Hospital performance management method and system based on big data mining

Abstract

The invention discloses a hospital performance management method and system based on big data mining. The method comprises the steps of building six benchmarking dimensions; building a benchmarking cluster; performing detailed item grouping on claim settlement data corresponding to benchmarking dimensions of in-hospital claim settlement containing operation processes, outpatient service claim settlement containing operation processes and outpatient chronic disease and outpatient specific item claim settlement containing operation processes according to operation names, insurance types, hospital levels, medical institution types and insured person risk score sections to obtain corresponding benchmarking cluster claim settlement data, and performing detailed item grouping on claim settlementdata corresponding to benchmarking dimensions of in-hospital claim settlement not containing operation processes, outpatient service claim settlement not containing operation processes and outpatientchronic disease and outpatient specific item claim settlement not containing operation processes according to selected disease groups, risk types, hospital leaves, medical institution types and insured person risk score sections to obtain corresponding benchmarking cluster claim settlement data; calculating a benchmarking value for each benchmarking cluster claim settlement data; comparing and summarizing cost controlled space data; performing specific cost item comparison on disease entities and hospitals with the higher priorities.

Description

technical field [0001] The invention relates to the technical field of hospital performance management, in particular to a hospital performance management method and system based on big data mining. Background technique [0002] The operation of medical insurance funds is quite stressful, and the control of medical expenses has always been a key issue of medical insurance focus. As the main body of medical treatment, the hospital is also the main body of controlling medical expenses. However, due to the different levels of hospitals, the difficulty of receiving patients, and the different methods of diagnosis and treatment, it is difficult to directly compare the medical costs and medical quality of different hospitals. Furthermore, it is also impossible to lock in what items, what diseases, and what expenses cause the hospital's medical expenses to be too high. [0003] Based on a large amount of medical insurance compensation data and medical treatment information accumul...

AI Technical Summary

Problems solved by technology

As the main body of medical treatment, the hospital is also the main body of controlling medical expenses. However, due to different levels of hospitals, different difficulties in receiving patients, and different methods of diagnosis and treatment, it is difficult to directly compare the medical costs and medical quality of different hospitals.

Furthermore, it is also impossible to determine what items, what diseases, and what expenses cause the hospital's medical expenses to be too high

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