JP5964338B2 - Patient classification support system, patient classification support method, and patient classification support program - Google Patents

Description

  The present invention relates to a patient classification support system, a patient classification support method, and a patient classification support program for grasping a health condition based on a receipt.

  Today, electronic reception is being performed in medical institutions. In addition, the results of medical checkups for insured persons are being digitized. And the technique which provides medical information using such information is examined. For example, a health business support system that predicts a medical cost reduction effect by health guidance and selects a guidance target who is highly cost-effective has been studied (for example, see Patent Document 1). In the technology described in this document, the severity and test values of health insurance subscribers using a health business support system that selects health guidance subjects based on the receipt information, medical examination information, and health guidance information. A medical cost model indicating the predicted medical cost for each is created.

  Furthermore, medical / health information analysis software for supporting health plan formulation / evaluation of health insurance associations / mutual aid associations is also being studied (for example, see Non-Patent Document 1). This medical / health information analysis software creates a database that integrates medical information (receipt) and health information (health checkup data), so it can analyze current conditions and create statistical materials with simple operations. Support (planning, execution, evaluation, improvement).

JP 2012-128670 A (first page, FIG. 1)

Mizuho Information & Research Institute, “Enhancement of Health and Health Information Analysis Software“ healthage ”” [online], November 28, 2013, Mizuho Information & Research Institute website, [Search December 22, 2013], Internet <http://www.mizuho-ir.co.jp/company/release/2013/healthage1128.html>

  Here, in order to realize a medical cost reduction by effective health guidance, it is important to analyze the medical cost required for the treatment of each sickness and illness. By using such analysis information, the insurer can perform effective health guidance. However, in addition to the patient's original injury or illness, there are cases where the corresponding injury or illness is intentionally used for therapeutic drugs or medical treatment, and it may be difficult to determine the number of patients by specific injury or illness.

  In addition, each injury or illness can be specified using an injury or illness name code included in the receipt. However, in medical institutions, there are cases in which the rules for describing wound name codes in the reception are not observed. In this case, an appropriate wound name cannot be identified from the wound name code, and classification based on the wound name is difficult.

  The present invention has been made to solve the above-described problems, and its purpose is to provide a patient classification support system, a patient classification support method, and a patient classification for grasping the health condition of an evaluation subject based on a receipt. To provide support programs.

Patients classification support system for solving the above-sick name code for a specific illness to be classified, the a specific victim information storage unit of the therapeutic agent identified illness storing therapeutic agent list recorded, evaluated subjects A receipt information storage unit that stores the dispensing receipt and the medical receipt, and a control unit that classifies the patient as a specific injury patient based on the receipt recorded in the receipt information storage unit . Then, the control unit specifies a medical receipt of the person to be evaluated in the receipt information storage unit, searches for a dispensing receipt in which the medical institution information and the insured person information recorded in the medical receipt are common, and When the dispensing receipt of the same medical treatment date of the medical receipt can be extracted, the therapeutic agent recorded in the therapeutic agent list is identified by the therapeutic agent described in the extracted dispensing receipt, and the same medical receipt of the medical receipt is identified. When the medical treatment receipt of the medical receipt cannot be extracted, the medical institution and the insured that are recorded in the medical receipt in the medical treatment receipt of the medical receipt in the prescription period included in a predetermined period user information searching recorded dispensing receipts, If it can be extracted to identify therapeutic agents based on said dispensing receipts, said therapeutic agent and said Osamu Based on the medicine list for classifying the evaluation target person as the specific sick patient. As a result, it is possible to classify patients with specific injuries in consideration of not only the names of injuries and diseases described in the reception but also therapeutic drugs.

In the above-patient classification support system, pre-SL control unit, the therapeutic agents described above medical receipts, it is preferable to identify the therapeutic agent that is recorded in the therapeutic agent list. Thereby, the patient of a specific injury and illness can be classified based on the therapeutic agent prescribed in the hospital.

In the patient classification support system, when the control unit identifies a specific injury based on the therapeutic agent and the therapeutic agent list and the specific injury is recorded in the medical receipt, It is preferable to classify the person to be evaluated for the reception as a specific patient. Thereby, even when a specific therapeutic agent prescribed in the hospital is applied to a plurality of injuries and diseases, it is possible to specify patients with specific injuries and diseases.

In the above-patient classification support system, the use of the dispensing receipts, based on the therapeutic agent is formulated in hospital, it is possible to classify the patient's specific illness.

