women program member.

3) in the health insurance project each case compensate type compensation cost angle and program member's age angle into New health is generated on the basis of the Claims Resolution analysis of row case informs that case, the new health of generation inform case equally more targetedly.

Specifically, being carried out in above-mentioned parameter determining module 134 from compensation cost angle and program member's age angle Case Claims Resolution analysis optional way realize on the basis of, the case generation module 136 is from compensating cost angle and project Member age's angle set out progress it is new health inform case generate in the following way realize:

A, in the case where the dispersion degree is low dispersion degree, determine that the Claims Resolution case of the low dispersion degree is concentrated The low discrete age range at program member's age of history Claims Resolution charge sheet；

Wherein, the starting age of the low discrete age range and/or the age is terminated according to the reason of the low dispersion degree Paying for case concentrates the accounting of each age group program member to determine；

B, the health announcement that record has the case of the low dispersion degree to compensate type and the low discrete age range is generated Know that case informs case as the new health.

For example, above-mentioned calculate 50 history Claims Resolutions in the corresponding Claims Resolution case collection S1 of disease A this compensation kinds of Diseases The variance at case each self-recording program member's age, the project as corresponding 50 program members of 50 history Claims Resolution cases The dispersion degree of member age；

Based on this, the variance at 50 history Claims Resolution case each self-recording program member's ages in Claims Resolution case collection S1 is judged Whether the corresponding discrete threshold values of low dispersion degree are less than, if so, the case collection S1 that settles a claim to be determined as to the Claims Resolution of low dispersion degree Corresponding this compensation kinds of Diseases of disease A of case collection S1, Claims Resolution case collection S1 are the compensation kinds of Diseases of low dispersion degree；And And according to the accounting of all age group program member in Claims Resolution case collection S1, determine that the case age is 25 in Claims Resolution case collection S1 Year to 35 years old this age bracket is low discrete age range, wherein being within 25 years old the starting age of low discrete age range, is within 35 years old The termination age of low discrete age range, low discrete age range show the program member of 25 years old to 35 years old this age bracket compared with It is more, and program member's number of this age bracket substantially conforms to normal distribution law, shows the program member of this age bracket Stability is relatively high,

As it can be seen that the program member with disease A relatively concentrates on 25 years old to 35 years old this low discrete age range, then generate Record has disease A and the new health of 25 years old to 35 years old this low discrete age range to inform case, shows to inform ring in health Save the informing that disease A is carried out to the program member that the age is in 25 years old to 35 years old this low discrete age range.

4) each case compensates compensation cost angle, program member's occupational information and the item of type in the health insurance project The new health of generation informs case, the new health informing case of generation on the basis of mesh member's gender angle carries out case Claims Resolution analysis Equally more targetedly.

Specifically, in above-mentioned parameter determining module 134 from compensating cost angle, program member's occupational information and program member Gender angle set out progress case Claims Resolution analysis optional way realize on the basis of, the case generation module 136 is from compensation Pay the new health informing case generation use that cost angle, program member's occupational information and program member's gender angle set out progress As under type is realized:

A, the compensation of the corresponding practical loss ratio of each Claims Resolution case collection risk incidence corresponding with each Claims Resolution case collection is calculated Pay ratio；

B, judge whether the compensation ratio is greater than compensation threshold value；

If so, showing that case compensates the practical loss ratio height for the history Claims Resolution case that the corresponding Claims Resolution case collection of type includes The risk incidence of type is compensated in the case, following step c is executed and further determines whether for case compensation type to be included in Health informs range；

If it is not, showing that the practical loss ratio for the history Claims Resolution case that the corresponding Claims Resolution case collection of case compensation type includes is low In or equal to the case compensate type risk incidence, without be included in health inform range, be not processed；

C, it calculates the ratio of compensating and is greater than each Claims Resolution case concentration history Claims Resolution charge sheet for compensating threshold value The dispersion degree of program member's occupational information；

D, in the case where the dispersion degree is low dispersion degree, determine that the Claims Resolution case of the low dispersion degree is concentrated The low discrete items member occupation set of projects member's occupational information；

Wherein, projects member occupational information that the low discrete items member occupation set includes is according to affiliated Claims Resolution case The accounting that part concentrates projects member's occupational information to correspond to program member determines；

E, generating record has the case of the low dispersion degree to compensate type, program member's gender and described low discrete The health of program member's occupation set informs that case informs case as the new health.

