CN114334112A - Medical insurance-based hospital refined resource management method and device - Google Patents
Medical insurance-based hospital refined resource management method and device Download PDFInfo
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Abstract
The embodiment of the invention provides a hospital refined resource management method and device based on medical insurance, wherein the method comprises the following steps: acquiring department resource parameters of at least one resource management object in each department, wherein the department resource parameters comprise department resource consumption and department resource cost; for each resource management object, determining that the resource management object pays DIP (dual in-line package) resources according to disease category scores in departments of the departments based on department resource consumption of the resource management object in the departments; and for each department, determining a department resource balance based on the DIP resource and the department resource parameter of each resource management object in the department. The DIP resources, the cost and the like of the resource management object are distributed to all departments of the department of the branch department, so that the balance or the loss of a case is reasonably distributed to all departments, the deviation existing in the resource management of the hospital internal medicine department is avoided, and the fine management of the resources in the hospital is realized.
Description
Technical Field
The embodiment of the invention relates to the technical field of medical finance, in particular to a hospital fine resource management method and device based on medical insurance.
Background
At present, the state is strongly promoting the innovation of a multi-component medical insurance payment mode mainly based on the disease-mediated payment (DIP).
The DIP theory can be used for fine management of hospitals and used for evaluating the medical service capacity and the resource consumption degree of departments. The medical insurance department forms a payment standard based on the disease category value and the value point value, realizes standardized payment for each case of the medical institution according to the combination of diagnosis and treatment modes in the first page of the case and case records, and feeds back the result to the hospital. The hospital can compare the DIP medical insurance income of a case with the total amount of hospitalization spent by the case or the cost of the case for the resource analysis management of the department. However, the current resource analysis and management method collects the cost of the cases directly according to the discharge departments of the cases, so that deviation exists during operation and analysis of the internal medical department of the hospital, and fine management in the hospital is influenced.
Disclosure of Invention
The embodiment of the invention provides a hospital fine resource management method and device based on medical insurance, so as to realize fine management of resources in a hospital.
In a first aspect, an embodiment of the present invention provides a hospital fine resource management method based on medical insurance, including:
acquiring department resource parameters of at least one resource management object in each department, wherein the department resource parameters comprise department resource consumption and department resource cost;
for each resource management object, determining that DIP resources are paid by the resource management object according to disease category scores in departments of each department based on department resource consumption of the resource management object in each department;
and determining the department resource balance based on the DIP resources and the department resource parameters of the resource management objects in the departments aiming at each department.
Optionally, further, determining a department resource balance based on the department DIP resource and the department resource parameter of each resource management object in the department, includes:
determining the total office DIP resources of the departments according to the office DIP resources of each resource management object in the department;
determining department general parameters of departments according to department resource parameters of each resource management object in the departments;
and determining the balance of department resources according to the total DIP resources and the total parameters of the departments.
Optionally, further, determining a general department parameter of the department according to the department resource parameter of each resource management object in the department, includes:
determining the total department consumption of departments according to the department resource consumption of each resource management object in the department;
correspondingly, determining the department resource balance according to the total DIP resources and the total department parameters comprises the following steps:
and determining the department account balance of the department according to the total resource of the DIP of the department and the total consumption of the department.
Optionally, further, determining a general department parameter of the department according to the department resource parameter of each resource management object in the department, includes:
determining the total department cost of the department according to the department resource cost of each resource management object in the department;
correspondingly, determining the department resource balance according to the total DIP resources and the total department parameters comprises the following steps:
and determining the net balance of departments according to the total resource of the DIP of the departments and the total cost of the departments.
Optionally, further, determining, based on department resource consumption of the resource management object in each department, that the resource management object pays the DIP resource according to the disease category score in each department, includes:
determining the resource occupation ratio of the resource management object in each department according to the department resource consumption of the resource management object in each department;
and determining the DIP resources of the resource management objects in the departments according to the resource occupation ratio of each department.
Optionally, further determining, according to the resource occupation ratio of each department, a department DIP resource of the resource management object in each department, including:
acquiring the total resource of an object DIP of a resource management object;
and for each department, determining the DIP resources of the department of the resource management object in the department according to the resource occupation ratio of the department and the total DIP resources of the object.
