JP2008276465A - Method and system for processing data-cleansing - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To reduce a newly occurring data-cleansing processing burden by unifying special collection accompanying the foundation of the latter-stage elderly medical insurance system. <P>SOLUTION: In pensioner information transmitted to each cooperation system of the care insurance system 30, the latter-stage elderly medical insurance system 40, or the National Health Insurance system 50 from a pensioner information management system 10, a function of creating and outputting correspondence information between a basic pension number and a basic resident individual number is added to the care insurance system 30 where the data-cleansing is already executed by using the unique basic pension number added to an individual and the unique basic resident individual number added to the individual inside each cooperation system, and a function of acquiring the correspondence information outputted from the care insurance system 30 is added to the latter-stage elderly medical insurance system 40 and the national health insurance system 50 to reduce a work burden of the data-cleansing processing in national health insurance special collection correspondence information and latter-stage elderly special collection correspondence information. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a name identification processing method and a name identification processing system.

From April 2008, an independent medical system called “Late Elderly Medical Insurance System” was established for elderly people over 75 years old. Special collection (subtraction of insurance premiums from pensions) is unified in the system.
At that time, in order to calculate the special collection amount, the pensioner information from the pensioner information management system and the insured person information possessed by each of the above-mentioned three systems are used for name identification. The special collection amount is set so that the total special collection amount does not exceed 1/2 of the pension receipt amount. For this reason, it is necessary to perform a name identification process in each system. However, a system other than the long-term care insurance has not conventionally performed a name identification process, and therefore a new name identification process needs to be performed. In addition, as of April 2007, a system for long-term care insurance already exists and is operated by insurers nationwide, but there are no systems under the two systems of late elderly medical insurance and national health insurance. It is necessary to start up a new system.

Here, “name identification” is a term mainly used in the financial industry, and it is necessary to identify depositors that are subject to deposit protection as a premise for calculating the total deposit amount of one depositor. The work is called name identification. Recently, not only financial institutions but also many public institutions and companies have become required to unify customer data, and dedicated package software has also emerged.
For example, a financial institution is a process that considers customers with the same address and name as the same depositor, and corrects the ambiguity in the name and address notation, and performs a process that increases the accuracy by matching within a certain tolerance. . Generally, it is a high-load process. For example, if the result of name identification processing is accumulated once, and the corresponding information is accumulated at the next time of name identification processing, the past name identification result is used. A customer management system that can reduce the load of name identification processing is also known (see, for example, Patent Document 1).
JP-A-11-191124 (paragraphs “0005” to “0007”, FIG. 1)

According to the technique disclosed in Patent Document 1 described above, it is possible to construct a database in which customer information for each individual or household is unified by using past name identification results. All past data cannot be processed mechanically, and some must be processed by human naval tactics. At this time, the judgment of the person in charge of name identification is included, so the result of name identification processing is not consistent. The problem remains.
In the same way as the name identification process newly required in the above-mentioned elderly medical care system for the elderly and the national health insurance system, all processes cannot be processed mechanically, and some data needs to be judged by the person in charge. Therefore, it is still a high-load process that takes time and effort. Specifically, it has a work period of about 10 to 14 days in a single name identification process for a population of 180,000 people. In addition, in the system of three systems of long-term care insurance, elderly medical care for the elderly, and national health insurance, common information can be obtained from the pensioner information management system for pensioner information that is subject to special collection. There is a problem that there is a possibility that the result of the name identification between the systems may be shifted due to the judgment of the person in charge of the system in the three systems in the process of name identification.

  The present invention has been made to solve the above-described problems, and reduces the burden of name identification processing newly generated due to the unification of special collection accompanying the establishment of the late-stage elderly medical insurance system. It is an object of the present invention to provide a name identification processing method and a name identification processing system capable of maintaining consistency of name identification processing results between systems.

  In order to solve the above-mentioned problem, the name identification processing method and the name identification processing system of the present invention are characterized in that the name identification processing is performed in the late elderly medical system / national health insurance system based on the result of the name identification processing in the care insurance system. To do.

  According to the present invention, there is provided a name identification processing method and a name identification processing system capable of reducing the name identification processing load caused by unifying special collection and maintaining the consistency of the name identification processing results among a plurality of systems. Can be provided.

  The premise in the name identification processing method and name identification processing system according to the embodiment of the present invention will be briefly described.

  The name identification processing method and name identification processing system according to the present invention is a basic pension granted to an individual in pensioner information 100 (see FIG. 7) sent from the pensioner information management system 10 (see FIG. 1) to each system. The number 101 is unique, and the Juki personal number 117 (see FIG. 8) given to the individual in the long-term care insurance system 30 (see FIG. 1), the late elderly medical insurance system 40, and the national health insurance system 50. Also take advantage of being unique.

  In addition, those who are subject to special collection for long-term care insurance are 65 years old or older, those who are subject to special collection for National Health Insurance are 65 years old or older and less than 75 years old, and those who are subject to special collection for late elderly medical insurance are 75 years old or older Therefore, as long as it is limited to those who are subject to special collection, those who are eligible for long-term care insurance include all those who are eligible for national health insurance and late-stage elderly medical insurance. Therefore, the pensioner / resident registry correspondence information 140 in which the basic pension number 101 (see FIG. 11) and the residence group personal number 117 are associated with each other is created and output from the result of the name identification process already performed in the care insurance system 30. In the latter-stage elderly medical system 40 and the national health insurance system 50, the pension recipient / residence correspondence information 140 output from the care insurance system 30 is acquired and the name identification process is performed.

  Hereinafter, a name identification processing method and a name identification processing system according to an embodiment of the present invention will be described in detail with reference to FIGS.

FIG. 1 is a diagram showing a system configuration of a name identification processing system according to an embodiment of the present invention.
As shown in FIG. 1, a name identification processing system according to an embodiment of the present invention includes a pensioner information management system 10 managed and operated by a social insurance agency, a dwelling system 20 managed and operated by a municipality, and a long-term care insurance. The system 30, the late elderly medical insurance system 40, and the national health insurance system 50 are connected via a wide area network, here, a WAN (Wide Area Network) 60.

