Control method based on medical insurance fund flight inspection data detection rule script making

Abstract

The invention provides a control method based on medical insurance fund flight inspection data detection rule script making. A terminal, a function module, a database and a production database are included. The front-end page comprises a preview area, an editing area and the like. Automatically initiating a medical insurance fund test data request, and constructing a preview area table; responding to an operation instruction of the preview area table, generating a check script fragment, and rendering an editing area table based on a script execution result; responding to an operation instruction of the edit area table, expanding the check script, and rendering edit area table data; responding to the test instruction, re-rendering the edit area table based on the current check script, responding to the generation instruction, and storing the current check script and related description information; according to the method, the technical requirements of rule script making are obviously reduced, the script making efficiency is improved through visual interface operation, and the problems that errors are prone to occurring and the efficiency is low when codes are written manually are solved. The leakage and misoperation risks of the flying inspection data are effectively reduced, and the rules of flying inspection confidentiality, avoidance and the like are followed.

Description

Technical Field

[0001] The present invention relates to the technical field of information-based medical insurance fund flight inspection, and in particular to a control method based on the production of medical insurance fund flight inspection data detection rule scripts. Background Art

[0002] With the continuous development of the medical security system, the rational use and supervision of medical insurance funds have become increasingly important. ‌Medical insurance flight inspection refers to an on-site supervision and inspection of designated medical institutions, etc., organized and implemented by the medical security administrative department without prior notice. It aims to ensure the rational use of medical insurance funds and prevent fraud and abuse. ‌ However, due to the huge amount of data in the flight inspection, in the current medical insurance fund flight inspection process, facing the huge amount of data, information personnel are usually required to write different data inspection scripts for different inspection items and execute them manually with the help of database tools. This requires the flight inspection executors to have high professional information processing skills and high professional and technical requirements for the flight inspection executors. The efficiency of manually writing codes to make flight inspection rule scripts is low. Secondly, the database data is completely exposed to the executors, and direct operation of the database is prone to data tampering, leakage and other risks, which poses certain data security risks. This makes the labor cost of verification script production in the medical insurance fund flight inspection high, the implementation efficiency is low, and there are data security risks. Summary of the invention

[0003] The purpose of the present invention is to solve the shortcomings existing in the prior art and to propose a control method based on the production of medical insurance fund flight inspection data detection rule scripts.

[0004] To achieve the above object, the present invention adopts the following technical solutions: A control method based on the production of medical insurance fund flight inspection data detection rule scripts, including a terminal, a functional module, a database and a production database; The functional module is installed on the terminal, and the functional module includes a front-end page, and the front-end page includes a preview area, an editing area, a storage module and a test button; the functional module is connected to a database; the test data is stored in the database, and the production database is used to store the final verification script; The following steps are involved: S1: Automatically initiate a request for medical insurance fund test data and build a preview area table based on the response data; In response to the user accessing the function module, trigger an automatic request, connect to the database, obtain the medical insurance fund test data from the database, display it in the preview area, and build a preview area table; The preview area table consists of a standard header and test data. The standard header specifies the field code, field Chinese name, data type, length and database table of the medical insurance fund data. S2: Responding to the operation instruction of the preview area table, generating a verification script fragment, and rendering the edit area table based on the script execution result of the verification script fragment; Select the header field in the preview area, associate the corresponding field code and library table name according to the header field information selected by the user in the preview area, generate an executable database SQL script, generate an execution verification script fragment, submit a request to execute the verification script fragment to the database, obtain the execution result, and render the execution result to the table in the editing area; S3: respond to the operation instructions of the table in the editing area, expand the verification script, and automatically render the table data in the editing area; Configure the permission of the table in the editing area to be editable. Users can edit the table in the editing area, supplement and improve the verification script fragment, build an executable database SQL script, and trigger re-rendering; S4: respond to the test instruction, re-render the editing area table based on the current verification script, and throw a corresponding exception prompt when the script execution is abnormal; The front-end page also includes a test button, and a click trigger event is configured for the test button. The test instruction is an event triggered by a user clicking the test button. The event submits the check script to the database for execution and renders the response result into a table. When an execution exception occurs, a pop-up window is triggered to prompt the exception. S5: respond to the generation instruction and save the current verification script and related description information; The generation instruction is to store the currently generated verification script content in the production database, and the relevant description information is filled in by the user when storing.