Optionally, further, determining the resource proportion of the resource management object in each department according to the department resource consumption of the resource management object in each department includes:
determining the total resource consumption of the resource management object in each department according to the department resource consumption of the resource management object in each department;
and for each department, determining the resource occupation ratio of the department according to the ratio of the department resource consumption of the department to the total resource consumption.
In a second aspect, an embodiment of the present invention further provides a hospital refined resource management device based on medical insurance, including:
the department resource parameter acquiring module is used for acquiring department resource parameters of at least one resource management object in each department, and the department resource parameters comprise department resource consumption and department resource cost;
a department DIP resource determining module, configured to determine, for each resource management object, a DIP resource to be paid by the resource management object according to a disease category score in departments of the departments based on department resource consumption of the resource management object in the departments;
and the department resource balance determining module is used for determining the department resource balance for each department based on the DIP resources and the department resource parameters of each resource management object in the department.
In a third aspect, an embodiment of the present invention further provides a computer device, where the computer device includes:
one or more processors;
storage means for storing one or more programs;
when executed by one or more processors, cause the one or more processors to implement a method for medical insurance-based hospital fine resource management as provided by any of the embodiments of the present invention.
In a fourth aspect, an embodiment of the present invention further provides a computer-readable storage medium, on which a computer program is stored, where the computer program, when executed by a processor, implements the medical insurance-based hospital refined resource management method according to any embodiment of the present invention.
According to the hospital refined resource management method based on the medical insurance, the department resource parameters of at least one resource management object in each department are obtained, and the department resource parameters comprise department resource consumption and department resource cost; for each resource management object, determining that the resource management object pays DIP resources according to disease category scores in departments of the departments based on department resource consumption of the resource management object in the departments, and realizing allocation of the DIP resources, cost and the like of the resource management object to each department of the department; and determining the balance of department resources based on the DIP resources and the parameters of the department resources of the department of each resource management object, so that the balance or loss of the case is reasonably distributed to each department, the deviation existing in the hospital and medical department resource management is avoided, and the fine management of the resources in the hospital is realized.
Drawings
Fig. 1 is a schematic flowchart of a hospital fine resource management method based on medical insurance according to an embodiment of the present invention;
fig. 2 is a flowchart illustrating a hospital fine resource management method based on medical insurance provided in the second embodiment of the present invention;
fig. 3 is a schematic structural diagram of a hospital refined resource management device based on medical insurance provided by a third embodiment of the present invention;
fig. 4 is a schematic structural diagram of a computer device according to a fourth embodiment of the present invention.
Detailed Description
The present invention will be described in further detail with reference to the accompanying drawings and examples. It is to be understood that the specific embodiments described herein are merely illustrative of the invention and are not limiting of the invention. It should be further noted that, for the convenience of description, only some of the structures related to the present invention are shown in the drawings, not all of the structures.
Example one
Fig. 1 is a flowchart illustrating a hospital fine resource management method based on medical insurance provided in an embodiment of the present invention. The embodiment is applicable to the situation when resource management is performed on a hospital, and particularly applicable to the situation when resource management is performed on each department inside the hospital. The method can be performed by a medical insurance-based hospital fine resource management device, which can be implemented in software and/or hardware, for example, the medical insurance-based hospital fine resource management device can be configured in a computer device. As shown in fig. 1, the method includes:
s110, acquiring department resource parameters of at least one resource management object in each department, wherein the department resource parameters comprise department resource consumption and department resource cost.
Considering that there may be a case of department transfer during hospital diagnosis and treatment, in order to avoid the deviation during the resource analysis and management of the hospital and internal medicine department, the hospitalization cost of the case is specifically calculated for the department in the implementation. In this embodiment, the resource management may be to manage resources owned by a hospital, such as managing operations in the hospital. The resource management object can be understood as a case with completed hospitalization, and the fine management of the hospital cost is realized according to the hospitalization cost of the hospitalization case in each department.
It should be noted that in this embodiment, hospital resources can be analyzed in real time by executing the hospital refined resource management method based on medical insurance provided in the embodiment of the present invention, and hospital resources can also be analyzed at regular time. When resource management is carried out, department expenses of the cases in each department in the time period corresponding to the resource management are obtained as department resource parameters, and the balance of the departments is determined based on the department expenses of all the cases in each department.
Exemplarily, assume that there are 3 hospitalization cases within the resource management period: case 1, case 2 and case 3, respectively, the department hospitalization cost of case 1, case 2 and case 3 in each department is obtained as the corresponding department resource consumption, and the department diagnosis cost of case 1, case 2 and case 3 in each department is obtained as the corresponding department resource cost.