The pensioner information management system 10 is configured such that a server and a plurality of input / output devices are commonly connected by a LAN (Local Area Network) (see FIG. 1).
As shown in FIG. 2, the server uses a calculation control device 11 including a CPU as a control center, and includes at least a storage device 12 and a communication device 13. The storage device 12 includes a pensioner DB (Data Base) 14 and a pensioner provided for each system (care insurance system 30, late elderly medical insurance system 40, national health insurance system 50). Information 100 is allocated and stored. An example of the data structure of the pensioner information 100 will be described later.

The Juki system 20 includes a server and a plurality of input / output devices that are commonly connected by a LAN (see FIG. 1).
As shown in FIG. 3, the server has an arithmetic control device 21 composed of a CPU as a control center, and includes at least a storage device 22 and a communication device 23. In the storage device 22, the Juki DB 24 and the Juki information 110 provided to the system of each system are allocated and stored. An example of the data structure of the Juki information 110 will be described later.

The care insurance system 30 is configured by connecting a server and a plurality of input / output devices 3 (see FIG. 1) through a LAN.
As shown in FIG. 4, the server uses a calculation control device 31 composed of a CPU as a control center, and at least a storage device 32, a communication device 33, a care DB 34, a care name identification processing unit 35, and a special care collection The correspondence information generation unit 36, the pensioner / resident base correspondence information generation unit 37, and the insured person correspondence information generation unit 38 are configured. In the storage device 32, insured person correspondence information 120, special care collection information 130, pensioner / resident base correspondence information 140, and name identification result correspondence information 150 are allocated and stored. An example of the data structure of the insured person correspondence information 120, the special care collection information 130, the pensioner / resident base correspondence information 140, and the name identification result correspondence information 150 will be described later.

The care name identification processing unit 35 is based on the pensioner information 100 (see FIG. 7) acquired from the pensioner information management system 10 (see FIG. 2) and the Juki system 20 (see FIG. 3) via the communication device 33. A name identification process is performed based on the acquired subject information of the long-term care insurance system, and the result is stored in the storage device 32 (name identification result correspondence information 150) via the arithmetic and control unit 31.
The special care collection information generating unit 36 is based on the name collation result correspondence information 150 generated by the care name collation processing unit 35 and the pension recipient information 100. And the special collection amount is stored as one of the data items in the storage device 32 (care special collection correspondence information 130).

Based on the result of the name identification process performed by the care name identification processing unit 35, the pensioner / residence group correspondence information generation unit 37 has a unique basic pension number 101 (see FIG. 7) and a personal identification number 117 (see FIG. 8). The pensioner / residence group correspondence information 140 (see FIG. 11) associated with each other is generated and stored in the storage device 32 via the arithmetic control device 31. The pensioner / resident group correspondence information generation unit 37 also obtains the pensioner information 100 from the name identification result correspondence information 150 (see FIG. 12) for each basic pension number included in the pensioner information 100 (see FIG. 7). The insured person number 151 corresponding to the basic pension number 101 is extracted, the insured person personal number 127 is extracted from the insured person correspondence information 120 (see FIG. 9) regarding the extracted insured person number 151, and the pensioner is received.・ The basic pension number 152 of the name identification result correspondence information 150 is set to the basic pension number 141 of the Juki correspondence information 140 (see FIG. 11), and the insured person is assigned to the Juki personal number 142 of the pension recipient / residential group correspondence information 150 The insured individual number 127 of the correspondence information 120 is set.
The arithmetic and control unit 31 transmits the pensioner / resident base correspondence information 140 to the late elderly medical insurance system 40 (see FIG. 1) and the national health insurance system 50 via the communication device 33, or input / output. It can be stored in a portable storage medium such as a DVD disk or a portable external hard disk via the device 3.

The latter-stage elderly medical insurance system 40 is configured by commonly connecting a server and a plurality of input / output devices 4 (see FIG. 1) via a LAN.
As shown in FIG. 5, the server has an arithmetic control device 41 composed of a CPU as a control center, and at least a storage device 42, a communication device 43, a late elderly DB 44, a late elderly name identification processing unit 45, and a late term. An elderly special collection correspondence information generation unit 46, a late elderly matching processing unit 47, and an insured person correspondence information generation unit 48 are configured. In the storage device 42, insured person correspondence information 160, name identification result correspondence information 180, and late elderly special collection correspondence information 200 are allocated and stored. An example of the data structure of the insured person correspondence information 160, the name identification result correspondence information 180, and the late elderly special collection correspondence information 200 will be described later.

The communication device 43 receives the pension recipient / resident base correspondence information 140 that associates the unique basic pension number 141 (see FIG. 11) and the personal residence personal number 142 via the WAN 60 from the care insurance system 30 (see FIG. 1). It has a function to acquire by communication.
The latter-stage elderly matching processing unit 47 performs the name identification process based on the pensioner information 100 and the target person information of the latter-stage elderly medical insurance system acquired from the Juki system 20, and the acquired pensioner / resident It has a function of matching the special collection target person information based on the base correspondence information 140 and generating name identification result correspondence information 180 (see FIG. 12) that unifies the special collection target person information. On the other hand, the late elderly name identification processing unit 45 did not acquire the pension recipient / residence correspondence information 140 in which the unique basic pension number 141 and the resident personal number 142 are associated with each other via the WAN 60 from the care insurance system 30. In this case, the name identification process was performed based on the basic pension number 101 included in the pensioner information 100 and the target information of the late elderly medical insurance system acquired from the Juki System 20, and the special collection target person information was unified. It has a function of generating name identification result correspondence information 180.

  The late elderly special collection correspondence information generation unit 46 is based on the name identification result correspondence information 180 generated by the late elderly matching processing unit 47 or the late elderly name identification processing unit 45 and the pension recipient information 100. A special collection amount according to the system is calculated in accordance with the state, and the late elderly special collection correspondence information 200 (see FIG. 10) with the calculated special collection amount as one of the data items is generated and stored in the storage device 42 It has the function to do.

The national health insurance system 50 is configured such that a server and a plurality of input / output devices 5 (see FIG. 1) are commonly connected by a LAN.
As shown in FIG. 6, the server uses a calculation control device 51 composed of a CPU as a control center, and at least a storage device 52, a communication device 53, a national health insurance DB 54, a national health insurance name identification processing unit 55, and a national health insurance special collection. The correspondence information generation unit 56, the national insurance matching processing unit 57, and the insured person correspondence information generation unit 58 are configured. In the storage device 52, insured person correspondence information 170, name identification result correspondence information 190, and National Health Insurance special collection correspondence information 210 are allocated and stored. An example of the data structure of the insured person correspondence information 170, the name identification result correspondence information 190, and the National Health Insurance special collection correspondence information 210 will be described later.

