JP2001243289A - Method for generating care service plan, its performing device and recording medium recording its processing program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a technique by which the burden of care service plan generation is relieved. SOLUTION: A care service plan generating method for generating a care service plan which indicates the contents of a care service to be provided is provided with a step for inputting the care service plan which indicates the contents of the care service to be provided to a person insured, a step for calculating the usage total points or the user burden total amount of the care service to be provided by the inputted care service plan and a step for outputting alarm when the calculated points is larger than an allowance limit reference amount or when the calculated burden total amount is larger than a burden amount desired by the user.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a care service plan creating apparatus for creating a care service plan showing the contents of a provided care service, and more particularly, to a total use point or a user burden of the provided care service. The present invention relates to a technology effective when applied to a care service plan creation device that efficiently creates a care service plan while checking.

[0002]

2. Description of the Related Art When receiving a long-term care service under the long-term care insurance system, an application is made to the insurer, municipalities, for certification of the need for long-term care, and a survey is conducted to determine the degree of long-term care required. The degree of care required is determined. In response, the care manager of the care support company creates a care service plan for each individual insured.

[0003] As a result of creating a care service plan,
Calculate how much you spend on the entire service,
The insurer and the insured bear the cost. At that time, there are two types of limits for the benefits to be paid by the insurer: the maximum amount of class payment (points) and the maximum amount of type payment (points). In addition, there is a limit (in yen) desired by the insured person as a limitation on the burden on the insured person. Therefore, when a care support provider prepares a care service plan for an insured person, the care service plan must be taken into consideration so as not to exceed any of the category payment limit, the type payment limit, and the individual's desired burden. Need to create.

[0004] A care service plan support device that supports the work of a care manager who creates a care service plan is described in Japanese Patent Application Laid-Open No. H11-53455. Display of an input screen, and according to the supporter information input from the input / output means, a care needs determination support means for determining the care needs of the supporter, and a service providing a service satisfying the care needs. Service combination optimally combining means for retrieving from the user information, creating a service plan of an optimal combination that satisfies the living environment condition and economic condition of the supporter required from the service, and outputting the service plan from the input / output means.

[0005]

In the conventional nursing care service plan support apparatus, since the total point of use and the user's burden of the nursing care service provided by the created nursing care service plan are not calculated, the nursing care service is provided. A care service plan cannot be created while checking the total number of services used and the user's burden. Therefore, when the total number of points used or the amount paid by the user exceeds any of the maximum amount of the classified payment, the maximum amount of the type of payment, and the desired amount of the individual, a trouble of re-creating the care service plan occurs.

[0006] An object of the present invention is to solve the above-mentioned problems and to provide a technique capable of reducing the load of preparing a care service plan.

[0007]

According to the present invention, there is provided a care service plan creating apparatus for creating a care service plan showing the contents of provided care services. Is calculated to support the creation of a care service plan.

According to the present invention, a care manager of a care support company selects a care service according to the physical condition of the insured person, and further specifies a care service company that provides the care service, a provided day of the week, a provided time zone, and the like. It is determined and registered in the care support provider side device which is a care service plan creation device.

When the care manager of the care support company hears from the insured that there is a limit to the amount paid by the insured in receiving the care service,
The amount is registered in the care support provider's device as a personal desired burden.

[0010] The care support provider side device displays the contents of the registered care service on the screen, calculates the care payment points and the number of times of use of the care service based on the registered care service information, and Calculate the total points for one month of the month in which the service is provided. Further, the total points of the previous type or section are read out according to the type or section of the nursing care service and the calculated total points are added to obtain the total score of the type or section including the total point of the newly registered nursing care service.

[0011] The calculated total score is multiplied by the unit price of the provider of the nursing care service to calculate a one-month use amount for the nursing care service, and the usage amount is multiplied by the burden rate of the insured person. To calculate the user burden. Further, the previous user's total amount is read out, and the calculated user's total amount is added to obtain the total user's total amount including the newly registered nursing care user's total amount. Then, the calculated total score and the total user burden are displayed on the same screen as the care service.

