CN110866835A - Intelligent expense control system for hospital - Google Patents
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- CN110866835A CN110866835A CN201911102053.3A CN201911102053A CN110866835A CN 110866835 A CN110866835 A CN 110866835A CN 201911102053 A CN201911102053 A CN 201911102053A CN 110866835 A CN110866835 A CN 110866835A
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Abstract
The invention discloses an intelligent charge control system for a hospital, which comprises a client, wherein the client comprises a passive charge control subsystem and a main charge control subsystem. The invention innovatively and intelligently carries out horizontal and vertical comparison on the hospitalization cost of each patient, and medical care personnel can analyze whether the charges of various items are reasonable or not in real time and quickly and correctly find a method for reducing the cost of the patient.
Description
Technical Field
The invention relates to the technical field of software, in particular to an intelligent expense control system for hospitals.
Background
The hospital establishes a three-dimensional monitoring system covering the medical insurance, the hospital and doctors in the aspects of advance reminding, in-situ discipline and after-event analysis and simultaneously establishes a set of medical insurance control fee management system suitable for the hospital and the doctor on the premise of perfecting data base, and is combined with medical quality indexes to really place all policies of the medical insurance in the real places, thereby improving the use performance of medical insurance funds while continuously improving the medical service level.
In 7 months in 2018, a social security center medical security in a certain city intelligently audits a system to be on line comprehensively and successfully in advance, 1090 families of fixed-point medical institutions on line and 5983 doctors in doctor workstations come on line at 8600, all types of medical security fixed-point institutions in hospital, outpatient service and pharmacy are covered, the fixed-point medical institutions are covered completely, the coverage types are wide, the number is large, and the system is at a leading level in the whole province. Since the trial operation, more than 9000 rules in advance are checked, the violation cost is reduced, the violation cost is 1000 ten thousand yuan, and the transition from the traditional field inspection to the intelligent supervision with data as a core is realized.
In order to cooperate with the stable operation of the system, an intelligent expense control system for hospitals is provided, aiming at solving the problems that the system in the prior medical insurance intelligent audit has the following defects in the operation:
the hospital cost of each patient cannot be automatically compared transversely and vertically, medical care personnel cannot analyze whether the charge of various items is reasonable or not in real time, the method for reducing the cost of the patient cannot be found rapidly and correctly, the method still needs to be manually counted, analyzed and controlled by clinical medical care personnel, the working efficiency of the medical care personnel is greatly influenced, the medical care personnel cannot actively and actively participate in medical insurance control cost, the cost of the department patients with serious medical insurance standard exceeding is high, the medical cost of the medical care patients cannot be effectively reduced, and the quality of medical service is influenced.
Disclosure of Invention
Aiming at the defects of the prior art, the invention aims to provide an intelligent charge control system for hospitals, which innovatively and intelligently automatically carries out horizontal and vertical comparison on the hospitalization cost of each patient, enables medical care personnel to analyze whether the charges of various projects are reasonable or not in real time and quickly and correctly find a method for reducing the cost of the patients, greatly lightens the fatigue of clinical medical care manual statistical analysis, greatly improves the working efficiency of the medical care personnel, enables the medical care personnel to actively participate in medical care control cost, ensures that the medical care personnel consciously and actively control the medical care cost, obviously reduces the cost of the department patients with serious medical care standard exceeding, has stability and sustainability in the reduction range, better reduces the medical care cost of the medical care patients, improves the medical service quality, and makes due contribution to the health modern hospital management system, to solve the problems set forth in the background art described above.
In order to achieve the purpose, the invention provides the following technical scheme:
an intelligent cost control system for a hospital comprises a client, wherein the client comprises a passive cost control subsystem and a main cost control subsystem, and the passive cost control subsystem is used for formulating and generating a regulation file for restricting medical staff to follow execution according to policies and indexes of medical insurance cost control; the active charge control subsystem is used for automatically analyzing and comparing the transverse data and the longitudinal data of the historical data of the inpatient medical insurance patients with the same disease types among different diagnosis and treatment groups of a department through complete intelligent data analysis, and helps medical staff to accurately analyze whether various charging items are reasonable or not in real time, quickly find a method for reducing the inpatient cost, and enable the medical staff to actively participate in reasonable charge control.
Furthermore, the passive charge control subsystem comprises an informatization management and control module and a charge control index database, and the charge control index database is connected with the informatization management and control module.