The communication device 53 receives the pension recipient / resident base correspondence information 140 that associates the unique basic pension number 141 (see FIG. 11) with the personal residence number 142 via the WAN 60 from the care insurance system 30 (see FIG. 1). It has a function to acquire by communication.
The National Health Insurance matching processing unit 57 performs the name identification process based on the pensioner information 100 and the target information of the national health insurance system acquired from the Juki system 20, and receives the pension receipt acquired through the communication device 53. Matching processing of the special collection target person information based on the person / resident base correspondence information 140, and a function of generating name identification result correspondence information 190 (see FIG. 12) in which the special collection target person information is unified. In addition, the National Health Insurance name identification processing unit 55 has not acquired the pension recipient / residence correspondence information 140 in which the unique basic pension number 141 and the resident personal number 142 are associated with each other via the WAN 60 from the care insurance system 30. , Name identification process based on the basic pension number 101 included in the pensioner information 100 and the target information of the National Health Insurance system acquired from the Juki System 20 It has a function of generating information 190.

  The National Health Insurance special collection correspondence information generation unit 56 is adapted to the state of the pension recipient based on the name identification result correspondence information 190 generated by the National Health Insurance matching processing unit 57 or the National Health Insurance name identification processing unit 55 and the pension recipient information 100. It has a function of calculating a special collection amount according to the system, generating national insurance special collection correspondence information 210 (see FIG. 10) having the special collection amount as one of the data items, and storing it in the storage device 52.

  7-12 is a figure which shows an example of the data structure of the various correspondence information used in the name collation processing system which concerns on embodiment of this invention, pension recipient information (FIG. 7), Juki information (figure) 8), insured person correspondence information (FIG. 9), special collection correspondence information (FIG. 10), pensioner / resident base correspondence information (FIG. 11), name identification result correspondence information (FIG. 12).

  In FIG. 7, the pensioner information 100 is distributed by the pensioner information management system 10 (see FIG. 1) to each system of the care insurance system 30, the late elderly medical insurance system 40, and the national health insurance system 50. It is correspondence information. As shown in FIG. 7 (a), the pensioner information 100 includes a basic pension number 101 that is uniquely set, a date of birth 102 used in the name identification process, a gender 103, a name 104, an address 105, and An annual amount 106 paid to the pensioner is included as a data item. An example of specific data is shown in FIG.

  In FIG. 8, Juki information 110 is correspondence information distributed to each system of the long-term care insurance system 30, the late elderly medical insurance system 40, and the national health insurance system 50 by the Juki system 20 (see FIG. 1). As shown in FIG. 8 (a), the Juki information 110 includes an insurer number 111, a Juki municipality code 112, a date of birth 113, a sex 114, a name 115, an address 116, and a uniquely set residence. The basic personal number 117 is included as a data item. An example of specific data is shown in FIG.

In FIG. 9, insured person correspondence information 120, 160, and 170 are correspondence information generated in the long-term care insurance system 30, the late elderly medical insurance system 40, and the national health insurance system 50, respectively.
As shown in FIG. 9A, the insured person correspondence information 120, 160, 170 includes insurer numbers 121, 161, 171 and the insured person number 122 set uniquely in each system, respectively. , 162, 172, date of birth 123, 163, 173, gender 124, 164, 174, name 125, 165, 175, address 126, 166, 176, insured individual number 127, 167, 177 Including. An example of specific data is shown in FIG.

In FIG. 10, special collection correspondence information 130, 200, and 210 is correspondence information generated in the long-term care insurance system 30, the late elderly medical insurance system 40, and the national health insurance system 50, respectively.
As shown in FIG. 10 (a), the special collection correspondence information 130, 200, 210 includes basic pension numbers 131, 201, 211, dates of birth 132, 202, 212, genders 133, 203, 213, respectively. Each data item includes names 134, 204, 214, addresses 135, 205, 215, and amounts 136, 206, 216. An example of specific data is shown in FIG.

In FIG. 11, the pensioner / resident base correspondence information 140 is correspondence information generated by the long-term care insurance system 30, and is referred to in each of the late elderly medical insurance system 40 and the national health insurance system 50.
As shown in FIG. 11A, the basic pension number 141 and the Juki personal number 142 are set as data items in the pensioner / resident group correspondence information 140. An example of specific data is shown in FIG.

In FIG. 12, name identification result correspondence information 150, 180, and 190 are correspondence information generated in the care insurance system 30, the late elderly medical insurance system 40, and the national health insurance system 50, respectively.
As shown in FIG. 12A, the name identification result correspondence information 150, 180, 190 includes insured person numbers 151, 181, 191 and basic pension numbers 152, 182, 192 as data items. An example of specific data is shown in FIG.

  Hereinafter, the operation of the name identification processing system according to the embodiment of the present invention will be described in detail with reference to flowcharts. First, the operation of the care insurance system 30 will be described with reference to the flowchart shown in FIG. 13 (see FIG. 4 as appropriate).

  In the flowchart of FIG. 13, the care insurance system 30 (calculation control device 31) first acquires the Juki information 110 delivered from the communication device 33 via the WAN 60 (step S131). Alternatively, the Juki information 110 is acquired via the input / output device 3 (see FIG. 1). The arithmetic and control unit 31 activates the insured person correspondence information generation unit 38 when the Juki information 110 (see FIG. 8) is acquired, and the insured person correspondence information generation unit 38 responds to the insured person from the contents of the Juki information 110. Information 120 (see FIG. 9) is generated (step S132). At that time, the insurer number 121, the date of birth 123, the sex 124, the name 125, the address 126, and the insured individual number 127 of the insured person correspondence information 120 include the insurer number 111 and the year of birth of the residence group information 110, respectively. The date 113, gender 114, name 115, address 116, and Juki personal number 117 are stored. For the insured person number 122 of the insured person correspondence information 120, a unique value managed by the care insurance system 30 is set.

