WO2020082788A1

WO2020082788A1 - Medical data processing method, apparatus and device, and storage medium

Info

Publication number: WO2020082788A1
Application number: PCT/CN2019/094999
Authority: WO
Inventors: 刘耀东; 郝光升; 程园园
Original assignee: 平安医疗健康管理股份有限公司
Priority date: 2018-10-27
Filing date: 2019-07-08
Publication date: 2020-04-30
Also published as: CN109523399A; WO2020082788A8

Abstract

Disclosed are a medical data processing method, apparatus and device, and a storage medium. The method comprises: acquiring hospitalization information from hospitalization credential information of a target user, wherein the hospitalization information comprises information of a diagnosed disease and diagnosis and treatment information, and according to the information of the diagnosed disease, screening out target diagnosis and treatment information from the diagnosis and treatment information; determining, according to the target diagnosis and treatment information, whether the target user has an abnormal hospitalization behavior; and according to the determination result of whether the target user has an abnormal hospitalization behavior, acquiring, from a pre-set reimbursement strategy set, a reimbursement strategy corresponding to the determination result so as to reimburse, according to the reimbursement strategy, the target user for hospitalization expenses. The method can effectively recognize an abnormal hospitalization behavior.

Description

Medical data processing method, device, equipment and storage medium

This application requires the priority of the Chinese patent application filed on October 27, 2018 in the Chinese Patent Office, with the application number 201811265503.6 and the application name "a medical data processing method, device, equipment and storage medium", all of which are approved by The reference is incorporated in this application.

Technical field

This application relates to the medical technology field, and in particular, to a medical data processing method, device, equipment, and storage medium.

Background technique

The medical security system is an integral part of the social security system and an important part of the health field. It is closely related to the vital interests of the people. With the continuous reform and improvement of China ’s social medical security system, the number of people covered by medical insurance is getting wider and wider. The medical needs of the people provide greater convenience. However, in recent years, there have been more and more cases of fraud involving abnormal hospitalization, such as the creation of fake hospitalization certificates and the use of fake hospitalization certificates to reimburse medical expenses to the national social security department, which not only brings economic losses to the country, but also makes the public The interests have been seriously damaged, so how to identify abnormal hospitalization behavior is an urgent problem to be solved.

Summary of the invention

Embodiments of the present application provide a medical data processing method, device, equipment, and storage medium, which can effectively identify abnormal hospitalization behaviors.

In a first aspect, an embodiment of the present application provides a medical data processing method. The method includes:

Obtain hospitalization information from the target user's hospitalization voucher information. The hospitalization information includes information about diagnosed diseases and medical treatment information. The medical treatment information includes any one or more of the following: treatment items, length of hospitalization, medication information, and hospitalization costs , The information of the diagnosed disease includes the name or type of the disease;

According to the information of the diagnosed disease, screening out target diagnosis and treatment information from the diagnosis and treatment information;

Judging whether the target user has abnormal hospitalization behavior according to the target diagnosis and treatment information;

According to a judgment result of whether the target user has abnormal hospitalization behavior, obtain a reimbursement strategy corresponding to the judgment result from a set of preset reimbursement strategies to reimburse the target user's hospitalization expenses according to the reimbursement strategy.

In a second aspect, an embodiment of the present application provides a medical data processing device, which includes:

The obtaining unit is used for obtaining hospitalization information from the hospitalization voucher information of the target user, the hospitalization information includes information of diagnosed diseases and diagnosis and treatment information, and the diagnosis and treatment information includes any one or more of the following: treatment items, length of hospitalization, Medication information and hospitalization costs, the information of the diagnosed disease includes the name or type of the disease;

A screening unit for screening out target diagnosis and treatment information from the diagnosis and treatment information based on the information of the diagnosed disease;

The judging unit is used to judge whether the target user has abnormal hospitalization behavior according to the target diagnosis and treatment information;

The reimbursement unit is configured to obtain a reimbursement strategy corresponding to the judgment result from a preset reimbursement strategy set according to the judgment result of whether the target user has abnormal hospitalization behavior, so as to hospitalize the target user according to the reimbursement strategy Expenses are reimbursed.

In a third aspect, an embodiment of the present application provides a medical management device, the device includes: a processor and a memory, the processor and the memory are connected to each other; wherein, the memory stores one or more instructions, so The one or more instructions are suitable to be loaded by the processor and execute the following steps:

Obtain hospitalization information from the target user's hospitalization voucher information. The hospitalization information includes information about diagnosed diseases and medical treatment information. The medical treatment information includes any one or more of the following: treatment items, length of hospitalization, medication information, and hospitalization costs , The information of the diagnosed disease includes the name or type of the disease; according to the information of the diagnosed disease, the target diagnosis and treatment information is selected from the diagnosis and treatment information; and whether the target user is abnormal is determined according to the target diagnosis and treatment information Hospitalization behavior; according to the judgment result of whether the target user has abnormal hospitalization behavior, obtain a reimbursement strategy corresponding to the judgment result from a preset reimbursement strategy set, so as to carry out hospitalization expenses of the target user according to the reimbursement strategy Reimbursement.

According to a fourth aspect, an embodiment of the present application provides a computer-readable storage medium storing one or more instructions, the one or more instructions being suitable for being loaded by a processor and performing the following steps :

In the embodiment of the present application, abnormal hospitalization behavior can be easily identified, that is, the behavior of providing fake hospitalization certificate information can be easily identified, which can reduce national economic losses and protect the public interest; screening medical information to improve the detection of abnormal hospitalization The efficiency of the behavior reduces the resource consumption of medical management equipment; and selects the reimbursement strategy according to the judgment result, and uses the selected reimbursement strategy to reimburse the target user ’s hospitalization expenses, which can improve the flexibility of reimbursement and effectively combat abnormal hospitalization behaviors.

BRIEF DESCRIPTION

In order to more clearly explain the embodiments of the present application or the technical solutions in the prior art, the following will briefly introduce the drawings required in the embodiments. Obviously, the drawings in the following description are only some of the applications For the embodiment, for those of ordinary skill in the art, without paying any creative labor, other drawings may be obtained based on these drawings.

1 is a schematic flowchart of a medical data processing method provided by an embodiment of the present application;

2 is a schematic flowchart of a medical data processing method provided by another embodiment of the present application;

3 is a schematic structural diagram of a medical data processing device provided by an embodiment of the present application;

4 is a schematic structural diagram of a medical management device according to another embodiment of the present application.

detailed description

The technical solutions in the embodiments of the present application will be described clearly and completely in conjunction with the drawings in the embodiments of the present application. Obviously, the described embodiments are part of the embodiments of the present application, but not all of the embodiments. Based on the embodiments in this application, all other embodiments obtained by a person of ordinary skill in the art without creative work fall within the scope of protection of this application.

