A control method based on the production of medical insurance fund flight inspection data detection rule scripts

Abstract

The present invention provides a control method for 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 front-end page includes a preview area, an editing area, etc. The method automatically initiates a request for medical insurance fund test data and constructs a preview area table; responds to the operation instructions of the preview area table, generates a verification script fragment, and renders the editing area table based on the script execution result; responds to the operation instructions of the editing area table, expands the verification script, and renders the editing area table data; responds to the test instruction, re-renders the editing area table based on the current verification script, responds to the generation instruction, and saves the current verification script and related description information; the present invention significantly reduces the technical requirements for rule script production, and the visual interface operation improves the efficiency of script production, avoiding the problems of easy errors and low efficiency in manually written code. It effectively reduces the risk of leakage and misoperation of flight inspection data, and complies with the confidentiality and avoidance regulations of flight inspections.

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 insurance system, the rational use and supervision of medical insurance funds are becoming increasingly important. Medical insurance unannounced inspections refer to unannounced on-site inspections of designated medical institutions organized and implemented by the medical insurance administrative department. They aim to ensure the rational use of medical insurance funds and prevent fraud and abuse.

[0003] However, due to the massive amount of data required for unannounced inspections, current unannounced inspections of medical insurance funds typically require information personnel to write different data inspection scripts for different inspection items and manually execute them using database tools. This requires high-level professional information processing skills and technical expertise from unannounced inspection executors. Manually writing code to create unannounced inspection rule scripts is inefficient. Furthermore, database data is completely exposed to executors, and direct database manipulation can easily lead to risks such as data tampering and leakage, posing certain data security risks. This results in high labor costs, low implementation efficiency, and data security risks associated with the production of verification scripts for unannounced inspections of medical insurance funds. Summary of the Invention

[0004] The purpose of the present invention is to solve the shortcomings of the existing technology and propose a control method based on the production of medical insurance fund flight inspection data detection rule scripts.

[0005] To achieve the above object, the present invention adopts the following technical solutions:

[0006] 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;

[0007] The functional module is installed on the terminal, and includes a front-end page, which includes a preview area, an editing area, a storage module, and a test button; a connection between the functional module and a database; the database stores test data, and the production database is used to store the final verification script;

[0008] The following steps are involved:

[0009] S1: Automatically initiates a request for medical insurance fund test data and constructs a preview area table based on the response data;

[0010] In response to user access to the function module, trigger an automatic request to 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;

[0011] The table in the preview area 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.

[0012] S2: Responding to an 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;

[0013] Select a header field in the preview area. Based on the 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. An execution verification script fragment is generated, and a request to execute the verification script fragment is submitted to the database to obtain the execution result. The execution result is rendered to the table in the editing area.

[0014] S3: responds to operation instructions of the table in the editing area, expands the verification script, and automatically renders the table data in the editing area;

[0015] Configure the edit area table permissions to editable. Users edit the edit area table, supplement and improve the verification script fragment, build an executable database SQL script, and trigger re-rendering.

[0016] 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;

[0017] The front-end page also includes a test button, which is configured with a click trigger event. The test instruction 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 an execution exception occurs, a pop-up window is triggered to prompt the exception.

[0018] S5: Respond to the generation instruction and save the current verification script and related description information;

[0019] The generation instruction is to store the content of the currently generated verification script in the production database, and the relevant description information is filled in by the user when storing.

[0020] Furthermore, in step S2, the operation instruction of the preview area table is the user dragging and clicking the header field; a monitoring event is configured to monitor the user's click and drag operations; in response to the operation instruction and the selected header field, the field code and library table name corresponding to all selected header fields are obtained, and a SELECT statement of an SQL query is constructed to generate a database query script;

[0021] 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 database responds with a data set;

[0022] 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.

[0023] Furthermore, the configured listening events include:

[0024] 1) Mouse press event: triggered when the user clicks a standard header, records the initial position of the mouse, and marks the standard header as "selected";

[0025] 2) Mouse move event: The user presses the mouse and moves it to change the position of the standard header element, and the header element is dragged along with the mouse cursor;

[0026] 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.

[0027] 4. The control method for producing a script based on medical insurance fund flight inspection data detection rules 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 header fields; the formula editing includes totaling, counting, size comparison, null value judgment, and conditional combination.

[0028] Furthermore, the verification script is expanded to respond to the operation instructions of the table in the editing area, and the verification script fragment is supplemented and improved. The corresponding function is called according to the operation to make corresponding adjustments to the script;

[0029] 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 to execute the verification script fragment will be submitted to the database. The database response data set provides the execution result, and the execution result is rendered to the editing area table until all operations are completed and the re-rendering of the editing area table is completed.