  Next, the arithmetic and control unit 31 activates the communication device 33 and acquires the pensioner information 100 (see FIG. 7) via the WAN 60 by communication from the pensioner management system 10 (see FIG. 1) (step S133). . Alternatively, pension recipient information 100 is acquired via the input / output device 3. Subsequently, the nursing name identification processing unit 35 performs name identification processing using the pensioner information 100 and the insured person correspondence information 120, and generates name identification result correspondence information 150 (see FIG. 12) (step S134). In this name identification process, whether or not the information relates to the same person according to the degree of coincidence of the information on the four items of “birth date”, “gender”, “name”, and “address” (hereinafter referred to as four basic items) Is judged.

Details of the name identification process by the care name identification processing unit 35 will be described below. FIG. 14 is a block diagram showing a functional development of the configuration around the care name identification processing unit 35 of the care insurance system 30.
As shown in FIG. 14, the care name identification processing unit 35 functionally includes a basic item extraction unit 351, a notation changing unit 352, a matching processing unit 353, a GUI (Graphical User Interface) providing unit 354, and the like. Consists of. In FIG. 14, blocks denoted by the same reference numerals as those shown in FIG. 4 are blocks having the same names and functions as the blocks shown in FIG. 4. The functions and processing contents of the functional blocks described above are as described below.

That is, the basic item extraction unit 351 of the care name identification processing unit 35 extracts the four basic items of the pensioner information 100 and the insured person correspondence information 120 from the acquired pensioner information 100 and the insured person correspondence information 120, respectively. 4 basic items are extracted. Here, when comparing the extracted two, the name and address are not completely matched as they are due to differences in notation. For this reason, the notation conversion unit 352 converts all roaring sounds such as “Yu” and “Yo” into clear sounds such as “Yu” and “Yo”, and forms such as “Ding” and “Machime”. The address notation is all converted to “−”, for example, to perform a conversion process for unifying the notation method, and then the matching processing unit 353 performs a matching process for four basic items.
As a result, since the four basic items of the pensioner information 100 and the four basic items of the insured person correspondence information 120 match, it is mechanically recognized as information relating to the same person, and the name identification result correspondence information 150 The insured number 122 of the insured person correspondence information 120 is stored in the insurer number 151, and the basic pension number 101 of the pension recipient information 100 is stored in the basic pension number 152 of the name identification result correspondence information 150.

  However, even if the notation conversion unit 352 performs the conversion process for unifying the notation method described above, even if the information should be determined to be related to the same person due to a registration error or the like, the basic 4 Items may not be identical. In that case, for example, the person in charge must check the contents of the correspondence information displayed on the display monitor one by one via the GUI providing unit 354, and manually perform name identification processing by manual editing or the like based on human judgment. In other words, the workload is relatively large.

  After the above-described name identification process, the arithmetic and control unit 31 activates the pensioner / residential group correspondence information generation unit 37, and the pensioner / residential group correspondence information generation unit 37 is generated by the care name identification processing unit 35. Using the name identification result correspondence information 150, the insured person correspondence information 120, and the pension recipient information 100, the pension recipient / residence correspondence information 140 is generated (step S135).

Hereinafter, the pension recipient / residential base correspondence information generation process by the pensioner / residential base correspondence information generation unit 37 will be described in detail with reference to the flowchart shown in FIG.
The pensioner / resident base correspondence information generation unit 37 first rearranges the records of the pensioner information 100 (see FIG. 7) in ascending order of the basic pension number 101 (step S151). Then, the basic pension number 101 of the first record included in the pension recipient information 100 is extracted (step S152). Subsequently, the insured person number 151 corresponding to the basic pension number 101 of the pensioner information 100 is extracted from the name identification result correspondence information 150 (see FIG. 12) (step S153).

Next, the pensioner / resident base correspondence information generating unit 37 extracts the insured individual number 127 from the insured person correspondence information 120 regarding the insured person number 151 extracted as described above (step S154). Then, the basic pension number 152 of the name identification result correspondence information 150 is stored in the basic pension number 141 of the pension recipient / residence correspondence information 140 (see FIG. 11), and the inhabitant correspondence number 120 of the insured person correspondence information 120 is stored. The insured individual number 127 is stored (step S155).
Thereafter, it is determined whether or not processing has been performed on the last record of the pensioner information 100 (step S156). Here, in the case of “NO” determination, the processing after step S153 is repeated again for the basic pension number 101 of the next record included in the pensioner information 100 (step S157). In the case of “YES” determination in the determination process of step S156, the creation process by the pensioner / resident base correspondence information generation unit 37 is terminated.

  Here, the basic pension number 141 and the Juki personal number 142 of the pensioner / residence correspondence information 140 are unique in each of the long-term care insurance system 30, the late elderly medical insurance system 40, and the national health insurance system 50. Therefore, the correspondence relationship is maintained between the three systems. The name identification processing system according to the embodiment of the present invention pays attention to this, and the pensioner / resident base correspondence information 140 generated by the care insurance system 30 is used as the late elderly medical insurance system 40, the national health insurance system 50. This is a system construction that can be used in

The description returns to the flowchart of FIG. 13 (see FIG. 4 as appropriate). After the above-described pensioner / resident base correspondence information 140 is generated, the arithmetic and control unit 31 starts a special care collection information generation process by the special care collection information creation unit 36. At this time, the special care support collection information generation unit 36 uses the name identification result support information 150 and the pension recipient information 100 to generate special care collection information 130 (see FIG. 10) (step S136).
In the special care support collection information generation unit 36, the basic pension number 131, the date of birth 132, the gender 133, the name 134, and the address 135 of the special care collection information 130 are respectively pension recipient information 100 (see FIG. 7). The basic pension number 101, date of birth 102, gender 103, name 104, and address 105 are stored. In addition, the arithmetic and control unit 31 of the care insurance system 30 calculates a special collection amount according to the system according to the pensioner's condition based on the annual amount 106 of the pensioner information 100, and the amount is calculated as a special care collection amount. Stored in the amount 136 of the correspondence information 130.

  Then, the arithmetic and control unit 31 transmits the special care collection information 130 and the pensioner / resident group correspondence information 140 to the other cooperation system (see FIG. 1) via the WAN 60 by the communication device 33, or the input / output device. 3 is stored in a storage medium having portability (step S137).

  Thus, the name identification process and the pensioner / resident group correspondence information generation process by the care insurance system 30 are completed.

