CN115099847A - Hospital cost control method and device, electronic equipment and storage medium - Google Patents
Hospital cost control method and device, electronic equipment and storage medium Download PDFInfo
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Abstract
The application relates to a method, a device, an electronic device and a storage medium for controlling cost by a hospital, wherein the method comprises the following steps: acquiring a diagnosis list of admission records; determining a diagnostic code from the diagnostic list; determining a component group record according to the diagnostic code; determining DIP values according to the value group records; determining DIP medical insurance cost according to the DIP score, the hospital coefficient and the patient payment type average cost; and determining a DIP grouping scheme according to the DIP score and the DIP medical insurance cost. The method comprises the steps of obtaining a diagnosis list of admission records; determining a diagnostic code from the diagnostic list; determining a component group record according to the diagnostic code; determining DIP values according to the value group records; the method comprises the steps of determining the DIP medical insurance cost according to the DIP value, the hospital coefficient and the patient payment type average cost, and formulating diagnosis and treatment schemes which accord with the self conditions of the patient, such as the same disease, but have different treatment methods and costs, adjusting the optimal DIP grouping scheme for the patient, and facilitating the hospital doctor to predict the hospitalization cost and the cost factor in real time.
Description
Technical Field
The present application relates to the technical field of hospital fee control, and in particular, to a method, an apparatus, an electronic device and a storage medium for hospital fee control.
Background
In the DIP score payment implementation, the military hospitals are based on DIP grouping results obtained from discharge medical records, the process is delayed, the real-time prediction of hospitalization cost and cost factors by hospital doctors is not facilitated, and the better pushing of the DIP score payment mode by the hospitals is also not facilitated.
Disclosure of Invention
In view of the above, the present application provides a method, an apparatus, an electronic device and a storage medium for controlling costs in a hospital.
In a first aspect, an embodiment of the present application provides a method for controlling costs in a hospital, including:
acquiring a diagnosis list of admission records;
determining a diagnostic code from the diagnostic list;
determining a component group record according to the diagnostic code;
determining DIP values according to the value group records;
determining DIP medical insurance cost according to the DIP score, the hospital coefficient and the patient payment type average cost;
and determining a DIP grouping scheme according to the DIP score and the DIP medical insurance cost.
Further, in the method for controlling costs in a hospital, the obtaining of the diagnosis list of admission records includes:
admission recording documentation to the EMR system;
the diagnosis list of discharge admission records is extracted from the admission record document through the NLP medical natural language understanding model.
Further, in the above method for controlling costs in a hospital, determining a diagnosis code according to a diagnosis list includes:
and determining the diagnosis codes according to the diagnosis list of the local hospital and the corresponding relation table of the diagnosis codes.
Further, in the above method for controlling costs in a hospital, determining a cost of a DIP medical insurance based on the DIP score, the hospital coefficient and the patient payment type average cost includes:
when the DIP component group is the core disease species or the comprehensive disease species, determining the DIP medical insurance cost according to the following formula;
DIP medical care costs-DIP points-hospital factors-patient payment type-average costs.
Further, in the above method for controlling costs in a hospital, the method for determining a cost of a DIP medical insurance based on the DIP value, the hospital coefficient and the patient payment type average cost further includes:
when the DIP component group is the basic disease species, determining the DIP medical insurance cost according to the following formula;
DIP medical insurance cost ═ DIP score ═ 1 · patient type of payment score mean cost.
Further, in the above method for controlling costs in a hospital, determining score group records according to diagnosis codes includes:
and inquiring the score group records meeting the diagnostic code conditions in the score table according to the diagnostic codes.
Further, in the above method for controlling costs in a hospital, determining DIP values according to the score group records includes:
the records of the component group are displayed in an order of the size of the component;
the doctor determines DIP scores from the displayed score set records.
In a second aspect, an embodiment of the present application further provides a device for controlling costs in a hospital, including:
an acquisition module: a diagnosis list for obtaining admission records;
a first determination module: for determining a diagnostic code from the diagnostic list;
a second determination module: for determining point component records based on the diagnostic code;
a third determination module: for determining DIP scores from the score set records;
a fourth determination module: the system is used for determining the DIP medical insurance cost according to the DIP value, the hospital coefficient and the patient payment type average cost;
a fifth determination module: and determining a DIP group entering scheme according to the DIP value and the DIP medical insurance cost.
In a third aspect, an embodiment of the present application further provides an electronic device, including: a processor and a memory;
the processor is used for executing any one of the above hospital cost control methods by calling the program or the instructions stored in the memory.
