Medical insurance data processing method, system and equipment based on disease types and storage medium

A data processing and disease type technology, applied in the field of medical big data analysis, to achieve the effect of solving unreasonable distribution

Inactive Publication Date: 2019-05-10
TAIKANG LIFE INSURANCE CO LTD
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

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Problems solved by technology

[0004] Aiming at the problems in the prior art, the purpose of the present invention is to provide a disease-based medical insurance data processing method, system, equipment and storage medium, which overcomes the difficulties of

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  • Medical insurance data processing method, system and equipment based on disease types and storage medium
  • Medical insurance data processing method, system and equipment based on disease types and storage medium
  • Medical insurance data processing method, system and equipment based on disease types and storage medium

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Example Embodiment

[0045] Example embodiments will now be described more fully with reference to the accompanying drawings. However, the example embodiments can be implemented in various forms, and should not be construed as being limited to the embodiments set forth herein. On the contrary, these embodiments are provided so that the present invention will be comprehensive and complete, and will fully convey the concept of example embodiments to those skilled in the art. The same reference numerals in the figures indicate the same or similar structures, and thus their repeated description will be omitted.

[0046] figure 1 It is a flowchart of the medical insurance data processing method based on the disease type of the present invention. Such as figure 1 As shown, the embodiment of the present invention provides a medical insurance data processing method based on disease type, including:

[0047] S101. Obtain settlement information of the case, the settlement information includes: disease type inf...

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Abstract

The invention provides a medical insurance data processing method, system and device based on disease types and a storage medium, and the method comprises the steps: obtaining the settlement information of a case, the settlement information comprising the disease type information corresponding to the case and the total settlement cost S of the case; obtaining a standard cost C and a standard scoreA of the disease type; acquiring a preset reference cost D and a reference score E for medical insurance settlement; and determining a medical insurance settlement score R of the case according to the reference cost D, the reference score E, the standard cost C, the standard score A and the total settlement cost S. The medical insurance cost can be reasonably controlled through big data, settlement is reasonably carried out according to disease types, and the problem that current medical insurance resources are reasonably distributed is solved.

Description

Technical field [0001] The present invention relates to the field of medical big data analysis, and in particular, to a medical insurance data processing method, system, equipment and storage medium based on disease types. Background technique [0002] The current medical insurance settlement method is based on the actual expenses incurred. The lack of an effective cost control mechanism has caused great losses and waste. The score settlement by disease type is grouped according to different diseases, and each disease group (disease type) is assigned a corresponding score. A medical insurance settlement cycle accumulates the score of the medical structure, according to the total budget in the cycle, and the type of disease Value unit price, combined with performance evaluation and supervision results, to settle medical institutions. The settlement by disease scores realizes the total control of the medical insurance fund. While appropriately controlling the unreasonable expendit...

Claims

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Application Information

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IPC IPC(8): G06Q40/08G16H40/20
Inventor 鲁金币刘伟奇王坤魏文婷杜云强
Owner TAIKANG LIFE INSURANCE CO LTD
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