In the above patient classification support system, when the dispensing receipt of the same medical treatment date of the medical receipt cannot be extracted, the medical treatment date of the medical reception is set as a predetermined period with respect to the medical treatment date of the medical receipt. it is preferred to search for dispensing receipts of years adjacent.
In the above patient classification support system, if a dispensing receipt of the same medical treatment date of the medical receipt cannot be extracted, it is included in the valid period of the prescription as a predetermined period with respect to the medical treatment date of the medical receipt It is preferable to search for the dispensing receipt of the year and month . Thereby, even when the medical treatment date in the hospital is different from the prescription date of the therapeutic drug outside the hospital, it is possible to identify the therapeutic drug and classify the patient with the specific injury or illness.

  According to the present invention, it is possible to grasp the health condition of the person to be evaluated based on the receipt.

The system schematic of this embodiment. It is explanatory drawing of the data used in this embodiment, (a) is a basic information storage part, (b) is a receipt information storage part, (c) is a related receipt information storage part, (d) is a patient evaluation information storage part. Explanatory drawing of the data recorded on. Explanatory drawing of the process sequence of this embodiment. Explanatory drawing of the process sequence of this embodiment. Explanatory drawing of the process sequence of this embodiment. It is explanatory drawing of the process sequence of this embodiment, Comprising: (a) is condition 2-1 process, (b) is explanatory drawing of condition 2-2 process. Explanatory drawing of the process sequence of this embodiment.

  Hereinafter, an embodiment in which a patient classification support system, a patient classification support method, and a patient classification support program are embodied will be described with reference to FIGS. In the present embodiment, medical remuneration statement data (receipt data) is acquired with employees and dependents of organizations to which health insurance is applied as evaluation subjects, and patients with a predetermined disease based on these data Assume that the number is calculated. Here, “employee” includes “optional continuator” and “special retired employee”.

As shown in FIG. 1, in this embodiment, a management server 20 connected to the person-in-charge terminal 10 is used.
The person-in-charge terminal 10 is a computer terminal used by a person in charge of an insurer who performs health management and health guidance at each business office. The person-in-charge terminal 10 includes an output unit and an input unit. The output unit is a means for outputting various types of information, and includes a display or the like. The input unit is a means for inputting various types of information, and includes a keyboard, a pointing device, and the like.

  The management server 20 is a computer system for providing support for classification of the evaluation target person (patient). The management server 20 includes a control unit 21, a basic information storage unit 22, a receipt information storage unit 23, a related receipt information storage unit 24, and a patient evaluation information storage unit 25.

  The control unit 21 includes a control unit including a CPU, a RAM, a memory such as a ROM, and the like, and executes processing for supporting patient classification. By executing the patient classification support program for this purpose, the control unit 21 functions as a management unit 211, a classification unit 212, and a matching unit 213.

Based on an instruction from the person-in-charge terminal 10, the management unit 211 executes a process of outputting and providing the health status of the evaluation target person.
The classification unit 212 performs a process of performing a process of classifying the evaluation target person into each specific injury by evaluating the receipt data.
The matching unit 213 performs a process of associating a medical receipt and a dispensing receipt with each other in order to identify a therapeutic drug prescribed outside the hospital.

  As shown in FIG. 2A, a specific injury / illness list 221 for classifying patients and a therapeutic drug list 222 (treatment drug list) for each registered disease name are registered in the basic information storage unit 22 as a specific injury / illness information storage unit. Is done.

  In the specific injury / illness list 221, data relating to the injury / illness name of the specific injury / illness is recorded. In the present embodiment, for example, disease names such as “unsuspecting malignant neoplasm” and “unsuspecting specific wound” are recorded. As “unspecified illness (other than malignant neoplasm)”, for example, “depression”, “ischemic heart disease”, “cerebral vascular disease”, etc. Use.

In addition, in the therapeutic drug list 222 by indication disease name, the indication disease name, drug code, drug name, and drug effect classification code are recorded.
In the adaptive disease name data area, data relating to the name of each specific disease is recorded. In the present embodiment, for example, names of wounds such as “diabetes”, “hypertension”, “dyslipidemia” and the like are recorded.

In the drug code data area, data relating to an identifier for specifying a therapeutic drug used for this specific injury or illness is recorded.
In the drug name data area, data relating to the name of the therapeutic drug is recorded.

  In the medicinal effect classification code data area, data relating to an identifier for classifying medicinal effects is recorded.

  As shown in FIG. 2 (b), the receipt information 230 about the medical record of the person to be evaluated in the medical institution (hospital or pharmacy) is recorded in the receipt information storage unit 23. In the present embodiment, the receipt information storage unit 23 records a medical receipt provided by a hospital and a dispensing receipt provided by a pharmacy. The receipt data 230 is recorded when receipt data is acquired from each insurer. The receipt data 230 is configured to include data on registration date, organization code, receipt code, medical institution, medical treatment date, insured person, wound name, medical treatment content, and score.