S120, determining the department of the resource management object in each department to pay DIP resources according to disease category scores based on department resource consumption of the resource management object in each department for each resource management object.
After the department resource parameters of the resource management objects in each department are acquired, the DIP income of the resource management objects is distributed to different departments based on the department resource parameters, and the DIP income of each resource management object in each department is calculated to serve as the DIP resource of the department. For example, assuming that the departments of the subject of resource management include department 1, department 2, and department 3, the DIP revenue of the subject of resource management is distributed to department 1, department 2, and department 3. Optionally, the basis for the distribution of DIP income to each department is not limited herein. Optionally, the DIP income of the case can be distributed to each department according to the hospitalization time of the case in each department, and the DIP income of each department can be obtained and used as a DIP resource of the department; and the income of the DIP of the case can be distributed to each department according to the hospitalization cost of the case in each department, and the income of the DIP of each department can be obtained to be used as the resource of the DIP of the department.
And executing the operation aiming at each resource management object, and calculating to obtain the DIP resource paid by the department of each resource management object according to the disease category score.
In one embodiment of the present invention, determining that the department of the resource management object in each department pays DIP resources according to disease category scores based on the department resource consumption of the resource management object in each department comprises: determining the resource occupation ratio of the resource management object in each department according to the department resource consumption of the resource management object in each department; and determining the DIP resources of the resource management objects in the departments according to the resource occupation ratio of each department. It is understood that the income of the DIP of the department is strongly correlated with the hospitalization cost of the case in the department. Therefore, the DIP of a case can be distributed to each department based on the department resource consumption (i.e., department hospitalization cost) of the case in each department. In order to accurately allocate the DIP income of the case, the proportion of the hospitalization cost of the case in each department to the total hospitalization cost can be calculated, and the DIP income of the case can be distributed to each department based on the occupation proportion of each department.
In one embodiment, determining the department DIP resource of the resource management object in each department according to the resource occupation ratio of each department includes: acquiring the total resource of an object DIP of a resource management object; and for each department, determining the DIP resources of the department of the resource management object in the department according to the resource occupation ratio of the department and the total DIP resources of the object. The determination method of the total DIP resource of the object DIP of the resource management object, i.e. the total DIP income of the case, can refer to the estimation method of DIP in the prior art, and is not limited herein. For example, the grouping of the cases is determined according to the disease symptoms of the cases, and the floating amount corresponding to the parameters such as the age of the cases, the illness state and the like is superposed on the basis of the grouping reference amount to obtain the total income of the DIP of the cases. After the total resource of the object DIP is determined, the total resource of the object DIP is distributed to each department based on the resource proportion of each department. Illustratively, assuming that the total resource of the subject DIP is a, the department of the case includes department 1, department 2 and department 3, and the resource proportion of department 1 is 1/6, the resource proportion of department 2 is 1/3, and the resource proportion of department 3 is 1/2, the department DIP resource of department 1 is a/6, the department DIP resource of department 2 is a/3, and the department DIP resource of department 3 is a/2.
In one embodiment, determining the resource proportion of the resource management object in each department according to the department resource consumption of the resource management object in each department comprises: determining the total resource consumption of the resource management object in each department according to the department resource consumption of the resource management object in each department; and for each department, determining the resource occupation ratio of the department according to the ratio of the department resource consumption of the department to the total resource consumption. In order to accurately calculate the resource occupation ratio of each department, the resource occupation ratio of each department can be determined according to the ratio of the department resource consumption (namely, the department hospitalization cost) of the case in each department to the total resource consumption (namely, the total hospitalization cost). Illustratively, it is also assumed that the department of the case includes department 1, department 2 and department 3, the department resource consumption of department 1 is M1, the department resource consumption of department 2 is M2, and the department resource consumption of department 3 is M3, then the resource occupation ratio of department 1 is M1/(M1+ M2+ M3), the resource occupation ratio of department 2 is M2/(M1+ M2+ M3), and the resource occupation ratio of department 3 is M3/(M1+ M2+ M3). The department resource occupation ratio can be calculated according to the department resource consumption of the case in each department, so that the department resource occupation ratio is more accurate.
S130, determining department resource balance based on the DIP resources and the department resource parameters of the resource management objects in the departments for each department.
