Medical project consumable cost abnormity accounting method and system

Abstract

The invention discloses a medical project consumable cost abnormity accounting method and system, and relates to the technical field of medical cost accounting, and the method comprises the following steps: collecting resource consumption data of a target hospital in a monitoring period, and calling a standard consumption data set of each medical project; the consumables are divided into charge consumables and obligational consumables, compliance anomaly detection is carried out, compliance items enter a subsequent detection step, the total use cost and number of the obligational consumables are counted, an ideal floating interval is constructed based on standard consumption data to judge whether an anomaly exists or not, and if not, the charge consumables and the obligational consumables are stored. If yes, a consumption rate evaluation model is established in combination with the duration of the medical project and the data of the charged consumables, the consumption quantity proportion of the charged consumables in the equal-length time period is determined, whether the charged consumables are abnormal or not is finally judged, and the accuracy and compliance of cost accounting of the medical project are effectively improved.

Description

Technical Field

[0001] This invention relates to the field of medical cost accounting technology, specifically to a method and system for abnormal accounting of medical consumable costs. Background Technology

[0002] With the rapid development of modern healthcare, the types and complexity of medical services are gradually increasing, posing growing challenges to hospital operations and management, particularly in the control and optimization of medical service costs. Currently, most hospitals rely on traditional cost accounting methods, which are largely based on simple budgeting and bookkeeping, neglecting the diversity of medical service items and the cost differences between departments. Traditional cost accounting systems lack precise analysis of each department and medical service item, resulting in significant blind spots in hospital cost management and decision-making, hindering the effective allocation of resources and precise cost control.

[0003] In existing technologies, the cost of medical services in a hospital is often obtained by calculating the cost of medical services in each department. CN110619950A discloses a method, apparatus, equipment, and storage medium for calculating the cost of medical services. The method includes: acquiring medical service items; collecting basic data of the medical service items; wherein the basic data includes revenue data, workload, and cost data; aggregating cost data of the medical service items based on the basic data; dividing the aggregated cost data into tasks according to departments to form a task library; forming the cost of medical services in each department based on the task library; and obtaining the cost of medical services in the hospital based on the cost of medical services in each department. However, this method only focuses on the revenue, workload, and cost data of medical service items, failing to provide a more objective comparison based on actual data. It suffers from limitations due to its reliance on historical data and estimation models. Furthermore, the static cost data aggregation makes it impossible to analyze and identify anomalies in a timely manner and make adjustments, thus reducing the accuracy and effectiveness of medical cost accounting.

[0004] The information disclosed in the background section is only intended to enhance the understanding of the background of this disclosure, and therefore may include information that does not constitute prior art known to those skilled in the art. Summary of the Invention

[0005] The purpose of this invention is to provide a method and system for abnormal accounting of medical consumable costs, so as to solve the problems mentioned in the background art.

[0006] To achieve the above objectives, the present invention provides the following technical solution: A method for accounting for abnormal costs of medical consumables, comprising the following steps: S1, collect resource consumption data of each medical project in the target hospital during the monitoring period, and retrieve the standard consumption dataset corresponding to each medical project; S2, classify the consumables used in different medical projects according to the charging method, divide the consumables used into chargeable consumables and obligatory consumables, and perform compliance anomaly detection based on the standard consumable data of the corresponding medical project to centralize the consumable types, and execute step S3 for medical projects that pass the compliance anomaly detection. S3, Calculate the total usage cost and quantity of compulsory consumables in medical projects, and construct an ideal fluctuation range based on the centralized data distribution of the corresponding standard consumable data. Determine whether there are any abnormalities in compulsory consumables based on whether the total usage cost and quantity of compulsory consumables fall within the corresponding ideal fluctuation range. For medical projects without abnormalities in compulsory consumables, execute step S4. S4. By combining the duration of medical projects with the quantity of consumable items consumed, a consumption rate assessment model is established to determine the proportion of consumable items consumed within a time period of equal length. This model is then compared with the proportion of consumable items consumed within the corresponding time period determined by the corresponding standard consumption dataset to determine whether there are any abnormalities in consumable items. Medical projects without abnormal consumable items are judged as having no abnormal costs.

[0007] Furthermore, the medical services include appendectomy, coronary artery bypass surgery, postoperative care, and emergency imaging. The resource consumption data of the medical project includes the type, quantity, cost, and usage timestamp of consumables. The specific method for constructing the standard consumption dataset corresponding to the medical project is as follows: for any medical project, collect the resource consumption data of multiple compliant medical projects of the same type to form the standard consumption dataset of the corresponding medical project.