In the registration date data area, data related to the date on which the receipt data is registered is recorded.
In the organization code data area, data relating to an identifier for identifying the organization to which the evaluation target person (employee) belongs is recorded. In this embodiment, as an organization code, an identifier that can identify each layer from an upper layer to a lower layer is used for the organization to which the employee belongs. For example, an organization code that can specify each hierarchy such as a business office, a department, and a section to which the evaluation target person belongs in order from the upper hierarchy.

In the receipt code data area, data relating to an identifier for identifying each receipt is recorded.
In the medical institution data area, data relating to medical institution information (medical institution code or the like) for specifying the medical institution (hospital or pharmacy) that issued the receipt is recorded.

In the medical care date data area, data relating to the date of medical care (diagnosis and prescription of therapeutic drugs) in this medical institution is recorded. In the dispensing receipt, the “dispensing date” is used, but here, the name “medical treatment date” is used.
In the insured person data area, data relating to insured person information (name, insured person code, etc.) for specifying the insured person is recorded.

In the wound name data area, data related to an identifier (wound name code or wound name) for identifying the wound or disease for which this evaluation target person has received medical care at a medical institution is recorded in the medical receipt.
In the medical treatment content data area, data related to an identifier for specifying a medical practice, a medicine, a specific device, or the like performed for an evaluation subject in a medical institution is recorded.
In the score data area, data related to the claim score generated by the medical treatment contents is recorded. Based on this score, the medical cost can be calculated.

  As shown in FIG. 2 (c), the related-receipt information storage unit 24 records related-receipt management data 240 for specifying a medical receipt and a dispensing receipt that are related to each other. The related receipt management data 240 is recorded when a receipt matching process is performed. The related receipt management data 240 includes data related to medical receipts and dispensing receipts.

In the medical receipt data area, data relating to an identifier (receipt code) for specifying the medical receipt is recorded.
In the dispensing receipt data area, data relating to an identifier for specifying a dispensing receipt (receipt code) prescribed based on the medical receipt is recorded.

  As shown in FIG. 2D, patient evaluation data 250 that classifies patients with a specific disease is recorded in the patient evaluation information storage unit 25. The patient evaluation data 250 is recorded when the patient classification support process is executed. The patient evaluation data 250 includes data related to the year, month, organization code, medical receipt, and specific disease name.

In the year / month data area, data relating to the medical year / month is recorded.
In the organization code data area, data relating to an identifier for identifying the organization to which the evaluation target person (employee) belongs is recorded.
In the medical receipt data area, data relating to an identifier (receipt code) for specifying the medical receipt is recorded.
Data relating to the name of each disease is recorded in the specific disease name data area.

Next, a method for assisting patient classification in the above-described system will be described.
(Registration of receipt data)
First, when registering the receipt data, the person-in-charge terminal 10 is used to upload the receipt data to the management server 20. This receipt data includes information on the medical institution's examinee (evaluation target), the date of medical treatment, the name of the wound, and the content of the medical treatment. In this case, the management unit 211 of the control unit 21 of the management server 20 registers the receipt data 230 in which the organization code of the organization to which the evaluation target person (employee) belongs is registered in the receipt information storage unit 23.

(Patient classification support processing)
Next, with reference to FIG. 3, an outline of a patient classification support process for classifying a patient based on a wound name code and a therapeutic drug will be described. When performing the patient classification support process, the person in charge of each business operator accesses the management server 20 using the person-in-charge terminal 10. Then, the person-in-charge terminal 10 designates the evaluation target year and the organization to which the evaluation target person (employee) belongs. In this case, the management unit 211 of the control unit 21 of the management server 20 sequentially identifies medical receipts in the belonging organization (whole hierarchy, lower hierarchy), and receives the following receipts for the medical receipts to be processed. Repeat the classification process.

  First, the control unit 21 of the management server 20 executes a list matching process for the receipt description information (step S1-1). Specifically, the classification unit 212 of the control unit 21 compares the wound and disease names recorded in the specific wound and disease list 221 recorded in the basic information storage unit 22 with the wound and disease names recorded in the medical receipt.

  Next, the control part 21 of the management server 20 performs the determination process about whether it can classify | categorize into a specific disease (step S1-2). Specifically, the classification unit 212 of the control unit 21 determines that classification is possible for a specific injury or disease when the injury or disease name recorded in the medical receipt is recorded in the injury or disease name data area of the specific injury or disease list 221. .

  If it is determined that the specific injury or illness can be classified ("YES" in step S1-2), the control unit 21 of the management server 20 executes the specific injury and illness classification process (step S1-3). Specifically, the classification unit 212 of the control unit 21 generates patient evaluation data 250 that records the medical receipt medical date, the evaluation subject's organization code, and the medical receipt receipt code, and the patient evaluation information storage unit 25. Register with. Further, the classification unit 212 records the injury / illness name recorded in the medical receipt in the specific disease name data area of the patient evaluation data 250.