In a fourth aspect, embodiments of the present application further provide a computer-readable storage medium storing a program or instructions for causing a computer to perform any one of the above methods for controlling costs in a hospital.
The embodiment of the application has the advantages that: the application relates to a method, a device, an electronic device and a storage medium for controlling cost by a hospital, wherein the method comprises the following steps: acquiring a diagnosis list of admission records; determining a diagnostic code from the diagnostic list; determining a component group record according to the diagnostic code; determining DIP values according to the value group records; determining the DIP medical insurance cost according to the DIP value, the hospital coefficient and the patient payment type average cost; the DIP grouping scheme is determined according to the DIP score and the DIP medical insurance cost. The method comprises the steps of obtaining a diagnosis list of admission records; determining a diagnostic code from the diagnostic list; determining a component group record according to the diagnostic code; determining DIP values according to the value group records; the method comprises the steps of determining the DIP medical insurance cost according to the DIP value, the hospital coefficient and the patient payment type average cost, formulating diagnosis and treatment schemes which accord with the self conditions of the patient, such as the same disease, but have different treatment methods and costs, adjusting the optimal DIP group entering scheme for the patient, facilitating the real-time prediction of hospitalization cost and cost factors of a hospital doctor and facilitating the better implementation of a DIP value payment mode of the hospital.
Drawings
In order to more clearly illustrate the technical solutions in the embodiments or the conventional technologies of the present application, the drawings used in the descriptions of the embodiments or the conventional technologies will be briefly introduced below, it is obvious that the drawings in the following descriptions are only some embodiments of the present application, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.
FIG. 1 is a first schematic view of a method for controlling costs in a hospital according to an embodiment of the present invention;
FIG. 2 is a schematic diagram of a method for controlling costs in a hospital according to an embodiment of the present invention;
FIG. 3 is a schematic view of a hospital cost control device according to an embodiment of the present application;
fig. 4 is a schematic block diagram of an electronic device provided in an embodiment of the present application.
Detailed Description
In order to make the aforementioned objects, features and advantages of the present application more comprehensible, embodiments accompanying the present application are described in detail below with reference to the accompanying drawings. In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present application. This application is capable of embodiment in many different forms than that described herein and those skilled in the art will be able to make similar modifications without departing from the spirit of the application and therefore should not be limited to the specific embodiments disclosed below.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs. The terminology used herein in the description of the present application is for the purpose of describing particular embodiments only and is not intended to be limiting of the application. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.
Fig. 1 is a schematic view illustrating a method for controlling costs in a hospital according to an embodiment of the present application.
In a first aspect, an embodiment of the present application provides a method for controlling costs in a hospital, which, with reference to fig. 1, includes six steps S101 to S106:
s101: a diagnostic list of admission records is obtained.
Specifically, in the embodiment of the present application, the diagnosis list of admission records, such as the preliminary diagnosis of viral hepatitis b, is obtained by interfacing with the EMR system, and the specific obtaining steps are described below.
S102: the diagnostic code is determined from the diagnostic list.
Specifically, in the embodiment of the present application, the diagnosis codes of the diagnosis list may be determined according to the correspondence table between the diagnosis codes ICD10 and the diagnosis codes of the local hospital.
S103: a component group record is determined from the diagnostic code.
Specifically, in the embodiment of the present application, the score group records meeting the diagnostic coding condition are looked up in the score table according to the diagnostic code, so as to determine the score group records, for example, the diagnostic code of the hepatitis B is B18.1, and a plurality of score group records meeting the diagnostic code of B18.1 are provided.
S104: DIP scores were determined from the score group records.
Specifically, in the embodiment of the present application, different DIP values are provided according to different subsequent diagnosis and treatment operation modes, and the DIP value is determined according to the score group record, and illustratively, the DIP value is 217.15 if the subsequent diagnosis and treatment operation mode is gastroscopy, and the DIP value is 95.56 if the subsequent diagnosis and treatment operation mode is liver biopsy under ultrasound guidance.
S105: and determining the DIP medical insurance cost according to the DIP value, the hospital coefficient and the patient payment type average cost.
Specifically, in the embodiment of the present application, after the DIP value is determined, the DIP medical insurance cost is determined according to the DIP value, the hospital coefficient and the patient payment type average cost, and when the DIP value is the core disease type or the comprehensive disease type and when the DIP value is the basic disease type, the DIP medical insurance cost is determined through different formulas, and a specific determination method is described below.
S106: the DIP grouping scheme is determined according to the DIP score and the DIP medical insurance cost.