In the prior art, the patient's physical parameters (such as heart rate and pulse rate) are mainly reviewed by manual review to determine whether the patient has abnormal hospitalization behavior. For example, when a patient is reimbursed for hospitalization expenses, the staff related to medical reimbursement management compares the patient ’s sign parameters during hospitalization with the data in the sign parameter database, which includes the normal state (i.e. health The physical parameters of the human body under the status), when the staff examines and finds that the patient's physical parameters are consistent with the data in the physical parameter database, it is determined that the patient has abnormal hospitalization behavior. This method requires a lot of manpower and the audit efficiency is low.

Based on the defects in the prior art that consume a lot of manpower and have low audit efficiency, embodiments of the present application provide a medical data processing method, which may be performed by a medical management device, which may refer to an intelligent terminal , Servers, computers or medical service terminals. This method can be applied to medical reimbursement scenarios or to auditing scenarios for hospitals. For example, in medical reimbursement scenarios, users can submit medical voucher information to medical management equipment of medical reimbursement units (such as social security bureaus or insurance companies), such as Hospitalization voucher information, medical management equipment screens the medical voucher information submitted by the user, audits the screened medical information, selects a reimbursement strategy according to the audit results, and reimburses the user's medical expenses according to the selected reimbursement strategy, which can be effectively detected The act of providing fake hospitalization certificate information reduces the national economic loss and protects the public interest; in addition, by reviewing the selected medical information, it is not necessary to review all the medical information, which can improve the efficiency of the audit, nor Need manual review, can save manpower.

Please refer to FIG. 1, which is a schematic flowchart of a medical data processing method provided in an embodiment of the present application. The method in the embodiment of the present application may be executed by the medical management device mentioned above. In this embodiment, the medical data processing method includes the following steps.

S101. Obtain hospitalization information from the target user's hospitalization voucher information. The hospitalization information includes diagnosed disease information and diagnosis and treatment information. The diagnosis and treatment information includes any one or more of the following: treatment items, length of hospitalization, medication information, and hospitalization costs The information of the diagnosed disease includes the name or type of the disease.

In the embodiment of the present application, the medical management device may obtain the hospitalization credential information of the target user from the local database, or receive the hospitalization credential information of the target user sent by other devices, and obtain the hospitalization information from the hospitalization credential information.

In one embodiment, the medical management device stores the hospitalization voucher information of the target user. The hospitalization voucher information may be stored in the medical management device in the format of an image. The medical management device may obtain the hospitalization information through the image. Specifically, the medical management The device can use text recognition to obtain initial hospitalization information from the image corresponding to the hospitalization credential information. In order to improve the recognition accuracy, the initial hospitalization information can be corrected to obtain the target user's hospitalization information. Here, the character recognition method may refer to an optical character recognition method (Optical Character Recognition, OCR), etc. Correcting the initial hospitalization information here refers to correcting wrong characters in character recognition, filtering out redundant characters, or normalizing the format of characters, and so on.

In another embodiment, the medical management device stores the hospitalization credential information of the target user. The hospitalization credential information may be stored in the medical management device in a table format. The hospitalization credential information is shown in Table 1, which includes the target The user's logo, the diagnosed disease and diagnosis information, etc., the target user's logo may refer to an identity logo, such as an ID card or name, and the target user's logo may also refer to the number of the hospitalization. The medical management device can obtain the hospitalization information from the table corresponding to the hospitalization certificate information.

Table 1

Target user's ID

Diagnosed diseases

...

Medical information

In one embodiment, in order to reduce the pressure of the medical management device on the review of hospitalization information, the medical management device may only review the hospitalization information of the target user (ie, the designated user). For example, the target user may refer to a user with a lower credit rating. Or users with more medical claims. For example, take a user with a lower credit rating as the target user and receive the user ’s medical reimbursement request. The medical reimbursement request carries the user ’s identity information. The user ’s identity information includes the credit rating and identity identification. When the user ’s credit rating When it is less than the preset value, it indicates that the user has a high probability of providing fake hospitalization credential information. The user is regarded as the target user, and step S101 is performed; when the user's credit rating is higher than or equal to the preset value, it indicates that the user provides counterfeit If the probability of hospitalization certificate information is low, the user's medical expenses (such as hospitalization expenses) can be reimbursed without reviewing the hospitalization certificate information provided by the user.

In another embodiment, in order to improve the accuracy of identifying the behavior of providing fake hospitalization credential information, the medical management device may review the hospitalization credential information of all users, and the target user refers to any one of all users who provide hospitalization credential information.

S102. Screen target diagnosis and treatment information from the diagnosis and treatment information based on the diagnosed disease information.

In the embodiment of the present application, when reviewing the hospitalization credential information provided by the target user through all the medical information, the review process takes a long time and consumes a lot of resources of medical management equipment. Therefore, in order to reduce the resource consumption of medical management equipment , And improve the efficiency of the audit, the medical management equipment can filter out the target medical information from the medical information, and use the target medical information to detect whether the target user provides fake hospitalization certificate information. Specifically, the medical management equipment can use the information of the diagnosed disease to The target medical information is selected from the medical information.

In one embodiment, the medical management device stores the correspondence between the diagnosed disease information and the target diagnosis and treatment information. The medical management device may filter the target diagnosis and treatment information from the diagnosis and treatment information according to the correspondence. The correspondence may refer to The history information of fake hospitalization certificate information (that is, abnormal hospitalization certificate information) is determined, for example, the diagnosed disease information includes the name of the disease, the name of the disease is cold, and the number of times the user provides counterfeit medication information is greater than the preset number of times, then establish a cold and Correspondence of medication information.

S103: Determine whether the target user has abnormal hospitalization behavior according to the target diagnosis and treatment information.

In the example of the present application, the medical management device can determine whether the target user has abnormal hospitalization according to the target diagnosis and treatment information. Specifically, based on the target diagnosis and treatment information, whether the target user has prescribed drugs that do not match the illness and whether the hospitalization cost is fraudulent Waiting for abnormal hospitalization behavior, when the judgment result is that the target user has abnormal hospitalization behavior, it indicates that the hospitalization credential information provided by the target user is fake hospitalization credential information; when the judgment result is that the target user does not have abnormal hospitalization behavior, indicating that the target user provides The hospitalization certificate information is real hospitalization certificate information.

In one embodiment, when the judgment result is that the target user has abnormal hospitalization behavior, the medical management device may obtain the identity information of the target user from the hospitalization credential information, and record the identity information of the target user in a blacklist, so that The next time it is detected that the target user submits the hospitalization credential information, the hospitalization credential information provided by the target user may be reviewed as an audit object. The blacklist is used to record the identity information of users who have abnormal hospitalization behavior. The identity information of the target user includes the ID number and / or name of the target user.