Further, the information management and control module is used for performing information, normalization and automatic management and control on the auxiliary medication of each department, solidifying the upper limit of the DDD value of the monthly auxiliary medication, setting a monthly auxiliary medication accumulated DDD assessment target value by each department according to the upper limit of the DDD value, and when the monthly auxiliary medication accumulated DDD assessment target value is exceeded, the information management and control module dynamically monitors and then sends out an index early warning prompt and automatically stops the prescription right of the medication of the department and a treatment group doctor.
Further, the charge control index database comprises normalized drug catalogue data which is made by pharmacy department personnel in a unified and standardized way strictly according to the provincial medical insurance drug catalogue requirements, data of medical consumables which are made by financial personnel to check detailed diagnosis and treatment items one by one and are charged strictly according to the provincial object price standards, and data of establishment of a medical record room first page disease seed bank, a ward bed number, a medical department and a doctor code which are made in a unified and standardized way according to the medical insurance regulations and uploaded in real time.
Further, the information management and control module includes supplementary management module, antibiotic medicine management module and high value consumptive material management module of using medicine, supplementary management module of using medicine is used for formulating each clinical department's supplementary DDD accumulative target value of using medicine every month to with the supplementary DDD accumulative target value of using medicine of hospital decompose each department and each treatment group, form each treatment group's supplementary cumulative DDD value upper limit of using medicine every month, antibiotic medicine management module is used for carrying out the best effect of clinical treatment and infection prevention and reducing the antibiotic medicine management of unnecessary medical expense, high value consumptive material management module is used for carrying out the operation consumptive material and carries out the system of examining and approving step by step according to the price height.
Furthermore, the active charge control subsystem comprises an electronic medical record generation module, a medical insurance expense detail generation module, a total hospitalization expense settlement module and a disease type database of a first page of a medical record room.
Furthermore, the electronic medical record generation module is used for generating an electronic medical record, and the electronic medical record is used for recording the medical activity processes of occurrence, development, outcome, examination, diagnosis and treatment of the diseases of the patient.
Further, the medical insurance expense detail generating module is used for generating a constituent list of the hospitalization expense of the patient, including users and billing personnel of various medicines, items and high-value materials.
Further, the total hospitalization cost settlement module is used for generating total hospitalization cost and medical insurance reimbursement cost of the patient and self-payment cost.
Further, the medical record room first page medical species database comprises medical species classification data which is classified according to an 2016 national standard ICD10 medical species database.
In summary, the invention mainly has the following beneficial effects:
the invention innovatively and intelligently carries out horizontal and vertical comparison on the hospitalization cost of each patient, and medical care personnel can analyze whether the charges of various items are reasonable in real time and quickly and correctly find a method for reducing the cost of the patient.
Drawings
FIG. 1 is a schematic diagram of an embodiment of an intelligent hospital billing system;
FIG. 2 is a schematic diagram of an embodiment of an architecture of a passive toll subsystem;
FIG. 3 is a schematic diagram of an active toll subsystem according to an embodiment;
FIG. 4 is a detailed view of a cost detail for one embodiment;
FIG. 5 is a diagram illustrating the structure of the content of an electronic medical record according to an embodiment;
FIG. 6 is a diagram illustrating the display of an on-menu entry of a patient's hospital number according to one embodiment;
FIG. 7 is a diagram illustrating a display of a date on period according to one embodiment;
FIG. 8 is a diagram illustrating the display of the date of the input discharge area and the discharge diagnosis and the input date interval according to one embodiment;
FIG. 9 is a graph illustrating the trend of the usage amount of the adjuvant drug in three years in a hospital of a city according to an embodiment;
FIG. 10 is a graph illustrating the trend of the last three years of antimicrobial usage strength DDD in a hospital of a certain city according to one embodiment;
FIG. 11 is a graph illustrating the trend of the medical insurance drug ratio of a city hospital in the last three years according to an embodiment;
FIG. 12 is a diagram illustrating a comparison of hospital average hospital cost for medical insurance in recent years in one embodiment;
FIG. 13 is a graph illustrating the trend of the average cost increase rate of hospital care hospitalization in one embodiment.
Detailed Description
The present invention is described in further detail below with reference to figures 1-13.
Examples
An intelligent cost control system for hospitals, as shown in fig. 1, comprises a client, wherein the client comprises a passive cost control subsystem and a active cost control subsystem, and the passive cost control subsystem is used for formulating and generating a regulation file for restricting medical staff to follow execution according to policies and indexes of medical insurance cost control; the active charge control subsystem is used for automatically analyzing and comparing the transverse data and the longitudinal data of the historical data of the inpatient medical insurance patients with the same disease types among different diagnosis and treatment groups of a department through complete intelligent data analysis, and helps medical staff to accurately analyze whether various charging items are reasonable or not in real time, quickly find a method for reducing the inpatient cost, and enable the medical staff to actively participate in reasonable charge control.