Next, the care support provider side apparatus obtains, from the user information, a supply limit reference amount indicating the limit of the care service that the insured receives within one month or within a specific period. The obtained payment limit reference amount is compared with the calculated total points of the type or classification of the nursing service, the remaining points and the ratio of the total points are calculated, and the result is displayed on the same screen as the nursing service. . If the total score exceeds the supply limit reference amount, a warning indicating that the total limit is exceeded is displayed.

The supply limit reference amount may be set for each type of care service, or may be set as a group of a plurality of care service types. . In the present invention, the type and the classification are determined based on the contents of the nursing care service, and the comparison is made with respect to all of these supply limit reference amounts.

[0014] In addition, when the user information includes the user's desired burden, the care support provider's device compares the desired user's burden with the calculated total of the user's burden, and determines that the user's total is If the required amount is exceeded, a warning is displayed that the required amount is exceeded.

As described above, according to the nursing care service planning apparatus of the present invention, the input of the total number of use of the nursing care service and the user's burden are calculated to support the preparation of the nursing care service plan. It is possible to reduce the load of planning.

[0016]

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a block diagram showing an example of a care service plan creating apparatus for creating a care service plan showing contents of a care service provided by a care insurance system.

FIG. 1 is a diagram showing a schematic configuration of a care service plan creation device of the present embodiment. As shown in FIG. 1, a care support provider side device 100 of the present embodiment includes a central processing unit 1.
01, the screen display device 102, the storage device 103, the input device 104, the user information file 105, the score table file 106, and the weekly nursing care service plan file 10.
7 are provided.

The central processing unit 101 is a device for controlling the operation of the care support provider side device 100 as a care service plan creation device. The screen display device 102 is a device that displays a care service plan and the like. Storage device 103
Is a device for loading various processing programs and data when controlling the operation of the entire care support provider side device 100.

The input device 104 is a device for inputting operation instructions such as registration of a care service plan. The user information file 105 is a file for storing data such as the name of the user. The score table file 106 is a file for storing, for each care service provider, the number of care payment points according to the care service. Weekly care service plan file 10
Reference numeral 7 denotes a file for storing the weekly care service plan created by the care manager.

The care support provider side apparatus 100 includes a care service plan input processing unit 110 and a use information processing unit 11.
1 and a use content inspection processing unit 112.

The care service plan input processing section 110 is a processing section for inputting a care service plan indicating the contents of the care service provided to the insured person. Usage information processing unit 11
Reference numeral 1 denotes a processing unit that calculates the total use points or the total user burden of the nursing care service provided by the input nursing care service plan. The use content inspection processing unit 112 outputs a warning when the calculated total use point is larger than the payment limit reference amount or when the calculated total user burden is larger than the user's desired burden. It is.

A program for causing the care support provider side apparatus 100 to function as the care service plan input processing section 110, the use information processing section 111, and the use content inspection processing section 112 is recorded on a recording medium such as a CD-ROM and is magnetically recorded. After being stored on a disk or the like, it is assumed to be loaded into a memory and executed. The recording medium for recording the program may be a recording medium other than the CD-ROM.

FIG. 2 is a diagram showing an example of data of a weekly nursing care service plan of the present embodiment. FIG. 2 shows a data example of a care service plan stored in the weekly care service plan file 107.

In FIG. 2, the insured person number is a number for identifying a person who provides the nursing care service, and the insured person name represents the name of the insured person identified by the insured person number. . The month in which the nursing care service is provided is the month in which the nursing care service is provided, the name of the nursing care service is the name of the nursing care service to be provided, the provided day is the day of the week in which the nursing care service is provided, and the name of the service provider is the name of the business providing the above nursing care service. The time zone indicates a time zone in which the above service is provided. The name of the care service, the day of the service provided, the name of the service provider, and the time of the service provision have data for each registered care service. Welfare equipment lending is an item of welfare equipment lent to the insured. Here, in the items of item numbers 4 to 7, a plurality of data are registered according to the number of registered care services, and similar care service plan data is created for each of a plurality of insured persons.

