JP2513865B2 - Medical office processing equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Outline] The present invention relates to a medical office processing apparatus, which aims to input a common medical care act master code so that insurance-specific data can be referred to. In a medical office processing apparatus that refers to a master file that stores predetermined data corresponding to a code, a conversion file that stores the medical care code by insurance corresponding to each master code corresponding to medical care in a distinguishable manner, and a patient And a code determining unit for converting the master code of the patient, which is input by referring to the conversion file based on the insurance information, into the corresponding medical care code by insurance, Based on the insurance information of the patient, the medical code for each insurance is converted and the master file is referred to.

[Industrial applications]

 The present invention relates to improvements in medical office processing equipment.

2. Description of the Related Art Medical office processing devices for calculating fees (points) for insurance treatment are widely used in hospitals and clinics.

In this fee calculation, it is very difficult to automatically calculate all scoring systems due to the complexity and peculiarities of the reward fee system.

The background to this is the reassessment of the scoring system and the change of behavior in each year of medical law revision, but among them, the difference in the calculated scores due to owned insurance, outpatient care, and hospitalization is remarkable.

For this reason, although it is currently left to the input side to make decisions,
Data input is complicated, and there is a demand for a medical office processing device that solves this problem.

[Conventional technology]

 FIG. 5 is a block diagram of a conventional example.

 FIG. 5 shows a main part of the medical office processing apparatus.

The points (fee) for medical treatment are: health insurance, old-age insurance,
It is determined by different standards for each medical practice, depending on the type of insurance such as occupational accident insurance and the type of hospitalization or outpatient.

Therefore, even for the same medical treatment, different medical treatment codes (hereinafter referred to as insurance-specific medical treatment codes) 21
Is set and corresponding score data is registered in the medical care action master file (hereinafter referred to as master file) 5.

Since this master file 5 is referred to when calculating the fee for the patient, the operator checks the insurance type and inpatient / outpatient type of the patient, and selects and inputs the insurance-specific medical action code 21 for the medical action given to the patient. To do.

When the medical care code by insurance 21, patient ID, etc. is entered,
The reading unit 10 searches the master file 5 by using the insurance-specific medical care action code 21 as a key, reads the corresponding record and passes it to the score calculation unit 9, and the score calculation unit 9 extracts the score data from this record and calculates the charge. To do.

As a result, the reading unit 10 refers to a patient file (not shown), and displays the calculated score along with the medical care action name on the display unit 6.

[Problems to be Solved by the Invention]

Under the conventional scoring system, one master and one score must be used, and even for the same medical treatment, the medical treatment code to be input differs depending on the insurance of the patient.

As described above, since the input code is left to the operator's judgment, there is a problem that the operation cannot be performed efficiently and that if the scoring system is changed, it takes more time to select the input code.

The present invention has been made in view of the above problems, and an object thereof is to provide a medical office processing apparatus capable of inputting a medical care action code without being aware of the insurance type.

[Means for solving the problem]

In order to achieve the above object, the medical office processing apparatus of the present invention comprises: (1) As shown in the configuration diagram of FIG. 1 in the first embodiment, medical treatment by insurance corresponding to each master code 20 corresponding to medical treatment. A code determining unit 1 that converts the input master code 20 into the corresponding insurance-specific medical care action code 21 by referring to the conversion file 4 that stores the action code 21 in a distinguishable manner and the conversion file 4 based on the insurance information of the patient. With.

(2) Also, as shown in the configuration diagram of the second embodiment of FIG.
The master record 5a that stores the data corresponding to the master code 20 in the master record 5b that stores the data corresponding to the master code 20 so that the corresponding medical practice code of other insurance can be discriminated, and the master record based on the input master code 20 5b
And the insurance information 22 of the target patient is referred to, and when the insurance type of the master code 20 does not match the insurance type of the patient, the medical record code corresponding to the patient is referred to by referring to the master record 5b. And a code determining unit 1a for reading the corresponding record.

[Action]

The code determination unit 1 identifies the insurance type from the registered insurance information 22 of the target patient, refers to the conversion file 4, and converts the input master code 20 of the prescribed medical care action into the medical care action code by insurance 21. .

In this way, by inputting the common master code 20, it is possible to refer to the data that is converted into the insurance-specific medical care action code 21 corresponding to the insurance of the target patient and registered by insurance.

Further, a medical care code of specific insurance such as health insurance is input as the master code 20, and the record (master record) 5b of the master code 20 is read.

If this specific insurance is the same as the patient's insurance type, use the master record 5b as it is, and if it is different,
The applicable medical care code for each insurance is determined by referring to the master record 5b, and the applicable record is reread from the master file 5a.

From the above, the operator only needs to use one type of medical care action code, and does not have to be aware of it even if the scoring system is changed.

〔Example〕

 Embodiments of the present invention will be described in detail with reference to the drawings.

[First Embodiment] FIG. 1 is a configuration diagram of a first embodiment. In the figure, reference numeral 4 is a conversion table. For each master code 20 for each medical practice, the medical care code for each insurance 21 corresponds to insurance, that is, X
Those arranged in the order of insurance, Y insurance, Z insurance (including outpatient and inpatient), 3 is a patient file, patient information such as patient name and age,
Insurance information 22 such as insurance type, hospitalization / outpatient type, etc. is registered based on the patient identification code (ID), 1 is the code determination unit, which extracts the insurance information 22 of the target patient by the input patient ID, Based on the master code 20 input at the same time, the conversion file 4 is searched to determine the insurance-specific medical care action code 21 corresponding to the patient. Reference numeral 2 is a reading unit, which is based on the determined insurance-specific medical care action code 21a. The corresponding record is read from the master file 5 and passed to the score calculation unit 9, and the score of the calculation result and the patient information of the patient file 3 are output to the display unit 6.