Preferably, as shown in fig. 2, the passive charge control subsystem includes an information management and control module and a charge control index database, and the charge control index database is connected to the information management and control module.
Preferably, the informatization management and control module is used for carrying out informatization, normalization and automatic management and control on the auxiliary medicines in each department, solidifying the upper limit of the DDD value of the monthly auxiliary medicine, setting a cumulative DDD assessment target value of the monthly auxiliary medicines by the upper limit of the DDD value of each department, and when the DDD assessment target value of the monthly auxiliary medicines exceeds the cumulative DDD assessment target value, the informatization management and control module dynamically monitors and then sends out an index early warning prompt and automatically stops the prescription right of the medicines of the department and the treatment group doctors.
Preferably, the charge control index database comprises standardized drug catalogue data which is made by pharmacy personnel in a unified and standardized way strictly according to the requirement of provincial medical insurance drug catalogue, data of medical consumables which are checked by financial personnel one by one and are charged strictly according to the provincial object price standard, and data of establishment of a medical record room medical record first page disease seed bank, a ward bed number, a medical department and a doctor code which are made in a unified and standardized way according to medical insurance regulations and uploaded in real time.
Preferably, as shown in fig. 2, the information management and control module includes an auxiliary medication management module, an antibacterial management module and a high-value consumable management module, the auxiliary medication management module is configured to set up a DDD cumulative target value for each clinical department per month, and decompose the DDD cumulative target value for the hospital-wide auxiliary medications into each department and each treatment group, so as to form an upper limit of the DDD cumulative value for each treatment group per month, and at the same time, the auxiliary medications in the same general category with substantially the same pharmacological actions cannot be combined, and the medications with different pharmacological actions (different categories) cannot be used more than two at the same time, so as to achieve the purposes of total amount control and fine assessment, the antibacterial management module is configured to perform the antibacterial management of optimal effect of clinical treatment and infection prevention and reduction of unnecessary medical expenses, and perform sensory control participation through administrative management and control, the high-value consumable management module is used for executing a step-by-step approval system of operation consumables according to the price, and can be approved by clinical department masters, pharmacy department managers, medical insurance masters, medical department masters and branch administration administrators respectively according to the unit price of 3000-10000 Yuan, and the unit price of more than 10000 Yuan is approved by the competent administrators besides the approval.
Preferably, as shown in fig. 3, the active charge control subsystem includes an electronic medical record generation module, a medical insurance cost detail generation module, a total hospitalization cost settlement module and a first page medical record database of a medical record room, and the active charge control subsystem automatically analyzes and compares the transverse and longitudinal historical data of the hospitalized medical insurance patients of the same medical record among different medical treatment groups of a department through a complete intelligent data analysis system, so as to help medical care personnel to accurately analyze whether various charging items are reasonable in real time, quickly find a method for reducing the hospitalization cost of the patient, and enable the medical personnel to actively participate in reasonable charge control.
Preferably, the electronic medical record generation module is used for generating an electronic medical record, and the electronic medical record is used for recording the medical activity processes of occurrence, development, outcome, examination, diagnosis and treatment of the disease of the patient, so that medical care personnel can clearly see the occurrence, development, outcome, examination, diagnosis and treatment of the bed disease of the medical care personnel on a computer, and an effective basis is provided for the subsequent treatment of the patient.
Preferably, the medical insurance expense detail generating module is used for generating a constituent list of the detailed expense of the patient in the hospital, so that the patient can know the specific expense generated in the hospital stay period conveniently, and disputes between the patient and the hospital due to unclear expense are effectively avoided.
Preferably, the total hospitalization cost settlement module is used for generating total hospitalization cost and medical insurance reimbursement cost of the patient and self-payment cost, so that the patient can know the total cost and medical insurance reimbursement cost generated during hospitalization and self-payment cost, the aim of transparent charging is achieved, and good public praise is achieved for the hospital.
Preferably, the first page disease database of the medical record room comprises disease classification data classified according to a 2016 national standard ICD10 disease database, provides more detailed disease classification basis for carrying out settlement of single disease and DRGS (classification related to disease diagnosis) and the like in the future of medical insurance, and simultaneously needs all diagnosis and treatment groups in a ward to be strictly classified according to the beds of the ward, the group lengths of all diagnosis and treatment groups, the work numbers and names of bed doctors and the like are programmed in a computer and timely adjusted according to changes, and in addition, the admission main diagnosis and the discharge main diagnosis in the expense are all taken from the first page disease database of the medical record.