Next, the latter-stage elderly medical insurance system 40 will be described. FIG. 16 is a block diagram showing a functional development of the configuration around the arithmetic and control unit 41 included in the late elderly medical insurance system.
As shown in FIG. 16, the late elderly medical insurance system 40 includes a late elderly name identification processing unit 45, a late elderly special collection correspondence information generation unit 46, a late elderly matching processing unit 47, and insured person correspondence information generation. And a functional block including the unit 48.
Further, in FIG. 16, the correspondence information denoted by the same reference numerals as the blocks shown in FIG. 5 has the same name and data structure as the correspondence information shown in FIG. 5.

  The functions and processing contents of the functional blocks 45 to 48 described above are shown in the flowchart shown in FIG. 17 (see FIG. 16 as appropriate).

  In the flowchart of FIG. 17, the arithmetic and control unit 41 first activates the communication device 43 and acquires the Juki information 110 (see FIG. 8) from the Juki system 20 (see FIG. 1) via the WAN 60 (Step S <b> 171). . Alternatively, the Juki information 110 is acquired via the input / output device 4 (see FIG. 1). Then, at the time of acquisition of the Juki information 110, the insured person correspondence information generation unit 48 generates the insured person correspondence information 160 (see FIG. 9) from the Juki information 110 (step S172). At that time, the insurer number 161, the date of birth 163, the gender 164, the name 165, the address 166, and the insured individual number 167 of the insured person correspondence information 160 are the insurer number 111 and the year of birth of the residence group information 110, respectively. The date 113, gender 114, name 115, address 116, and Juki personal number 117 are stored. For the insured person number 162 of the insured person correspondence information 160, a unique value managed in the late elderly medical insurance system 40 is set.

  Next, the arithmetic and control unit 41 acquires the pensioner information 100 from the pensioner information management system 10 (see FIG. 1) via the WAN 60 by the communication device 43 (step S173). Alternatively, the pensioner information 100 is acquired via the input / output device 4 (see FIG. 1). Subsequently, whether or not the arithmetic and control unit 41 acquires the pensioner / resident base correspondence information 140 (see FIG. 11) generated in the care insurance system 30 via the communication device 43 or the input / output device 4. A determination is made (step S174). Here, the acquisition of the pensioner / residence correspondence information 140 is assumed to be acquired at an arbitrary communication timing between the late elderly medical insurance system 40 and the care insurance system 20.

  In the determination process in step S174, if “YES”, the late senior matching processing unit 47 is activated, and the late senior matching processing unit 47 includes the pension recipient / residential group correspondence information 140, the pension recipient information 100, and the insured. The matching process (comparison collation) is performed using the person correspondence information 160 (step S177), and the name identification result correspondence information 180 (see FIG. 12) is generated.

  The late elderly matching processing unit 47 uses the correspondence relationship between the basic pension number 141 of the pensioner / residence group correspondence information 140 and the resident personal number 142, such as the name identification process described in the care insurance system 30. Without performing complicated processing, the correspondence between the pensioner information 100 and the insured person correspondence information 160 can be confirmed uniquely, and the insured person number 181 of the name identification result correspondence information 180 has the insured person correspondence information 160 insured. The insurer number 162 can be stored, and the basic pension number 101 of the pensioner information 100 can be stored in the basic pension number 182 of the name identification result correspondence information 180.

  Therefore, since the judgment process of the person in charge accompanying the name identification process is not newly entered in the late-stage elderly medical insurance system 40 by the name identification process method according to the embodiment of the present invention, the result of the name identification process in the care insurance system 30 It is possible to match, and the consistency of the name identification results between the systems can be maintained. Moreover, since the manual work by the person in charge can be eliminated, the name identification processing load can be reduced.

  On the other hand, in the case of “NO” determination in the determination process of step S174, the late elderly name collation processing unit 45 is activated, and the late elderly name collation processing unit 45 receives an annuity as in the case of the name collation processing of the care insurance system 30 described above. Name identification processing is performed using the person information 100 and the insured person correspondence information 160, and the name identification result correspondence information 180 needs to be created manually by some persons in charge using the GUI environment. Is high (step S175). Moreover, when the person in charge of name identification processing in the nursing care insurance system 30 is different from the person in charge of name identification processing in the late elderly medical insurance system 40, the judgment result for the same special collection target person is different, resulting in a problem in consistency in the result of name identification processing. there is a possibility.

  According to the name identification processing method (late elderly medical care system 40) according to the embodiment of the present invention, either the late elderly name identification processing unit 45 or the late elderly matching processing unit 47 is activated by the determination process in step S174. Depending on whether or not (whether or not the pensioner / resident base correspondence information 140 generated by the care name collation processing result is acquired from the care insurance system 30), the workload of the pensioner name collation process is determined.

Further, the late elderly special collection correspondence information generation unit 46 acquires the name matching result correspondence information 180 generated by the late elderly name collation processing unit 45 or the late elderly matching processing unit 47 and the pensioner information management system 10. Using the pensioner information 100, the late-aged special collection correspondence information 200 (see FIG. 10) is generated (step S176).
The late elderly special collection correspondence information generation unit 46 includes the pension recipient information 100 (see FIG. 7) in the basic pension number 201, the date of birth 202, the gender 203, the name 204, and the address 205 of the late elderly special collection correspondence information 200, respectively. ) Basic pension number 101, date of birth 102, gender 103, name 104, and address 105. In addition, the arithmetic and control unit 41 of the latter-stage elderly medical insurance system 40 calculates a special collection amount according to the system according to the state of the pensioner based on the annual amount 106 of the pensioner information 100, and calculates the amount. It is stored in the amount 206 of the late elderly special collection correspondence information 200.

  Then, the arithmetic and control unit 41 transmits the content of the late elderly special collection correspondence information 200 to the other linkage system (see FIG. 1) via the WAN 60 by the communication device 43 or has portability via the input / output device 4. Store in the storage medium (step S178). Thus, the processing of the late elderly medical insurance system 40 is completed.