After determining the DIP resources of each department of each resource management object, determining the balance of department resources by combining the department resource parameters, and realizing the fine department resource management of the hospital. It can be understood that the fine management of departments is to perform resource management in units of departments, that is, to manage financial data such as cost, budget, balance and the like of each department. Determining the balance of department resources based on the DIP resources of all the department resource management objects in the department and the parameters of the department resources in the department unit.
Optionally, determining a department resource balance based on the department DIP resource and the department resource parameter of each resource management object in the department includes: determining the total office DIP resources of the departments according to the office DIP resources of each resource management object in the department; determining department general parameters of departments according to department resource parameters of each resource management object in the departments; and determining the balance of department resources according to the total DIP resources and the total parameters of the departments. In general, for a single department, the total department DIP resource of the department is obtained by summing up the department DIP resources of all cases in the department, the total department DIP parameter is obtained by summing up the department resource parameters of all cases in the department, and the difference between the total department DIP resource and the total department parameter is used as the department resource balance.
For example, assume that three resource management objects of case 1, case 2 and case 3 are included, and the related departments include three departments of department 1, department 2 and department 3. Case 1 the department DIP resource in department 1 was DIP11, the department DIP resource in department 2 was DIP12, and the department DIP resource in department 3 was DIP 13; case 2 the department DIP resource in department 1 was DIP21, the department DIP resource in department 2 was DIP22, and the department DIP resource in department 3 was DIP 23; case 3 the department DIP resource in department 1 was DIP31, the department DIP resource in department 2 was DIP32, and the department DIP resource in department 3 was DIP 33. The department resource parameter of case 1 in department 1 is resource parameter 11, the department resource parameter in department 2 is resource parameter 12, and the department resource parameter in department 3 is resource parameter 13; the department resource parameter of case 2 in department 1 is resource parameter 21, the department resource parameter in department 2 is resource parameter 22, and the department resource parameter in department 3 is resource parameter 23; in case 3, the department resource parameter in department 1 is resource parameter 31, the department resource parameter in department 2 is resource parameter 32, and the department resource parameter in department 3 is resource parameter 33. Then the total office DIP resources and the total office parameters are calculated for department 1, department 2, and department 3, respectively. The total department DIP resource of department 1 is DIP11+ DIP21+ DIP31, and the total department parameter is resource parameter 11+ resource parameter 21+ resource parameter 31; the total department DIP resource of department 2 is DIP12+ DIP22+ DIP32, and the total department parameter is resource parameter 12+ resource parameter 22+ resource parameter 32; the total departmental DIP resource of department 3 is DIP13+ DIP23+ DIP33, and the total departmental parameter is resource parameter 13+ resource parameter 23+ resource parameter 33.
In department fine management, department resource balances may include department account balances and department net balances. It is understood that the department account balance is calculated based on the total resource of the department DIP and the total consumption of the department, and the department net balance is calculated based on the total resource of the department DIP and the total cost of the department.
In one embodiment, determining a general department parameter of a department according to the department resource parameters of each resource management object in the department comprises: determining the total department consumption of departments according to the department resource consumption of each resource management object in the department; correspondingly, determining the department resource balance according to the total DIP resources and the total department parameters comprises the following steps: and determining the department account balance of the department according to the total resource of the DIP of the department and the total consumption of the department. For a single department, the total department consumption is obtained by summing up the department resource consumption (namely the hospitalization cost of the department) of all cases in the department, and the difference value between the total department DIP resource and the total department consumption is used as the account balance of the department. For example, assuming that the total office DIP resource of department 1 is DIP11+ DIP21+ DIP31 and the total office consumption is resource consumption 11+ resource consumption 21+ resource consumption 31, the account balance of department 1 is (DIP11+ DIP21+ DIP31) - (resource consumption 11+ resource consumption 21+ resource consumption 31). And calculating the account balance of the department based on the DIP total resources and the total consumption of the department, so that the resource management of the department is more refined.