[0008] Furthermore, the logic behind classifying the consumables used in different medical projects for fee collection is as follows: based on payment records, the chargeable consumables are determined from the resource consumption data of the medical project, and the remaining consumables are treated as mandatory consumables. The logic for compliance anomaly detection is as follows: obtain the consumable types of the medical project and compare them with all consumable types involved in the corresponding standard consumable dataset. Determine whether there are any consumable types not involved in the corresponding standard consumable dataset. If there are any consumable types not involved, the project does not meet the compliance requirements, and the medical project is marked as an anomaly, indicating that the cost of the medical project is abnormal. If there are no consumable types not involved, the compliance anomaly detection is passed.

[0009] Furthermore, the logic behind constructing the ideal floating range based on the centralized data distribution of standard consumable data is as follows: for any type of compulsory consumable in a medical project, extract the total usage cost and usage quantity of that type of compulsory consumable in each compliant medical project of the same type, and obtain the total usage cost sequence and usage quantity sequence of that type of compulsory consumable by arranging them in ascending order.

[0010] Furthermore, the length of the floating window is determined based on the number of elements in the total usage cost sequence. The floating window slides within the total usage cost sequence, and the difference between the maximum and minimum values ​​within the floating window is defined as the width of the floating window. The minimum and maximum values ​​within the floating window with the smallest width are extracted as the upper and lower limits of the ideal floating range for the total usage cost of this type of compulsory consumable. Similarly, the ideal floating range for the usage quantity of this type of compulsory consumable is determined. The method for determining the size of the floating window is as follows: obtain the number of elements in the total usage cost sequence and preset a proportional coefficient. The product of the preset proportional coefficient and the number of elements in the total usage cost sequence is rounded up, and the processed data is used as the length of the floating window.

[0011] Furthermore, the logic for determining whether there are any abnormalities in mandatory consumables is as follows: determine whether the total cost and total quantity of each mandatory consumable in the medical project fall within the corresponding ideal fluctuation range; If the total cost and total quantity of each type of compulsory consumables fall within the corresponding ideal fluctuation range, it is determined that there are no abnormalities in compulsory consumables for the medical project, and further analysis will be conducted. If the total cost or total quantity of compulsory consumables used does not fall within the corresponding ideal fluctuation range, the medical project is judged to have an abnormality in compulsory consumables, and the medical project is marked as abnormal and will not be further analyzed.

[0012] Furthermore, the consumption rate assessment model is established to determine the proportion of consumption of chargeable consumables within equal time periods. The specific logic is as follows: obtain the duration of the medical project and divide it into several sub-time segments at equal intervals. Calculate the proportion of consumption of each chargeable consumable in the medical project within each sub-time segment. The specific method includes: for different medical projects, obtain the consumption quantity of each chargeable consumable within the corresponding sub-time segment, collect the duration of the corresponding sub-time segment, and use the ratio of the consumption quantity of the chargeable consumable within the corresponding sub-time segment to the duration of the sub-time segment as the proportion of consumption of each chargeable consumable within the sub-time segment.

[0013] Furthermore, the logic for determining whether there are any abnormalities in the consumption of chargeable consumables is as follows: calculate the difference between the proportion of consumption of various chargeable consumables for the corresponding medical project in the same sub-time period and the average proportion of consumption of chargeable consumables for multiple compliant medical projects, specifically using Euclidean distance to represent the difference in the proportion of consumption.

[0014] Furthermore, a threshold for the proportion of chargeable consumables of the corresponding type is set in different sub-time periods. The difference in the proportion of the consumption of the corresponding chargeable consumables is compared with the corresponding threshold for the proportion of chargeable consumables. If the difference in the proportion of the consumption of the chargeable consumables is greater than or equal to the threshold for the proportion of chargeable consumables, it is determined that the chargeable consumables of the corresponding medical project have an abnormality in the corresponding sub-time period. If the difference in the proportion of the consumption of chargeable consumables is less than the threshold for the proportion of chargeable consumables, it is determined that there is no abnormality in the chargeable consumables for the corresponding medical project within the corresponding sub-time period; similarly, it is checked whether there are any abnormalities in chargeable consumables within each sub-time period. If there are no abnormalities in chargeable consumables, it is determined that the cost of the medical project is not abnormal.