  On the other hand, when it is determined that the specific injury or illness cannot be classified based on the description in the medical receipt (in the case of “NO” in step S1-2), the control unit 21 of the management server 20 executes the treatment drug specifying process ( Step S1-4). Specifically, the classification unit 212 of the control unit 21 uses the description of the medical receipt when the medicine is prescribed in the hospital, and uses the description of the dispensing receipt when prescribed in the pharmacy outside the hospital. To do. For this reason, a receipt matching process described later is performed. And the classification | category part 212 specifies the pharmaceutical prescribed with respect to this patient based on the description of a medical receipt, and the description of a dispensing receipt.

  Next, the control part 21 of the management server 20 performs the list collation process about a therapeutic agent (step S1-5). Specifically, the classification unit 212 of the control unit 21 selects the drug name specified by the medical receipt or the dispensing receipt and the drug name recorded in the therapeutic agent list 222 for each indication of disease recorded in the basic information storage unit 22. Compare.

  Next, the control part 21 of the management server 20 performs the determination process about whether it can classify | categorize into a specific disease (step S1-6). Specifically, the classification unit 212 of the control unit 21 can classify a specific injury or illness when the drug name specified by the medical receipt or the dispensing receipt is recorded as the drug name of the therapeutic drug list 222 for each applicable disease name. Is determined.

  If it is determined that the specific injury or illness can be classified ("YES" in step S1-6), the control unit 21 of the management server 20 executes the specific injury and illness classification process (step S1-3). Specifically, the classification unit 212 of the control unit 21 identifies the disease name of the specific injury using the adaptive disease name associated with the drug name in the therapeutic agent list 222 for each adaptive disease name. Then, the classification unit 212 generates patient evaluation data 250 in which the medical receipt medical date, the evaluation subject's organization code, and the medical receipt receipt code are recorded, and is registered in the patient evaluation information storage unit 25. Furthermore, the classification unit 212 records the adaptive disease name associated with the drug name in the specific disease name data area of the patient evaluation data 250.

  On the other hand, when it is determined that the specific medical condition cannot be classified based on the therapeutic drug (in the case of “NO” in step S1-6), the control unit 21 of the management server 20 performs list matching based on the receipt description information and the therapeutic drug. Processing is executed (step S1-7). Specifically, the classification unit 212 of the control unit 21 identifies the description information (sickness name) of the medical receipt that could not be classified into the specific wound based on the therapeutic agent. Then, the classification unit 212 compares the adaptive disease name recorded in the therapeutic agent list for each adaptive disease name 222 recorded in the basic information storage unit 22 with the description information of the medical receipt.

  Next, the control part 21 of the management server 20 performs the determination process about whether it can classify | categorize into a specific disease (step S1-8). Specifically, if the classification unit 212 of the control unit 21 can identify the name of the applicable disease corresponding to the description information of the medical receipt that could not be classified into the specific wound based on the therapeutic agent, it can be classified into the specific wound. judge.

  When it is determined that the specific injury / illness can be classified ("YES" in step S1-8), the control unit 21 of the management server 20 executes the specific injury / illness classification process (step S1-3). Specifically, the classification unit 212 of the control unit 21 generates patient evaluation data 250 that records the medical receipt medical date, the evaluation subject's organization code, and the medical receipt receipt code, and the patient evaluation information storage unit 25. Register with. Further, the classification unit 212 records the name of the wound corresponding to the description information of the medical receipt in the specific disease name data area of the patient evaluation data 250.

On the other hand, when it is determined that the specific injury / illness cannot be classified (in the case of “NO” in step S1-8), the control unit 21 of the management server 20 executes a classification process as others (step S1-9). Specifically, the classification unit 212 of the control unit 21 generates patient evaluation data 250 that records the medical receipt medical date, the evaluation subject's organization code, and the medical receipt receipt code, and the patient evaluation information storage unit 25. Register with. Further, the classification unit 212 records “others” in the specific disease name data area of the patient evaluation data 250.
The above-described receipt classification process is repeated until all the layers to which the evaluation target person belongs are completed.

  And when a receipt classification | category process is complete | finished, the control part 21 of the management server 20 performs a result output process (step S1-10). Specifically, the management unit 211 of the control unit 21 calculates the number of patients by counting the medical reception code for each tissue code and specific disease name recorded in the patient evaluation information storage unit 25. Then, the management unit 211 outputs the organization code and the number of patients calculated for each specific disease name to the person-in-charge terminal 10.