[0005] Furthermore, the operation instruction of the preview area table in step S2 is the user's dragging and clicking operation on the header field; configure the monitoring event to monitor the user's click and drag operations; respond to the operation instruction and the selected header field, obtain the field code and library table name corresponding to all the selected header fields, construct the SELECT statement of the SQL query, and generate the database query script; The execution result is that when the number of table headers selected in the preview area changes, a request to execute the verification script fragment is automatically submitted to the database, and the database responds with a data set; The rendering refers to automatically converting the header code in the execution result into the Chinese name of the field according to the standard field information and filling it into the editing area table, and the data in the execution result is automatically filled into the editing area table according to the header.

[0006] Furthermore, the configured listening events include: 1) Mouse press event: triggered when the user clicks on a standard header, records the initial position of the mouse, and marks the standard header as "selected"; 2) Mouse move event: The user presses the mouse and moves it to change the position of the standard header element and drag the header element to follow the mouse cursor; 3) Mouse release event: The user releases the mouse, stops the dragging operation, and locates the target rendering position of the table in the editing area.

[0007] 4. The control method based on the production of the medical insurance fund flight inspection data detection rule script as described in claim 1 is characterized in that: the operation instructions of the editing area table in step S3 are the user's addition, editing, header sorting, content sorting and formula editing of the header field; the formula editing includes totaling, counting, size comparison, null value judgment, and conditional combination.

[0008] Furthermore, the extended verification script is used to respond to the operation instructions of the table in the editing area, and the verification script fragment is supplemented and improved, and the script is adjusted accordingly according to the operation calling the corresponding function; The automatic rendering of the editing area table is in response to the editing area operation instructions. After each operation, the extended verification script fragment will be automatically executed, and a request to execute the verification script fragment will be submitted to the database. The database responds with a data set providing the execution result, and the execution result will be rendered to the editing area table until all operations are completed and the editing area table is re-rendered.

[0009] Furthermore, the test data is non-production medical insurance fund data, which is data provided by the database and has no actual value. It is only used to provide feedback on the script execution effect during the script production process.

[0010] Furthermore, the related description information includes the script name, rule description, creator, and creation time.

[0011] Compared with the prior art, the invention has the following beneficial effects: the invention significantly reduces the technical requirements for the production of flight inspection data detection rule scripts, and users can produce rule scripts according to the rule requirements without database-related skills. Visual interface operation improves the efficiency of script production and avoids the problems of easy errors and low efficiency in manually written codes. Without directly using database operations, the risk of leakage and misoperation of flight inspection data is effectively reduced, and the regulations on flight inspection confidentiality and avoidance are followed. BRIEF DESCRIPTION OF THE DRAWINGS

[0012] Figure 1 This is a flow chart of the steps of the control method produced based on the medical insurance fund flight inspection data detection rule script of the present invention. DETAILED DESCRIPTION

[0013] In order to provide a further understanding of the purpose, structure, features, and functions of the present invention, the following detailed description is given in conjunction with the embodiments.

[0014] like Figure 1As shown, a control method based on the production of medical insurance fund flight inspection data detection rule scripts includes a terminal, a functional module, a database and a production database; The functional module is installed on the terminal, and the functional module is a functional application program; the functional module includes a front-end page, and the front-end page includes a preview area, an editing area, a storage module, and the like.

[0015] A database driver is used to establish a connection between the functional module and the database; the test data is stored in the database, and the production database is used to store the verification script.

[0016] The following steps are involved: S1: Automatically initiate a request for medical insurance fund test data and build a preview area table based on the response data; In response to the user accessing the function module, the automatic request is triggered, the database driver is used to connect to the database, the medical insurance fund test data of the database is obtained, and it is displayed in the preview area, and the preview area table is constructed; The test data is non-production medical insurance fund data, which is provided by the database and has no actual value. It reflects the characteristics of production medical insurance fund data and is only used to feedback the script execution effect during the script production process; The preview area table is a medical insurance fund data display table, which is the basic reference object for generating flight inspection and verification scripts. The preview area table consists of a standard header and test data. The standard header is a set of standardized medical insurance fund data field standards; it specifies the field code, field Chinese name, data type, length and library table of the medical insurance fund data; the flight inspection data using this method needs to meet this standard to ensure the standardization of fee reduction data.