[0015] This invention also provides a system for calculating abnormal costs of medical consumables, which is used to execute the above-described method for calculating abnormal costs of medical consumables, including: The standard data acquisition module is used to collect resource consumption data of each medical project in the target hospital during the monitoring period and retrieve the standard consumption dataset corresponding to each medical project. The compliance detection module is used to classify the consumables used in different medical projects in terms of fee collection, divide the consumables used into chargeable consumables and obligatory consumables, and perform compliance anomaly detection based on the standard consumable data of the corresponding medical project to centralize the consumable types. For medical projects that pass the compliance anomaly detection, step S3 is executed. The mandatory consumables anomaly detection module is used to statistically analyze the total usage cost and quantity of mandatory consumables in medical projects, and construct an ideal fluctuation range based on the centralized data distribution of the corresponding standard consumables data. It determines whether there is an anomaly in mandatory consumables based on whether the total usage cost and quantity of mandatory consumables fall within the corresponding ideal fluctuation range. For medical projects where no anomaly in mandatory consumables is found, step S4 is executed. The cost anomaly detection module is used to combine the duration of medical projects with the quantity of consumable items consumed to establish a consumption rate assessment model, determine the proportion of consumable items consumed within a time period of equal length, and compare it with the proportion of consumable items consumed within the corresponding time period determined by the corresponding standard consumption dataset to determine whether there are any anomalies in consumable items. Medical projects without anomalies in consumable items are judged as having no cost anomalies.

[0016] Compared with the prior art, the beneficial effects of the present invention are: This solution deploys data acquisition nodes in various medical operation centers to collect resource consumption data from different hospitals and medical projects. By combining this data with the standard consumption dataset of the reference hospital, it ensures that the cost accounting of medical projects is based on real and extensive data sources. This eliminates the problem of inaccurate cost accounting caused by a single data source and ensures that the accounting results have high reliability and representativeness. By categorizing consumables used in medical procedures into chargeable and mandatory consumables, and conducting compliance anomaly detection based on a standard consumable dataset, this method effectively solves the problem of mismatched consumable classifications in traditional methods. Real-time monitoring of the usage of various consumables and screening for medical procedures exhibiting compliance anomalies ensures the accuracy and compliance of fee collection. Through this compliance detection, hospitals can avoid management loopholes caused by unclear consumable classifications or irregular fee collection, thereby improving financial transparency and management standardization. Simultaneously, a consumption rate assessment model is introduced to dynamically monitor the consumption rate of medical items, promptly detect abnormal consumption rates, and generate accurate cost accounting results. Through this dynamic monitoring, this solution effectively avoids the drawbacks of relying on manual statistics in traditional methods, improves the hospital's resource monitoring capabilities and cost management level, and enables the hospital to grasp the consumption status of each medical item in real time, thereby making more timely and reasonable resource adjustments. Attached Figure Description

[0017] Figure 1 This is a schematic diagram of the overall method flow of the present invention; Figure 2 A chart showing the cost and quantity of consumables used for compulsory services; Figure 3 This is a schematic diagram of the overall system structure of the present invention. Detailed Implementation

[0018] To make the objectives, technical solutions, and advantages of this invention clearer, the invention will be further described in detail below with reference to specific embodiments.

[0019] It should be noted that, unless otherwise defined, the technical or scientific terms used in this invention should have the ordinary meaning understood by one of ordinary skill in the art to which this invention pertains. The terms "first," "second," and similar terms used in this invention do not indicate any order, quantity, or importance, but are merely used to distinguish different components. Terms such as "comprising" or "including" mean that the element or object preceding the word encompasses the elements or objects listed following the word and their equivalents, without excluding other elements or objects. Terms such as "connected" or "linked" are not limited to physical or mechanical connections, but can include electrical connections, whether direct or indirect. Terms such as "upper," "lower," "left," and "right" are used only to indicate relative positional relationships; when the absolute position of the described object changes, the relative positional relationship may also change accordingly.

[0020] Example: Please see Figures 1-2 The present invention provides a technical solution: A method for accounting for abnormal costs of medical consumables, comprising the following steps: S1 collects resource consumption data for each medical project in the target hospital during the monitoring period and retrieves the standard consumption dataset corresponding to each medical project.