In one embodiment, determining a general department parameter of a department according to the department resource parameters of each resource management object in the department comprises: determining the total department cost of the department according to the department resource cost of each resource management object in the department; correspondingly, determining the department resource balance according to the total DIP resources and the total department parameters comprises the following steps: and determining the net balance of departments according to the total resource of the DIP of the departments and the total cost of the departments. For a single department, the total cost of department resources (namely, the diagnosis and treatment cost of the department) of all cases in the department is summed to obtain the total cost of the department, and the difference value between the total resource DIP of the department and the total cost of the department is used as the net balance of the department. For example, assuming that the total office DIP resource of department 1 is DIP11+ DIP21+ DIP31 and the total office cost is resource cost 11+ resource cost 21+ resource cost 31, the account balance of department 1 is (DIP11+ DIP21+ DIP31) - (resource cost 11+ resource cost 21+ resource cost 31). And calculating the account balance of the department based on the DIP total resources and the total cost of the department, so that the resource management of the department is more refined.
The hospital refined resource management method based on the medical insurance obtains department resource parameters of at least one resource management object in each department, wherein the department resource parameters comprise department resource consumption and department resource cost; for each resource management object, determining that the resource management object pays DIP resources according to disease category scores in departments of each department based on department resource consumption of the resource management object in each department, and realizing that the DIP resources, cost and the like of the resource management object are distributed to each department of the department; and for each department, determining the balance of department resources based on the DIP resources and the parameters of the department resources of each resource management object in the department, so that the balance or loss of the case is reasonably distributed to each department, the deviation existing in the analysis and management of the resources of the medical department in the hospital is avoided, and the fine management in the hospital is realized.
Example two
Fig. 2 is a flowchart illustrating a hospital fine resource management method based on medical insurance provided in the second embodiment of the present invention. The present embodiment provides a preferred embodiment based on the above-described embodiments.
As shown in fig. 2, the method provided by this embodiment mainly includes the following steps:
(1) for each case, the total amount of hospitalizations of the case in the different departments of the branch is obtained.
According to the hospitalization time of the case in different departments, the various medical expenses generated by the case in the time period are summarized to be used as the total hospitalization sum of the case in the department.
(2) Determining the cost of a case in different departments
According to documents such as 'official hospital cost accounting standard' issued by the state, the cost of the case generated in different departments is determined, and the costs of the branch departments are summarized.
(3) Determining DIP apportionment cost of case in different departments of the branch
On the basis of the total cost of the DIP of the case, the total cost of the DIP of the case is distributed to different departments according to the proportion of the total sum of hospitalizations of the case in different departments, and the DIP cost distributed by the case history in each department is obtained.
Carrying out accounting according to the following steps:
A. determining the total medical cost and proportion of the cases in different departments for each case
The ratio of the total sum of the cases in a department can be determined by the total sum of the cases in the department and the total sum of the cases.
B. Determine the DIP cost of the case to be allocated to each department
The DIP cost of a case to be allocated to each department can be determined by the total DIP cost of the case and the total hospitalization cost of the case in the department.
C. Determining total cost of DIP of department
The total cost of the DIP of the department can be determined by the total cost of the DIP of each case which is distributed to each department, namely, the sum of the cost of the DIP of the cases of all medical records in the department is the total cost of the DIP of the department.
(4) Determining post-apportionment department net balance
The department net balance may be determined by the total cost of the department DIP and the total cost of the department.
(5) Determining post-apportionment department account balance
The department account balance may be determined by the total cost of the department DIP and the total amount of the department hospitalizations.
The department net balance and the department account balance for each department can be obtained by calculation as above. By using the method, under the condition of case transfer, case revenue under the DIP payment mode can be reasonably distributed to different transfer departments, so that the analysis and management results of department resources are more accurate, and comprehensive budget management and fine management of departments of a hospital are facilitated.
EXAMPLE III
Fig. 3 is a schematic structural diagram of a hospital refined resource management device based on medical insurance provided by a third embodiment of the present invention. The hospital refined resource management device based on medical insurance can be implemented in a software and/or hardware manner, for example, the hospital refined resource management device based on medical insurance can be configured in a computer device. As shown in fig. 3, the apparatus includes a department resource parameter obtaining module 310, a department DIP resource determining module 320, and a department resource balance determining module 330, wherein:
a department resource parameter obtaining module 310, configured to obtain department resource parameters of at least one resource management object in each department, where the department resource parameters include department resource consumption and department resource cost;
a department DIP resource determining module 320, configured to determine, for each resource management object, a department resource consumption of the resource management object in each department based on the department resource consumption of the resource management object in each department, that the resource management object pays a DIP resource according to a disease category score in each department;
the department resource balance determining module 330 is configured to determine, for each department, a department resource balance based on the department DIP resource and the department resource parameter of each resource management object in the department.