For example, the program member that the low discrete items member occupation set in male program member with spinal disease includes Occupation has: programmer, lawyer and scientific research personnel, then generating record has male gender, spinal disease and programmer, lawyer and scientific research The new health of personnel informs case, shows to inform that link carries out vertebra to male programmer, lawyer and scientific research personnel in health The informing of disease.

4, the case update module 138.

New healthy case update to the health that above-mentioned case generation module 136 is generated is informed in database 110.

For example, the new health that record has disease A is informed that case write-in health is informed in database 110, show in health Inform that link needs to be informed for disease A；

Alternatively, there is the new health of disease A and male gender to inform that case write-in health is informed in database 110 record, Show that male program member informs that link needs to carry out the informing of disease A in health；

Again alternatively, thering is disease A and the new health of 25 years old to 35 years old this low discrete age range to inform that case is write record Enter health to inform in database 110, shows to inform that link is in 25 years old to 35 years old this low discrete age to the age in health The program member in section carries out the informing of disease A.

Health provided by the present application informs case maintemance system, passes through first maintenance platform 120 and second dimension The cooperation between the two of platform 130 is protected, is accused analyzing new health in longer maintenance period using first maintenance platform 120 While knowing case and inform that database 110 is updated maintenance to the health, to timely respond to the health insurance project New health informs case, using second maintenance platform 130 in shorter maintenance period to each of the health insurance project Case is compensated type and is analyzed, so that will compensate the case that cost changes greatly in shorter time period compensates type as new strong Health informs that case informs that database 110 is updated maintenance to the health, informs that health is accused in database 110 to the health Know that the maintenance of case is more perfect, improve health and inform the validity of case maintemance, while also making to inform number in the health It is more comprehensive to inform that the health carried out on the basis of case is informed according to health in library 110.

A kind of health provided by the present application informs that case maintemance embodiment of the method is as follows:

In the above-described embodiment, a kind of health informing case maintemance system is provided, in addition, present invention also provides one Kind health informs that case maintemance method, the health inform that case maintemance method informs case maintemance system based on health based on described The second maintenance platform in system realizes that relevant part refers to the corresponding explanation of the system embodiment of above-mentioned offer, under The embodiment for stating description is only schematical.

Referring to attached drawing 2, it illustrates a kind of health informing case maintemance method process flow diagrams provided in this embodiment.

Step S202 obtains the case details of the history Claims Resolution case of fitness programme according to the second maintenance period；

Step S204 extracts the case for including in the case details of the history Claims Resolution case and compensates type and case compensation Information, and information is compensated based on the case and determines that each case compensates the case compensation parameter of type；

Step S206 compensates type based on the case that case compensates the default case compensation condition of parameter satisfaction and generates newly health Inform case；

The new health of generation is informed that case update to health is informed in database by step S208.

A kind of health provided by the present application informs that case maintemance Installation practice is as follows:

In the above-described embodiment, a kind of health informing case maintemance method is provided, corresponding, the application is also A kind of health informing case maintemance device is provided, is illustrated with reference to the accompanying drawing.

Referring to attached drawing 3, it illustrates a kind of schematic diagrames of health informing case maintemance Installation practice provided by the present application.

Since Installation practice is substantially similar to embodiment of the method, so describing fairly simple, relevant part please join The corresponding explanation of the embodiment of the method for above-mentioned offer is provided.Installation practice described below is only schematical.

The application provides a kind of health informing case maintemance device, comprising:

Case acquiring unit 302 is configured as obtaining the history Claims Resolution case of fitness programme according to the second maintenance period Case details；

Parameter determination unit 304, the case for being configured as in the case details for extracting the history Claims Resolution case including are paid for It pays type and case compensates information, and information is compensated based on the case and determines that each case compensates the case compensation parameter of type；

Case generation unit 306 is configured as compensating the case compensation that parameter meets default case compensation condition based on case It pays type and generates new health informing case；

Case update unit 308, the new health for being configured as to generate inform that case update to health is informed in database.

Optionally, the case acquiring unit 302 is specifically configured to according to second maintenance period from described in storage The case details of the history Claims Resolution case are read in the Claims Resolution case database of the case details of history Claims Resolution case.

