An abnormal case identification method based on data analysis and a computing device

A technology of computing equipment and data analysis, applied in the field of medical insurance, which can solve problems such as difficulties

Pending Publication Date: 2019-03-29
PING AN MEDICAL & HEALTHCARE MANAGEMENT CO LTD
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Problems solved by technology

However, for the overall environment of China's medical care, there are far fewer than 26,000 common diseases in each region, and when medical personnel record cases, due to the diversity and complexity of diseases in the prior art, medical personnel often do not Classification according to international standards, each region has a regional language description, which brings certain difficulties to the implementation of payment by disease type

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  • An abnormal case identification method based on data analysis and a computing device
  • An abnormal case identification method based on data analysis and a computing device
  • An abnormal case identification method based on data analysis and a computing device

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Embodiment Construction

[0094] In order to enable those skilled in the art to better understand the solutions of the present invention, the following will clearly and completely describe the technical solutions in the embodiments of the present invention in conjunction with the accompanying drawings in the embodiments of the present invention. Obviously, the described embodiments are Some, but not all, embodiments of the invention. Based on the embodiments of the present invention, all other embodiments obtained by persons of ordinary skill in the art without creative efforts fall within the protection scope of the present invention.

[0095] It should be noted that the terms used in the embodiments of the present invention are only for the purpose of describing specific embodiments, and are not intended to limit the present invention. As used in the embodiments of the present invention and the appended claims, the singular forms "a", "said" and "the" are also intended to include the plural forms unl...

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Abstract

The embodiment of the invention discloses an abnormal case identification method based on data analysis and a computing device. The method includes the following steps: the computing device receives case data of a first case, the case data includes actual medical insurance cost; Finding a first basic disease score corresponding to a first disease classification to which the first case belongs in adisease score dictionary table, and calculating a predicted medical insurance expense of the first case according to the first basic disease score, wherein the disease score dictionary table comprises a corresponding relationship between the disease classification and the basic disease score; Further, it is judged whether the first case is an abnormal case according to the actual medical insurance cost and the predicted medical insurance cost, and if so, prompting information for prompting the first case to be abnormal is outputted, and by performing the above method, it is possible to realize the identification of the abnormal case.

Description

technical field [0001] The invention relates to the technical field of medical insurance, in particular to an abnormal case identification method and computing equipment based on data analysis. Background technique [0002] With the layout of the national public medical care and the continuous deepening of medical reform, the reform of the payment system is a system engineering, a manifestation of the major changes in the management concept of medical insurance and the role of medical insurance agencies. The implementation of payment according to the type of disease fully reflects that the payment system is the key to comprehensive medical reform. [0003] The so-called payment by disease refers to scientifically formulating a fixed payment standard for each disease through a unified disease diagnosis classification. The social security agency pays the hospitalization fee to the designated medical institution according to the standard and the number of hospitalizations, so a...

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Application Information

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Patent Type & Authority Applications(China)
IPC IPC(8): G06Q40/08G16H50/70
CPCG06Q40/08G16H50/70
Inventor 刘俊芳
Owner PING AN MEDICAL & HEALTHCARE MANAGEMENT CO LTD
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