The visiting care / total points are the total points of all the nursing services classified as visiting nursing services among the registered nursing services. The visiting care / supply limit reference amount is the supply limit point of the visiting care service stored in the user information file 105 for each insured person. Visiting care / proportion represents the ratio of visiting care / total points to the visiting care / payment limit reference amount. Visiting nursing care / remaining points represent points obtained by subtracting visiting nursing care / total points from the home care / payment limit reference amount. In the above four items (item numbers 9 to 12), a plurality of data are registered according to the number of registered care services, and similar care service plan data is created for each of a plurality of insured persons.

The visiting care place service category / total score is the total score of all the nursing care services belonging to the visiting care place service category among the registered care services. The visiting place service category / supply limit reference amount represents the limit score stored in the user information file 105 for the total point of the nursing care service belonging to the visiting place service category. Visiting place service category / rate is based on visiting place service category / supply limit
Shows the percentage of the total points. The total user-paid amount is the amount borne by the user among the usage amounts for all registered care services. Here, the ratio of the user's burden is represented as 10% of the total usage. The desired amount excess amount indicates how much the user's total amount exceeds the individual's desired amount.

FIG. 3 is a diagram showing an outline of a weekly nursing care service plan of the present embodiment. FIG. 3 shows an outline of a one-week nursing care service plan as an example of a weekly nursing care service plan created by a care manager, and a service provider CCC establishment is provided to the insured person Taro Yamada. A weekly nursing care service plan, such as providing on-site nursing care services at 9:00 to 10:30 on Monday, is shown.

FIG. 4 is a diagram showing a data example of the user information of the present embodiment. In FIG. 4, the user information file 105
Shows an example of user information data stored in.

In FIG. 4, the insurer number is a number for identifying an insurer such as a municipal government, and the insurer name represents a name of the municipal office identified by the insurer number. The insured person number is a number for identifying a target person to whom the care service is provided, and the insured person name represents the name of the insured person identified by the insured person number. The individual's desired burden represents the limit that the insured user, the user, desires as the self-paid amount. The burden condition represents a condition concerning the burden set for each insured person. The insurance benefit rate represents the ratio paid by the insurer to the nursing care service usage amount, and the user burden ratio represents the ratio paid by the insured person to the nursing service usage amount. The home care / payment limit reference amount indicates the limit of the amount used for the home care service. As the payment limit reference amount, a plurality of data are registered according to the number of care services. The visiting bureau service category / classification limit represents the maximum score of the total amount of use of all nursing care services belonging to the visiting bureau service category. The category payment limit is registered for each category, and a plurality of data are registered.

FIG. 5 is a diagram showing an example of data of the nursing care benefit score table of the present embodiment. In FIG. 5, the score table file 106
Shows an example of the data of the score table stored in.

In FIG. 5, the name of the nursing care service provider represents the name of a nursing care service provider registered as a care service provider. The score unit price is a price per point determined for each care service provider. The care service name indicates the name of a care service provided by a care service provider. The nursing care benefit point is a point determined for each nursing care service, and represents the benefit price of the nursing care service in points.

It is assumed that a plurality of data are recorded for the name of the nursing care service and the number of nursing care benefits according to the type of nursing care service that can be implemented by the nursing care service provider. It is also assumed that a similar score table is created for each of a plurality of care service providers.

FIG. 6 is a flowchart showing the procedure of the weekly nursing care service plan creation process of this embodiment. In step 601, the care service plan input processing unit 110 of the care support provider side apparatus 100 receives an insured person number for which a care service plan is to be created and an input of a provision month from an operator and registers the input in the weekly care service plan file 107. Then, in step 602, the insured person name is retrieved from the user information file 105 based on the insured person number and displayed on the screen display device 102.

