Quality monitoring method and device for insurance cooperative hospitals, storage medium and terminal

A cooperative hospital and quality technology, applied in the field of data processing, can solve the problems of inability of insurance companies to provide expenses, services, medical quality, and differences, achieve automatic and accurate quality monitoring, improve efficiency, and avoid inefficiencies.

Pending Publication Date: 2018-08-28
PING AN HEALTH INSURANCE CO LTD
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Problems solved by technology

[0004] The embodiment of the present invention provides a quality monitoring method and device, a storage medium, and a terminal of an insurance cooperative hospital, which solves the problem that in the related art, due to differ

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  • Quality monitoring method and device for insurance cooperative hospitals, storage medium and terminal
  • Quality monitoring method and device for insurance cooperative hospitals, storage medium and terminal
  • Quality monitoring method and device for insurance cooperative hospitals, storage medium and terminal

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Embodiment Construction

[0049] Exemplary embodiments of the present disclosure will be described in more detail below with reference to the accompanying drawings. Although exemplary embodiments of the present disclosure are shown in the drawings, it should be understood that the present disclosure may be embodied in various forms and should not be limited by the embodiments set forth herein. Rather, these embodiments are provided for more thorough understanding of the present disclosure and to fully convey the scope of the present disclosure to those skilled in the art.

[0050] The embodiment of the present invention provides a quality monitoring method of an insurance cooperative hospital, such as figure 1 As shown, the method includes:

[0051] 101. Obtain the claim settlement data of different cooperative hospitals for the insured personnel, as well as the pre-entered evaluation information of cooperative hospitals.

[0052] Wherein, the claims data includes medical expenses, medical service in...

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Abstract

The invention discloses a quality monitoring method and device for insurance cooperative hospitals, a storage medium and a terminal, relates to the data processing technology field and mainly solves aproblem that different patients have different evaluations of medical service items and can not reasonably provide insurance companies with the accurate information about costs, services and the medical quality. The method comprises steps that claims data of different cooperative hospitals for the insured personnel and the pre-inputted evaluation information of the cooperative hospitals are acquired; according to disease categories, disease subtypes and treatment strategies, diagnosis disease-related group DRGs grouping of the claims data is carried out, and expected values of the medical expenses are determined; the cost consumption index and the time consumption index in the evaluation information are analyzed; predictive classification is carried out according to the expected values ofthe medical expenses of the different cooperative hospitals, the cost consumption index and the time consumption index, and the quality results of the cooperative hospitals are determined. The methodis advantaged in that the method is suitable for carrying out quality monitoring of the insurance cooperative hospitals.

Description

technical field [0001] The invention relates to the field of data processing, in particular to a quality monitoring method and device, a storage medium and a terminal of an insurance cooperative hospital. Background technique [0002] In the process of business development, insurance companies need to designate hospitals in a certain area that meet the claims and medical conditions as designated hospitals for insured persons according to actual needs, so that insured persons can conduct inspections and issue medical certificates. In order to sign the specific cooperative inspection items of the designated hospitals, it is necessary to determine whether the service quality of the hospital meets the insurance company's claim settlement items, etc., and then sign a cooperation agreement with the qualified hospital to ensure that the cooperative hospital provides effective and reasonable medical treatment for the insured. Serve. [0003] At present, the existing determination o...

Claims

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Application Information

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IPC IPC(8): G06Q40/08G06Q50/22
CPCG06Q40/08G06Q50/22
Inventor 孙翔戴斯韦陆夏飞
Owner PING AN HEALTH INSURANCE CO LTD
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