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Extracting method and apparatus for case auditing rule, and case auditing method and system

A technology of cases and rules, applied in the medical field, can solve problems such as inability to guarantee the safety of medical insurance funds, low review efficiency, time-consuming and labor-intensive problems

Active Publication Date: 2016-01-06
NEUSOFT CORP
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Problems solved by technology

The manual review method is cumbersome, time-consuming and labor-intensive, and the review efficiency is low
In addition, since the structured case data is easily tampered with, the security of the medical insurance fund cannot be guaranteed

Method used

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  • Extracting method and apparatus for case auditing rule, and case auditing method and system
  • Extracting method and apparatus for case auditing rule, and case auditing method and system
  • Extracting method and apparatus for case auditing rule, and case auditing method and system

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Embodiment Construction

[0082] Specific embodiments of the present invention will be described in detail below in conjunction with the accompanying drawings. It should be understood that the specific embodiments described here are only used to illustrate and explain the present invention, and are not intended to limit the present invention.

[0083] figure 1 A flowchart showing a method for extracting case review rules for a single disease according to an embodiment of the present invention. Such as figure 1 As shown, the method may include:

[0084] In step S101, word segmentation is performed on each case in the training case set to obtain multiple word segmentations, wherein the training case set may include multiple cases belonging to a preset single disease.

[0085] In the present invention, the cases included in the training case set may be unstructured case data, for example, surgical procedure texts used to record surgical procedures. Since the operation process text contains a large amo...

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Abstract

The invention discloses an extracting method and apparatus for a case auditing rule of a single disease, and a case auditing method and system for the single disease. The extracting method comprises the steps of performing word segment processing on each case of a training case set to obtain a plurality of segmented words, wherein the training case set comprises a plurality of cases belonging to preset single disease; establishing a word co-occurrence graph with multiple segmented words, wherein each segmented word is used as a top point of the word co-occurrence graph, and the weight of the side boundary between two top points is the co-occurrence time of the segmented word, corresponding to the two top points, in the training case set; obtaining key words from the multiple segmented words according to the word co-occurrence graph; forming a key word set according to the obtained key words; and extracting the case auditing rule specific to the single disease from the key word set, wherein the case auditing rule is a sequential key word sequence formed by the multiple key words from the key word set. Therefore, the case auditing rule for the single disease can be extracted for realizing the automatic auditing for cases of the single disease.

Description

technical field [0001] The present invention relates to the medical field, in particular to a method and device for extracting case review rules, and a case review method and system. Background technique [0002] With the expansion of social insurance coverage, the improvement of security levels, and the improvement of service convenience, driven by interests, criminals have begun to illegally extract social security funds in some places. This phenomenon is particularly prominent in the field of health insurance. [0003] A single disease refers to a single disease with no complications. Single-disease payment refers to the costs of laboratory tests, surgery, hospitalization, medical consumables and other expenses incurred during the whole process of patients being admitted to the hospital after being diagnosed, receiving corresponding treatment according to the prescribed clinical pathway, and finally discharged after meeting the clinical curative effect standard. The med...

Claims

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Application Information

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IPC IPC(8): G06F19/00
Inventor 赵大哲栗伟周庆华陈锡民王军搏孟勤柳玉辉
Owner NEUSOFT CORP
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