In step 603, the care service plan input processing section 110 checks whether or not the care service plan has been input from the input device 104 of the care support provider side apparatus 100. If the care service plan has not been input, the process proceeds to step 603. Proceeding to 619, if a care service plan has been entered, proceed to step 604.

Here, the input of the care service plan means that a care manager or the like who is an operator selects a care service necessary for the insured person from a plurality of care services, and provides the selected care service on a day of the week. It refers to determining and inputting a care service providing time zone and a care service provider to provide.

In step 604, the care service plan input processing unit 110 registers the input care service plan in the weekly care service plan file 107, and in step 605.
Then, the weekly care service plan registered in the weekly care service plan file 107 in step 604 is displayed on the screen display device 102.

In step 606, the usage information processing unit 111
Calculates the number of service providing days in the providing month in consideration of the day of the week when the providing month starts. In step 607, the nursing care service provider name and the nursing care service point and the unit price of the nursing care service corresponding to the name of the nursing care service are stored in the score table file 1
06, and in step 608, the user's desired burden amount, user burden ratio, and supply limit reference amount are acquired from the user information file 105 based on the insured person number.

In step 609, the usage information processing unit 111
Acquires from the weekly care service plan file 107 the total score corresponding to the care service input in step 604. Then, in step 610, step 607
The value obtained by multiplying the number of care payments obtained in the above and the number of provided days calculated in step 606 is added to the total points obtained in step 609, and is substituted again as the total points.

In step 611, the usage information processing unit 111
Calculates the total user burden corresponding to the insured person number entered in step 601 in the weekly care service plan file 1
07. Then, in step 612, a value obtained by multiplying the number of the nursing care benefits, the number of provided days, the point unit price, and the user share is added to the total user share, and is substituted again as the total user share.

At step 613, the usage information processing unit 111
Calculates the ratio by dividing the total score calculated in step 610 by the payment limit reference amount. The remaining points are calculated by subtracting the total points from the payment limit reference amount. In step 614, the total score, the total user burden, their ratio, and the remaining score are registered in the weekly care service plan file 107,
In step 615, the total points, the total amount of the user's burden, their ratio, the remaining points, the supply limit reference amount, and the user's desired burden are displayed on the screen display device 102.

At step 616, the use content inspection processing section 11
2 is to compare the total score with the payment limit reference amount, and if the total score is larger than the payment limit reference amount, then step 61
If the total score is equal to or less than the payment limit reference amount, the process proceeds to step 617. In step 617, the total user burden is compared with the individual's desired burden. If the total user's burden is greater than the individual's desired burden, the process proceeds to step 618, and the total user's burden is the user's desired burden. If it is less than the burden amount, the process proceeds to step 619.

In step 618, the use content inspection processing section 11
2 displays, on the screen display device 102, a sentence of a warning indicating that the total use point of the nursing care service exceeds the payment limit reference amount and that the user's total amount exceeds the individual's desired amount. . In this embodiment, a warning sentence is displayed as a means for notifying a warning.
Any means that can be recognized by the operator, such as displaying the color or shape (font) of the character differently from the others, notifying by voice, or the like, may be used.

In step 619, if there is no registration from the operator that the weekly nursing care service plan creation processing has been completed, the flow returns to step 603. The creation processing ends.

FIG. 7 is a diagram showing an example of a weekly nursing care service plan creation screen of the present embodiment. The weekly nursing care service plan creation screen is a screen displayed on the screen display device 102 when a care manager or the like who is the operator of the nursing care provider side apparatus 100 creates a weekly nursing care service plan.

In the example of the weekly nursing care service planning screen shown in FIG. 7, the contents of the nursing care service registered by the operator are displayed in the weekly nursing care service plan column 701, and the total score, the remaining points, etc. calculated according to the weekly nursing care service plan are displayed. To the type payment limit column 702 and the classification payment limit column 70
3, a comparison between the calculation result of the user's share and the desired share is displayed in the user share column 704, respectively. Type payment limit column 702 and classification payment limit column 703
In any of the cases, when any of the total points exceeds the payment limit reference amount, and when the total user burden amount in the user burden column 704 exceeds the individual's desired burden amount, a warning column 705 is displayed.
Warning message is displayed on the screen.