[0021] The specific method for collecting resource consumption data for each medical project in the target hospital during the monitoring period is as follows: Data collection nodes are deployed in each medical operation center. These nodes are used to determine the resource consumption data for each medical operation center. The specific division of these medical operation centers is based on a clear understanding of the hospital's overall campus structure. The basic configuration of operation centers in each campus includes: clinical services, medical technology, medical support, administrative and logistical support, and other departments. The types of medical projects include, but are not limited to, outpatient medical projects, inpatient medical projects, emergency medical projects, rehabilitation medical projects, and preventive healthcare projects; specifically, they include, but are not limited to, appendectomy, coronary artery bypass surgery, postoperative care, emergency imaging, cardiopulmonary resuscitation, trauma emergency care, blood pressure measurement, blood glucose testing, and electrocardiogram (ECG).

[0022] The resource consumption data of the medical project includes the type, quantity, cost, and usage timestamp of consumables. The specific method for constructing the standard consumption dataset corresponding to the medical project is as follows: for any medical project, collect the resource consumption data of multiple compliant medical projects of the same type to form the standard consumption dataset of the corresponding medical project.

[0023] S2, classify the consumables used in different medical projects according to the charging method, divide the consumables used into chargeable consumables and obligatory consumables, and perform compliance anomaly detection based on the standard consumable data of the corresponding medical project to centralize the consumable types, and execute step S3 for medical projects that pass the compliance anomaly detection.

[0024] The logic behind classifying consumables used in different medical projects for fee collection is as follows: based on payment records, the chargeable consumables are determined from the resource consumption data of the medical project, and the remaining consumables are treated as mandatory consumables. The specific steps include collecting all relevant data for medical projects, including billing records, resource consumption data, and consumable lists. Based on the payment records, the consumables that have been paid for by patients in specific medical projects are identified. The bills for each medical project are checked, the consumables actually paid for by patients are recorded, and it is determined which consumables are directly included in the billing, such as medicines and disposable equipment. The consumables paid for by patients are classified as chargeable consumables.

[0025] The logic for conducting compliance anomaly detection is as follows: obtain the consumable types of medical projects and compare them with all consumable types involved in the corresponding standard consumable dataset to determine whether there are any consumable types not involved in the corresponding standard consumable dataset; The method for obtaining the types of consumables for medical procedures is as follows: Determine the data source for obtaining the consumable types. Common data sources include: Electronic Medical Record System: records the patient's diagnosis and treatment process and the consumables used; Hospital Information System (HIS): manages the hospital's administrative and financial work, and usually includes consumable usage records; Insurance Claims System: records the patient's cost settlement information, which may include the consumables used; Inventory Management System: tracks the procurement, use, and inventory of consumables. Obtain consumable type information for medical procedures based on each data source.

[0026] For each medical project, extract a list of all consumable types actually used to ensure that each medical project and its corresponding consumable type data can be uniquely identified. Extract a list of all permitted consumable types for the project from the standard consumable dataset. Compare the actual list and the standard list to determine if there are any consumable types included in the actual list but not in the standard list. If there are any consumable types that are not included, the project does not meet compliance requirements and is marked as abnormal, indicating that the cost of the medical project is abnormal. If there are no consumable types that are not included, the project passes the compliance anomaly detection.

[0027] S3: Calculate the total usage cost and quantity of compulsory consumables in medical projects, and construct an ideal fluctuation range based on the centralized data distribution of the corresponding standard consumable data. Determine whether there are any abnormalities in compulsory consumables based on whether the total usage cost and quantity of compulsory consumables fall within the corresponding ideal fluctuation range. For medical projects without abnormalities in compulsory consumables, proceed to step S4.

[0028] The logic behind constructing an ideal floating range based on the centralized data distribution of standard consumable data is as follows: For any type of compulsory consumable in a medical project, extract the total usage cost and quantity of that type of compulsory consumable in each compliant medical project of the same type, and obtain the total usage cost sequence and usage quantity sequence of that type of compulsory consumable by sorting them in ascending order. The length of the floating window is determined based on the number of elements in the total usage cost sequence. The floating window slides through the total usage cost sequence. The difference between the maximum and minimum values ​​in the floating window is defined as the width of the floating window. The minimum and maximum values ​​in the floating window with the smallest width are extracted as the upper and lower limits of the ideal floating range of the total usage cost of this type of compulsory consumable. Similarly, the ideal floating range of the usage quantity of this type of compulsory consumable is determined. The ideal fluctuation range is generated based on actual data distribution and can dynamically adapt to the specific circumstances of different medical projects. This means it can reflect the true usage level of various consumables in different medical projects, rather than relying on fixed standards or thresholds. The ideal fluctuation range determined by the sliding window method can more accurately identify abnormal data, taking into account the overall distribution of the data, thus effectively capturing situations that do not conform to normal usage patterns. Compared with fixed standards, the ideal fluctuation range can reduce the subjectivity and bias introduced by manually setting standards. At the same time, the ideal fluctuation range analysis method is applicable to the actual situation where the consumption of resources in medical projects fluctuates, increasing the objectivity and reliability of the analysis.