Optionally, the parameter determination unit 304, comprising:

Case compensates the amount of money and extracts subelement, is configured as extracting in the case details of the history Claims Resolution case and includes Case compensates type, and extracts the case for including in the case details and compensate the amount of money as case compensation information；

First cluster subelement is configured as gathering history Claims Resolution case according to case compensation type Class obtains each case and compensates the corresponding Claims Resolution case collection of type；

First practical compensation amount of money computation subunit, is configured as compensating the corresponding Claims Resolution case collection of type according to each case The case of middle history Claims Resolution case compensates the amount of money, calculates the practical compensation gold that each case compensates the corresponding Claims Resolution case collection of type Volume；The practical amount of money of compensating refers to that each case compensates the corresponding Claims Resolution case of type and the case of history Claims Resolution case is concentrated to compensate The sum of amount of money；

First practical loss ratio computation subunit is configured as compensating the corresponding practical compensation gold of type according to each case Volume, each case compensate program member's sum of the corresponding case Claims Resolution number of type and the fitness programme, calculate each case and pay for The practical loss ratio for paying type compensates parameter as the case.

Optionally, the case generation unit 306 is specifically configured to judge the practical loss ratio that each case compensates type Whether the compensation ratio for compensating the risk incidence of type with each case is greater than compensation threshold value；If so, having generated record respectively It states compensation ratio and is greater than the health informing case of each case compensation type for compensating threshold value as the new healthy informing case Example.

Optionally, the parameter determination unit 304, comprising:

Program member's gender extracts subelement, is configured as extracting in the case details of the history Claims Resolution case and includes Case compensates type, and extracts the program member's gender for including in the case details and compensate information as the case；

Second cluster subelement is configured as gathering history Claims Resolution case according to case compensation type Class obtains each case and compensates the corresponding Claims Resolution case collection of type；

Gender accounting computation subunit is configured as calculating each case and compensates the corresponding Claims Resolution case of type and concentrates projects The gender accounting of the included program member of member's gender compensates parameter as the case.

Optionally, the case generation unit 306, comprising:

Gender accounting difference computation subunit is configured as calculating male program member accounting and female in the gender accounting The gender accounting difference of property program member's accounting；

First new health informs that case generates subelement, is configured as being greater than the first accounting threshold in the gender accounting difference In the case where value, the case that generating record has the gender accounting difference to be greater than the first accounting threshold value compensates type and male The health of gender informs that case informs case as the new health；

Second new health informs that case generates subelement, is configured as in the gender accounting difference less than the second accounting threshold In the case where value, the case that generating record has the gender accounting difference to be less than the second accounting threshold value compensates type and women The health of gender informs that case informs case as the new health.

Optionally, the parameter determination unit 304, comprising:

First case compensates information extraction subelement, is configured as wrapping in the case details for extracting the history Claims Resolution case The case that contains compensates type, and extracts the case for including in the case details and compensate the amount of money and described in program member's age is used as Case compensates information；

Third clusters subelement, is configured as gathering history Claims Resolution case according to case compensation type Class obtains each case and compensates the corresponding Claims Resolution case collection of type；

Second practical compensation amount of money computation subunit, is configured as compensating the corresponding Claims Resolution case collection of type according to each case The case of middle history Claims Resolution case compensates the amount of money, calculates the practical compensation gold that each case compensates the corresponding Claims Resolution case collection of type Volume；The practical amount of money of compensating refers to that each case compensates the corresponding Claims Resolution case of type and the case of history Claims Resolution case is concentrated to compensate The sum of amount of money；

Second practical loss ratio computation subunit is configured as compensating the corresponding practical compensation gold of type according to each case Volume, each case compensate program member's sum of the corresponding case Claims Resolution number of type and the fitness programme, calculate each case and pay for Pay the practical loss ratio of type；

First compensates ratio computation subunit, is configured as calculating practical loss ratio and each case that each case compensates type Compensate the compensation ratio of the risk incidence of type；

First compensates ratio judgment sub-unit, is configured as judging whether the compensation ratio is greater than compensation threshold value；If so, It calculates the compensation ratio and is greater than the corresponding Claims Resolution case concentration history Claims Resolution case of each case compensation type for compensating threshold value The dispersion degree at program member's age of part record compensates parameter as the case.