The example of FIG. 7 shows that a care service plan has been registered every Monday and Thursday, and the contents can be confirmed by selecting the registration display portion 706 displayed in a belt shape with the input device 104. I can do it. In registering the nursing care service, it is assumed that the start time and the end time can be registered by selecting a time zone in a band of the input device 104 in the column of the day to be registered. The start time and end time of the service may be directly registered.

In the example of FIG. 7, the total points, the ratio, the remaining points, the total amount of the user's burden, and the excess amount of the desired amount with respect to the user's desired amount are indicated by numerical values, respectively. It is sufficient if the operator can recognize the percentage of the total number of points used and the total amount of the payment limit reference amount and the user's desired burden amount, such as displaying in a chart, a radar chart, or a pie chart.

FIG. 8 is a diagram showing an example of a case where the type pay limit column 702 and the class pay limit column 703 in FIG. 7 of this embodiment are displayed in a bar graph. As shown in FIG. 8, the bar chart shows the ratio of the total points and the remaining points to the supply limit reference amount in the type payment limit column 702 of FIG. It may be displayed.

In the present embodiment, the nursing care service plan is prepared on a weekly basis. It is also possible to determine whether there are times and develop it into a monthly care service plan, and then display the monthly care service plan on the screen display device 102.

When the contents of the nursing care service plan are added, deleted, or modified on the screen developed in the monthly nursing care service plan, the nursing care service plan and the payment limit are added in the same manner as when the weekly nursing care service plan is created. The total points, the percentage, the remaining points, the total amount of the user's burden for the individual's desired burden, the excess of the desired amount, etc. are displayed at the same time.If the total score exceeds the payment limit standard amount, A warning message will be displayed if the amount exceeds the desired amount. At that time, as in the creation of the weekly nursing care service plan, the total points, percentage, remaining points, the total user's contribution to the individual's desired contribution, and the amount in excess of the desired amount are shown in a bar graph, radar chart, yen It may be displayed as a graph or the like.

However, when the contents of the nursing care service plan are added, deleted, or modified on the screen developed in the monthly nursing care service plan, the total points and the total user burden are calculated in the weekly nursing care service plan. Although the number of nursing care services per month was determined based on the provided month, the monthly nursing care service plan is calculated based on the number of nursing care services registered in the monthly nursing care service plan column.

FIG. 9 is a view showing an example of a screen developed in the monthly care service plan of the present embodiment. In FIG. 9, FIG.
Based on the weekly nursing care plan shown in, based on the day of the week when the month starts, determine how many days of the month of the month are provided by each nursing care service and develop it into a monthly nursing care plan,
This shows an example of a case where addition, deletion, or modification has been made to the contents of a monthly care service plan.

That is, in FIG. 9, after the weekly nursing care service plan shown in FIG. 7 is developed into a monthly nursing care service plan, the number of visiting nursing care is reduced to make the total score 7000 points.
A short-term admission service for four days has been added, and as a result, the total user burden exceeds the personal burden desired, and a warning message is displayed. In FIG. 9, the “payment limit reference amount of 21 days” of the short-term entrance service represents the number of days in which a short-term admission is possible in a unit period such as six months. This indicates that short-term admission of 9 days is possible in the remaining 3 months of the unit period.

As described above, according to the nursing care service planning apparatus of the present embodiment, the total number of use of the nursing care service and the user's burden are calculated to support the preparation of the nursing care service plan. It is possible to reduce the load of creating a care service plan.

[0055]

According to the present invention, since the input of the total number of use of the nursing care service and the user's burden are calculated to support the preparation of the nursing care service plan, the load of the nursing care service planning can be reduced. It is possible.

[Brief description of the drawings]

FIG. 1 is a diagram illustrating a schematic configuration of a care service plan creation device according to an embodiment.