(Receive matching process)
Next, the receipt matching process will be described with reference to FIG. Here, the medical receipt and the dispensing receipt are collated using information (insured person information) for specifying a medical institution and an individual and a medical treatment date.

  First, the control unit 21 of the management server 20 executes a dispensing receipt search process corresponding to a medical receipt (step S2-1). Specifically, the matching unit 213 of the control unit 21 specifies the dispensing receipt in which the same date as the medical treatment date of the medical receipt is recorded in the receipt information storage unit 23. Then, the matching unit 213 searches the specified dispensing receipt for a dispensing receipt in which medical institution information (medical institution code, etc.) and insured information (name, insured code, etc.) of the medical department record are recorded.

  Next, the control part 21 of the management server 20 performs the determination process about whether there exists a dispensing receipt (step S2-2). Specifically, the matching unit 213 of the control unit 21 determines that there is a dispensing receipt when the dispensing receipt in which the medical institution information and the insured person information are recorded can be identified in the same date and time as the medical receipt. .

  When it is determined that there is a dispensing receipt (in the case of “YES” in step S2-2), the control unit 21 of the management server 20 executes an association process (step S2-3). Specifically, the matching unit 213 of the control unit 21 records the medical receipt code and the dispensing code in the related receipt information storage unit 24 in association with each other.

  On the other hand, when it is determined that there is no dispensing receipt (in the case of “NO” in step S2-2), the control unit 21 of the management server 20 executes a dispensing receipt search process for adjacent years (step S2-4). ). Specifically, the matching unit 213 of the control unit 21 specifies a dispensing receipt in which the medical date of the medical receipt and the date adjacent thereto are recorded. Then, the matching unit 213 searches the specified dispensing receipt for a dispensing receipt in which medical institution information (medical institution code, etc.) and insured information (name, insured code, etc.) of the medical department record are recorded.

  Next, the control part 21 of the management server 20 performs the determination process about whether there exists a dispensing receipt (step S2-5). Specifically, the matching unit 213 of the control unit 21 determines that there is a dispensing receipt when the dispensing receipt in which the date, medical institution information, and insured person information adjacent to the medical receipt are identified. To do.

  When it is determined that there is a dispensing receipt (in the case of “YES” in step S2-5), the control unit 21 of the management server 20 executes an association process (step S2-3). On the other hand, when it determines with there being no dispensing receipt (in the case of "NO" in step S2-5), the control part 21 of the management server 20 complete | finishes a receipt matching process.

(Concrete example)
Next, a specific example of the above-described receipt classification process will be described with reference to FIGS. Here, as will be described later, determination processing of Condition 1-1, Condition 2-1 to Condition 2-3 is performed. Here, when classifying each injury and illness, the control unit 21 of the management server 20 generates patient evaluation data 250 in which the medical receipt medical date, the evaluation subject's organization code, and the medical receipt receipt code are recorded. And is registered in the patient evaluation information storage unit 25.

(Condition 1-1 determination process)
Next, the determination process of Condition 1-1 will be described using FIG.
First, the control unit 21 of the management server 20 executes processing for acquiring a disease name code from a medical receipt (step S3-1). Specifically, the classification unit 212 of the control unit 21 acquires a wound name code recorded on a medical receipt to be processed.

  Next, the control part 21 of the management server 20 performs the determination process about whether it is a malignant neoplasm which is not doubtful in a wound name code (step S3-2). Specifically, the classification unit 212 of the control unit 21 records a wound name code (here, a malignant neoplasm that is not suspected) included in the specific wound list 221 recorded in the basic information storage unit 22 in the medical receipt. Check whether it is.

  When it is determined that the malignant neoplasm is not suspicious in the wound name code (in the case of “YES” in step S3-2), the control unit 21 of the management server 20 executes a classification process as a cancer patient (step S3- 3). Specifically, the classification unit 212 of the control unit 21 identifies this medical receipt as a cancer patient. Then, the classification unit 212 records “cancer” in the specific disease name data area of the patient evaluation data 250.

  On the other hand, when it is determined in the wound name code that the malignant neoplasm is not suspicious (in the case of “NO” in step S3-2), the control unit 21 of the management server 20 performs the classification process as a cancer patient (step S3- 3) is skipped.

  Next, the control part 21 of the management server 20 performs the determination process about whether it is a specific wound which is not doubtful in a wound name code (step S3-4). Specifically, the classification unit 212 of the control unit 21 has a wound name code (in this case, a specific wound other than a malignant neoplasm) included in the specific wound list 221 recorded in the basic information storage unit 22 in the medical receipt. Check if it is recorded.