Optionally, the case generation unit 306, comprising:

Low discrete age range determines subelement, is configured as in the case where the dispersion degree is low dispersion degree, Determine that the Claims Resolution case of the low dispersion degree concentrates the low discrete age area at program member's age of history Claims Resolution charge sheet Between；The starting age and/or termination age of the low discrete age range concentrate according to the Claims Resolution case of the low dispersion degree The accounting of each age group program member determines；

The new health of third informs that case generates subelement, and being configurable to generate record has the case of the low dispersion degree to pay for The health for paying type and the low discrete age range informs that case informs case as the new health.

Optionally, the parameter determination unit 304, comprising:

Second case compensates information extraction subelement, is configured as wrapping in the case details for extracting the history Claims Resolution case The case contained compensates type, and extracts the case for including in the case details and compensate the amount of money, program member's occupational information and item Mesh member gender compensates information as the case；

4th cluster subelement, is configured as compensating type according to the case and program member's gender is gone through to described History Claims Resolution case is clustered, at least one Claims Resolution case collection is obtained；

The practical compensation amount of money computation subunit of third is configured as concentrating the case of history Claims Resolution case according to each Claims Resolution case Part compensates the amount of money, calculates the practical compensation amount of money of each Claims Resolution case collection；The practical amount of money of compensating refers to that each Claims Resolution case is concentrated The case of history Claims Resolution case compensates the sum of amount of money；

The practical loss ratio computation subunit of third, be configured as according to each Claims Resolution case collection it is corresponding it is practical compensate the amount of money, Program member's sum of each corresponding case Claims Resolution number of Claims Resolution case collection and the fitness programme, calculates each Claims Resolution case collection pair The practical loss ratio answered compensates parameter as the case.

Optionally, the case generation unit 306, comprising:

Second compensates ratio computation subunit, is configured as calculating the corresponding practical loss ratio of each Claims Resolution case collection and each reason Pay for the compensation ratio of the corresponding risk incidence of case collection；

Second compensates ratio judgment sub-unit, is configured as judging whether the compensation ratio is greater than compensation threshold value；

If so, operation dispersion degree computation subunit, low discrete items member occupation set determine subelement and the "four news" (new ideas Health informs that case generates subelement；

The dispersion degree computation subunit is configured as calculating each reason that the compensation ratio is greater than the compensation threshold value Pay for the dispersion degree that case concentrates program member's occupational information of history Claims Resolution charge sheet；

The low discrete items member occupation set determines subelement, is configured as in the dispersion degree being low discrete journey In the case where degree, determine that the Claims Resolution case of the low dispersion degree concentrates the low discrete items member of projects member's occupational information Occupation set；Projects member occupational information that the low discrete items member occupation set includes is according to affiliated Claims Resolution case collection The accounting that middle projects member occupational information corresponds to program member determines；

Described 5th new health informs that case generates subelement, is configurable to generate the case that record has the low dispersion degree The health that part compensates type, program member's gender and the low discrete items member occupation set is informed described in case conduct New health informs case.

A kind of calculating apparatus embodiments provided by the present application are as follows:

Fig. 4 is to show the structural block diagram of the calculating equipment 400 according to one embodiment of this specification.The calculating equipment 400 Component include but is not limited to memory 410 and processor 420.Processor 420 is connected with memory 410 by bus 430, Database 450 is for saving data.

Calculating equipment 400 further includes access device 440, access device 440 enable calculate equipment 400 via one or Multiple networks 460 communicate.The example of these networks includes public switched telephone network (PSTN), local area network (LAN), wide area network (WAN), the combination of the communication network of personal area network (PAN) or such as internet.Access device 440 may include wired or wireless One or more of any kind of network interface (for example, network interface card (NIC)), such as IEEE802.11 wireless local area Net (WLAN) wireless interface, worldwide interoperability for microwave accesses (Wi-MAX) interface, Ethernet interface, universal serial bus (USB) connect Mouth, cellular network interface, blue tooth interface, near-field communication (NFC) interface, etc..

In one embodiment of this specification, unshowned other component in above-mentioned and Fig. 4 of equipment 400 is calculated It can be connected to each other, such as pass through bus.It should be appreciated that calculating device structure block diagram shown in Fig. 4 is merely for the sake of example Purpose, rather than the limitation to this specification range.Those skilled in the art can according to need, and increase or replace other portions Part.

Calculating equipment 400 can be any kind of static or mobile computing device, including mobile computer or mobile meter Calculate equipment (for example, tablet computer, personal digital assistant, laptop computer, notebook computer, net book etc.), movement Phone (for example, smart phone), wearable calculating equipment (for example, smartwatch, intelligent glasses etc.) or other kinds of shifting Dynamic equipment, or the static calculating equipment of such as desktop computer or PC.Calculating equipment 400 can also be mobile or state type Server.

