Hospital management analysis system, method for controlling hospital management analysis system, and program

Abstract

To analyze a medical care performance at a DPC object hospital, in order to present a measure plan for improving the coefficients by medical institution.SOLUTION: A hospital management analysis system that is capable of generating a measure plan for improving the medical institution-specific coefficients of a DPC object hospital, includes: a medical care performance information storing part having stored medical care performance information containing each piece of information indicating the number of hospitalization days of a patient, the corresponding DPC, and inclusion range output points, for each case corresponding to the DPC for which medical care has been provided at a DPC object hospital; a method storing part for storing methods for improving an index, with regard to the prescribed index to be used in calculating a medical institution-specific coefficient; a DPC identification part for identifying a DPC for which the improvement effect of the prescribed index can be expected, from among DPCs for which medical care performances exist at the DPC object hospital, on the basis of the medical care performance information, and tabulation information in which medical care performances for all DPC object hospitals are tabulated; and a measure plan generating part for generating a measure plan describing the contents of the methods, and the DPCs for which the improvement effect can be expected.SELECTED DRAWING: Figure 12

Description

[Technical field]

[0001] The present invention relates to a hospital management analysis system, and a control method and program for a hospital management analysis system. [Background technology]

[0002] Currently, the DPC / PDPS system (a comprehensive daily fee evaluation system) is being implemented as a comprehensive evaluation system for medical fees for acute inpatient care, and is contributing to improving the quality of medical care and management at hospitals that are subject to the DPC / PDPS system (hereinafter referred to as DPC-eligible hospitals).

[0003] In order to support such hospital management, a hospital management support system has been developed that organizes various data showing the hospital's management status and visualizes the results, making it possible to analyze the management issues facing the hospital (see, for example, Patent Document 1). [Prior art documents] [Patent documents]

[0004] [Patent Document 1] JP 2018-60252 A Summary of the Invention [Problem to be solved by the invention]

[0005] However, even with such a system, hospitals themselves must interpret the data, understand their management issues, and devise improvement measures, etc. However, the DPC / PDPS system is extremely complex and undergoes frequent revisions, so the burden on DPC-targeted hospitals required to devise such policy proposals is heavy.

[0006] Therefore, there is a demand for technology that can support the management of DPC-targeted hospitals by assisting in the formulation of various policy proposals to provide higher quality medical services and improve hospital management efficiency under the DPC / PDPS system, in particular by assisting in the formulation of policy proposals to improve the medical institution-specific coefficients stipulated in the DPC / PDPS system.

[0007] The present invention has been made in consideration of the above-mentioned problems, and aims to provide a hospital management analysis system, a control method and a program for the hospital management analysis system, which are capable of analyzing the medical treatment records of DPC-targeted hospitals and proposing measures to improve coefficients for each medical institution. [Means for solving the problem]

[0008] One embodiment of the hospital management analysis system is a hospital management analysis system capable of generating policy proposals to improve medical institution-specific coefficients at DPC-target hospitals, and comprises: a medical performance information storage unit that stores medical performance information including information indicating the patient's length of hospitalization, the corresponding DPC, and the comprehensive range output point for each case corresponding to a DPC for which treatment was performed at the DPC-target hospital; a method storage unit that stores methods for improving a specific index used to calculate the medical institution-specific coefficient; a DPC identification unit that identifies a DPC that has a medical performance record at the DPC-target hospital, from among the DPCs for which treatment has been performed at the DPC-target hospital, a DPC that is expected to have an improvement effect on the specific index when the method is applied to the DPC-target hospital, based on the medical performance information and aggregated information that aggregates the medical performance at all DPC-target hospitals; and a policy proposal generation unit that generates the policy proposal describing the content of the method and the DPC for which the improvement effect is expected.