In one embodiment, when the judgment result is that the target user has abnormal hospitalization behavior, the number of times the target user has abnormal hospitalization behavior is obtained, and if the obtained number is greater than a preset number, a prompt message is output, and the prompt message is used to prompt the The target user has abnormal hospitalization behavior, so that the staff can deal with the corresponding information according to the prompt information, for example, the information related to the target user's abnormal hospitalization behavior is sent to the alarm system, and the law enforcement personnel will target the user's abnormal hospitalization behavior Penalize.

S104: Obtain a reimbursement strategy corresponding to the judgment result from a preset reimbursement strategy set according to the judgment result of whether the target user has abnormal hospitalization behavior, so as to reimburse the target user's hospitalization expenses according to the reimbursement strategy .

In the embodiment of the present application, in order to severely combat abnormal hospitalization, the medical management device may obtain a reimbursement strategy corresponding to the judgment result from the preset reimbursement strategy set according to the judgment result, and use the acquired reimbursement strategy to reimburse the target user ’s hospitalization expenses Specifically, when the judgment result is that the target user has abnormal hospitalization behavior, the first reimbursement strategy is selected from the preset reimbursement strategy set, and the first reimbursement strategy is used to reimburse the target user's hospitalization expenses; when the judgment result is that the target user does not exist In case of abnormal hospitalization behavior, the second reimbursement strategy is selected from the preset reimbursement strategy set, and the second reimbursement strategy is used to reimburse the target user's hospitalization expenses. Among them, the first reimbursement strategy may be a reimbursement strategy that refuses to be reimbursed, or a reimbursement strategy that reduces the normal reimbursement ratio, and the second reimbursement strategy may refer to a strategy that is reimbursed according to the normal reimbursement ratio. For example, the normal reimbursement ratio is 50%. The reimbursement ratio for the first reimbursement strategy is 20%, and the reimbursement ratio for the second reimbursement strategy is 50%. A variety of reimbursement strategies are included from the preset reimbursement strategy set, such as the first and second reimbursement strategies mentioned above.

In the embodiments of the present application, abnormal hospitalization behaviors can be easily identified, that is, behaviors that provide counterfeit hospitalization certificate information can be easily identified, reducing national economic losses, and protecting the public interest; and screening medical information to improve abnormal detection The efficiency of hospitalization behavior reduces the resource consumption of medical management equipment; and selects the reimbursement strategy according to the judgment result, and uses the selected reimbursement strategy to reimburse the target user's hospitalization expenses, which can increase the flexibility of reimbursement and effectively combat abnormal hospitalization behaviors.

Please refer to FIG. 2, which is a schematic flowchart of another medical data processing method provided in an embodiment of the present application. The method in the embodiment of the present application may be performed by the medical management device mentioned above. In this embodiment, the medical data processing method includes the following steps.

S201. Obtain hospitalization information from the target user's hospitalization voucher information. The hospitalization information includes diagnosed disease information and diagnosis and treatment information. The diagnosis and treatment information includes any one or more of the following: treatment items, length of hospitalization, medication information, and hospitalization costs The information of the diagnosed disease includes the name or type of the disease.

S202. Screen target diagnosis and treatment information from the diagnosis and treatment information based on the diagnosed disease information.

In the embodiment of the present application, the medical management device may filter out the first type of target diagnosis information or the second target diagnosis information from the diagnosis information based on the diagnosed disease information. When the diagnosis information is obtained from the diagnosis information When the first type of target diagnosis and treatment information is selected, and step S203 is performed to determine whether the target user has abnormal hospitalization behavior according to the first type of target diagnosis and treatment information; when the second type of target is selected from the diagnosis and treatment information based on the diagnosed disease information When the diagnosis and treatment information is performed, step S204 is executed to determine whether the target user has abnormal hospitalization behavior according to the second type of target diagnosis and treatment information.

Among them, the target diagnosis and treatment information includes the first type of target diagnosis and treatment information or the second type of target diagnosis and treatment information. The first type of target diagnosis and treatment information includes any one or more of the following: treatment items, hospitalization costs or length of hospitalization, the second type The target diagnosis and treatment information includes medication information.

In one example, the information of the diagnosed disease includes the name of the disorder, and step S202 includes the following steps S11 to S13.

S11. Query the difficulty index for treating the disease from the first visit database according to the disease name. The first visit database includes multiple disease names and the difficulty index for treating each disease.

S12. When the determined difficulty index is greater than the preset threshold, acquire the first type of target diagnosis and treatment information from the diagnosis and treatment information as the target diagnosis and treatment information.

S13. When the determined difficulty index is less than or equal to the preset threshold, acquire second-type target diagnosis and treatment information from the diagnosis and treatment information as target diagnosis and treatment information.

In steps S11 to S13, the medical management device can filter out the target diagnosis and treatment information from the diagnosis and treatment information according to the name of the illness, specifically, query the difficulty index for treating the illness from the first consultation database according to the illness name, when the determined difficulty index When it is greater than the preset threshold, it indicates that it is more difficult to treat the disease. The characteristics of treating the disease include: the need for medical items such as health check items and physical therapy items. The cost of hospitalization is higher and the length of hospitalization is longer. The characteristics of the illness create fake hospitalization voucher information, so the first type of target medical information can be obtained from the medical information as target medical information, and step S203 is performed to determine whether the target user has abnormal hospitalization behavior based on the first type of target medical information; when When the determined difficulty index is less than or equal to the preset threshold, it indicates that it is less difficult to treat the disease, and the characteristics of treating the disease include: mainly through drug treatment, therefore, the second information including medication information can be obtained from the diagnosis and treatment information Similar target diagnosis and treatment information as target diagnosis and treatment information, and execute Step S204 is performed to determine whether the target user has abnormal hospitalization behavior according to the second-type target diagnosis and treatment information.

In one example, the information of the diagnosed disease includes the type of disorder, and step S202 includes the following steps S21 to S23.

S21. Search and determine the treatment strategy for treating the condition corresponding to the condition type from the second consultation database according to the condition type, the second treatment database includes the condition type, and the treatment strategy for treating the condition corresponding to each condition type .

S22. When the treatment strategy is a surgical treatment strategy, acquire first-class target diagnosis and treatment information from the hospitalization information as target diagnosis and treatment information.

S23. When the treatment strategy is a non-surgical treatment strategy, obtain second-type target diagnosis and treatment information from the hospitalization information as target diagnosis and treatment information.