The application provides a kind of calculating equipment, including memory 410, processor 420 and storage are on a memory and can be The computer instruction run on processor, the processor 410 is for executing following computer executable instructions:

A kind of computer readable storage medium embodiment provided by the present application is as follows:

One embodiment of the application also provides a kind of computer readable storage medium, is stored with computer instruction, the instruction To be used for when being executed by processor:

A kind of exemplary scheme of above-mentioned computer readable storage medium for the present embodiment.It should be noted that this is deposited The technical solution of storage media and above-mentioned health inform that the technical solution of case maintemance method belongs to same design, storage medium The detail content that technical solution is not described in detail may refer to retouching for the technical solution of above-mentioned health informing case maintemance method It states.

The computer instruction includes computer program code, the computer program code can for source code form, Object identification code form, executable file or certain intermediate forms etc..The computer-readable medium may include: that can carry institute State any entity or device, recording medium, USB flash disk, mobile hard disk, magnetic disk, CD, the computer storage of computer program code Device, read-only memory (ROM, Read-Only Memory), random access memory (RAM, Random Access Memory), Electric carrier signal, telecommunication signal and software distribution medium etc..It should be noted that the computer-readable medium include it is interior Increase and decrease appropriate can be carried out according to the requirement made laws in jurisdiction with patent practice by holding, such as in certain jurisdictions of courts Area does not include electric carrier signal and telecommunication signal according to legislation and patent practice, computer-readable medium.

It should be noted that for the various method embodiments described above, describing for simplicity, therefore, it is stated as a series of Combination of actions, but those skilled in the art should understand that, the application is not limited by the described action sequence because According to the application, certain steps can use other sequences or carry out simultaneously.Secondly, those skilled in the art should also know It knows, the embodiments described in the specification are all preferred embodiments, and related actions and modules might not all be this Shen It please be necessary.

In the above-described embodiments, it all emphasizes particularly on different fields to the description of each embodiment, there is no the portion being described in detail in some embodiment Point, it may refer to the associated description of other embodiments.

The application preferred embodiment disclosed above is only intended to help to illustrate the application.There is no detailed for alternative embodiment All details are described, are not limited the invention to the specific embodiments described.Obviously, according to the content of this specification, It can make many modifications and variations.These embodiments are chosen and specifically described to this specification, is in order to preferably explain the application Principle and practical application, so that skilled artisan be enable to better understand and utilize the application.The application is only It is limited by claims and its full scope and equivalent.

Claims

1. a kind of health informs case maintemance system characterized by comprising

The health informs database, is configured as storage user and applies for that the health executed during fitness programme, which is added, informs ring The health of section informs case；

First maintenance platform is configured as going through healthy reference data and the fitness programme according to the first maintenance period History Claims Resolution data are analyzed, and the new health that analysis is obtained informs that case update to the health is informed in database；

Second maintenance platform, including case obtain module, parameter determination module, case generation module and case update mould Block；

Wherein, the case obtains module, is configured as obtaining the history Claims Resolution of the fitness programme according to the second maintenance period The case details of case；The duration of second maintenance period is less than the duration of first maintenance period；

The parameter determination module, the case for being configured as in the case details for extracting the history Claims Resolution case including compensate kind Class and case compensate information, and compensate information based on the case and determine that each case compensates the case compensation parameter of type；

The case generation module is configured as compensating the case compensation kind that parameter meets default case compensation condition based on case Class generates new health and informs case；

The case update module, the new health for being configured as to generate inform that case update to the health informs database In.

2. health according to claim 1 informs case maintemance system, which is characterized in that further include Claims Resolution case data Library is configured as storing the case details of the history Claims Resolution case；

Correspondingly, the case obtains module, it is specifically configured to according to second maintenance period from the Claims Resolution case number of packages According to the case details for reading the history Claims Resolution case in library.