[0029] The method for determining the size of the floating window is as follows: Obtain the number of elements in the total usage cost sequence, preset a scaling factor, and round up the product of the preset scaling factor and the number of elements in the total usage cost sequence. Use this rounded data as the floating window length. The specific formula for calculating the floating window length is as follows: In the formula, The length of the floating window. This is a preset proportional coefficient. The number of elements in the sequence. This indicates a round-up operation. The preset scaling factor is used. It is generally taken to be between 0.8 and 0.9.

[0030] It should be noted that choosing a floating window length of 80% to 90% of SL means including the vast majority of historical data in the sliding window analysis, ensuring the representativeness and validity of the data within the window. The formula calculates the floating window length by setting an appropriate scaling factor, aiming to balance the representativeness of the data sample and the flexibility of the analysis. Choosing a scaling factor of 0.8 to 0.9 can ensure sufficient data for analysis while avoiding excessive smoothing of information, thereby improving the sensitivity of anomaly detection and the accuracy of decision-making.

[0031] The narrowest floating window represents the window where the difference between the maximum and minimum values ​​is smallest. This typically means the data is relatively concentrated within this range, with low volatility, thus better reflecting the normal usage level of the consumable item. In practice, the usage of consumable items may change over time and under different conditions. By calculating the width of each window, it is possible to dynamically adjust and adapt to changes in the data, ensuring that the obtained ideal floating range always reflects the current actual situation.

[0032] The logic for determining whether there are any abnormalities in mandatory consumables is as follows: determine whether the total cost and total quantity of each mandatory consumable in the medical project fall within the corresponding ideal fluctuation range. If the total cost and total quantity of each type of compulsory consumables fall within the corresponding ideal fluctuation range, it is determined that there are no abnormalities in compulsory consumables for the medical project, and further analysis will be conducted. If the total cost or total quantity of compulsory consumables used does not fall within the corresponding ideal fluctuation range, the medical project is judged to have an abnormality in compulsory consumables, and the medical project is marked as abnormal and will not be further analyzed.

[0033] S4. By combining the duration of medical projects with the quantity of consumable items consumed, a consumption rate assessment model is established to determine the proportion of consumable items consumed within a time period of equal length. This model is then compared with the proportion of consumable items consumed within the corresponding time period determined by the corresponding standard consumption dataset to determine whether there are any abnormalities in consumable items. Medical projects without abnormal consumable items are judged as having no abnormal costs.

[0034] The logic behind establishing a consumption rate assessment model to determine the proportion of consumption of chargeable consumables within equal time periods is as follows: Obtain the duration of a medical procedure and divide it into several equally spaced sub-time segments. Calculate the proportion of consumption of each chargeable consumable within each sub-time segment. Specifically, the method involves: for different medical procedures, obtaining the consumption quantity of each chargeable consumable within its corresponding sub-time segment, collecting the duration of each sub-time segment, and using the ratio of the consumption quantity of each chargeable consumable within a sub-time segment to the duration of that sub-time segment as the proportion of consumption of each chargeable consumable within that sub-time segment. The formula for calculating the proportion of consumption of each chargeable consumable within a sub-time segment is as follows: In the formula, Let q be the type of chargeable consumable in the j-th medical project, and q be the percentage of consumption in the u-th sub-time period. Let be the consumption quantity of the q-th chargeable consumable in the j-th medical project within the u-th sub-time interval. Let j be the index of the u-th sub-time interval, where j is the index of medical items without any mandatory consumable anomalies, and q is the index of the types of chargeable consumables. This is the index for the sub-time segment.

[0035] It should be noted that the core purpose of this formula is to calculate the relative consumption of each type of chargeable consumable within a specific time period, by measuring the actual consumption quantity. Divide by time interval This allows us to determine the percentage of a particular consumable item used during that time period. This relativistic calculation method provides a clearer view of the usage of different consumable items over time. The larger the value, the more the q-th chargeable consumable in the j-th medical project is consumed in the u-th sub-time period.