When it is determined that the specific injury / illness is not suspicious in the injury / illness name code (“YES” in step S3-4), the control unit 21 of the management server 20 executes the classification process as the specific injury / illness patient (step S3-5). ). Specifically, the classification unit 212 of the control unit 21 records the specified injury / illness name in the specific disease name data area of the patient evaluation data 250.
On the other hand, if it is determined in the wound name code that it is not a suspicious specific wound ("NO" in step S3-4), the control unit 21 of the management server 20 performs a classification process as a specific wound patient (step S3-5). ) Is skipped.

Next, the control part 21 of the management server 20 performs the receipt matching process shown in FIG. 4 (step S3-6).
Next, the control part 21 of the management server 20 performs the determination process about whether it is prescription of a specific therapeutic agent (step S3-7). Specifically, the classification unit 212 of the control unit 21 determines whether or not a medicine name included in the therapeutic drug list 222 for each indication of disease indicated in the basic information storage unit 22 is included in the medical receipt or the dispensing receipt. Check. When the drug name included in the therapeutic agent list 222 for each indication of disease is recorded, it is determined that the specific therapeutic agent is prescribed.

  When it determines with prescription of a specific therapeutic agent (in the case of "YES" in step S3-7), the control part 21 of the management server 20 performs a basic disease classification | category process (step S3-8). Specifically, the classification unit 212 of the control unit 21 executes a determination process using each condition described later. In the present embodiment, the determination process of conditions 2-1 to 2-3 is executed.

  On the other hand, when it determines with it not being the prescription | regulation of a specific therapeutic agent (in the case of "NO" in step S3-7), the control part 21 of the management server 20 performs other disease classification processes (step S3-9). Specifically, the classification unit 212 of the control unit 21 records “other” in the specific disease name data area of the patient evaluation data 250.

(Condition 2-1 determination process)
Next, the condition 2-1 determination process will be described with reference to FIG.
First, the control part 21 of the management server 20 performs the determination process about whether it is prescription of a diabetes therapeutic drug (step S4-1). Specifically, the classification unit 212 of the control unit 21 sets the medicine code of the medicine name associated with the indication name “diabetes” in the medical treatment receipt or the dispensing receipt in the therapeutic agent list 222 for each indication of the indication in the basic information storage unit 22. Check if it is recorded.

  When it determines with prescription of a diabetes treatment drug (in the case of "YES" in step S4-1), the control part 21 of the management server 20 performs the classification process as a diabetes patient (step S4-2). Specifically, the classification unit 212 of the control unit 21 records “diabetes” in the specific disease name data area of the patient evaluation data 250.

  On the other hand, if it is determined that it is not a prescription for diabetes treatment (in the case of “NO” in step S4-1), the control unit 21 of the management server 20 skips the classification process (step S4-2) as a diabetic patient. Then, the condition 2-1 determination process is terminated.

(Condition 2-2 determination process)
Next, the condition 2-2 determination process will be described with reference to FIG.
First, the control part 21 of the management server 20 performs the determination process about whether it is prescription of a dyslipidemic drug (step S5-1). Specifically, the classification unit 212 of the control unit 21 indicates that the medicine code of the medicine name associated with the indication name “dyslipidemia” is a medical receipt or dispensing in the therapeutic agent list 222 for each indication name in the basic information storage unit 22. Check if it is recorded in the receipt.

  When it determines with prescription of the dyslipidemic agent (in the case of "YES" in step S5-1), the control part 21 of the management server 20 performs the classification process as a dyslipidemic patient (step S5-2). . Specifically, the classification unit 212 of the control unit 21 records “dyslipidemia” in the specific disease name data region of the patient evaluation data 250.

  On the other hand, when it is determined that the prescription is not a dyslipidemic drug (in the case of “NO” in step S5-1), the control unit 21 of the management server 20 classifies the patient as a dyslipidemic patient (step S5-2). Is skipped and the condition 2-2 determination process is terminated.

(Condition 2-3 determination process)
Next, the condition 2-3 determination process will be described with reference to FIG.
First, the control part 21 of the management server 20 performs the determination process about whether it is prescription of an antihypertensive drug (step S6-1). Specifically, the classification unit 212 of the control unit 21 checks whether or not the drug code of the antihypertensive drug is recorded in the medical receipt or the dispensing receipt in the therapeutic agent list by indication disease name 222 of the basic information storage unit 22.

  When it determines with prescription of an antihypertensive drug (in the case of "YES" in step S6-1), the control part 21 of the management server 20 performs the acquisition process of a wound name code (step S6-2). Specifically, the classification unit 212 of the control unit 21 acquires a wound name code recorded in the medical receipt. In addition, when it determines with it not being a prescription of an antihypertensive drug (in the case of "NO" in step S6-1), the control part 21 of the management server 20 complete | finishes the condition 2-3 determination process.