It should be noted that, in this embodiment, the DDD is a abbreviation for introducing a limited daily dose (Defined DailyDose) of an auxiliary drug, and the medical insurance makes various cost control indexes, such as average medical insurance cost, material cost ratio, and over-rating quota of total cost of each department every month, so as to evaluate the execution condition of each department every month, distribute the evaluation result in a hospital intranet, and give a report to a serious department exceeding the standard,
in addition, the system is used for trial in a certain city of hospitals as follows:
since the control, the use amount of the auxiliary drugs is reduced from 15819 ten thousand yuan in 2016 to 4740 thousand yuan in 2018 by 70%, (see fig. 9), wherein antibacterial drug prescription authority is set by informatization, the antibacterial drugs are managed in a grading way according to legal requirements and correspond to the doctor's job title with the corresponding prescription and the pharmacist's job title with the prescription regulation right one by one, a lower doctor does not have the right to offer the antibacterial drugs in a grade-exceeding way, and the system can automatically block and prompt, and the system can also automatically monitor whether the situations of overdose, repeated medication, compatibility, drug allergy contraindication and the like exist in the antibiotic medication orders, so that the use rate of the I-type incision antibacterial drugs is ensured to be about 30%. The use intensity of the hospital antibiotics is reduced from 45.79 in 2016 to 41.36 in 2018 (see fig. 10), the proportion of the medical insurance medicines is reduced year by year as the times and the total cost of the medical insurance increase year by year, (see fig. 11), the average cost of the medical insurance decreases year by year, (see fig. 12), and the increase rate of the average cost of the medical insurance decreases obviously (see fig. 13).
Secondly, through the establishment of the system, medical care personnel can clearly see various real-time diagnosis and treatment items, names of medicine consumables, charge, use dates and names of bookkeeping personnel of bed patients on a computer, and can also see the total cost and ranking of other discharged patients with the same similar disease types in departments, when the patients are out of the areas, the cost automatically enters the cost ranking of the patients, and meanwhile, the detailed cost constitution of hospitalization and the electronic medical record condition of each patient can be seen, so that the medical care personnel can make real-time cost analysis.
In addition, the system is provided with a set menu and a set page, a medical insurance cost condition ranking menu is additionally arranged in a doctor and nurse workstation, a user opens the menu to input a certain inpatient number, namely displays a certain inpatient, department and admission diagnosis, during the opening date period, 20 days are taken as an example, the lower part of the page jumps to be figure 6, the system can automatically display the inpatient number, name, total cost, diagnosis and treatment group, group leader name and total cost ranking of the outpatient in the department with similar or same disease type of the outpatient diagnosis and the admission diagnosis as figure 7, when the patient is out, all the costs are stopped to be booked, the date of the outpatient area and the outpatient diagnosis are input, the date interval is input, the lower part of the page is displayed as figure 8, and at this time, a certain ranking is in the page;
the detailed expense and the electronic medical record mark are finally arranged on each page, the left square frame of the hospitalization number of each patient is clicked, the system can automatically mark a square root in the square frame, the lowest detailed expense page is selected after selection, the lowest detailed expense page automatically jumps to the graph 4, the detailed information of the hospitalization expense of the patient is displayed, the detailed information comprises project codes, project name specifications, units, quantity, unit price, amount and classified payment amount information, if the condition that the patient is to see the medical record is, the graph 4 page is closed, the medical record mark is clicked, the page automatically jumps to the electronic medical record page of the patient, and the individual condition of the patient is clear at a glance, as shown in the graph 5.
In summary, the system is hooked with the medical quality index because the treatment cost and the treatment result are two basic latitudes for evaluating the medical activities. In order to strengthen the supervision of medical behaviors by the medical insurance, the supervision focus is changed from medical expense control to medical expense and medical quality dual control, and meanwhile, the system is matched with an intelligent medical insurance monitoring platform for use, so that the system is convenient, quick, time-saving and labor-saving, has remarkable effects of obtaining the consistent praise of vast medical staff and patients, better reduces the medical expense of medical insurance patients, improves the medical service quality, and makes due contribution to the health of modern hospital management systems.
The parts not involved in the present invention are the same as or can be implemented by the prior art. The present embodiment is only for explaining the present invention, and it is not limited to the present invention, and those skilled in the art can make modifications of the present embodiment without inventive contribution as needed after reading the present specification, but all of them are protected by patent law within the scope of the claims of the present invention.