[0036] The logic for determining whether there are abnormalities in chargeable consumables is as follows: Calculate the difference between the percentage of consumption of various chargeable consumables for the corresponding medical item within the same sub-time period and the average percentage of consumption of chargeable consumables for multiple compliant medical items. Specifically, the difference in consumption percentage is represented by Euclidean distance, and the formula used to calculate the difference in consumption percentage is as follows: In the formula, For the j-th medical item, within the u-th sub-time period, the difference in the proportion of consumption of the q-th chargeable consumable item. This represents the average percentage of consumption of the q-th type of chargeable consumable within the u-th sub-time interval of the corresponding compliant medical item in the standard consumption dataset. This represents the total number of chargeable consumable items; among which... Specifically, it refers to the average percentage of different consumption standards under the corresponding compliant medical items in the standard consumption dataset.

[0037] It should be noted that this formula is calculated. and The difference is quantified using Euclidean distance, a commonly used method for measuring the distance between two points, which intuitively reflects the degree of difference between them. The larger the value, the greater the deviation between the consumption of medical consumables charged for and the standard consumption, and the greater the probability of abnormalities in the charged consumables.

[0038] Set thresholds for the percentage of chargeable consumables of a certain type in different sub-time periods. Compare the difference in the percentage of consumption of the corresponding chargeable consumables with the corresponding threshold. If the difference in the percentage of consumption of the chargeable consumables is greater than or equal to the threshold, it is determined that the chargeable consumables of the corresponding medical project have an abnormality in the corresponding sub-time period. If the difference in the proportion of the consumption of chargeable consumables is less than the threshold for the proportion of chargeable consumables, it is determined that there is no abnormality in the chargeable consumables for the corresponding medical project within the corresponding sub-time period; similarly, it is checked whether there are any abnormalities in chargeable consumables within each sub-time period. If there are no abnormalities in chargeable consumables in any of them, it is determined that the cost of the medical project is not abnormal; the specific steps are as follows: Set thresholds for the percentage of each type of chargeable consumable item in different sub-time periods. Compared with the corresponding threshold for the proportion of paid consumables, if At that time, it is determined that in the j-th medical item in the u-th sub-time period, the q-th chargeable consumable item has an anomaly. like When determining whether there is an anomaly in the q-th type of consumable item for the j-th medical item within the u-th sub-time interval, similarly, the system checks for anomalies in consumable items within each sub-time interval. If no anomalies are found in any of these sub-time intervals, then the target cost of the medical item is determined to be normal. In the formula... This refers to the threshold value for the percentage of chargeable consumable type q within the u-th sub-time period of the j-th medical project. The specific threshold values ​​for the percentage of chargeable consumable type q within different sub-time periods can be set based on expert experience.

[0039] Please see Figure 3 The present invention also provides a system for calculating abnormal costs of medical consumables, wherein the system is used to execute the above-described method for calculating abnormal costs of medical consumables, and includes: The standard data acquisition module is used to collect resource consumption data of each medical project in the target hospital during the monitoring period and retrieve the standard consumption dataset corresponding to each medical project. The compliance detection module is used to classify the consumables used in different medical projects in terms of fee collection, divide the consumables used into chargeable consumables and obligatory consumables, and perform compliance anomaly detection based on the standard consumable data of the corresponding medical project to centralize the consumable types. For medical projects that pass the compliance anomaly detection, step S3 is executed. The mandatory consumables anomaly detection module is used to statistically analyze the total usage cost and quantity of mandatory consumables in medical projects, and construct an ideal fluctuation range based on the centralized data distribution of the corresponding standard consumables data. It determines whether there is an anomaly in mandatory consumables based on whether the total usage cost and quantity of mandatory consumables fall within the corresponding ideal fluctuation range. For medical projects where no anomaly in mandatory consumables is found, step S4 is executed. The cost anomaly detection module is used to combine the duration of medical projects with the quantity of consumable items consumed to establish a consumption rate assessment model, determine the proportion of consumable items consumed within a time period of equal length, and compare it with the proportion of consumable items consumed within the corresponding time period determined by the corresponding standard consumption dataset to determine whether there are any anomalies in consumable items. Medical projects without anomalies in consumable items are judged as having no cost anomalies.

[0040] The above formulas are all dimensionless calculations. The formulas are derived from software simulations based on a large amount of collected data to obtain the most recent real-world results. The preset parameters in the formulas are set by those skilled in the art according to the actual situation.