The department resource parameters of at least one resource management object in each department are obtained, and the department resource parameters comprise department resource consumption and department resource cost; for each resource management object, determining that the resource management object pays DIP resources according to disease category scores in departments of each department based on department resource consumption of the resource management object in each department, and realizing that the DIP resources, cost and the like of the resource management object are distributed to each department of the department; and determining the balance of department resources based on the DIP resources and the parameters of the department resources of the department of each resource management object, so that the balance or loss of the case is reasonably distributed to each department, the deviation existing in the analysis and management of the resources of the medical department of the hospital is avoided, and the fine management of the resources in the hospital is realized.
Optionally, on the basis of the foregoing scheme, the department resource balance determining module 330 includes:
the department DIP total resource unit is used for determining the department DIP total resource of the department according to the department DIP resource of each resource management object in the department;
the department general parameter unit is used for determining department general parameters of departments according to department resource parameters of all resource management objects in the departments;
and the department resource balance unit is used for determining the department resource balance according to the DIP total resources and the department total parameters.
Optionally, on the basis of the above scheme, the department general parameter unit is specifically configured to:
determining the total department consumption of departments according to the department resource consumption of each resource management object in the department;
correspondingly, the department resource balance unit is specifically configured to:
and determining the department account balance of the department according to the total resource of the DIP of the department and the total consumption of the department.
Optionally, on the basis of the above scheme, the department general parameter unit is specifically configured to:
determining the total department cost of the department according to the department resource cost of each resource management object in the department;
correspondingly, the department resource balance unit is specifically configured to:
and determining the net balance of departments according to the total resource of the DIP of the departments and the total cost of the departments.
Optionally, on the basis of the foregoing scheme, the department DIP resource determining module 320 includes:
the resource occupation ratio determining unit is used for determining the resource occupation ratio of the resource management object in each department according to the department resource consumption of the resource management object in each department;
and the department DIP resource unit is used for determining the department DIP resources of the resource management object in each department according to the resource occupation ratio of each department.
Optionally, on the basis of the foregoing scheme, the department DIP resource unit is specifically configured to:
acquiring the total resource of an object DIP of a resource management object;
and for each department, determining the DIP resources of the department of the resource management object in the department according to the resource occupation ratio of the department and the total DIP resources of the object.
Optionally, on the basis of the above scheme, the resource proportion determining unit is specifically configured to:
determining the total resource consumption of the resource management object in each department according to the department resource consumption of the resource management object in each department;
and for each department, determining the resource occupation ratio of the department according to the ratio of the department resource consumption of the department to the total resource consumption.
The hospital refined resource management device based on the medical insurance provided by the embodiment of the invention can execute the hospital refined resource management method based on the medical insurance provided by any embodiment of the invention, and has corresponding functional modules and beneficial effects of the execution method.
Example four
Fig. 4 is a schematic structural diagram of a computer device according to a fourth embodiment of the present invention. FIG. 4 illustrates a block diagram of an exemplary computer device 412 suitable for use in implementing embodiments of the present invention. The computer device 412 shown in FIG. 4 is only one example and should not impose any limitations on the functionality or scope of use of embodiments of the present invention.
As shown in FIG. 4, computer device 412 is in the form of a general purpose computing device. Components of computer device 412 may include, but are not limited to: one or more processors 416, a system memory 428, and a bus 418 that couples the various system components (including the system memory 428 and the processors 416).
The system memory 428 may include computer system readable media in the form of volatile memory, such as Random Access Memory (RAM)430 and/or cache memory 432. The computer device 412 may further include other removable/non-removable, volatile/nonvolatile computer system storage media. By way of example only, storage 434 may be used to read from and write to non-removable, nonvolatile magnetic media (not shown in FIG. 4, and commonly referred to as a "hard drive"). Although not shown in FIG. 4, a magnetic disk drive for reading from and writing to a removable, nonvolatile magnetic disk (e.g., a "floppy disk") and an optical disk drive for reading from or writing to a removable, nonvolatile optical disk (e.g., a CD-ROM, DVD-ROM, or other optical media) may be provided. In these cases, each drive may be connected to bus 418 by one or more data media interfaces. Memory 428 can include at least one program product having a set (e.g., at least one) of program modules that are configured to carry out the functions of embodiments of the invention.