In steps S21 to S23, the medical management device can filter out the target diagnosis and treatment information from the diagnosis and treatment information according to the type of the disease, specifically, search for the historical treatment strategy for the disease in the historical consultation information from the second consultation database according to the disease type, The historical treatment strategy found is determined as the treatment strategy for treating the condition. When the treatment strategy is a surgical treatment strategy, it also indicates that the treatment of the condition is more difficult. The characteristics of treating the condition include: the need for health examination items and physical Treatment items, such as treatment items, have higher hospitalization costs and longer hospitalization duration. Users usually use the characteristics of treating the disease to create fake hospitalization certificate information. Therefore, the first type of target diagnosis and treatment information can be obtained from the hospitalization information as target diagnosis and treatment information And execute step S203 to determine whether the target user has abnormal hospitalization behavior according to the first type of target diagnosis and treatment information. When the treatment strategy is a non-surgical treatment strategy, it indicates that it is less difficult to treat the disease. The characteristics of treating the disease include: Drug treatment, therefore, the information obtained from this hospitalization Take the second type of target diagnosis and treatment information as the target diagnosis and treatment information, and perform step S204 to determine whether the target user has abnormal hospitalization behavior according to the second type of target diagnosis and treatment information.

S203: Determine whether the target user has abnormal hospitalization behavior according to the first-type target diagnosis and treatment information.

In the embodiment of the present application, the medical management device can determine whether the target user has treatment items or abnormal hospitalization expenses according to the first type of target diagnosis and treatment information. When these abnormal conditions exist, it is determined that the target user has abnormal hospitalization behavior; when there is no such thing In these abnormal situations, it is determined that the target user does not have abnormal hospitalization behavior.

In one example, the target diagnosis and treatment information is the first type of target diagnosis and treatment information. The first type of target diagnosis and treatment information includes the hospitalization cost and the length of hospitalization. The hospitalization cost includes the drug cost and the total hospitalization cost. Step S203 includes: obtaining the drug cost and The first ratio between the total costs of hospitalization, when the first ratio is greater than the first preset threshold, it is determined that the target user has abnormal hospitalization behavior, and the first preset threshold is determined according to the length of hospitalization.

The medical management device can detect whether the target user has abnormal hospitalization behavior through the drug cost. Specifically, the first ratio between the drug cost and the total cost of the hospitalization is obtained. If the first ratio is greater than the first preset threshold, it indicates that the target user There is an abnormal behavior that raises the cost of medicines, and indicates that the target user has the possibility to provide fake hospitalization credential information. Therefore, it is determined that the target user has abnormal hospitalization behavior. Among them, the first preset threshold is determined according to the length of hospitalization, for example, the medical management equipment records the medical expenses corresponding to the length of hospitalization of multiple regions or multiple hospitals, and corresponds to the length of hospitalization of multiple regions or multiple hospitals For the cost of medicine, each hospital stay corresponds to the maximum medicine cost as the first preset threshold corresponding to the hospital stay.

For example, assuming that the first preset threshold is 85%, when the first ratio between the acquired drug cost and the total hospitalization cost is 90%, it is determined that the target user has abnormal hospitalization behavior.

In another embodiment, the target diagnosis and treatment information is the first type of target diagnosis and treatment information. The first type of target diagnosis and treatment information includes hospitalization expenses, and the hospitalization expenses include the cost of medical examination items and the total cost of hospitalization; step S203 includes: obtaining the medical treatment A second ratio between the cost of the inspection item and the total cost of hospitalization; if the second ratio is greater than a second preset threshold, it is determined that the target user has abnormal hospitalization behavior, and the second preset threshold is based on the diagnosis The disease information is determined.

The medical management device can detect whether the target user has abnormal hospitalization behavior through the cost of the medical examination item. Specifically, obtain the second ratio between the cost of the medical examination item and the total cost of hospitalization; if the second ratio is greater than the second preset The threshold value indicates that the target user has abnormal behaviors that increase the cost of medical examination items, and indicates that the target user has the possibility of providing fake hospitalization credential information. Therefore, it is determined that the target user has abnormal hospitalization behaviors. Among them, the second preset threshold is determined based on the diagnosed disease information, for example, the medical management equipment records the cost of each region or each hospital ’s medical examination items for each disease and the total cost of hospitalization. The device finds the cost of the medical examination item corresponding to the condition in the diagnosed disease information and the total cost of hospitalization, and obtains the second preset threshold according to the ratio of the found medical examination item cost to the total hospitalization cost.

For example, assuming that the second preset threshold is 70%, when the second ratio between the cost of the obtained medical examination item and the total cost of hospitalization is 80%, it is determined that the target user has abnormal hospitalization behavior.

In yet another embodiment, the target diagnosis and treatment information is the first type of target diagnosis and treatment information. The first type of target diagnosis and treatment information includes treatment items. Step S203 includes: determining whether the target user's treatment items include a health check item within a preset time period. And physical therapy items, when it is determined that the target user's treatment item includes the health check item and the physical therapy item is not included, it is determined that the target user has abnormal hospitalization behavior; or, when the target user's treatment item is determined to include physical If the treatment item does not include the health check item, it is determined that the target user has abnormal hospitalization behavior.

The medical management device can determine whether the target user has abnormal hospitalization behavior according to the treatment item. Specifically, determine whether the target user's treatment item includes a health check item and a physical therapy item within a preset period of time, because according to the name of the disease or the disease It is difficult to determine the type of treatment for the disease or the surgical treatment strategy is required to treat the disease. Therefore, the medical items corresponding to the treatment of the disease generally include health check items and physical therapy items. When the target user ’s treatment item includes the When the health check item does not include the physical therapy item, it indicates that the target user has the possibility of providing fake hospitalization credentials information, and it is determined that the target user has abnormal hospitalization behavior; or, when the target user's treatment item is determined to include the physical therapy item, and When the health check item is not included, it indicates that the target user has the possibility of providing fake hospitalization certificate information, and it is determined that the target user has abnormal hospitalization behavior.

S204: Determine whether the target user has abnormal hospitalization behavior according to the second-type target diagnosis and treatment information.

In the embodiment of the present application, the medical management device can determine whether the target user has abnormal medication behavior according to the second type of target diagnosis and treatment information. When there is abnormal medication behavior, it indicates that the target user has provided the behavior of providing fake hospitalization credential information to determine the existence of the target user Abnormal hospitalization behavior; when there is no abnormal medication behavior, it indicates that the hospitalization credential information provided by the target user is real hospitalization credential information, and it is determined that the target user does not have abnormal hospitalization behavior.

In one embodiment, the target diagnosis and treatment information is the second type of target diagnosis and treatment information, and the second type of target diagnosis and treatment information includes medication information; step S204 includes: searching for the medicine information required for treatment of the disease from the medical knowledge base according to the name of the disease. Recorded the medicine information needed to treat various diseases; when the medicine information does not match the found medicine information, it is determined that the target user has abnormal hospitalization behavior.