3. health according to claim 2 informs case maintemance system, which is characterized in that first maintenance platform, tool Body is configured as:

The case details of the history Claims Resolution case generated in first maintenance period are read from the Claims Resolution case database；

Based on the illness rate for each kinds of Diseases for including in the healthy reference data, the illness rate of each kinds of Diseases is calculated Changing value；

Statistics case compensates the history Claims Resolution case that type is the kinds of Diseases that illness rate changing value is greater than default change threshold Number of cases；

If the number of cases for the history Claims Resolution case that the statistics obtains is greater than number of cases threshold value, generates and carry the disease The health of type informs that case informs case as the new health；

4. health according to claim 2 informs case maintemance system, which is characterized in that the parameter determination module, tool Body is configured as:

It extracts the case for including in the case details of the history Claims Resolution case and compensates type, and extract and wrapped in the case details The case contained compensates the amount of money as the case and compensates information；

Type is compensated according to the case to cluster history Claims Resolution case, is obtained each case and is compensated the corresponding reason of type Pay for case collection；

Compensating the corresponding Claims Resolution case of type according to each case concentrates the case of history Claims Resolution case to compensate the amount of money, calculates each case Compensate the practical compensation amount of money of the corresponding Claims Resolution case collection of type；The practical amount of money of compensating refers to that each case is compensated type and corresponded to Claims Resolution case concentrate the case of history Claims Resolution case to compensate the sum of amount of money；

The corresponding practical compensation amount of money of type is compensated according to each case, each case compensates the corresponding case Claims Resolution number of type and institute The program member's sum for stating fitness programme, calculates the practical loss ratio that each case compensates type, compensates parameter as the case.

5. health according to claim 4 informs case maintemance system, which is characterized in that the case generation module, tool Body is configured as:

Judge each case compensate type practical loss ratio and each case compensate type risk incidence compensation ratio whether Greater than compensation threshold value；

If so, the health for generating each case compensation type that record has the payout ratio value to be greater than the compensation threshold value respectively is informed Case informs case as the new health.

6. health according to claim 2 informs case maintemance system, which is characterized in that the parameter determination module, tool Body is configured as:

It extracts the case for including in the case details of the history Claims Resolution case and compensates type, and extract and wrapped in the case details The program member's gender contained compensates information as the case；

Calculating the corresponding Claims Resolution case of each case compensation type concentrates the gender of the included program member of projects member's gender to account for Than compensating parameter as the case.

7. health according to claim 6 informs case maintemance system, which is characterized in that the case generation module, tool Body is configured as:

In the case where the gender accounting difference is greater than the first accounting threshold value, generating record has the gender accounting difference to be greater than The case of the first accounting threshold value compensates type and the health of male gender informs that case informs case as the new health；

In the case where the gender accounting difference is less than the second accounting threshold value, generating record has the gender accounting difference to be less than The case of the second accounting threshold value compensates type and the health of female gender informs that case informs case as the new health.

8. health according to claim 2 informs case maintemance system, which is characterized in that the parameter determination module, tool Body is configured as:

It extracts the case for including in the case details of the history Claims Resolution case and compensates type, and extract and wrapped in the case details The case contained compensates the amount of money and program member's age as the case and compensates information；

The corresponding practical compensation amount of money of type is compensated according to each case, each case compensates the corresponding case Claims Resolution number of type and institute The program member's sum for stating fitness programme, calculates the practical loss ratio that each case compensates type；

It is gone through if so, calculating the ratio Claims Resolution case concentration corresponding greater than each case compensation type for compensating threshold value of compensating The dispersion degree at program member's age of history Claims Resolution charge sheet, compensates parameter as the case.

9. health according to claim 8 informs case maintemance system, which is characterized in that the case generation module, tool Body is configured as:

In the case where the dispersion degree is low dispersion degree, determine that the Claims Resolution case of the low dispersion degree concentrates history reason Pay for the low discrete age range at program member's age of charge sheet；The starting age and/or end of the low discrete age range Only the age concentrates the accounting of each age group program member to determine according to the Claims Resolution case of the low dispersion degree；

Generate the health informing case that record has the case of the low dispersion degree to compensate type and the low discrete age range Case is informed as the new health.

10. health according to claim 2 informs case maintemance system, which is characterized in that the parameter determination module, tool Body is configured as:

It extracts the case for including in the case details of the history Claims Resolution case and compensates type, and extract and wrapped in the case details The case contained compensates the amount of money, program member's occupational information and program member's gender as the case and compensates information；

It concentrates the case of history Claims Resolution case to compensate the amount of money according to each Claims Resolution case, calculates the practical compensation gold of each Claims Resolution case collection Volume；The practical amount of money of compensating refers to that each Claims Resolution case concentrates the case of history Claims Resolution case to compensate the sum of amount of money；

Practical the amount of money, the corresponding case Claims Resolution number of each Claims Resolution case collection and described strong are compensated according to each Claims Resolution case collection is corresponding Health item purpose program member's sum, calculates the corresponding practical loss ratio of each Claims Resolution case collection, compensates parameter as the case.