[0041] The above embodiments can be implemented, in whole or in part, by software, hardware, firmware, or any other combination thereof. When implemented in software, the above embodiments can be implemented, in whole or in part, as a computer program product. Those skilled in the art will recognize that the units and algorithm steps of the various examples described in conjunction with the embodiments disclosed herein can be implemented by electronic hardware, or a combination of computer software and electronic hardware. Whether these functions are implemented in hardware or software depends on the specific application and design constraints of the technical solution.

[0042] The units described as separate components may or may not be physically separate. The components shown as units may or may not be physical units; they may be located in one place or distributed across multiple network units. Some or all of the units can be selected to achieve the purpose of this embodiment, depending on actual needs.

[0043] The above description is merely a specific embodiment of this application, but the scope of protection of this application is not limited thereto. Any changes or substitutions that can be easily conceived by those skilled in the art within the scope of the technology disclosed in this application should be included within the scope of protection of this application.

Claims

1. A method for accounting for abnormal costs of medical consumables, characterized in that, The specific steps include: S1, collect resource consumption data of each medical project in the target hospital during the monitoring period, and retrieve the standard consumption dataset corresponding to each medical project; S2, classify the consumables used in different medical projects according to the charging method, divide the consumables used into chargeable consumables and obligatory consumables, and perform compliance anomaly detection based on the standard consumable data of the corresponding medical project to centralize the consumable types, and execute step S3 for medical projects that pass the compliance anomaly detection. S3, Calculate the total usage cost and quantity of compulsory consumables in medical projects, and construct an ideal fluctuation range based on the centralized data distribution of the corresponding standard consumable data. Determine whether there are any abnormalities in compulsory consumables based on whether the total usage cost and quantity of compulsory consumables fall within the corresponding ideal fluctuation range. For medical projects without abnormalities in compulsory consumables, execute step S4. S4. By combining the duration of medical projects with the quantity of consumable items consumed, a consumption rate assessment model is established to determine the proportion of consumable items consumed within a time period of equal length. This model is then compared with the proportion of consumable items consumed within the corresponding time period determined by the corresponding standard consumption dataset to determine whether there are any abnormalities in consumable items. Medical projects without abnormal consumable items are judged as having no abnormal costs.

2. The method for abnormal cost accounting of medical consumables according to claim 1, characterized in that: The medical services include appendectomy, coronary artery bypass surgery, postoperative care, and emergency imaging. The resource consumption data of the medical project includes the type, quantity, cost, and usage timestamp of consumables. The specific method for constructing the standard consumption dataset corresponding to the medical project is as follows: for any medical project, collect the resource consumption data of multiple compliant medical projects of the same type to form the standard consumption dataset of the corresponding medical project.

3. The method for abnormal cost accounting of medical consumables according to claim 2, characterized in that: The logic behind classifying consumables used in different medical projects for fee collection is as follows: based on payment records, the chargeable consumables are determined from the resource consumption data of the medical project, and the remaining consumables are treated as mandatory consumables. The logic for compliance anomaly detection is as follows: obtain the consumable types of the medical project and compare them with all consumable types involved in the corresponding standard consumable dataset. Determine whether there are any consumable types not involved in the corresponding standard consumable dataset. If there are any consumable types not involved, the project does not meet the compliance requirements, and the medical project is marked as an anomaly, indicating that the cost of the medical project is abnormal. If there are no consumable types not involved, the compliance anomaly detection is passed.

4. The method for abnormal cost accounting of medical consumables according to claim 3, characterized in that: The logic behind constructing an ideal floating range based on the centralized data distribution of standard consumable data is as follows: For any type of compulsory consumable in a medical project, extract the total usage cost and quantity of that type of compulsory consumable in each compliant medical project of the same type, and obtain the sequence of total usage cost and quantity of that type of compulsory consumable by arranging them in ascending order.

5. The method for abnormal cost accounting of medical consumables according to claim 4, characterized in that: The length of the floating window is determined based on the number of elements in the total usage cost sequence. The floating window slides within the total usage cost sequence, and the difference between the maximum and minimum values ​​within the floating window is defined as the width of the floating window. The minimum and maximum values ​​within the floating window with the smallest width are extracted to serve as the upper and lower limits of the ideal floating range for the total usage cost of this type of compulsory consumable. Similarly, the ideal floating range for the usage quantity of this type of compulsory consumable is determined. The method for determining the size of the floating window is as follows: obtain the number of elements in the total usage cost sequence and preset a proportional coefficient. The product of the preset proportional coefficient and the number of elements in the total usage cost sequence is rounded up, and the processed data is used as the length of the floating window.