FIG. 2 is a diagram illustrating an example of data of a weekly care service plan according to the embodiment;

FIG. 3 is a diagram showing an outline of a weekly nursing care service plan of the present embodiment.

FIG. 4 is a diagram illustrating a data example of user information according to the embodiment;

FIG. 5 is a diagram illustrating an example of data of a nursing care benefit score table according to the present embodiment.

FIG. 6 is a flowchart illustrating a procedure of a weekly care service plan creation process according to the embodiment;

FIG. 7 is a diagram illustrating an example of a weekly care service plan creation screen according to the embodiment.

FIG. 8 is a diagram showing an example of a case where a type pay limit column 702 and a class pay limit column 703 in FIG. 7 of this embodiment are displayed in a bar graph.

FIG. 9 is a diagram illustrating an example of a screen developed in a monthly care service plan according to the embodiment.

[Explanation of symbols]

100: Nursing care support company side device, 101: Central processing unit, 102: Screen display device, 103: Storage device, 104
... input device, 105 ... user information file, 106 ... score table file, 107 ... weekly care service plan file, 110 ... care service plan input processing section, 111 ... usage information processing section, 112 ... usage content inspection processing section, 701 …
Weekly care service plan column, 702 ... Kind of supply limit column,
703: Category payment limit column, 704: User burden column,
705: warning column, 706: registration display part.

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[Procedure amendment]

[Submission date] February 29, 2000 (200.2.2
9)

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] Name of invention

[Correction method] Change

[Correction contents]

[Title of the Invention] care service planning method and its implementation apparatus arrangement Niso of processing program recorded recording medium

Continued on the front page (72) Inventor Atsushi Enomoto 890 Kashimada, Saiwai-ku, Kawasaki-shi, Kanagawa Prefecture, Ltd.Business Solution Development Headquarters, Hitachi, Ltd. Business Solution Development Headquarters (72) Inventor Toyotomi Ishikawa 890 Kashimada, Saiwai-ku, Kawasaki-shi, Kanagawa F-term in Business Solution Development Headquarters, Hitachi, Ltd. 5B049 AA02 BB41 CC11 CC32 DD01 EE02 FF03 FF06

Claims (5)

[Claims] 1. A care service plan creation method for creating a care service plan indicating the contents of a provided care service, comprising: inputting a care service plan indicating the contents of a care service provided to an insured person; Calculating the total use points or the total user burden of the nursing service provided in the input nursing service plan, and calculating the total use point when the calculated total use point is larger than the payment limit reference amount, or Outputting a warning when the total user burden is greater than the user's desired burden. 2. Calculate and output the ratio of the total use points to the payment limit reference amount and the remaining points up to the payment limit reference amount, or the desired amount excess amount indicating the excess amount of the user's contribution amount to the individual's desired burden amount. 2. The method according to claim 1, further comprising the step of: 3. The care service plan creating method according to claim 1, wherein the warning is issued based on a difference in color, shape, or sound of output contents. 4. A care service plan creation device for creating a care service plan indicating the contents of a provided care service, wherein the care service plan inputting a care service plan indicating the contents of the care service provided to the insured person. An input processing unit;
A use information processing unit for calculating a total use point or a user's burden of the nursing service provided in the input nursing service plan, and a case where the calculated total use point is larger than a payment limit reference amount or A nursing care service plan creating apparatus, comprising: a use content inspection processing unit that outputs a warning when the calculated total user burden is larger than the individual's desired burden. 5. A computer-readable recording medium on which a program for causing a computer to function as a care service plan creation device for creating a care service plan showing the contents of provided care services is provided to the insured person. A care service plan input processing unit for inputting a care service plan indicating the content of the care service to be performed;
A use information processing unit for calculating a total use point or a user's burden of the nursing service provided in the input nursing service plan, and a case where the calculated total use point is larger than a payment limit reference amount or A recording medium on which is recorded a program for causing a computer to function as a use content inspection processing unit for outputting a warning when the calculated total user burden is larger than the user's desired burden.