Specifically, in the embodiment of the present application, the attending physician may formulate a diagnosis and treatment plan meeting the self condition of the patient according to the recommended DIP component group and the corresponding cost information, adjust an optimal DIP grouping scheme for the patient, such as the same disease, but have different treatment methods and costs, and determine the optimal DIP grouping scheme for the patient.
Fig. 2 is a schematic diagram illustrating a method for controlling costs in a hospital according to an embodiment of the present application.
Further, in the method for controlling costs in a hospital, the step of obtaining a diagnosis list of admission records, with reference to fig. 2, includes two steps S201 to S202:
s201: admission recording documentation to the EMR system;
s202: the diagnosis list of the discharge admission records is extracted from the admission record document through the NLP medical natural language understanding model.
Specifically, in the embodiment of the present application, the NLP medical natural language understanding model extracts the diagnosis list of the discharge and admission records from the admission record document by interfacing with the admission record document of the EMR system. For example, the list of diagnoses recorded in the admission is a preliminary diagnosis of viral hepatitis B.
Further, in the above method for controlling costs in a hospital, determining a diagnosis code according to a diagnosis list includes:
and determining the diagnosis codes according to the diagnosis list of the local hospital and the corresponding relation table of the diagnosis codes.
Specifically, in the embodiment of the present application, the diagnosis code of the diagnosis list may be determined according to the diagnosis list of the local hospital and the correspondence table of the diagnosis code ICD 10.
Further, in the above method for controlling costs in a hospital, determining a cost of a DIP medical insurance based on the DIP score, the hospital coefficient and the patient payment type average cost includes:
when the DIP value is the core disease species or the comprehensive disease species, determining the DIP medical insurance cost according to the following formula;
DIP medical care costs-DIP points-hospital factors-patient payment type-average costs.
Specifically, in the embodiment of the present application, when the DIP component value group is the core disease species or the combined disease species, the formula is as follows: the DIP medical insurance cost is determined by the DIP point value hospital coefficient and the patient payment type average cost.
Further, in the above method for controlling costs in a hospital, the method for determining a cost of a DIP medical insurance based on the DIP value, the hospital coefficient and the patient payment type average cost further includes:
when the DIP component group is the basic disease species, determining the DIP medical insurance cost according to the following formula;
the DIP medical insurance cost is DIP score 1 and the patient payment type is average cost.
Specifically, in the embodiment of the present application, when the DIP component value group is the basic disease species, the hospital coefficient is equal to 1, and according to the formula: the DIP medical insurance cost is determined by the DIP score value 1 and the patient payment type average cost.
Further, in the above method for controlling costs in a hospital, determining score group records according to diagnosis codes includes:
and inquiring the score group records meeting the diagnostic code conditions in the score table according to the diagnostic codes.
Specifically, in the embodiment of the present application, score group records meeting the diagnostic coding conditions are searched in a score table according to the diagnostic codes, so as to determine the score group records, for example, the diagnostic code of the viral hepatitis B is B18.1, and a plurality of score group records meeting the diagnostic code of B18.1 are provided.
Further, in the above method for controlling costs in a hospital, determining DIP values according to the score group records includes:
the records of the component group are displayed in an order of the size of the component;
the doctor determines DIP scores from the displayed score set records.
Specifically, in the embodiment of the present application, the score group records are displayed in order of the size of the score, so that the DIP score can be directly determined through the displayed score group records.
Fig. 3 is a schematic view of a hospital cost control device according to an embodiment of the present application.
In a second aspect, an embodiment of the present application further provides a device for controlling costs in a hospital, which, with reference to fig. 3, includes:
the acquisition module 301: a diagnostic list for obtaining admission records.
Specifically, in the embodiment of the present application, the obtaining module 301 obtains the diagnosis list of admission records, such as the preliminary diagnosis of viral hepatitis b, by interfacing with the EMR system, according to the steps described above.
The first determination module 302: for determining a diagnostic code from the diagnostic list.
Specifically, in this embodiment of the present application, the first determining module 302 may determine the diagnosis codes of the diagnosis list according to the correspondence table between the diagnosis codes ICD10 and the diagnosis codes of the local hospital.
The second determination module 303: for determining a set of component records from the diagnostic code.
Specifically, in this embodiment of the present application, the second determining module 303 queries, from the score table, score group records meeting the condition of the diagnostic code according to the diagnostic code, so as to determine the score group records, for example, the diagnostic code of the viral hepatitis B is B18.1, and a plurality of score group records meeting the diagnostic code of B18.1 are provided.
The third determination module 304: for determining DIP scores from the score set records.