6. The method for abnormal cost accounting of medical consumables according to claim 5, characterized in that: The logic for determining whether there are any abnormalities in mandatory consumables is as follows: determine whether the total cost and total quantity of each mandatory consumable in the medical project fall within the corresponding ideal fluctuation range. If the total cost and total quantity of each type of compulsory consumables fall within the corresponding ideal fluctuation range, it is determined that there are no abnormalities in compulsory consumables for the medical project, and further analysis will be conducted. If the total cost or total quantity of compulsory consumables used does not fall within the corresponding ideal fluctuation range, the medical project is judged to have an abnormality in compulsory consumables, and the medical project is marked as abnormal and will not be further analyzed.

7. The method for abnormal cost accounting of medical consumables according to claim 6, characterized in that: The logic behind establishing a consumption rate assessment model to determine the proportion of consumption of chargeable consumables within equal time periods is as follows: Obtain the duration of a medical procedure and divide it into several equally spaced sub-time segments. Calculate the proportion of consumption of each chargeable consumable within each sub-time segment. Specifically, the method involves: for different medical procedures, obtaining the consumption quantity of each chargeable consumable within its corresponding sub-time segment, collecting the duration of each sub-time segment, and using the ratio of the consumption quantity of each chargeable consumable within its corresponding sub-time segment to the duration of the sub-time segment as the proportion of consumption of each chargeable consumable within that sub-time segment.

8. The method for abnormal cost accounting of medical consumables according to claim 7, characterized in that: The logic for determining whether there are any abnormalities in chargeable consumables is as follows: calculate the difference between the percentage of consumption of various chargeable consumables for the corresponding medical project in the same sub-time period and the average percentage of consumption of chargeable consumables for multiple compliant medical projects, specifically using Euclidean distance to represent the difference in the percentage of consumption.

9. The method for abnormal cost accounting of medical consumables according to claim 8, characterized in that: Set thresholds for the percentage of chargeable consumables of a certain type in different sub-time periods. Compare the difference in the percentage of consumption of the corresponding chargeable consumables with the corresponding threshold. If the difference in the percentage of consumption of the chargeable consumables is greater than or equal to the threshold, it is determined that the chargeable consumables of the corresponding medical project have an abnormality in the corresponding sub-time period. If the difference in the proportion of the consumption of chargeable consumables is less than the threshold for the proportion of chargeable consumables, it is determined that there is no abnormality in the chargeable consumables for the corresponding medical project within the corresponding sub-time period; similarly, it is checked whether there are any abnormalities in chargeable consumables within each sub-time period. If there are no abnormalities in chargeable consumables, it is determined that the cost of the medical project is not abnormal.

10. A system for anomaly accounting of medical consumable costs, characterized in that: The aforementioned medical consumable cost anomaly accounting system is used to execute the medical consumable cost anomaly accounting method according to any one of claims 1-9, including: The standard data acquisition module is used to collect resource consumption data of each medical project in the target hospital during the monitoring period and retrieve the standard consumption dataset corresponding to each medical project. The compliance detection module is used to classify the consumables used in different medical projects in terms of fee collection, divide the consumables used into chargeable consumables and obligatory consumables, and perform compliance anomaly detection based on the standard consumable data of the corresponding medical project to centralize the consumable types. For medical projects that pass the compliance anomaly detection, step S3 is executed. The mandatory consumables anomaly detection module is used to statistically analyze the total usage cost and quantity of mandatory consumables in medical projects, and construct an ideal fluctuation range based on the centralized data distribution of the corresponding standard consumables data. It determines whether there is an anomaly in mandatory consumables based on whether the total usage cost and quantity of mandatory consumables fall within the corresponding ideal fluctuation range. For medical projects where no anomaly in mandatory consumables is found, step S4 is executed. The cost anomaly detection module is used to combine the duration of medical projects with the quantity of consumable items consumed to establish a consumption rate assessment model, determine the proportion of consumable items consumed within a time period of equal length, and compare it with the proportion of consumable items consumed within the corresponding time period determined by the corresponding standard consumption dataset to determine whether there are any anomalies in consumable items. Medical projects without anomalies in consumable items are judged as having no cost anomalies.

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