[0009] In addition, the problems and solutions disclosed in this application will be made clear by the description in the section of the preferred embodiment of the invention and the descriptions in the drawings. Effect of the Invention

[0010] It will be possible to analyze the medical treatment records at DPC-eligible hospitals and present policy proposals to improve coefficients for each medical institution. [Brief description of the drawings]

[0011] [Figure 1] 1 is a configuration diagram of an entire system including a hospital management analysis system. [Diagram 2] 1 is a diagram showing the hardware configuration of a DPC medical care record providing device and a hospital management analysis system. [Diagram 3] FIG. 2 is a diagram illustrating a storage device of the hospital management analysis system. [Figure 4] FIG. 13 is a diagram showing a case-by-case data table. [Diagram 5] FIG. 13 is a diagram showing a master table. [Figure 6] FIG. 13 is a diagram showing a disease-specific evaluation data table. [Figure 7] FIG. 13 is a diagram showing a procedure for creating a disease-specific evaluation data table. [Figure 8] FIG. 13 illustrates an improvement method management table. [Figure 9] 1 is a diagram illustrating a functional configuration of a hospital management analysis system. [Figure 10] FIG. 13 is a diagram for explaining measures to improve the efficiency index. [Figure 11] FIG. 13 is a diagram for explaining measures to improve the efficiency index. [Figure 12] FIG. 13 is a diagram showing an example of a display screen for efficiency index improvement measures. [Figure 13] FIG. 13 is a diagram for explaining a measure for improving the complexity index. [Figure 14] FIG. 13 is a diagram for explaining a measure for improving the complexity index. [Figure 15] FIG. 13 is a diagram showing an example of a display screen for a complexity index improvement measure. [Figure 16] FIG. 13 is a diagram for explaining a measure for improving the coverage rate. [Figure 17] FIG. 13 is a diagram for explaining a measure for improving the coverage rate. [Figure 18] FIG. 13 is a diagram showing an example of a display screen for measures to improve coverage. [Figure 19] FIG. 13 is a diagram for explaining measures to improve medical density. [Figure 20] FIG. 13 is a diagram for explaining measures to improve medical density. [Figure 21] FIG. 13 is a diagram showing an example of a display screen for measures to increase medical density. [Figure 22] 1 is a flowchart showing the processing flow of the hospital management analysis system. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0012] At least the following matters will become apparent from the description of this specification and the accompanying drawings. Hereinafter, the present invention will be described in detail based on an embodiment thereof with reference to the accompanying drawings. ==Overall Configuration== 1 shows an example of the configuration of an overall system 1000 including a hospital management analysis system 300 according to an embodiment of the present invention. The hospital management analysis system 300 is communicably connected to a DPC medical result providing device 100 via a network 500 such as the Internet, a LAN (Local Area Network), or a telephone network.

[0013] The DPC medical treatment results providing device 100 is an information processing device such as a computer that provides aggregated information on medical treatment results (DPC survey data) such as medical treatment details and length of hospital stay collected by the Ministry of Health, Labor and Welfare from DPC-targeted hospitals nationwide (hereinafter referred to as all DPC-targeted hospitals or nationwide) by DPC (diagnosis group classification).

[0014] The hospital management analysis system 300 generates various information for improving management efficiency, such as measures to improve the "coefficient by medical institution" of the DPC hospital, using the medical record of the DPC hospital performing the management analysis and the aggregated information of the medical record of all DPC hospitals obtained from the DPC medical record providing device 100. The hospital management analysis system 300 then outputs this information as shown in Figs. 12, 15, 18, 21, etc.

[0015] Here, the "coefficient by medical institution" is a coefficient calculated for each DPC-eligible hospital, and is used when calculating the "medical fee" for medical procedures performed on patients with DPC-eligible cases. Therefore, by implementing various measures to increase the "coefficient by medical institution," it is possible to improve the medical services of the DPC-eligible hospital and increase the "medical fee" amount.

[0016] The "medical fee amount" is calculated according to the following formula (1).

[0017] "Medical fee amount" = "Comprehensive evaluation portion" + "Fee-for-service portion" ... (Formula 1) The "fee-for-service portion" refers to the cost of medical procedures that are approved for fee-for-service calculation, such as surgery, anesthesia, radiation therapy, and procedures that cost 1,000 points or more. The "comprehensive evaluation portion" refers to the cost of medical procedures that are stipulated to be calculated as a comprehensive fee per day, such as tests, diagnostic imaging, injections, medication, procedures that cost less than 1,000 points, and basic hospitalization fees.

[0018] The “comprehensive evaluation portion” is calculated as shown below in Equation 2.