Claims (10)
1. The utility model provides a hospital is with intelligent expense system, includes the client, its characterized in that: the client comprises a passive charge control subsystem and a active charge control subsystem, wherein the passive charge control subsystem is used for formulating and generating a regulation file for restricting medical staff to follow execution according to the policy and the index of medical insurance charge; the active charge control subsystem is used for automatically analyzing and comparing the transverse data and the longitudinal data of the historical data of the inpatient medical insurance patients with the same disease types among different diagnosis and treatment groups of a department through complete intelligent data analysis, and helps medical staff to accurately analyze whether various charging items are reasonable or not in real time, quickly find a method for reducing the inpatient cost, and enable the medical staff to actively participate in reasonable charge control.
2. The hospital intelligent charging system according to claim 1, wherein: the passive charge control subsystem comprises an informatization control module and a charge control index database, and the charge control index database is connected with the informatization control module.
3. The hospital intelligent charging system according to claim 2, wherein: the information management and control module is used for performing informatization, normalization and automatic management and control on the auxiliary medicine of each department, solidifying the upper limit of the DDD value of the monthly auxiliary medicine, setting a monthly auxiliary medicine accumulated DDD assessment target value by the upper limit of the DDD value of each department, and when the monthly auxiliary medicine accumulated DDD assessment target value is exceeded, the information management and control module dynamically monitors and then sends an index early warning prompt and automatically stops the prescription right of the department and the treatment group doctor for the medicine taking.
4. The hospital intelligent charging system according to claim 2, wherein: the charge control index database comprises standardized medicine catalogue data which is made by pharmacy department personnel in a unified and standardized way strictly according to the provincial medical insurance medicine catalogue requirements, data of medical consumables which are checked by financial personnel one by one and are charged strictly according to the provincial price standards, data of establishment of a medical record first page disease seed bank of a medical record room, a ward bed number, a medical department and doctor codes, which are made in a unified and standardized way according to medical insurance regulations and uploaded in real time.
5. The hospital intelligent charging system according to claim 2, wherein: the information-based management and control module comprises an auxiliary medication management module, an antibacterial drug management module and a high-value consumable management module, wherein the auxiliary medication management module is used for formulating each clinical department auxiliary medication DDD accumulated target value every month, decomposing the hospital auxiliary medication DDD accumulated target value into each department and each treatment group, forming each treatment group auxiliary medication accumulated DDD value upper limit every month, the antibacterial drug management module is used for realizing the optimal effect of clinical treatment and infection prevention and reducing the antibacterial drug management of unnecessary medical expenditure, and the high-value consumable management module is used for executing the operation consumables according to the price level to realize a step-by-step approval system.
6. The hospital intelligent charging system according to claim 1, wherein: the active charge control subsystem comprises an electronic medical record generation module, a medical insurance charge detail generation module, a total hospitalization charge settlement module and a medical record room front page medical record database.
7. The hospital intelligent charging system according to claim 6, wherein: the electronic medical record generation module is used for generating an electronic medical record, and the electronic medical record is used for recording the medical activity processes of occurrence, development and regression of diseases of patients, examination, diagnosis and treatment.
8. The hospital intelligent charging system according to claim 6, wherein: the medical insurance expense detail generating module is used for generating a hospital detail expense composition list of the patient.
9. The hospital intelligent charging system according to claim 6, wherein: the total hospitalization cost settlement module is used for generating total hospitalization cost and medical insurance reimbursement cost of the patient and self-payment cost.
10. The hospital intelligent charging system according to claim 6, wherein: the medical record room first page medical species database comprises medical species classification data which is classified and completed according to an 2016 national standard ICD10 medical species database.
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| CN112635030A (en) * | 2020-11-30 | 2021-04-09 | 望海康信(北京)科技股份公司 | Automatic generation system and method for fee control prompt, corresponding equipment and storage medium |
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| CN114464301A (en) * | 2021-12-24 | 2022-05-10 | 武汉金豆医疗数据科技有限公司 | Abnormal case point settlement management system |
| CN114464301B (en) * | 2021-12-24 | 2023-03-24 | 武汉金豆医疗数据科技有限公司 | Abnormal case point settlement management system |
| CN116563038A (en) * | 2023-06-26 | 2023-08-08 | 江南大学附属医院 | Medical insurance fee control recommendation method, system and storage medium based on regional big data |
| CN116563038B (en) * | 2023-06-26 | 2023-09-22 | 江南大学附属医院 | Medical insurance fee control recommendation method, system and storage medium based on regional big data |
| CN116563039A (en) * | 2023-07-06 | 2023-08-08 | 山东贝森医院管理咨询有限公司 | Medical insurance management method and system based on DRG/DIP |
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