Next, the national health insurance system 50 will be described. FIG. 18 is a block diagram showing the functional development of the configuration around the arithmetic and control unit 51 included in the national health insurance system 50.
As shown in FIG. 18, the national health insurance system 50 includes a National Health Insurance name identification processing unit 55, a National Health Insurance special collection correspondence information generation unit 56, a National Health Insurance matching processing unit 57, and an insured person correspondence information generation unit 58. Consists of functional blocks. Further, in FIG. 18, the correspondence information denoted by the same reference numerals as those in the block illustrated in FIG. 6 has the same name and data configuration as the correspondence information illustrated in FIG. 6.

The functions and processing contents of the respective functional blocks 55 to 58 are shown in the flowchart shown in FIG. 19 (see FIG. 18 as appropriate).
In the flowchart of FIG. 19, the arithmetic and control unit 51 first acquires the dwell base information 110 (see FIG. 8) from the dwell base system 20 (see FIG. 1) via the WAN 60 by the communication device 53 (step S <b> 191). Alternatively, the Juki information 110 is acquired via the input / output device 5 (see FIG. 1). When the Juki information 110 is acquired, the insured person correspondence information generation unit 58 is activated, and the insured person correspondence information generation unit 58 generates the insured person correspondence information 170 (see FIG. 9) from the Juki information 110. (Step S192). At that time, the insurer number 171, the date of birth 173, the sex 174, the name 175, the address 176, and the insured individual number 177 of the insured person correspondence information 170 are the insurer number 111 and the year of birth of the residence group information 110, respectively. The date 113, gender 114, name 115, address 116, and Juki personal number 117 are stored. For the insured number 172 of the insured person correspondence information 170, a unique value managed in the national health insurance system 50 is set.

  Next, the arithmetic and control unit 51 acquires the pensioner information 100 from the pensioner information management system 10 (see FIG. 1) via the WAN 60 by the communication device 53 (step S193). Alternatively, the pensioner information 100 is acquired via the input / output device 5 (see FIG. 1). Subsequently, whether or not the arithmetic and control unit 51 has acquired the pensioner / resident base correspondence information 140 (see FIG. 11) generated in the care insurance system 30 via the communication device 53 or the input / output device 5. Is determined (step S194).

  If “YES” is determined in the determination process of step S194, the National Health Insurance matching processing unit 57 is activated, and the National Health Insurance matching processing unit 57 includes the pensioner / resident base correspondence information 140, the pensioner information 100, and the insured person. Matching processing is performed using the correspondence information 170 (step S197), and name identification result correspondence information 190 (see FIG. 12) is generated.

  The National Health Insurance matching processing unit 57 uses the correspondence relationship between the basic pension number 141 of the pension recipient / residence correspondence information 140 and the resident personal number 142, so that the complicated process such as the name identification process of the care insurance system 30 described above is performed. The correspondence relationship between the pensioner information 100 and the insured person correspondence information 170 can be confirmed uniquely without performing processing, and the insured person number 191 of the name identification result correspondence information 190 is the insured person number of the insured person correspondence information 170. 172 is stored, and the basic pension number 101 of the pension recipient information 100 is stored in the basic pension number 192 of the name identification result correspondence information 190.

  Therefore, according to the name collation processing method according to the embodiment of the present invention, in the national health insurance system 50, since the person in charge associated with the name collation process is not newly entered, it is matched with the result of the name collation processing in the care insurance system 30. It is possible to maintain the consistency of the name identification results between the systems. Moreover, since the manual work by the person in charge can be eliminated, the name identification processing load can be reduced.

  On the other hand, in the case of “NO” determination in the determination process of step S194, the National Health Insurance name collation processing unit 55 is activated, and the National Health Insurance name collation processing unit 55 is connected to the pension recipient information 100 in the same manner as the name collation processing of the care insurance system 30. Using the insured person correspondence information 170, it is necessary to carry out name identification processing in the National Health Insurance name identification processing unit 55 and to create name identification result correspondence information 190 manually by a part of the person in charge, which is very expensive. (Step S195). Also, if the person in charge of name identification processing in the care insurance system 30 and the person in charge of name identification processing in the national health insurance system 50 are different, there is a possibility that the judgment result for the same person will be different and there will be a problem in consistency in the result of name identification processing.

  According to the name collation processing system (National Health Insurance System 50) according to the embodiment of the present invention, which of the national health insurance name collation processing unit 55 or the national health insurance matching processing unit 57 is activated by the determination processing in step S194 (care Whether or not the pensioner / resident group correspondence information 140 generated from the care name collation process result is obtained from the insurance system 30) determines the size of the workload for the pensioner name collation process.

  On the other hand, the National Health Insurance special collection correspondence information generation unit 56 includes the name identification result correspondence information 190 generated by the National Health Insurance name identification processing unit 55 or the national health insurance matching processing unit 57 and the pensioner acquired from the pensioner information management system 10. Using the information 100, the national insurance special collection correspondence information 210 is generated (step S196).

  The National Health Insurance Special Collection Correspondence Information Generation Unit 56 receives the pension recipient information 100 for the basic pension number 211, date of birth 212, gender 213, name 214, and address 215 of the National Health Insurance special collection correspondence information 210 (see FIG. 10). The basic pension number 101, the date of birth 102, the gender 103, the name 104, and the address 105 of (see FIG. 7) are stored. In addition, the arithmetic and control unit 51 of the national health insurance system 50 calculates a special collection amount according to the system according to the condition of the pensioner based on the annual amount 106 of the pensioner information 100, and the amount is calculated by the National Health Insurance Special Stored in the amount 216 of the collection correspondence information 210.

  Then, the arithmetic and control unit 51 transmits the National Health Insurance special collection correspondence information 210 from the communication device 53 to another cooperative system (see FIG. 1) via the WAN 60, or to a portable storage medium via the input / output device 5. Store (step S198). Thus, the process of the national health insurance system 50 ends.

