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DRG or DIP settlement method and system for daytime operation

A technology of surgery and time, applied in the field of DRG or DIP settlement method and system for day surgery, which can solve problems such as settlement, restrictions on the effective implementation of day surgery, and inability to apply DRG or DIP to day surgery

Pending Publication Date: 2022-04-12
上海柯林布瑞信息技术有限公司
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

[0004] However, the existing DRG / DIP management scheme for medical insurance cost control cannot be applied to DRG or DIP settlement for day surgery, which largely restricts the effective implementation of day surgery

Method used

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  • DRG or DIP settlement method and system for daytime operation
  • DRG or DIP settlement method and system for daytime operation
  • DRG or DIP settlement method and system for daytime operation

Examples

Experimental program
Comparison scheme
Effect test

Embodiment 1

[0031] figure 1 It is a flowchart of a DRG or DIP settlement method for day surgery provided in Embodiment 1 of the present invention. This embodiment is applicable to the determination of the patient's self-payment, especially applicable to the determination of the patient's self-payment after refunding the difference for the inspection and test items performed before day surgery. The method can be performed by the DRG or DIP settlement system for day surgery provided by the embodiment of the present invention, the system can be implemented by software and / or hardware, and the system can be integrated on the DRG or DIP settlement device for day surgery, The device may be various user terminals or a server.

[0032] see figure 1 , the method of the embodiment of the present invention specifically includes the following steps:

[0033] S110. Obtain patient data of patients to be settled, wherein the patient data includes admission and discharge data, operation data, hospital...

Embodiment 2

[0044] figure 2 It is a flowchart of a DRG or DIP settlement method for day surgery provided in Embodiment 2 of the present invention. This embodiment is optimized on the basis of the above-mentioned technical solutions. In this embodiment, optionally, the above-mentioned DRG or DIP settlement method for daytime surgery may also include: obtaining the admission and discharge registration form, operation record form, hospitalization expense list and outpatient expense list; Settle the patient data of the patient, which can include: obtain the admission and discharge data from the admission and discharge registration table based on the patient index number of the patient to be settled, and obtain the outpatient expense data from the outpatient expense schedule; The operation data is obtained from the record table, and the hospitalization expense data is obtained from the hospitalization expense list; the admission and discharge data, operation data, hospitalization expense dat...

Embodiment 3

[0065] Figure 4 It is a flowchart of a DRG or DIP settlement method for day surgery provided in Embodiment 3 of the present invention. This embodiment is optimized on the basis of the above-mentioned technical solutions. In this embodiment, optionally, the above-mentioned DRG or DIP settlement method for day surgery may further include: determining the target group of day surgery according to the operation data, wherein the target group includes DRG group or DIP group; The first data of the day surgery under the group under the first object, the first average cost is determined according to the first data, wherein the first data includes the first data of the day surgery under the target group under the first object The total cost of hospitalization of the patient; obtain the second data of day surgery under the target group under the second object, and determine the second average cost according to the second data, wherein the second data includes the target grouping perfor...

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Abstract

The embodiment of the invention discloses a DRG or DIP settlement method and system for a daytime operation. The method comprises the steps that patient data of a patient to be settled is acquired, and the patient data comprises hospital exit and admission data, operation data, hospitalization cost data and outpatient service cost data; when the hospitalization of the patient to be settled is determined to be the daytime operation hospitalization according to the exit and admission data and the operation data, determining the total hospitalization cost and the hospitalization medical insurance reimbursement cost according to the hospitalization cost data, and determining the first medical insurance reimbursement cost and the second medical insurance reimbursement cost according to the outpatient cost data; according to the first medical insurance reimbursement expense and the second medical insurance reimbursement expense, obtaining a difference expense, according to the hospitalization total expense, the hospitalization medical insurance reimbursement expense and the difference expense, determining the self-payment of the patient, and taking the self-payment of the patient as a DRG or DIP settlement result of the daytime operation. According to the technical scheme provided by the embodiment of the invention, the effect of timely settlement of the DRG or DIP of the daytime operation is achieved.

Description

technical field [0001] Embodiments of the present invention relate to the technical field of medical insurance fee control DIP / DRG, in particular to a DRG or DIP settlement method and system for day surgery. Background technique [0002] Day surgery is a surgery or operation completed within 24 hours of admission and discharge of the patient. In special cases, the hospitalization needs to be postponed due to the illness, and the maximum length of hospitalization should not exceed 48 hours. Day surgery can significantly shorten the hospitalization time of patients, reduce hospitalization expenses, increase the bed turnover rate, reduce the probability of nosocomial infection, and improve the utilization efficiency of medical resources, which is conducive to the rational allocation of health resources. [0003] After day surgery is included in Diagnosis Related Groups (DRG) and / or Big Data Diagnosis-Intervention (DIP), the cost of preoperative examinations will be included in ...

Claims

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Application Information

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IPC IPC(8): G06Q20/14G06Q40/08G16H40/20
Inventor 秦晓宏叶大江
Owner 上海柯林布瑞信息技术有限公司
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