11. health according to claim 10 informs case maintemance system, which is characterized in that the case generation module, It is specifically configured to:

Calculate the compensation ratio of the corresponding practical loss ratio of each Claims Resolution case collection risk incidence corresponding with each Claims Resolution case collection；

If so, calculating the ratio of compensating is greater than the item that each Claims Resolution case for compensating threshold value concentrates history Claims Resolution charge sheet The dispersion degree of mesh member's occupational information；

In the case where the dispersion degree is low dispersion degree, determine that the Claims Resolution case of the low dispersion degree concentrates projects The low discrete items member occupation set of member's occupational information；Projects that the low discrete items member occupation set includes at Member's occupational information is determined according to the accounting that affiliated Claims Resolution case concentrates projects member's occupational information to correspond to program member；

Generate record have the case of the low dispersion degree compensate type, program member's gender and the low discrete items at The health of member's occupation set informs that case informs case as the new health.

12. a kind of health informs case maintemance method characterized by comprising

It extracts the case for including in the case details of the history Claims Resolution case and compensates type and case compensation information, and be based on institute It states case and compensates the case compensation parameter that information determines each case compensation type；

13. health according to claim 12 informs case maintemance method, which is characterized in that described according to the second maintenance week Phase obtains the case details of the history Claims Resolution case of fitness programme, comprising:

It is read from the Claims Resolution case database of case details for storing the history Claims Resolution case according to second maintenance period Take the case details of the history Claims Resolution case.

14. health according to claim 13 informs case maintemance method, which is characterized in that described to extract the history reason It pays for the case for including in the case details of case and compensates type and case compensation information, and information is compensated based on the case and is determined The case that each case compensates type compensates parameter, comprising:

15. health according to claim 14 informs case maintemance method, which is characterized in that described to compensate ginseng based on case The case that number meets default case compensation condition compensates type and generates new health informing case, comprising:

16. health according to claim 13 informs case maintemance method, which is characterized in that described to extract the history reason It pays for the case for including in the case details of case and compensates type and case compensation information, and information is compensated based on the case and is determined The case that each case compensates type compensates parameter, comprising:

17. health according to claim 16 informs case maintemance method, which is characterized in that described to compensate ginseng based on case The case that number meets default case compensation condition compensates type and generates new health informing case, comprising:

18. health according to claim 13 informs case maintemance method, which is characterized in that described to extract the history reason It pays for the case for including in the case details of case and compensates type and case compensation information, and information is compensated based on the case and is determined The case that each case compensates type compensates parameter, comprising:

19. health according to claim 18 informs case maintemance method, which is characterized in that described to compensate ginseng based on case The case that number meets default case compensation condition compensates type and generates new health informing case, comprising:

20. health according to claim 13 informs case maintemance method, which is characterized in that described to extract the history reason It pays for the case for including in the case details of case and compensates type and case compensation information, and information is compensated based on the case and is determined The case that each case compensates type compensates parameter, comprising:

21. health according to claim 20 informs case maintemance method, which is characterized in that described to compensate ginseng based on case The case that number meets default case compensation condition compensates type and generates new health informing case, comprising:

22. a kind of health informs case maintemance device characterized by comprising

Case acquiring unit, the case for being configured as obtaining the history Claims Resolution case of fitness programme according to the second maintenance period are detailed Feelings；

Parameter determination unit, be configured as extracting the case in the case details of the history Claims Resolution case included compensate type and Case compensates information, and compensates information based on the case and determine that each case compensates the case compensation parameter of type；

Case generation unit, the case compensation type for being configured as compensating the default case compensation condition of parameter satisfaction based on case are raw Case is informed at new health；

23. a kind of calculating equipment characterized by comprising

Memory and processor；

The memory is for storing computer executable instructions, and for executing, the computer is executable to be referred to the processor It enables:

24. a kind of computer readable storage medium, is stored with computer instruction, which is characterized in that the instruction is held by processor The step of health described in claim 12 to 21 any one informs case maintemance method is realized when row.