As described above, according to the name identification processing method and the name identification processing system according to the embodiment of the present invention, from the pensioner information management system 10, the care insurance system 30, the late elderly medical insurance system 40, the national health insurance system. In the pension recipient information 100 transmitted to each of the 50 linked systems, the basic pension number 101 added to the individual is unique, and the Juki personal number 117 added to the individual in each linked system is also Utilizing the uniqueness, the pensioner / residence correspondence information 140 is created by associating the basic pension number 141 and the resident personal number 142 with the long-term care insurance system 30 that has already conducted name identification. -A function to output is added, and the nursing care insurance system is added to the late elderly medical insurance system 40 and the national health insurance system 50 which are partners. By adding a function to acquire pensioner / residence correspondence information 140 output from 30, the workload of name identification processing in late elderly special collection correspondence information 200 and National Health Insurance special collection correspondence information 210 is significantly reduced. Can do.
In addition, the consistency of information in the name identification process can be maintained. From the three linked systems of the long-term care insurance system 30, the late elderly medical insurance system 40, and the national health insurance system 50, the special care collection information 130, Late elderly special collection correspondence information 200 and National Health Insurance special collection correspondence information 210 can be generated and output. Further, by changing the processing method of the name identification process in the latter-stage elderly medical insurance system 40 and the national health insurance system 50 depending on whether or not the pensioner / resident base correspondence information 140 has been acquired, the conventional latter-stage elderly medical insurance system 40 The compatibility with the national health insurance system 50 can be maintained.

  4 and 14, the calculation control device 31, a care name identification processing unit 35 (basic item extraction unit 351, notation conversion unit 352, matching processing unit 353, GUI providing unit 354), pensioner / resident group Correspondence information generation unit 37, calculation control device 41, late elderly name identification processing unit 45, late elderly special collection correspondence information generation unit 46, late elderly matching processing unit 47, insured correspondence information generation unit shown in FIG. 5 and FIG. 48, and FIG. 6 and FIG. 18, the data in each of the arithmetic and control unit 51, the National Health Insurance name identification processing unit 55, the National Health Insurance special collection correspondence information generation unit 56, the National Health Insurance matching processing unit 57, and the insured person correspondence information generation unit 58 The processing may be realized on a computer by one or a plurality of programs, and at least a part thereof may be realized by hardware.

It is a figure which shows an example of the system configuration | structure of the name collation processing system which concerns on embodiment of this invention. It is a block diagram which shows an example of an internal structure of the pensioner information management system shown in FIG. It is a block diagram which shows an example of an internal structure of the Juki system shown in FIG. It is a block diagram which shows an example of an internal structure of the care insurance system shown in FIG. It is a block diagram which shows an example of an internal structure of the latter-stage elderly medical insurance system shown in FIG. It is a block diagram which shows an example of an internal structure of the national health insurance system shown in FIG. It is a figure which shows an example of the data structure of the pensioner information used in the name collation processing system which concerns on embodiment of this invention. It is a figure which shows an example of the data structure of Juki information used in the name collation processing system which concerns on embodiment of this invention. It is a figure which shows an example of the data structure of insured person corresponding information used in the name collation processing system which concerns on embodiment of this invention. It is a figure which shows an example of the data structure of the special collection corresponding | compatible information used in the name collation processing system which concerns on embodiment of this invention. It is a figure which shows an example of the data structure of the pensioner and residence group correspondence information used in the name collation processing system which concerns on embodiment of this invention. It is a figure which shows an example of the data structure of the name collation result corresponding | compatible information used in the name collation processing system which concerns on embodiment of this invention. It is a flowchart which shows the name collation process operation | movement of the name collation processing system (care insurance system) which concerns on embodiment of this invention. It is the block diagram which expanded and showed the internal structure of the name collation processing system (care insurance system) which concerns on embodiment of this invention. It is a flowchart which shows the generation | occurrence | production operation | movement of pension recipient and residence group correspondence information of the name collation processing system (care insurance system) which concerns on embodiment of this invention. It is the block diagram which expanded the function and showed the internal structure of the name collation processing system (late elderly medical insurance system) which concerns on embodiment of this invention. It is a flowchart which shows operation | movement of the name collation processing system (late elderly medical care system) which concerns on embodiment of this invention. It is the block diagram which expanded the function and showed the internal structure of the name collation processing system (national health insurance system) which concerns on embodiment of this invention. It is a flowchart which shows operation | movement of the name collation processing system (national health insurance system) which concerns on embodiment of this invention.

Explanation of symbols

1 Name identification processing system 3, 4, 5 Input / output device 10 Pensioner information management system 11, 21, 31, 41, 51 Arithmetic control device 12, 22, 32, 42, 52 Storage device 20 Juki system,
30 Nursing care insurance system 33, 43, 53 Communication device 35 Nursing care name identification processing unit 36 Special care collection information generation unit 37 Pension recipient / residence correspondence information generation unit 38, 48, 58 Insured correspondence information generation unit 40 Late elderly Healthcare insurance system 45 Late elderly name identification processing section 46 Late elderly special collection correspondence information generation section 47 Late elderly matching processing section 50 National health insurance system 55 National health insurance name identification processing section 56 National insurance special collection correspondence information generation section 57 National insurance matching processing section 60 network (WAN)
100 Pensioner information 110 Residential base information 120, 160, 170 Insured correspondence information 130, 200, 210 Special collection correspondence information 140 Pensioner / resident base correspondence information 150, 180, 190

Claims (13)