The medical management equipment can determine whether the target user has abnormal hospitalization behavior based on the medication information. Specifically, the medical knowledge database is used to find the drug information required for the treatment of the disease according to the name of the disease. The medical knowledge base records the drug information required for the treatment of various diseases. When the medication information does not match the found drug information, it indicates that the target user has abnormal behaviors for prescribing drugs, and that the target user has the possibility of providing fake hospitalization certificate information. Therefore, it is determined that the target user has abnormal hospitalization behavior.

For example, assuming that the name of the illness is cold, find the medicine information needed to treat the illness from the medical knowledge base according to the name of the illness. The medicine information includes A cold capsule or B cold medicine, etc., and the medication information includes health care product C and health product D. The medicine included in the medicine information and the medicine included in the medicine information do not belong to the same type or the same medicine. Therefore, it is determined that the medicine information does not match the found medicine information, and it is determined that the target user has abnormal hospitalization.

In one embodiment, the target diagnosis and treatment information is the second type of target diagnosis and treatment information. The second type of target diagnosis and treatment information includes the location information and identity information of the hospitalization. Step S204 includes: determining the hospital to which the target user visits according to the location information of the hospitalization, from The hospitalization data is retrieved from the medical management equipment corresponding to the determined hospital. The hospitalization data includes the identity information of the hospitalized patient. When the identity information of the target user does not match the retrieved hospitalization data, it indicates that the target user is visiting the hospital. It is determined that the target user has abnormal hospitalization behavior, and the patient's identity information may include at least one of the patient's face image, or hospitalization video data, name, or ID number.

S205. According to the judgment result of whether the target user has abnormal hospitalization behavior, obtain a reimbursement strategy corresponding to the judgment result from a preset reimbursement strategy set to reimburse the target user's hospitalization expenses according to the reimbursement strategy .

In the embodiment of the present application, the medical management device may obtain the reimbursement strategy corresponding to the judgment result from the preset reimbursement strategy set according to the judgment result, and use the acquired reimbursement strategy to reimburse the target user's hospitalization expenses, thereby improving the flexibility of reimbursement .

In the embodiments of the present application, the accuracy of identifying abnormal hospitalization behaviors can be improved, the national economic losses can be reduced, and the public interest can be protected; and screening of medical information can improve the efficiency of detecting abnormal hospitalization behaviors and reduce the resource consumption of medical management equipment; And by choosing the reimbursement strategy according to the judgment result and adopting the selected reimbursement strategy to reimburse the target user's hospitalization expenses, the flexibility of reimbursement can be improved and the abnormal hospitalization behavior can be effectively combated.

Please refer to FIG. 3, which is a schematic structural diagram of a medical data processing apparatus provided by an embodiment of the present application. The apparatus of the embodiment of the present application may be provided in the medical management equipment mentioned above. In this embodiment, the medical data processing device includes:

The obtaining unit 301 is configured to obtain hospitalization information from the target user's hospitalization voucher information, where the hospitalization information includes diagnosed disease information and diagnosis and treatment information, and the diagnosis and treatment information includes any one or more of the following: treatment items and length of hospitalization , Medication information and hospitalization costs, the information of the diagnosed disease includes the name or type of the disease.

The screening unit 302 is configured to filter out target diagnosis and treatment information from the diagnosis and treatment information based on the diagnosed disease information.

The judging unit 303 is configured to judge whether the target user has abnormal hospitalization behavior according to the target diagnosis and treatment information.

The reimbursement unit 304 is configured to obtain a reimbursement strategy corresponding to the judgment result from a preset reimbursement strategy set based on the judgment result of whether the target user has abnormal hospitalization behavior, so as to determine the target user's reimbursement strategy according to the reimbursement strategy Hospitalization expenses are reimbursed.

Optionally, the target diagnosis and treatment information includes the first type of target diagnosis and treatment information or the second type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes any one or more of the following: treatment items, hospitalization costs, or length of hospitalization, The second type of target diagnosis and treatment information includes medication information; the information of the diagnosed disease includes the name of the disease. According to the information of the diagnosed disease, the screening unit 302 is specifically used to query the difficulty index of treating the disease from the first medical database according to the name of the disease, the first medical database includes the names of various diseases , And the difficulty index for treating each condition; when the determined difficulty index is greater than a preset threshold, the first type of target diagnosis and treatment information is obtained from the diagnosis and treatment information as the target diagnosis and treatment information; when the determined difficulty index is less than or When it is equal to the preset threshold, the second type of target diagnosis and treatment information is obtained from the diagnosis and treatment information as the target diagnosis and treatment information.

Optionally, the target diagnosis and treatment information includes the first type of target diagnosis and treatment information or the second type of target diagnosis and treatment information. The first type of target diagnosis and treatment information includes one or more of the following: treatment items, hospitalization costs, or length of hospitalization. The second type of target diagnosis and treatment information includes medication information; the information of the diagnosed disease includes the type of the disease; the root is based on the information of the diagnosed disease, the screening unit 302 is specifically used to seek medical treatment from the second according to the type of the disease Searching the database for the treatment strategy corresponding to the condition corresponding to the condition type, the second consultation database includes multiple condition types, and the treatment strategy for treating the condition corresponding to each condition type; when the treatment strategy is a surgical treatment strategy , Acquiring the first type of target diagnosis and treatment information from the hospitalization information as the target diagnosis and treatment information; when the treatment strategy is a non-surgical treatment strategy, acquiring the second type of target diagnosis and treatment information from the hospitalization information as the target diagnosis and treatment information .

Optionally, the target diagnosis and treatment information is a first type of target diagnosis and treatment information, the first type of target diagnosis and treatment information includes hospitalization costs and length of hospitalization, and the hospitalization costs include drug costs and total hospitalization costs; the judgment unit 303, specific It is used to obtain a first ratio between the drug cost and the total hospitalization cost; when the first ratio is greater than a first preset threshold, it is determined that the target user has abnormal hospitalization behavior, and the first The threshold is determined according to the length of hospitalization.

Optionally, the target diagnosis and treatment information is the first type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes hospitalization costs, and the hospitalization costs include the cost of medical examination items and the total cost of hospitalization; the judgment unit 303, specific Used to obtain a second ratio between the cost of the medical examination item and the total cost of hospitalization; when the second ratio is greater than a second preset threshold, determining that the target user has abnormal hospitalization behavior, the The second preset threshold is determined according to the diagnosed disease information.

