Medical expense management method and system

Abstract

The invention discloses a medical expense management method and system. The medical expense management method comprises the following steps: establishing a medical expense management database; acquiring patient information, disease information and medical information; carrying out DRG / DIP grouping on the patients; subdividing each group into one or more layers of subgroups, dividing the patients into proper subgroups, and obtaining an expense management target; and decomposing the treatment scheme, comprehensively analyzing the treatment rationality and necessity of each sub-project, and giving an analysis result of cost management and control of the treatment scheme. The medical expense management system comprises a database module, an information acquisition module and an intelligent analysis module. According to the medical expense management method and system, medical expense management is carried out based on the DRG / DIP, each item of the treatment scheme or the treatment intensity of each item is adjusted, the medical expense can be precisely managed and controlled, medical resources are reasonably distributed, diagnosis and treatment behaviors are standardized, excessive treatment is avoided, and the economic burden of a patient is relieved.

Description

technical field [0001] The invention relates to the technical field of intelligent medical information processing, in particular to a medical expense management method and system. Background technique [0002] With the continuous improvement of living standards, people's demand for medical care has also increased significantly, and medical expenses have also shown a trend of rising sharply. In order to manage medical expenses more effectively, make the diagnosis and treatment behavior of medical institutions more standardized, medical expenses be compensated reasonably, and medical technology be fully developed; patients can enjoy high-quality medical services, avoid over-treatment, and reduce economic burden; Overspending, more efficient use, more accurate management of medical institutions and medical insurance patients, and more convenient settlement methods. [0003] Diagnosis Related Groups (DRG) is an important tool for measuring the quality and efficiency of medical ...

AI Technical Summary

Problems solved by technology

[0007] The main purpose of the present invention is to provide a medical expense management method for the problems of unreasonable allocation of medical resources and non-standard treatment behavior caused by the lack of management and control means for various item expenses in the specific diagnosis and treatment process of DRG / DIP in the medical expense management system and system, based on DRG to manage medical expenses, comprehensively analyze the necessity of each item in the treatment plan from the aspects of applicability, safety, effectiveness, economy and comfort, etc., remove or reduce unnecessary treatments in the treatment plan, increase Or replace the highly necessary treatment in the treatment plan, which can accurately control medical expenses, rationally allocate medical resources, standardize diagnosis and treatment behaviors, avoid over-treatment, and reduce medical insurance and the economic burden of patients

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