 In addition, the same reference numeral represents the same object throughout the drawings.

The following operations are performed by the medical office processing device having the above configuration.

(1) The operator inputs the patient ID of the target patient and the master code 20 of the medical treatment for the patient when performing the charge calculation work.

(2) The code determination unit 1 reads the record corresponding to the master code 20 input from the conversion file 4, and refers to the patient file 3 by the patient ID to determine the insurance type,
The hospitalization / outpatient classification is identified, and the insurance-specific medical care action code 21 is detected from the corresponding data position of the read record. The determined insurance-based medical care action code 21a and the data of the patient file 3 are passed to the reading unit 2.

(3) The reading unit 2 determines the determined medical care action code according to insurance 21.
The master file 5 is searched by a, the record is read out and passed to the score calculation unit 9, and the score calculated by the score calculation unit 9 is output to the display unit 6 together with the medical care action name and the like.

As described above, by inputting not the medical care code 21 for each insurance but the common medical care corresponding master code 20 for the same medical care, the score of the corresponding patient is read.

[Second Embodiment] FIG. 2 is a block diagram of the second embodiment, FIG. 3 is a diagram showing an example of a master record of the second embodiment, and FIG. 4 is an operation flow chart of the second embodiment. Is.

In this embodiment, each medical practice code of X insurance (for example, health insurance) is set as each master code 20, and the master code
As shown in FIG. 3, other insurance (Y insurance, Z insurance) is provided at a predetermined data position of the master record 5b that stores 20 data.
Register the corresponding medical care code by insurance 21 of.

In FIG. 2, the master code 20 (101
Is input), the reading unit 2a determines that the master file
Search for 5a, read master record 5b with code 101,
It is passed to the code determination unit 1a.

The code determination unit 1a verifies the insurance information 22 read by the insurance information reading unit 11, and when it matches the insurance type (here, health insurance) of the input master code 20, the code determination unit 1a passes it from the reading unit 2a. The master record 5b is directly passed to the score calculation unit 9, and when they do not match, the medical practice code 21 (code 102) is determined by referring to the predetermined data portion of the master record 5b, and the record of the code 102 from the master file 5a Is read and passed to the score calculation unit 9 instead of the master record 5b.

Thereby, the score calculation unit 9 calculates the score, and the calculated score is displayed on the display unit 6 by the reading unit 2a together with the medical practice name.

As described above, when the master code 2 is the health insurance code, most patients are in health insurance, so that there is an effect that the number of times of file access is reduced and the response becomes faster.

As described above, according to the present invention, since the operator inputs the common master code 20 corresponding to the medical practice, the score for each insurance is calculated, so that the input becomes easy even if the score system becomes complicated.

〔The invention's effect〕

As described above, the present invention provides a medical office processing apparatus which, when a common medical care act master code is input, determines a medical care act code for each insurance based on the patient's insurance information and refers to the master file. The operational effect is great that you can input without considering the type.

[Brief description of drawings]

1 is a block diagram of the first embodiment, FIG. 2 is a block diagram of the second embodiment, FIG. 3 is a diagram showing an example of a master record of the second embodiment, and FIG. 4 is a second block. FIG. 5 is an operation flowchart of the embodiment, and FIG. 5 is a configuration diagram of the conventional example. In the figure, 1,1a is a code determining unit, 2,2a is a reading unit, 3 is a patient file, 4 is a conversion file, 5,5a is a master file, and 6 is a file.
Is a display unit, 7 is an input unit, 8 is an input / output control unit, 9 is a score calculation unit, 10 is a reading unit, and 11 is an insurance information reading unit.

Claims (2)

(57) [Claims] 1. A medical office processing apparatus that refers to a master file (5) in which predetermined data is stored in correspondence with insurance-specific medical care action codes (21) set for each insurance type. A conversion file (4) in which the medical treatment code by insurance (21) corresponding to each (20) is stored in a distinguishable manner, and is input by referring to the conversion file (4) based on the patient insurance information (22). And a code determination unit (1) for converting the master code (20) of the patient into the corresponding medical care code (21) classified by insurance, and the master code of the inputted medical care is used as insurance information of the patient. On the basis of the insurance-based medical care action code, a corresponding medical-related master file is referred to, and a medical office processing apparatus. 2. In a medical office processing apparatus that refers to a master file storing predetermined data corresponding to insurance-specific medical care action codes set for each insurance type, a medical care action code of a specific insurance is used as a master code. And a master file in which data corresponding to the master code is stored so as to be able to discriminate other medical care action codes of insurance, and the master record is read based on the input master code. , Refer to the insurance information of the target patient, and when the insurance type of the master code does not match the insurance type of the patient, refer to the master record to determine the insurance-specific medical care action code corresponding to the patient and respond. A code determining unit for reading a record is provided, and the master record is read based on the input master code. Further, when the insurance type of the master code and the target insurance type do not match, the corresponding record is read out again with reference to the insurance-specific medical care action code stored in the master record. Processing equipment.