Optionally, the target diagnosis and treatment information is a first type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes treatment items; a judgment unit 303 is used to determine the treatment items of the target user within a preset time period Whether to include a health check item and a physical therapy item; when it is determined that the target user's treatment item includes the health check item and does not include the physical therapy item, determine that the target user has abnormal hospitalization behavior; or, when When it is determined that the treatment item of the target user includes the physical therapy item and the health check item is not included, it is determined that the target user has abnormal hospitalization behavior.

Optionally, the target diagnosis and treatment information is a second type of target diagnosis and treatment information, and the second type of target diagnosis and treatment information includes medication information; the judgment unit 303 is specifically configured to find and treat the condition from the medical knowledge base according to the name of the condition For the required medicine information, the medical knowledge base records the medicine information required for treating various diseases; when the medicine information and the found medicine information do not match, it is determined that the target user has abnormal hospitalization behavior.

Please refer to FIG. 4, which is a schematic structural diagram of a medical management device according to an embodiment of the present application. As shown in the figure, the medical management device in this embodiment may include: one or more processors 401; one or more inputs Device 402, one or more output devices 403 and memory 404. The processor 401, the input device 402, the output device 403, and the memory 404 are connected via a bus 405.

The processor 401 may be a central processing unit (Central Processing Unit, CPU), the processor may also be other general-purpose processors, digital signal processors (Digital Signal Processor, DSP), application specific integrated circuits (Application Specific Integrated Circuit, ASIC ), Ready-made programmable gate array (Field-Programmable Gate Array, FPGA) or other programmable logic devices, discrete gate or transistor logic devices, discrete hardware components, etc. The general-purpose processor may be a microprocessor or the processor may be any conventional processor or the like.

The input device 402 may include a touchpad, a fingerprint sensor (used to collect user's fingerprint information and fingerprint direction information), a microphone, etc. The output device 403 may include a display (LCD, etc.), a speaker, etc. The output device 403 may output a prompt Information, prompt information can be used to prompt the target user whether there is abnormal hospitalization behavior.

The memory 404 may include a read-only memory and a random access memory, and provide instructions and data to the processor 401. A part of the memory 404 may further include a non-volatile random access memory, the memory 404 is used to store a computer program, the computer program includes program instructions, and the processor 401 is used to execute the program instructions stored in the memory 404 to be used to execute a A medical data processing method, that is, used to perform the following operations: obtain hospitalization information from the target user's hospitalization voucher information, the hospitalization information includes diagnosed disease information and diagnosis and treatment information, and the diagnosis and treatment information includes any one or more of the following Item: treatment items, length of hospitalization, medication information and hospitalization expenses, the information of the diagnosed disease includes the name or type of the disease; according to the information of the diagnosed disease, the target diagnosis and treatment information is selected from the diagnosis and treatment information; The target diagnosis and treatment information determines whether the target user has abnormal hospitalization behavior; according to the judgment result of whether the target user has abnormal hospitalization behavior, obtain a reimbursement strategy corresponding to the judgment result from a preset reimbursement strategy set, based on Hospitalization expenses of the target user by the reimbursement strategy Line reimbursement.

Optionally, the target diagnosis and treatment information includes the first type of target diagnosis and treatment information or the second type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes any one or more of the following: treatment items, hospitalization costs, or length of hospitalization, The second type of target diagnosis and treatment information includes medication information; the diagnosed disease information includes a disease name; the processor 401 is used to execute program instructions stored in the memory 404 for performing the following operations: according to the disease name Query the difficulty index for treating the disease in the first consultation database, the first consultation database includes the names of various diseases, and the difficulty index for treating each disease; when the determined difficulty index is greater than a preset threshold, the diagnosis and treatment information Acquiring the first type of target diagnosis and treatment information as the target diagnosis and treatment information; when the determined difficulty index is less than or equal to the preset threshold, acquiring the second type of target diagnosis and treatment information from the diagnosis and treatment information as the target diagnosis and treatment information.

Optionally, the target diagnosis and treatment information includes the first type of target diagnosis and treatment information or the second type of target diagnosis and treatment information. The first type of target diagnosis and treatment information includes one or more of the following: treatment items, hospitalization costs, or length of hospitalization. The second type of target diagnosis and treatment information includes medication information; the diagnosed disease information includes the type of illness; the processor 401 is used to execute the program instructions stored in the memory 404 for performing the following operations: according to the type of illness from the second visit Search for a treatment strategy for treating a condition corresponding to the condition type in the database, the second consultation database includes a variety of condition types, and a treatment strategy for treating a condition corresponding to each condition type; when the treatment strategy is a surgical treatment strategy When the first type of target diagnosis and treatment information is obtained from the hospitalization information as the target diagnosis and treatment information; when the treatment strategy is a non-surgical treatment strategy, the second type of target diagnosis and treatment information is acquired from the hospitalization information as the target diagnosis and treatment information.

Optionally, the target diagnosis and treatment information is a first type of target diagnosis and treatment information, the first type of target diagnosis and treatment information includes hospitalization costs and length of hospitalization, the hospitalization costs include drug costs and total hospitalization costs; the processor 401 is used for Executing the program instructions stored in the memory 404 for performing the following operations: acquiring a first ratio between the drug cost and the total hospitalization cost; when the first ratio is greater than a first preset threshold, determining the The target user has abnormal hospitalization behavior, and the first preset threshold is determined according to the length of hospitalization.

Optionally, the target diagnosis and treatment information is a first type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes hospitalization costs, and the hospitalization costs include the cost of medical examination items and the total cost of hospitalization; the processor 401 is used for Executing the program instructions stored in the memory 404 for performing the following operations: obtaining a second ratio between the cost of the medical examination item and the total cost of the hospitalization; when the second ratio is greater than the second preset threshold, It is determined that the target user has abnormal hospitalization behavior, and the second preset threshold is determined according to the diagnosed disease information.

Optionally, the target diagnosis and treatment information is a first type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes treatment items; the processor 401 is used to execute program instructions stored in the memory 404, and is used to perform the following operations: Whether the treatment item of the target user includes a health check item and a physical therapy item within a preset time period; when it is determined that the treatment item of the target user includes the health check item and does not include the physical therapy item, It is determined that the target user has abnormal hospitalization behavior; or, when it is determined that the treatment item of the target user includes the physical therapy item and the health check item is not included, it is determined that the target user has abnormal hospitalization behavior.

Optionally, the target diagnosis and treatment information is a second type of target diagnosis and treatment information, and the second type of target diagnosis and treatment information includes medication information; the processor 401 is used to execute the program instructions stored in the memory 404 for performing the following operations: The name of the disorder looks up the medical information needed to treat the disorder from the medical knowledge base. The medical knowledge base records the drug information required to treat a variety of disorders; when the medication information does not match the found drug information, It is determined that the target user has abnormal hospitalization behavior.