Specifically, in the embodiment of the present application, the third determining module 304 determines the DIP value according to different DIP values of different subsequent medical and surgical modes, for example, the DIP value is 217.15 if the subsequent medical and surgical modes are gastroscopy, and the DIP value is 95.56 if the subsequent medical and surgical modes are liver biopsy under ultrasound guidance.
The fourth determination module 305: the method is used for determining the DIP medical insurance cost according to the DIP score, the hospital coefficient and the patient payment type average cost.
Specifically, in the embodiment of the present application, after determining the DIP value, the fourth determining module 305 determines the DIP medical insurance cost according to the DIP value, the hospital coefficient and the patient payment type average cost, and the specific determining method is described above.
The fifth determination module 306: and determining a DIP group entering scheme according to the DIP value and the DIP medical insurance cost.
Specifically, in this embodiment of the application, the fifth determining module 306 may formulate a diagnosis and treatment plan meeting the self condition of the patient according to the recommended DIP component group and the corresponding cost information, and adjust an optimal DIP grouping plan for the patient, such as the same disease, but with different treatment methods and costs, to determine the optimal DIP grouping plan for the patient.
In a third aspect, an embodiment of the present application further provides an electronic device, including: a processor and a memory;
the processor is used for executing any one of the above hospital cost control methods by calling the program or the instructions stored in the memory.
In a fourth aspect, the present application further provides a computer-readable storage medium storing a program or instructions for causing a computer to perform any one of the above methods for controlling costs in a hospital.
Fig. 4 is a schematic block diagram of an electronic device provided by an embodiment of the present disclosure.
As shown in fig. 4, the electronic apparatus includes: at least one processor 401, at least one memory 402, and at least one communication interface 403. The various components in the electronic device are coupled together by a bus system 404. A communication interface 403 for information transmission with an external device. It is understood that the bus system 404 is used to enable communications among the components. The bus system 404 includes a power bus, a control bus, and a status signal bus in addition to a data bus. For clarity of illustration, the various buses are labeled as bus system 404 in fig. 4.
It will be appreciated that the memory 402 in this embodiment can be either volatile memory or nonvolatile memory, or can include both volatile and nonvolatile memory.
In some embodiments, memory 402 stores the following elements, executable units or data structures, or a subset thereof, or an expanded set thereof: an operating system and an application program.
The operating system includes various system programs, such as a framework layer, a core library layer, a driver layer, and the like, and is used for implementing various basic services and processing hardware-based tasks. The application programs, including various application programs such as a Media Player (Media Player), a Browser (Browser), etc., are used to implement various application services. The program for implementing any one of the methods for controlling the cost of the hospital provided by the embodiment of the application can be contained in the application program.
In the embodiment of the present application, the processor 401 is configured to execute the steps of the embodiments of the method for controlling costs of a hospital, provided by the embodiments of the present application, by calling a program or an instruction stored in the memory 402, which may be specifically a program or an instruction stored in an application program.
Acquiring a diagnosis list of admission records;
determining a diagnostic code from the diagnostic list;
determining a component group record according to the diagnostic code;
determining DIP values according to the value group records;
determining the DIP medical insurance cost according to the DIP value, the hospital coefficient and the patient payment type average cost;
the DIP grouping scheme is determined according to the DIP score and the DIP medical insurance cost.
Any one of the methods for controlling costs in a hospital provided in the embodiments of the present application may be applied to the processor 401, or implemented by the processor 401. The processor 401 may be an integrated circuit chip having signal processing capabilities. In implementation, the steps of the above method may be performed by integrated logic circuits of hardware or instructions in the form of software in the processor 401. The Processor 401 may be a general-purpose Processor, a Digital Signal Processor (DSP), an Application Specific Integrated Circuit (ASIC), an off-the-shelf Programmable Gate Array (FPGA) or other Programmable logic device, discrete Gate or transistor logic device, or discrete hardware components. A general purpose processor may be a microprocessor or the processor may be any conventional processor or the like.
The steps of any one of the hospital cost control methods provided by the embodiments of the present application can be directly embodied as the execution of a hardware decoding processor, or the execution of the hardware decoding processor and a software unit in the decoding processor are combined. The software elements may be located in ram, flash, rom, prom, or eprom, registers, among other storage media that are well known in the art. The storage medium is located in a memory 402, and the processor 401 reads the information in the memory 402 and, in combination with its hardware, performs the steps of a method for controlling costs in a hospital.