[0030] 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 feedback the script execution effect during the script production process.

[0031] Furthermore, the relevant description information includes the script name, rule description, creator, and creation time.

[0032] Compared with existing technologies, the present invention significantly reduces the technical requirements for creating rule scripts for flight inspection data detection. Users can create rule scripts based on the required rules without requiring database skills. The visual interface improves script creation efficiency, avoiding the error-prone and inefficient nature of manual code creation. By not directly using database operations, the risk of flight inspection data leakage and misoperation is effectively reduced, ensuring compliance with flight inspection confidentiality and avoidance regulations. BRIEF DESCRIPTION OF THE DRAWINGS

[0033] Figure 1 This is a flowchart 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

[0034] In order to provide a further understanding of the purpose, structure, features, and functions of the present invention, the present invention is described in detail below with reference to the embodiments.

[0035] like Figure 1 As 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;

[0036] 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.

[0037] 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.

[0038] The following steps are involved:

[0039] S1: Automatically initiates a request for medical insurance fund test data and constructs a preview area table based on the response data;

[0040] In response to the user accessing the function module, an automatic request is triggered, the database driver is used to connect to the database, the medical insurance fund test data in the database is obtained, and the data is displayed in the preview area, and a preview area table is constructed;

[0041] 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;

[0042] 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 stipulates the field code, field Chinese name, data type, length and library table information 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.

[0043] S2: Responding to an 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;

[0044] The operation instruction of the table in the preview area is that the user drags, clicks, or performs other operations on the header field to select the header field;

[0045] The verification script fragment is a database query script composed of the table header selected in the preview area; based on the table header field information selected by the user in the preview area, the corresponding field code and library table name are associated and spliced ​​to generate an executable database SQL script.

[0046] 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.

[0047] Configure monitoring events to listen for 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 the SELECT statement of the SQL query, such as "select field code 1, field code 2 from table 1". The database query script generated is the verification script fragment. The table in the editing area is rendered based on 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.

[0048] The configured listening events include:

[0049] 1) Mouse press event: Triggered when the user clicks a standard header. The event records the initial position of the mouse and marks the standard header as "selected".

[0050] 2) Mouse move event: The user presses the mouse and moves it to change the position of the standard header element, and the header element is dragged along with the mouse cursor;

[0051] 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;

[0052] S3: responds to operation instructions of the table in the editing area, expands the verification script, and automatically renders the table data in the editing area;

[0053] The operation instructions of the editing area table are operations such as adding, editing, sorting header fields, sorting content and editing formulas by users; formula editing includes totaling, counting, size comparison, null value judgment, conditional combination, etc.

[0054] 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.

[0055] The extended verification script responds to the operation instructions of the table in the editing area and supplements and improves the verification script fragment. For example, if the name of the edit 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 fragment.

[0056] The automatic rendering of the editing area table responds 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 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, completing the re-rendering of the editing area table. Real-time rendering makes the verification script editing process more intuitive, facilitates editing of verification scripts, and reduces technical requirements for use. It realizes the control of table data range conditions, data calculation, grouping, sorting and other functions, thereby completing the improvement and expansion of the verification script.

[0057] 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;

[0058] The front-end page also includes a test button, and a click trigger event is configured for the test button.

[0059] The test command is triggered by a user clicking a test button. This event submits the verification script to the database for execution and renders the response results into a table. If an execution exception occurs, a pop-up window will be triggered to indicate the exception. This ensures the validity of the script, avoids script conflicts, reduces script errors, and improves script accuracy.

[0060] 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 executableness of the script.

[0061] S5: Respond to the generation instruction and save the current verification script and related description information;

[0062] The "Generate" command is to click the "Store" module to store the currently generated verification script in the production database. The user fills in the relevant information, including the script name, rule description, creator, creation time, and other basic information, when saving the script. This makes it easier to understand the verification script information and select it for use during spot checks, saving time.

[0063] This invention provides an automated, visual, safe and efficient data detection rule script production process, which effectively overcomes many drawbacks of traditional methods:

[0064] The visual table operation mechanism reduces operational complexity, eliminating the need for highly specialized information processing skills to create scripts. Ordinary staff can generate verification script logic by performing simple operations such as dragging and clicking table fields, significantly reducing labor costs and increasing the accessibility of the work.

[0065] 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.

[0066] A key feature of this invention is the improvement in script creation efficiency. By expanding the verification script logic in response to table operation instructions in the editing area, users can implement rich functions through various operations on the header fields without having to manually write complex code. The execution effect can be seen in real time, facilitating rapid iteration and optimization of the script, greatly shortening the creation cycle.

[0067] 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.

[0068] In addition, the present invention is adaptable to different application scenarios, with a wide range of applications and 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 warning.