The processor 401, the input device 402, and the output device 403 described in the embodiments of the present application may execute the implementation manners described in the first and second embodiments of the medical data processing method provided by the embodiments of the present application, or The implementation of the medical management device described in the embodiments of the present application will not be repeated here.

An embodiment of the present application also provides a computer-readable storage medium. The computer-readable storage medium stores a computer program. The computer program includes program instructions. The program instructions are executed by a processor to implement a diagram of the present application. 1 and the medical data processing method shown in the embodiment of FIG. 2.

In the several embodiments provided in this application, it should be understood that the disclosed control device and method may be implemented in other ways. For example, the device embodiments described above are schematic. For example, the division of the unit may be a logical function division. In actual implementation, there may be another division manner, for example, multiple units or components may be combined or may Integration into another system, or some features can be ignored, or not implemented. The above is only the specific implementation of this application, but the scope of protection of this application is not limited to this, any person skilled in the art can easily think of various equivalent modifications within the technical scope disclosed in this application Or replacement, these modifications or replacements should be covered within the scope of protection of this application. Therefore, the protection scope of the present application shall be subject to the protection scope of the claims.

Claims

A medical data processing method, characterized in that it includes:

Obtain hospitalization information from the target user's hospitalization voucher information. The hospitalization information includes information about diagnosed diseases and medical treatment information. The medical treatment information includes any one or more of the following: treatment items, length of hospitalization, medication information, and hospitalization costs , The information of the diagnosed disease includes the name or type of the disease;

According to the information of the diagnosed disease, screening out target diagnosis and treatment information from the diagnosis and treatment information;

Judging whether the target user has abnormal hospitalization behavior according to the target diagnosis and treatment information;

According to a judgment result of whether the target user has abnormal hospitalization behavior, obtain a reimbursement strategy corresponding to the judgment result from a set of preset reimbursement strategies to reimburse the target user's hospitalization expenses according to the reimbursement strategy.
The method according to claim 1, wherein the target diagnosis and treatment information includes a first

The first type of target diagnosis and treatment information or the second type of target diagnosis and treatment information. The first type of target diagnosis and treatment information includes any one or more of the following: treatment items, hospitalization costs or length of hospitalization, and the second type of target diagnosis and treatment information includes medication information; The information of the diagnosed disease includes the name of the disease;

The screening out target diagnosis and treatment information from the diagnosis and treatment information according to the diagnosed disease information includes:

Querying the difficulty index for treating the disorder from the first visit database according to the name of the disorder, the first visit database includes the names of multiple illnesses, and the difficulty index for treating each illness;

When the determined difficulty index is greater than a preset threshold, acquiring the first type of target diagnosis and treatment information from the diagnosis and treatment information as the target diagnosis and treatment information;

When the determined difficulty index is less than or equal to the preset threshold, the second type of target diagnosis and treatment information is acquired from the diagnosis and treatment information as the target diagnosis and treatment information.
The method according to claim 1, wherein the target diagnosis and treatment information includes a first type of target diagnosis and treatment information or a second type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes one or more of the following: treatment Items, hospitalization expenses or hospitalization duration, the second type of target diagnosis and treatment information includes medication information; the diagnosed disease information includes the type of illness;

The root selects target diagnosis and treatment information from the diagnosis and treatment information according to the diagnosed disease information, including:

Searching for a treatment strategy for treating a condition corresponding to the condition type from the second visit database according to the condition type, the second visit database includes multiple disease types, and a treatment strategy for treating the condition corresponding to each disease type;

When the treatment strategy is a surgical treatment strategy, the first type of target diagnosis and treatment information is obtained from the diagnosis and treatment information as the target diagnosis and treatment information;

When the treatment strategy is a non-surgical treatment strategy, the second type of target diagnosis and treatment information is obtained from the diagnosis and treatment information as the target diagnosis and treatment information.
The method according to claim 2 or 3, wherein the target diagnosis and treatment information is a first type of target diagnosis and treatment information, the first type of target diagnosis and treatment information includes hospitalization costs and length of hospitalization, and the hospitalization costs include medicine costs And the total cost of hospitalization;

The judging whether the target user has abnormal hospitalization behavior according to the target diagnosis and treatment information includes:

Obtaining a first ratio between the cost of the medicine and the total cost of the hospitalization;

When the first ratio is greater than a first preset threshold, it is determined that the target user has abnormal hospitalization behavior, and the first preset threshold is determined according to the length of hospitalization.
The method according to claim 2 or 3, wherein the target diagnosis and treatment information is a first type of target diagnosis and treatment information, the first type of target diagnosis and treatment information includes a hospitalization fee, and the hospitalization fee includes a medical examination item cost And the total cost of hospitalization;

The judging whether the target user has abnormal hospitalization behavior according to the target diagnosis and treatment information includes:

Obtaining a second ratio between the cost of the medical examination item and the total cost of hospitalization;

When the second ratio is greater than a second preset threshold, it is determined that the target user has abnormal hospitalization behavior, and the second preset threshold is determined according to the diagnosed disease information.
The method according to claim 2 or 3, wherein the target diagnosis and treatment information is a first type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes a treatment item;

The judging whether the target user has abnormal hospitalization behavior according to the target diagnosis and treatment information includes:

Determine whether the treatment items of the target user include a health check item and a physical therapy item within a preset time period;

When it is determined that the treatment item of the target user includes the health check item and the physical therapy item is not included, it is determined that the target user has abnormal hospitalization behavior; or,

When it is determined that the treatment item of the target user includes the physical therapy item and the health check item is not included, it is determined that the target user has abnormal hospitalization behavior.
The method according to claim 2 or 3, wherein the target diagnosis and treatment information is a second type of target diagnosis and treatment information, and the second type of target diagnosis and treatment information includes medication information;

The judging whether the target user has abnormal hospitalization behavior according to the target diagnosis and treatment information includes:

According to the name of the disease, find the drug information needed to treat the disease from the medical knowledge base, and the medical knowledge base records the drug information required to treat various diseases;

When the medication information does not match the found medication information, it is determined that the target user has abnormal hospitalization behavior.
The method according to claim 2 or 3, wherein the target diagnosis and treatment information is a second type of target diagnosis and treatment information, and the second type of target diagnosis and treatment information further includes hospitalization location information and identity information; The target diagnosis and treatment information determines whether the target user has abnormal hospitalization behavior, including:

Determine the hospital where the target user visits according to the hospitalized location information;

Retrieve hospitalization data from the medical management equipment corresponding to the hospital that the target user visits, the hospitalization data including identity information of the hospitalized patient;

When the identity information of the target user does not match the identity information of any patient in the retrieved hospitalization data, it is determined that the target user has abnormal hospitalization behavior.
The method according to claim 1, wherein the method further comprises:

Obtain the target user's credit rating; when the target user's credit rating is less than a preset value, perform the step of obtaining hospitalization information from the target user's hospitalization credential information.
The method according to claim 1, wherein the method further comprises:

Obtaining the medical reimbursement frequency of the target user; when the medical reimbursement frequency of the target user is greater than a preset number, the step of obtaining hospitalization information from the hospitalization credential information of the target user is performed.
A medical data processing device, characterized in that it includes:

The obtaining unit is used for obtaining hospitalization information from the hospitalization voucher information of the target user, the hospitalization information includes information of diagnosed diseases and diagnosis and treatment information, and the diagnosis and treatment information includes any one or more of the following: treatment items, length of hospitalization, Medication information and hospitalization costs, the information of the diagnosed disease includes the name or type of the disease;

A screening unit for screening out target diagnosis and treatment information from the diagnosis and treatment information based on the information of the diagnosed disease;

The judging unit is used to judge whether the target user has abnormal hospitalization behavior according to the target diagnosis and treatment information;

The reimbursement unit is configured to obtain a reimbursement strategy corresponding to the judgment result from a preset reimbursement strategy set according to the judgment result of whether the target user has abnormal hospitalization behavior, so as to hospitalize the target user according to the reimbursement strategy Expenses are reimbursed.
The apparatus according to claim 11, wherein the target diagnosis and treatment information includes a first type of target diagnosis and treatment information or a second type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes any one or more of the following: For treatment items, hospitalization expenses or hospitalization duration, the second type of target diagnosis and treatment information includes medication information; the diagnosed disease information includes the name of the disease;

The screening unit is specifically used to query the difficulty index for treating the disorder from the first visit database according to the name of the disorder. The first visit database includes multiple disorder names and the difficulty index for treating each disorder; when When the determined difficulty index is greater than a preset threshold, the first type of target diagnosis and treatment information is obtained from the diagnosis and treatment information as the target diagnosis and treatment information; when the determined difficulty index is less than or equal to the preset threshold, from The second type of target diagnosis and treatment information is obtained from the diagnosis and treatment information as the target diagnosis and treatment information.
The device according to claim 11, wherein the target diagnosis and treatment information includes a first type of target diagnosis and treatment information or a second type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes one or more of the following: treatment Items, hospitalization expenses or hospitalization duration, the second type of target diagnosis and treatment information includes medication information; the diagnosed disease information includes the type of illness;

The screening unit is specifically configured to search for a treatment strategy for treating a condition corresponding to the condition type from the second visit database according to the condition type, the second visit database includes multiple disease types, and treats each condition The treatment strategy of the disease corresponding to the type; when the treatment strategy is a surgical treatment strategy, the first type of target diagnosis and treatment information is obtained from the diagnosis and treatment information as the target diagnosis and treatment information; when the treatment strategy is a non-surgical treatment strategy At this time, the second type of target diagnosis and treatment information is acquired from the diagnosis and treatment information as the target diagnosis and treatment information.
The device according to claim 12 or 13, wherein the target diagnosis and treatment information is a first type of target diagnosis and treatment information, the first type of target diagnosis and treatment information includes hospitalization costs and length of hospitalization, and the hospitalization costs include medicine costs And the total cost of hospitalization;

The judgment unit is specifically configured to obtain a first ratio between the drug cost and the total hospitalization cost; when the first ratio is greater than a first preset threshold, determine that the target user has abnormal hospitalization behavior , The first preset threshold is determined according to the length of hospitalization.
The device according to claim 12 or 13, wherein the target diagnosis and treatment information is a first type of target diagnosis and treatment information, the first type of target diagnosis and treatment information includes a hospitalization fee, and the hospitalization fee includes a medical examination item cost And the total cost of hospitalization;

The judgment unit is specifically configured to obtain a second ratio between the cost of the medical examination item and the total cost of the hospitalization; when the second ratio is greater than a second preset threshold, determine that the target user exists For abnormal hospitalization behavior, the second preset threshold is determined according to the diagnosed disease information.
The device according to claim 12 or 13, wherein the target diagnosis and treatment information is a first type of target diagnosis and treatment information, and the first type of target diagnosis and treatment information includes a treatment item;

The judging unit is specifically configured to judge whether the target user's treatment item includes a health check item and a physical therapy item within a preset time period; when it is determined that the target user's treatment item includes the health check item, And if the physical therapy item is not included, it is determined that the target user has abnormal hospitalization behavior; or,

When it is determined that the treatment item of the target user includes the physical therapy item and the health check item is not included, it is determined that the target user has abnormal hospitalization behavior.
The device according to claim 12 or 13, wherein the target diagnosis and treatment information is a second type of target diagnosis and treatment information, and the second type of target diagnosis and treatment information includes medication information;

The judging unit is specifically configured to search for medical information required for treating the disease from the medical knowledge base according to the name of the disease, and the medical knowledge base records the drug information required for treating various diseases; when the drug information When the found drug information does not match, it is determined that the target user has abnormal hospitalization behavior.
A medical management device, comprising: a processor and a memory, the processor and the memory are interconnected; wherein the memory stores one or more instructions, the one or more instructions are suitable for The processor loads and executes the following steps: obtaining hospitalization information from the target user's hospitalization credential information, the hospitalization information includes diagnosed disease information and diagnosis and treatment information, and the diagnosis and treatment information includes any one or more of the following: Treatment items, length of hospital stay, medication information, and hospitalization expenses, the information of the diagnosed disease includes the name or type of the disease; based on the information of the diagnosed disease, the target diagnosis and treatment information is selected from the diagnosis and treatment information; The target diagnosis and treatment information determines whether the target user has abnormal hospitalization behavior; according to the judgment result of whether the target user has abnormal hospitalization behavior, obtain a reimbursement strategy corresponding to the judgment result from a preset reimbursement strategy set, in accordance with the The reimbursement strategy reimburses the target user's hospitalization expenses.
The device according to claim 18, wherein the processor is specifically configured to query a difficulty index for treating the disorder from a first visit database according to the name of the disorder, the first visit database includes multiple The name of the disease and the difficulty index for treating each disease; when the determined difficulty index is greater than the preset threshold, the first type of target diagnosis and treatment information is obtained from the diagnosis and treatment information as the target diagnosis and treatment information; when the determined When the difficulty index is less than or equal to the preset threshold, the second type of target diagnosis and treatment information is obtained from the diagnosis and treatment information as the target diagnosis and treatment information.
A computer-readable storage medium, characterized in that the computer-readable storage medium stores one or more instructions, the one or more instructions are suitable for being loaded by a processor and executed as claimed in any one of claims 1-7 Item.