Those skilled in the art will appreciate that although some embodiments described herein include some features included in other embodiments instead of others, combinations of features of different embodiments are meant to be within the scope of the application and form different embodiments.
Those skilled in the art will appreciate that the description of each embodiment has a respective emphasis, and reference may be made to the related description of other embodiments for those parts of an embodiment that are not described in detail.
While the invention has been described with reference to specific embodiments, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims. Therefore, the protection scope of the present invention shall be subject to the protection scope of the claims.
Claims (10)
1. A method for hospital cost control, comprising:
acquiring a diagnosis list of admission records;
determining a diagnostic code from the diagnostic list;
determining a set of component records from the diagnostic code;
determining a DIP score according to the score group record;
determining the DIP medical insurance cost according to the DIP value, the hospital coefficient and the patient payment type average cost;
and determining a DIP group entering scheme according to the DIP value and the DIP medical insurance cost.
2. The method of claim 1, wherein the obtaining of the diagnostic list of admission records comprises:
admission recording documentation to the EMR system;
the diagnosis list of discharge admission records is extracted from the admission record document through the NLP medical natural language understanding model.
3. The hospital cost control method of claim 1, wherein said determining a diagnostic code from said list of diagnoses comprises:
and determining the diagnosis codes according to the diagnosis list of the local hospital and the corresponding relation table of the diagnosis codes.
4. The method of hospital care costs of claim 1, wherein said determining a DIP medical insurance cost based on said DIP score, hospital coefficients and patient payment type average cost comprises:
when the DIP component group is a core disease species or a comprehensive disease species, determining the DIP medical insurance cost according to the following formula;
DIP medical care costs-DIP points-hospital factors-patient payment type-average costs.
5. The method of hospital care costs of claim 1, wherein said determining a DIP medical insurance cost based on said DIP score, hospital coefficients and patient payment type average cost, further comprises:
when the DIP component group is the basic disease species, determining the DIP medical insurance cost according to the following formula;
DIP medical insurance cost ═ DIP score ═ 1 · patient type of payment score mean cost.
6. The method of hospital controlled costs of claim 1 wherein said determining a set of component records from said diagnostic code comprises:
and inquiring score group records meeting the diagnostic code conditions in a score table according to the diagnostic codes.
7. The method of claim 1, wherein said determining DIP scores from said score set records comprises:
the records of the component group are displayed in the order of the size of the component;
the doctor determines DIP scores from the displayed score set records.
8. A hospital cost control device, comprising:
an acquisition module: a diagnosis list for obtaining admission records;
a first determination module: for determining a diagnostic code from the list of diagnoses;
a second determination module: for determining a set of component records from the diagnostic code;
a third determination module: for determining DIP values from the score set records;
a fourth determination module: the system is used for determining the DIP medical insurance cost according to the DIP value, the hospital coefficient and the patient payment type average cost;
a fifth determination module: and determining a DIP group entering scheme according to the DIP value and the DIP medical insurance cost.
9. An electronic device, comprising: a processor and a memory;
the processor is configured to execute a method for hospital cost control according to any one of claims 1 to 7 by invoking a program or instructions stored in the memory.
10. A computer-readable storage medium storing a program or instructions for causing a computer to perform a method for hospital controlled costs according to any of claims 1 to 7.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202210687790.XA CN115099847A (en) | 2022-06-17 | 2022-06-17 | Hospital cost control method and device, electronic equipment and storage medium |
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| CN202210687790.XA CN115099847A (en) | 2022-06-17 | 2022-06-17 | Hospital cost control method and device, electronic equipment and storage medium |
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| 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 |
| CN116798581A (en) * | 2023-06-13 | 2023-09-22 | 北京智诚民康信息技术有限公司 | System of DRG/DIP grouping method for inpatients based on clinical decision support |
| CN116825311A (en) * | 2023-07-18 | 2023-09-29 | 山东贝森医院管理咨询有限公司 | DRG/DIP-based hospital management and control operation method and system |
-
2022
- 2022-06-17 CN CN202210687790.XA patent/CN115099847A/en active Pending
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN116798581A (en) * | 2023-06-13 | 2023-09-22 | 北京智诚民康信息技术有限公司 | System of DRG/DIP grouping method for inpatients based on clinical decision support |
| 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 |
| CN116825311A (en) * | 2023-07-18 | 2023-09-29 | 山东贝森医院管理咨询有限公司 | DRG/DIP-based hospital management and control operation method and system |
| CN116825311B (en) * | 2023-07-18 | 2024-04-09 | 山东贝森医院管理咨询有限公司 | DRG/DIP-based hospital management and control operation method and system |
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