A program/utility 440 having a set (at least one) of program modules 442 may be stored, for instance, in memory 428, such program modules 442 including, but not limited to, an operating system, one or more application programs, other program modules, and program data, each of which examples or some combination thereof may comprise an implementation of a network environment. The program modules 442 generally perform the functions and/or methodologies of the described embodiments of the invention.
The computer device 412 may also communicate with one or more external devices 414 (e.g., keyboard, pointing device, display 424, etc.), with one or more devices that enable a user to interact with the computer device 412, and/or with any devices (e.g., network card, modem, etc.) that enable the computer device 412 to communicate with one or more other computing devices. Such communication may occur via input/output (I/O) interfaces 422. Also, computer device 412 may communicate with one or more networks (e.g., a Local Area Network (LAN), a Wide Area Network (WAN) and/or a public network, such as the Internet) through network adapter 420. As shown, network adapter 420 communicates with the other modules of computer device 412 over bus 418. It should be appreciated that although not shown in the figures, other hardware and/or software modules may be used in conjunction with the computer device 412, including but not limited to: microcode, device drivers, redundant processing units, external disk drive arrays, RAID systems, tape drives, and data backup storage systems, among others.
The processor 416 executes various functional applications and data processing by running the program stored in the system memory 428, for example, implementing the medical insurance-based hospital refined resource management method provided by the embodiment of the present invention, including:
acquiring department resource parameters of at least one resource management object in each department, wherein the department resource parameters comprise department resource consumption and department resource cost;
for each resource management object, determining that DIP resources are paid by the resource management object according to disease category scores in departments of each department based on department resource consumption of the resource management object in each department;
and determining the department resource balance based on the DIP resources and the department resource parameters of the resource management objects in the departments aiming at each department.
Of course, those skilled in the art can understand that the processor can also implement the technical solution of the hospital fine resource management method based on medical insurance provided by any embodiment of the present invention.
EXAMPLE five
The fifth embodiment of the present invention further provides a computer-readable storage medium, on which a computer program is stored, where the computer program, when executed by a processor, implements the medical insurance-based hospital refined resource management method provided in the embodiments of the present invention, where the method includes:
acquiring department resource parameters of at least one resource management object in each department, wherein the department resource parameters comprise department resource consumption and department resource cost;
for each resource management object, determining that DIP resources are paid by the resource management object according to disease category scores in departments of each department based on department resource consumption of the resource management object in each department;
and determining the department resource balance based on the DIP resources and the department resource parameters of the resource management objects in the departments aiming at each department.
Of course, the computer program stored on the computer readable storage medium provided in the embodiment of the present invention is not limited to the above method operations, and may also perform related operations of the hospital fine resource management method based on medical insurance provided in any embodiment of the present invention.
Computer storage media for embodiments of the invention may employ any combination of one or more computer-readable media. The computer readable medium may be a computer readable signal medium or a computer readable storage medium. A computer readable storage medium may be, for example, but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any combination of the foregoing. More specific examples (a non-exhaustive list) of the computer readable storage medium would include the following: an electrical connection having one or more wires, a portable computer diskette, a hard disk, a Random Access Memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or flash memory), an optical fiber, a portable compact disc read-only memory (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the foregoing. In the context of this document, a computer readable storage medium may be any tangible medium that can contain, or store a program for use by or in connection with an instruction execution system, apparatus, or device.
A computer readable signal medium may include a propagated data signal with computer readable program code embodied therein, for example, in baseband or as part of a carrier wave. Such a propagated data signal may take many forms, including, but not limited to, electro-magnetic, optical, or any suitable combination thereof. A computer readable signal medium may also be any computer readable medium that is not a computer readable storage medium and that can communicate, propagate, or transport a program for use by or in connection with an instruction execution system, apparatus, or device.
Program code embodied on a computer readable medium may be transmitted using any appropriate medium, including but not limited to wireless, wireline, optical fiber cable, RF, etc., or any suitable combination of the foregoing.
Computer program code for carrying out operations for aspects of the present invention may be written in any combination of one or more programming languages, including an object oriented programming language such as Java, Smalltalk, C + +, or the like, as well as conventional procedural programming languages, such as the "C" programming language or similar programming languages. The program code may execute entirely on the user's computer, partly on the user's computer, as a stand-alone software package, partly on the user's computer and partly on a remote computer or entirely on the remote computer or server. In the case of a remote computer, the remote computer may be connected to the user's computer through any type of network, including a Local Area Network (LAN) or a Wide Area Network (WAN), or the connection may be made to an external computer (for example, through the Internet using an Internet service provider).