Based on the results of the name identification process in the long-term care insurance system, the name identification processing method for performing the name identification process in the late elderly medical insurance system / national health insurance system,
The care insurance system includes:
Juki information associated with personal information of Juki personal number is received from the Juki system via a communication device, or input via an input / output device and stored in a storage device,
The pensioner information in which the basic pension number is linked to the personal information is received from the pensioner information management system via the communication device, or input via the input / output device and stored in the storage device,
Using the Juki information stored in the storage device, insured correspondence is made by associating personal information of the Juki information, Juki personal number, and an insured person number unique to the care insurance system. Create information,
Name identification processing is performed using personal information included in the pensioner information stored in the storage device and the created insured person correspondence information, and the insured person number of the insured person correspondence information and the pensioner Create name identification result correspondence information showing correspondence with basic pension number of information,
Using the created name identification result correspondence information, the insured correspondence information including the created Juki personal information, and the stored pension recipient information, the basic pension number of the pensioner information and the residence Create pensioner / residence correspondence information that shows the correspondence between the base information and the resident personal number,
The created pension recipient / residence group correspondence information is subjected to name identification processing, transmitted to at least one of the latter-stage elderly medical health system and the national health insurance system via the communication device, or via an input / output device. And storing the information in a portable storage medium. The care insurance system includes:
Using the pensioner information including the created name identification result correspondence information and the annual amount linked to the basic pension number and personal information, calculation control of the special collection amount of the pensioner in accordance with the long-term care insurance system The device calculates and creates special collection correspondence information that links the basic pension number, the personal information, and the special collection amount,
The created special collection correspondence information is transmitted to at least one of the late elderly medical health system and the national health insurance system via the communication device, or is stored in a portable storage medium via the input / output device. The name identification processing method according to claim 1, wherein the name identification processing method is stored. A name identification processing method for performing name identification processing using pensioner / residence correspondence information created by the name identification processing method according to claim 1,
Late elderly medical insurance system or national health insurance system
Juki information associated with personal information of Juki personal number is received from the Juki system via a communication device, or input via an input / output device and stored in a storage device,
The pensioner information in which the basic pension number is linked to the personal information is received from the pensioner information management system via the communication device, or input via the input / output device and stored in the storage device,
Using the Juki information stored in the storage device, the personal information of the Juki information, the Juki personal number, and the insured person number unique to the late elderly medical insurance system or the National Health Insurance system Create insured person correspondence information linked with
When the pensioner / residence correspondence information created in the long-term care insurance system is acquired via the communication device or the input / output device,
From the pensioner / resident base correspondence information, the pensioner information, and the created insured correspondence information, the insured number of the insured correspondence information and the basic pension number of the pensioner information A name identification processing method characterized by creating name identification result correspondence information indicating a correspondence relationship. The late elderly medical insurance system or the national health insurance system is:
When the pensioner / residence correspondence information created in the care insurance system has not been acquired via the communication device or the input / output device,
Name identification processing is performed using personal information included in the pensioner information stored in the storage device and the created insured person correspondence information, and the insured person number of the insured person correspondence information and the pensioner 4. The name identification processing method according to claim 3, wherein name identification result correspondence information indicating a correspondence relationship between information and a basic pension number is created. The late elderly medical insurance system or the national health insurance system is:
Using the pension recipient information including the created name identification result correspondence information and the annual amount linked to the basic pension number and personal information, pension receipt in accordance with the late elderly medical insurance system or national health insurance system The calculation and control device calculates the special collection amount of the person, and creates special collection correspondence information that links the basic pension number, the personal information, and the special collection amount,
4. The created special collection correspondence information is transmitted to the pensioner management system via the communication device, or stored in a portable storage medium via the input / output device. Or the name collation processing method of Claim 4. Based on the results of the name identification process in the long-term care insurance system, the name identification processing system that performs the name identification process in the late elderly medical insurance system / national health insurance system,
The care insurance system includes:
A communication device that receives from the Juki system the Juki information that links the Juki personal number to the personal information, and receives the pensioner information from the pensioner information management system that links the basic pension number to the personal information;
A storage device for storing the residence group information and the pensioner information;
Using the Juki information stored in the storage device, insured correspondence is made by associating personal information of the Juki information, Juki personal number, and an insured person number unique to the care insurance system. An insured person corresponding information generation unit for creating information;
Name identification processing is performed using personal information included in the pensioner information stored in the storage device and the created insured person correspondence information, and the insured person number of the insured person correspondence information and the pensioner A name collation processing system comprising a care name collation processing unit that creates name collation result correspondence information indicating a correspondence relationship between information and a basic pension number. The care insurance system includes:
Using the created name identification result correspondence information, the insured person correspondence information, and the stored pension recipient information, the basic pension number of the pensioner information and the resident personal number of the resident information The name identification processing system according to claim 6, further comprising a pensioner / residential group correspondence information generation unit that creates pensioner / residential group correspondence information indicating the correspondence relationship between the name recognition system and the pensioner / residential group correspondence information. The care insurance system includes:
The created pension recipient / residence group correspondence information is subjected to name identification processing, transmitted to at least one of the latter-stage elderly medical health system and the national health insurance system via the communication device, or via an input / output device. The name identification processing system according to claim 7, wherein the name identification processing system is stored in a portable storage medium. The care insurance system includes:
Using the pensioner information including the created name identification result correspondence information and the annual amount linked to the basic pension number and personal information, the special collection amount of the pensioner in accordance with the long-term care insurance system is calculated. 9. The name identification process according to claim 8, further comprising: a special care collection information generation unit that creates special collection correspondence information that links the basic pension number, the personal information, and the special collection amount. system. The care insurance system includes:
The created special collection correspondence information is transmitted to at least one of the late elderly medical health system and the national health insurance system via the communication device, or is stored in a portable storage medium via the input / output device. The name identification processing system according to claim 9, wherein the name identification processing system is stored. A name identification processing system for performing name identification processing using pensioner / residence correspondence information created by the name identification processing system according to any one of claims 7 to 10,
Late elderly medical insurance system or national health insurance system
A communication device that receives from the Juki system the Juki information that links the Juki personal number to the personal information, and receives the pensioner information from the pensioner information management system that links the basic pension number to the personal information;
A storage device for storing the residence group information and the pensioner information;
Using the Juki information stored in the storage device, the personal information of the Juki information, the Juki personal number, and the insured person number unique to the late elderly medical insurance system or the National Health Insurance system An insured person correspondence information generation unit for creating insured person correspondence information linked with
When the pensioner / residence group correspondence information has been acquired via the communication device or the input / output device,
From the pensioner / resident base correspondence information, the pensioner information, and the created insured correspondence information, the insured number of the insured correspondence information and the basic pension number of the pensioner information A name identification processing system comprising: a matching processing unit that creates name identification result correspondence information indicating a correspondence relationship. The late elderly medical insurance system or the national health insurance system is:
When the pensioner / resident group correspondence information is not acquired via the communication device or the input / output device,
Name identification processing is performed using personal information included in the pensioner information stored in the storage device and the created insured person correspondence information, and the insured person number of the insured person correspondence information and the pensioner The name identification processing system according to claim 11, further comprising a name identification processing unit that creates name identification result correspondence information indicating a correspondence relationship between the information and the basic pension number. The late elderly medical insurance system or the national health insurance system is:
Using the pension recipient information including the created name identification result correspondence information and the annual amount linked to the basic pension number and personal information, pension receipt in accordance with the late elderly medical insurance system or national health insurance system A special collection correspondence information generating unit that calculates the special collection amount of the person and creates a special collection correspondence information in which the calculation control device calculates the basic pension number, the personal information, and the special collection amount. The name collation processing system according to claim 12.

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