[0069] Specifically, during routine inspections of designated medical institutions and retail pharmacies by medical insurance departments, this invention can be used to quickly generate data detection rule scripts for different inspection items (such as compliance with drug reimbursement, reasonableness of charges for medical treatment items, and standardized use of items in the medical insurance catalogue). By regularly running these scripts, anomalies in the use of medical insurance funds can be promptly discovered, such as excessive medical treatment, false reimbursement, and drug substitution, ensuring the reasonable expenditure of medical insurance funds and protecting the rights and interests of the majority of insured persons.

[0070] For specific medical insurance fund audit projects, such as special reviews of medical insurance fund usage in a specific region, type of medical institution, or time period, this invention can generate customized verification scripts based on audit priorities and objectives. It can efficiently and accurately screen and analyze massive amounts of medical insurance data, helping auditors quickly identify suspicious data and conduct in-depth investigations, providing powerful data support and technical means for special audits of medical insurance funds.

[0071] When medical insurance policies are adjusted (e.g., expanding or reducing reimbursement coverage, changing reimbursement ratios, etc.), the medical insurance department needs to evaluate the impact of the policy adjustments on the use of medical insurance funds and the implementation of the policies by medical institutions and insured individuals. The method and device created by this invention can promptly create relevant detection scripts to dynamically monitor and analyze medical insurance data after policy adjustments, promptly identifying problems that arise during policy implementation and providing a basis for further policy optimization.

[0072] This helps build a big data analytics platform for medical insurance. By continuously running data detection rule scripts across different dimensions, it conducts in-depth mining and analysis of medical insurance fund operational data. This not only identifies potential risk points for violations but also allows for research and forecasting of revenue and expenditure trends, changes in cost structures, and the medical behavior patterns of insured individuals. This provides data support for medical insurance departments to formulate scientific and rational fund budgets and management decisions. It also provides early warning of medical insurance fund risks, enabling proactive mitigation measures and ensuring the sustainable operation of the fund.

[0073] The present invention has been described with reference to the above embodiments. However, the above embodiments are merely exemplary embodiments of the present invention. It should be noted that the disclosed embodiments do not limit the scope of the present invention. On the contrary, modifications and improvements that do not depart from the spirit and scope of the present invention are intended to be protected by the present invention.

Claims

1. A control method based on the production of medical insurance fund flight inspection data detection rule scripts, characterized by: Including terminals, functional modules, databases and production databases; The functional module is installed on the terminal, and includes a front-end page, which includes a preview area, an editing area, a storage module, and a test button; a connection between the functional module and a database; the database stores test data, and the production database is used to store the final verification script; The following steps are involved: S1: Automatically initiates a request for medical insurance fund test data and constructs a preview area table based on the response data; In response to user access to the function module, trigger an automatic request to 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 table in the preview area 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 an operation instruction of the preview area table, generating a verification script segment, and rendering the edit area table based on the script execution result of the verification script segment; Select a header field in the preview area. Based on the 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. An execution verification script fragment is generated, and a request to execute the verification script fragment is submitted to the database to obtain the execution result. The execution result is rendered to the table in the editing area. S3: responds to operation instructions of the table in the editing area, expands the verification script, and automatically renders the table data in the editing area; Configure the edit area table permissions to editable. Users edit the edit area table, 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, which is configured with a click trigger event. The test instruction 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 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 content of the currently generated verification script in the production database, and the relevant description information is filled in by the user when storing.

2. The control method for producing a script based on medical insurance fund flight inspection data detection rules according to claim 1, 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 selected header fields, construct the SQL query SELECT statement, and generate the database query script; 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 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 for producing a script based on medical insurance fund flight inspection data detection rules according to claim 2, characterized in that: The configured listening events include: 1) Mouse press event: triggered when the user clicks 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 the header element is dragged along with 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 for producing a script based on medical insurance fund flight inspection data detection rules according to claim 1, 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 fields; the formula editing includes totaling, counting, size comparison, null value judgment, and conditional combination.

5. The control method for producing a script based on medical insurance fund flight inspection data detection rules according to claim 4, characterized in that: Expand the verification script to respond to the operation instructions of the table in the editing area, supplement and improve the verification script fragment, and make corresponding adjustments to the script according to the corresponding function called according to the operation; 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 to execute the verification script fragment will be submitted to the database. The database response data set provides the execution result, and the execution result is rendered to the editing area table until all operations are completed and the re-rendering of the editing area table is completed.

6. The control method for producing a script based on medical insurance fund flight inspection data detection rules according to claim 1, 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 for producing a script based on medical insurance fund flight inspection data detection rules according to claim 1, characterized in that: The relevant description information includes the script name, rule description, creator, and creation time.

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