  Next, the control part 21 of the management server 20 performs the determination process about whether it is unsuspicious hypertension in a wound name code (step S6-3). Specifically, the classification unit 212 of the control unit 21 confirms whether the wound name code acquired from the medical receipt is “unsuspecting hypertension”.

  When it is determined that the hypertension is not suspicious in the wound name code (in the case of “YES” in step S6-3), the control unit 21 of the management server 20 executes the classification process as a hypertension patient (step S6-4). . Specifically, the classification unit 212 of the control unit 21 records “high blood pressure” in the specific disease name data area of the patient evaluation data 250 in the patient evaluation information storage unit 25.

  On the other hand, if it is determined that the hypertension is not suspicious (“NO” in step S6-3), the control unit 21 of the management server 20 skips the classification process (step S6-4) as a hypertension patient, The condition 2-3 determination process is terminated.

According to this embodiment, the following effects can be obtained.
(1) In this embodiment, the control part 21 of the management server 20 performs the list collation process about receipt description information (step S1-1). If it is determined that the specific injury or illness can be classified ("YES" in step S1-2), the control unit 21 of the management server 20 executes the specific injury and illness classification process (step S1-3). Thereby, when the injury or illness is clear in the receipt, the patient with the specific injury or illness can be classified based on the description in the receipt.

  (2) In the present embodiment, when it is determined that the specific injury / illness cannot be classified based on the description in the medical receipt (in the case of “NO” in step S1-2), the control unit 21 of the management server 20 The specific process is executed (step S1-4). Next, the control part 21 of the management server 20 performs the determination process about whether it can classify | categorize into a specific disease (step S1-6). Thereby, even when it cannot classify | categorize based on a receipt description matter, the patient of a specific injury and illness can be classified in consideration of the prescribed therapeutic agent.

  (3) In the present embodiment, when it is determined that the specific medical condition cannot be classified based on the therapeutic drug (in the case of “NO” in step S1-6), the control unit 21 of the management server 20 A list matching process is executed based on the therapeutic agent (step S1-7). Thereby, even when the therapeutic agent is applied to a plurality of injuries and diseases, it is possible to classify patients with specific injuries and diseases in consideration of the items described in the receipt.

  (4) In this embodiment, the control part 21 of the management server 20 performs a result output process (step S1-10). Here, the management unit 211 of the control unit 21 outputs the tissue code and the number of patients calculated for each specific disease name to the person-in-charge terminal 10. Thereby, the number of patients with a specific injury or illness can be grasped for each tissue, and health guidance according to the number of patients can be performed.

  (5) In the receipt matching process of the present embodiment, the medical receipt and the dispensing receipt are matched using information (insured person information) for specifying a medical institution and an individual and a medical date. When prescribed outside the hospital, the therapeutic agent cannot be identified by the description of the medical receipt, but the therapeutic agent can be identified based on the dispensing receipt related to this medical receipt.

  Furthermore, in the receipt matching process, when it is determined that there is no dispensing receipt (in the case of “NO” in step S2-2), the control unit 21 of the management server 20 executes a dispensing receipt search process for adjacent years and months. (Step S2-4). Thereby, even when the medical treatment at the hospital is different from the prescription time of the therapeutic drug outside the hospital, it is possible to identify the therapeutic drug and classify the patient with the specific injury or illness.

In addition, you may change each said embodiment as follows.
In each of the above embodiments, health maintenance and management is supported in an organization composed of a plurality of hierarchies. Here, the organization is not limited to a single company. In a corporate group that bundles multiple companies or a group of companies that belong to a health insurance association, the organization is hierarchized to support the maintenance and management of health. May be. Also in this case, as the organization code, a code that can specify each hierarchy from the upper hierarchy (such as a corporate group or a health insurance association) to the lower hierarchy to which the evaluation target person (employee) belongs is used.

  In each of the above-described embodiments, in the receipt matching process, the medical receipt and the dispensing receipt are matched using information (insured person information) for specifying a medical institution and an individual and a medical date. Here, you may make it match a receipt based on the difference of the medical treatment date described in the medical receipt, and the medical treatment date described in the dispensing receipt. In this case, only the receptors whose differences are included within a predetermined period (effective period of the prescription) are associated.

  DESCRIPTION OF SYMBOLS 10 ... Person in charge terminal, 20 ... Management server, 21 ... Control part, 211 ... Management part, 212 ... Classification part, 213 ... Matching part, 22 ... Basic information storage part, 23 ... Receipt information storage part, 24 ... Related receipt information Storage unit, 25... Patient evaluation information storage unit.