[0017] S2: Responding to the operation instruction of the preview area table, generating a verification script fragment, and rendering the edit area table based on the script execution result of the verification script fragment; The operation instruction of the table in the preview area is that the user drags, clicks, etc. on the header field to select the header field; The verification script fragment is a database query script composed of the table header selected in the preview area; according to the table header field information selected by the user in the preview area, the corresponding field code and library table name are associated, and an executable database SQL script is generated by splicing.

[0018] The editing area table is a new table composed of the table headers selected in the preview area. The table content is rendered by the execution results of the verification script fragment, presenting the execution effect of the verification script in real time.

[0019] Configure monitoring events to monitor user clicks, drags, and other operations; respond to operation instructions and selected header fields, obtain the field codes and library table names corresponding to all selected header fields, and construct SQL query SELECT statements, such as "select field code 1, field code 2 from table 1". The generated database query script is the verification script fragment. The table in the editing area is rendered according to the execution results of the verification script fragment, which is used to present the execution effect of the verification script fragment in real time. The execution result is that when the number of selected headers in the preview area changes, a request to execute the verification script fragment is automatically submitted to the database, and the data set responded by the database is the execution result. The rendering refers to automatically converting the header code in the execution result into the Chinese name of the field according to the standard field information and filling it into the editing area table. The data in the execution result is automatically filled into the table according to the header.

[0020] The configured listening events include: 1) Mouse press event: triggered when the user clicks on a standard header, records the initial position of the mouse, and marks the standard header as "selected".

[0021] 2) Mouse move event: The user presses the mouse and moves it to change the position of the standard header element and drag the header element to follow the mouse cursor; 3) Mouse release event: The user releases the mouse, stops the dragging operation, and locates the target rendering position of the table in the editing area; S3: respond to the operation instructions of the table in the editing area, expand the verification script, and automatically render the table data in the editing area; The operation instructions of the table in the editing area are operations such as adding, editing, sorting header fields, sorting content and formula editing by users; formula editing includes totaling, counting, size comparison, null value judgment, conditional combination, etc.

[0022] Configure the permissions of the editing area table to be editable. Users edit the editing area table, supplement and improve the verification script fragment, build an executable database SQL script, and trigger re-rendering.

[0023] The extended verification script supplements and improves the verification script fragments in response to the operation instructions of the table in the editing area. For example, if the name of the edited field 1 is field x, the script is changed from "select field 1 from table 1" to "select field 1as field x from table 1". The header sorting will replace the field code order in the select, and the content sorting will be spliced ​​with order by and the field code to be sorted at the end of the script. Other operations will also make corresponding adjustments to the script to achieve the supplement and improvement of the verification script fragments.

[0024] The automatic rendering of the editing area table is in response to the editing area operation instructions. After each operation, the expanded verification script fragment will be automatically executed, and a request for executing the verification script fragment will be submitted to the database. The database responds to the data set to provide the execution result, and the execution result is rendered to the editing area table until all operations are completed, completing the re-rendering of the editing area table. Real-time rendering makes the verification script editing process more intuitive, which is conducive to editing the verification script and reducing the technical requirements for use. It realizes the control of the table data range conditions, data calculation, grouping, sorting and other functions, thereby completing the improvement and expansion of the verification script.

[0025] S4: respond to the test instruction, re-render the editing area table based on the current verification script, and throw a corresponding exception prompt when the script execution is abnormal; The front-end page also includes a test button, and a click trigger event is configured for the test button.

[0026] The test command is an event triggered by the user clicking the test button. This event submits the verification script to the database for execution and renders the response result into a table. If the execution is abnormal, a pop-up window will be triggered to prompt the abnormality. This ensures the validity of the script, avoids script conflicts, reduces script errors, and improves the accuracy of the script.

[0027] The test instruction is to execute the currently generated verification script, aiming to analyze whether there are any anomalies such as conflicts in the script, so as to ensure the executability of the script.

[0028] S5: respond to the generation instruction and save the current verification script and related description information; The generation instruction is to click the storage module to store the currently generated verification script content in the production database. The related description information includes basic information such as script name, rule description, creator, creation time, etc., which is filled in by the user when storing. It is convenient to understand the verification script information and select it for use during flight inspection, saving time.