It is to be noted that the foregoing is only illustrative of the preferred embodiments of the present invention and the technical principles employed. It will be understood by those skilled in the art that the present invention is not limited to the particular embodiments illustrated herein, but is capable of various obvious changes, rearrangements and substitutions as will now become apparent to those skilled in the art without departing from the scope of the invention. Therefore, although the present invention has been described in greater detail by the above embodiments, the present invention is not limited to the above embodiments, and may include other equivalent embodiments without departing from the spirit of the present invention, and the scope of the present invention is determined by the scope of the appended claims.
Claims (10)
1. A hospital refined resource management method based on medical insurance is characterized by comprising the following steps:
acquiring department resource parameters of at least one resource management object in each department, wherein the department resource parameters comprise department resource consumption and department resource cost;
for each resource management object, determining that the resource management object pays DIP (dual in-line package) resources according to disease category scores in departments of the departments based on department resource consumption of the resource management object in the departments;
and for each department, determining a department resource balance based on the DIP resource and the department resource parameter of each resource management object in the department.
2. The method of claim 1, wherein determining a department resource balance based on a department DIP resource and a department resource parameter of each of the resource management objects at the department comprises:
determining total office DIP resources of the departments according to the office DIP resources of the resource management objects in the departments;
determining department general parameters of the departments according to department resource parameters of the resource management objects in the departments;
and determining the department resource balance according to the total department DIP resources and the total department parameters.
3. The method of claim 2, wherein determining a department total parameter for the department based on the department resource parameters for each resource management object in the department comprises:
determining the total department consumption of the departments according to the department resource consumption of each resource management object in the departments;
correspondingly, the determining the department resource balance according to the total department DIP resource and the total department parameter includes:
and determining the department account balance of the department according to the total resource of the DIP of the department and the total consumption of the department.
4. The method of claim 2, wherein determining a department total parameter for the department based on the department resource parameters for each resource management object in the department comprises:
determining the department total cost of the department according to the department resource cost of each resource management object in the department;
correspondingly, the determining the department resource balance according to the total department DIP resource and the total department parameter includes:
and determining the department net balance of the department according to the total resource of the DIP of the department and the total cost of the department.
5. The method of claim 1, wherein the determining that the resource management object pays the DIP resource for the disease category score in the departments of the departments based on the department resource consumption of the resource management object in the departments comprises:
determining the resource occupation ratio of the resource management object in each department according to the department resource consumption of the resource management object in each department;
and determining the DIP resources of the resource management object in each department according to the resource occupation ratio of each department.
6. The method of claim 5, wherein the determining the DIP resource of the resource management object in each department according to the resource occupation ratio of each department comprises:
acquiring the total resource of an object DIP of the resource management object;
and for each department, determining the DIP resource of the resource management object in the department according to the resource occupation ratio of the department and the total DIP resource of the object.
7. The method of claim 5, wherein determining the department resource consumption of the resource management object in each department according to the department resource consumption of the resource management object in each department comprises:
determining the total resource consumption of the resource management object in each department according to the department resource consumption of the resource management object in each department;
for each department, determining the resource occupation ratio of the department according to the ratio of the department resource consumption of the department to the total resource consumption.
8. The utility model provides a resource management device that becomes more meticulous based on medical insurance hospital which characterized in that includes:
the department resource parameter acquiring module is used for acquiring department resource parameters of at least one resource management object in each department, and the department resource parameters comprise department resource consumption and department resource cost;
a department DIP resource determining module, configured to determine, for each resource management object, a DIP resource to be paid by the resource management object according to a disease category score in departments of the departments based on department resource consumption of the resource management object in the departments;
and the department resource balance determining module is used for determining the department resource balance for each department based on the DIP resources and the department resource parameters of each resource management object in the department.
9. A computer device, the device comprising:
one or more processors;
storage means for storing one or more programs;
the one or more programs, when executed by the one or more processors, cause the one or more processors to implement the medical insurance-based hospital fine resource management method of any one of claims 1-7.
10. A computer-readable storage medium, on which a computer program is stored, wherein the program, when executed by a processor, implements the medical insurance-based hospital refined resource management method according to any one of claims 1 to 7.
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