Claims (7)

A specific injury / illness information storage unit that stores a list of treatments in which the specific injury / disease name code of the specific injury / disorder to be classified, and the therapeutic agent of the specific injury / disease are recorded;
Receipt information storage unit storing the dispensing receipt of the subject to be evaluated and the medical receipt;
A patient classification support system comprising a control unit for classifying a patient as a specific injury patient based on a receipt recorded in the receipt information storage unit ,
The control unit is
In the receipt information storage unit, specify the medical receipt of the person to be evaluated,
Search for a dispensing receipt that has the same medical institution information and insured information recorded in the medical receipt,
When the dispensing receipt of the same medical treatment date of the medical receipt can be extracted, the therapeutic agent recorded in the therapeutic agent list is identified by the therapeutic agent described in the extracted dispensing receipt,
When a dispensing receipt of the same medical treatment date of the medical receipt cannot be extracted, it is recorded in the medical receipt in a dispensing receipt of a date included in a predetermined period with respect to the medical treatment date of the medical receipt. If you can search and extract the dispensing receipt in which the medical institution and insured information is recorded , identify the therapeutic drug based on the dispensing receipt,
A patient classification support system, wherein the evaluation subject is classified as a specific injury patient based on the therapeutic agent and the therapeutic agent list. Before SL control unit, the therapeutic agents described above medical receipt, the patient classification support system according to claim 1, wherein the identifying a therapeutic agent that is recorded in the therapeutic agent list. The control unit identifies a specific disease based on the therapeutic agent and the therapeutic agent list ,
3. The patient classification support system according to claim 2, wherein when the specific injury is recorded in the medical receipt, the person to be evaluated for the medical receipt is classified as a specific injury patient. If it is not possible to extract a dispensing receipt of the same medical treatment date of the medical reception, the medical reception
Against clinical years of bets, as a predetermined period, to any one of claims 1 to 3, characterized in that to search for dispensing receipts of years adjacent to clinic date of the medical receipts The patient classification support system described. When a dispensing receipt of the same medical treatment date of the medical receipt cannot be extracted, a dispensing receipt of a date included in the effective period of the prescription is searched as a predetermined period with respect to the medical treatment date of the medical receipt. The patient classification support system according to any one of claims 1 to 3 . A specific injury / illness information storage unit that stores a list of treatments in which the specific injury / disease name code of the specific injury / disorder to be classified, and the therapeutic agent of the specific injury / disease are recorded;
Receipt information storage unit storing the dispensing receipt of the subject to be evaluated and the medical receipt;
Based on the receipt recorded in the receipt information storage unit, using a patient classification support system provided with a control unit that classifies as a specific injury patient, a method for grasping the health state,
The control unit is
In the receipt information storage unit, specify the medical receipt of the person to be evaluated,
Search for a dispensing receipt that has the same medical institution information and insured information recorded in the medical receipt,
When the dispensing receipt of the same medical treatment date of the medical receipt can be extracted, the therapeutic agent recorded in the therapeutic agent list is identified by the therapeutic agent described in the extracted dispensing receipt,
When a dispensing receipt of the same medical treatment date of the medical receipt cannot be extracted, it is recorded in the medical receipt in a dispensing receipt of a date included in a predetermined period with respect to the medical treatment date of the medical receipt. If you can search and extract the dispensing receipt in which the medical institution and insured information is recorded , identify the therapeutic drug based on the dispensing receipt,
A patient classification support method, wherein the evaluation subject is classified as a specific injury patient based on the therapeutic agent and the therapeutic agent list. A specific injury / illness information storage unit that stores a list of treatments in which the specific injury / disease name code of the specific injury / disorder to be classified, and the therapeutic agent of the specific injury / disease are recorded;
Receipt information storage unit storing the dispensing receipt of the subject to be evaluated and the medical receipt;
Based on the receipt recorded in the receipt information storage unit, using a patient classification support system including a control unit that classifies as a specific patient, a program for grasping the health state,
The control unit
In the receipt information storage unit, specify the medical receipt of the person to be evaluated,
Search for a dispensing receipt that has the same medical institution information and insured information recorded in the medical receipt,
When the dispensing receipt of the same medical treatment date of the medical receipt can be extracted, the therapeutic agent recorded in the therapeutic agent list is identified by the therapeutic agent described in the extracted dispensing receipt,
When a dispensing receipt of the same medical treatment date of the medical receipt cannot be extracted, it is recorded in the medical receipt in a dispensing receipt of a date included in a predetermined period with respect to the medical treatment date of the medical receipt. If you can search and extract the dispensing receipt in which the medical institution and insured information is recorded , identify the therapeutic drug based on the dispensing receipt,
The therapeutic agent and on the basis of the therapeutic agent list, patient classification support program for causing to function as a means you classifying the evaluation target person as the specific sick patient.

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