[0029] The present invention provides an automated, visual, safe and efficient data detection rule script production process, which effectively overcomes many disadvantages of traditional methods: In terms of reducing the difficulty of operation, the visual table operation mechanism makes script production no longer dependent on personnel with highly professional information processing skills. Ordinary staff only need to perform simple operations, such as dragging and clicking on table fields, to generate verification script logic, which greatly reduces labor costs and improves the popularization of work.

[0030] In terms of data security, non-production medical insurance fund data is used throughout the process to ensure that production data is not directly operated, fundamentally eliminating the risks of data tampering and leakage, and building a solid line of defense for the security of medical insurance fund data.

[0031] The improvement of script production efficiency is a highlight of the present invention. By responding to the table operation instructions in the editing area to expand the verification script logic, users can use various operations of the header fields to achieve rich functions without manually writing complex codes, and can see the execution effect in real time, which is convenient for rapid iteration and optimization of scripts, greatly shortening the production cycle.

[0032] The present invention comprehensively improves the efficiency, safety and standardization of medical insurance fund flight inspections, provides strong technical support for medical insurance fund supervision, and promotes the development of the medical insurance industry in a more scientific, orderly and healthy direction.

[0033] In addition, the present invention is suitable for different application scenarios, has a wide range of applications, and has strong universality, such as daily medical insurance fund supervision, special medical insurance fund audits, monitoring after medical insurance policy adjustments, and medical insurance big data analysis and risk warnings.

[0034] Specifically, in the routine inspection of designated medical institutions and designated retail pharmacies by the medical insurance department, the invention can be used to quickly generate data detection rule scripts for different inspection items (such as compliance of drug expense reimbursement, rationality of charges for diagnosis and treatment items, and use specifications of items in the medical insurance catalog, etc.). By running these scripts regularly, abnormal situations in the use of medical insurance funds can be discovered in a timely manner, such as excessive medical treatment, false reimbursement, substitution of drugs and other violations, to ensure the reasonable expenditure of medical insurance funds and protect the rights and interests of the majority of insured persons.

[0035] For specific medical insurance fund audit projects, such as special reviews of the use of medical insurance funds in a certain region, a certain type of medical institution, or a certain period of time, the invention can generate corresponding verification scripts based on audit priorities and goals. It can efficiently and accurately screen and analyze massive amounts of medical insurance data, help auditors quickly identify suspicious data, conduct in-depth investigations into problems, and provide powerful data support and technical means for special audits of medical insurance funds.

[0036] When the medical insurance policy is adjusted (such as the expansion or reduction of the scope of medical insurance reimbursement, changes in the reimbursement ratio, etc.), the medical insurance department needs to evaluate the impact of the policy adjustment on the use of medical insurance funds and the implementation of the policy by medical institutions and insured persons. Using the method and device created by the present invention, relevant detection scripts can be created in a timely manner to dynamically monitor and analyze the medical insurance data after the policy adjustment, timely discover problems in the policy implementation process, and provide a basis for further optimizing the policy.

[0037] It helps to build a big data analysis platform for medical insurance. By continuously running data detection rule scripts of different dimensions, it can deeply mine and analyze the operation data of medical insurance funds. It can not only discover potential risk points of violations, but also study and predict the revenue and expenditure trends of medical insurance funds, changes in cost structure, and medical behavior patterns of insured people. It provides data support for medical insurance departments to formulate scientific and reasonable fund budgets and management decisions, and at the same time realizes early warning of medical insurance fund risks, takes measures to prevent risks in advance, and ensures the sustainable operation of medical insurance funds.

[0038] The present invention has been described by the above-mentioned relevant embodiments, however, the above-mentioned embodiments are only examples for implementing the present invention. It must be pointed out that the disclosed embodiments do not limit the scope of the present invention. On the contrary, changes and modifications made without departing from the spirit and scope of the present invention are all within the scope of patent protection of the present invention.

Claims

1. A control method based on the production of medical insurance fund flight inspection data detection rule script, characterized in that: Includes terminals, functional modules, databases and production databases; The functional module is installed on the terminal, and the functional module includes a front-end page, and the front-end page includes a preview area, an editing area, a storage module and a test button; the functional module is connected to a database; the test data is stored in the database, and the production database is used to store the final verification script; The following steps are involved: S1: Automatically initiate a request for medical insurance fund test data and build a preview area table based on the response data; In response to the user accessing the function module, trigger an automatic request, connect to the database, obtain the medical insurance fund test data from the database, display it in the preview area, and build a preview area table; The preview area table consists of a standard header and test data. The standard header specifies the field code, field Chinese name, data type, length and database table of the medical insurance fund data. S2: Responding to the operation instruction of the preview area table, generating a verification script fragment, and rendering the edit area table based on the script execution result of the verification script fragment; Select the header field in the preview area, associate the corresponding field code and library table name according to the header field information selected by the user in the preview area, generate an executable database SQL script, generate an execution verification script fragment, submit a request to execute the verification script fragment to the database, obtain the execution result, and render the execution result to the table in the editing area; S3: respond to the operation instructions of the table in the editing area, expand the verification script, and automatically render the table data in the editing area; Configure the permission of the table in the editing area to be editable. Users can edit the table in the editing area, supplement and improve the verification script fragment, build an executable database SQL script, and trigger re-rendering; S4: respond to the test instruction, re-render the editing area table based on the current verification script, and throw a corresponding exception prompt when the script execution is abnormal; The front-end page also includes a test button, and a click trigger event is configured for the test button. The test instruction is an event triggered by a user clicking the test button. The event submits the check script to the database for execution and renders the response result into a table. When an execution exception occurs, a pop-up window is triggered to prompt the exception. S5: respond to the generation instruction and save the current verification script and related description information; The generation instruction is to store the currently generated verification script content in the production database, and the relevant description information is filled in by the user when storing.

2. The control method based on the production of medical insurance fund flight inspection data detection rule script according to claim 1 is characterized in that: In step S2, the operation instruction of the preview area table is the user's dragging and clicking operation on the header field; configure the monitoring event to monitor the user's click and drag operations; respond to the operation instruction and the selected header field, obtain the field code and library table name corresponding to all the selected header fields, construct the SELECT statement of the SQL query, and generate the database query script; The execution result is that when the number of table headers selected in the preview area changes, a request to execute the verification script fragment is automatically submitted to the database, and the database responds with a data set; The rendering refers to automatically converting the header code in the execution result into the Chinese name of the field according to the standard field information and filling it into the editing area table, and the data in the execution result is automatically filled into the editing area table according to the header.

3. The control method based on the production of medical insurance fund flight inspection data detection rule script as claimed in claim 2 is characterized by: The configured listening events include: 1) Mouse press event: triggered when the user clicks on a standard header, records the initial position of the mouse, and marks the standard header as "selected"; 2) Mouse move event: The user presses the mouse and moves it to change the position of the standard header element, and drags the header element to follow the mouse cursor; 3) Mouse release event: The user releases the mouse, stops the dragging operation, and locates the target rendering position of the table in the editing area.

4. The control method based on the production of medical insurance fund flight inspection data detection rule script according to claim 1 is characterized in that: The operation instructions of the editing area table in step S3 are the user's addition, editing, header sorting, content sorting and formula editing of the header field; the formula editing includes totaling, counting, size comparison, null value judgment, and conditional combination.

5. The control method based on the production of medical insurance fund flight inspection data detection rule script as claimed in claim 4 is characterized by: The extended verification script is to respond to the operation instructions of the table in the editing area, supplement and improve the verification script fragment, and adjust the script accordingly according to the operation call corresponding function; The automatic rendering of the editing area table is in response to the editing area operation instructions. After each operation, the extended verification script fragment will be automatically executed, and a request to execute the verification script fragment will be submitted to the database. The database responds with a data set providing the execution result, and the execution result will be rendered to the editing area table until all operations are completed and the editing area table is re-rendered.

6. The control method based on the production of medical insurance fund flight inspection data detection rule script according to claim 1 is characterized in that: The test data is non-production medical insurance fund data, which is provided by the database and has no actual value. It is only used to provide feedback on the script execution effect during the script production process.

7. The control method based on the production of medical insurance fund flight inspection data detection rule script according to claim 1 is characterized in that: The related description information includes script name, rule description, creator, and creation time.

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