[0019] "Comprehensive evaluation portion" = "Comprehensive score per day" x "Number of days of hospitalization" x "Coefficient by medical institution" …(Formula 2) The "comprehensive points per day" are based on the medical records (such as medical treatment details and length of stay) collected by the Ministry of Health, Labor and Welfare from all DPC-eligible hospitals and are set in three stages (hospitalization period I, hospitalization period II, hospitalization period III) according to the number of days of hospitalization for each DPC, and are updated every two years.

[0020] The "coefficient by medical institution" is a coefficient used to reflect the unique characteristics of each DPC hospital, such as its facilities, structure, and medical functions, and is determined as shown in (Equation 3). "Coefficient by medical institution" = "Basic coefficient" + "Functional evaluation coefficient I" + "Functional evaluation coefficient II" + "Drastic change mitigation coefficient" ... (Formula 3) The "basic coefficient" is a coefficient that evaluates the basic medical functions of DPC-eligible hospitals. The "basic coefficient" is assigned a value set for each group depending on whether the hospital falls into the "university hospital group," "DPC designated hospital group," or "DPC standard hospital group."

[0021] The "university hospital main group" refers to university hospitals and other facilities that also serve as research institutions.

[0022] The "DPC designated hospital group" includes hospitals that exceed the minimum values ​​of DPC-eligible hospitals in the "university main hospital group" in all of the "Performance requirements 1" to "Performance requirements 4" below (five out of six items for "Performance requirement 3").

[0023] The "DPC standard hospital group" refers to DPC-eligible hospitals that do not fall into either the "university main hospital group" or the "DPC designated hospital group."

[0024] "Performance requirement 1" is a requirement regarding "density of medical care" and is determined based on the "average score for comprehensive range volume per day (adjusted for total hospital patient composition and generic drugs)."

[0025] "Average daily comprehensive volume score (adjusted for total hospital patient composition and generic drugs)" is calculated by assuming that the DPC hospital provides medical care to a patient group similar to the average patient composition of all DPC hospitals for patients with a certain number of cases (1 case / month) at the DPC hospital, and further, for drugs used in inpatient medical care at the DPC hospital, for which generic drugs are available, the lowest drug price for the generic drug is substituted, based on the comprehensive volume score per day. "Density of medical care" is calculated specifically using the following formula 4.

[0026] "Density of medical care" = "Total comprehensive range volume points after adjusting for patient composition" ÷ "Total length of stay after adjusting for patient composition" =Σ("Average points for comprehensive scope of output per hospitalization for each DPC at our hospital" x "Number of cases for each DPC nationwide") ÷ Σ("Average length of stay for each DPC at our hospital" x "Number of cases for each DPC nationwide") However, the DPCs in question are those that are subject to comprehensive claims and have a medical record of treating 12 or more cases per year at our hospital ... (Formula 4) "Performance requirement 2" is a requirement regarding "implementation of physician training" and is determined by the number of clinical training physicians employed per registered hospital bed.

[0027] "Performance requirement 3" is a requirement regarding "implementation of medical technology" and is judged based on the index of six prescribed medical technology items, including surgery and internal medicine. If five of the six items exceed the minimum values ​​of DPC-eligible hospitals that fall into the university hospital group, it is considered to meet performance requirement 3.

[0028] "Performance requirement 4" is a requirement regarding the "adjusted complexity index (after correction for severe DPC)" and is judged based on the "complexity index" calculated for DPCs that have an average length of stay longer than the average length of stay at all DPC-eligible hospitals and have a daily comprehensive range volume performance score higher than the average.

[0029] The "complexity index" evaluates the patient composition from the perspective of medical resource input per hospitalization, and is evaluated based on the number of cases with high comprehensive range output points per hospitalization nationwide. The "complexity index" is specifically calculated using the following (Formula 5).

[0030] "Complexity index" = "The score obtained by replacing the comprehensive range volume of the DPC-eligible hospital with the national average for each DPC" ÷ "Average comprehensive score per hospitalization for all DPC-eligible hospitals" =Σ("Number of cases of each DPC at our hospital" x "Comprehensive range output points per hospitalization for each DPC nationwide") ÷ ("Number of cases nationwide" x "Average comprehensive points per hospitalization for all DPC-eligible hospitals") However, the DPCs in question are those that are subject to comprehensive billing and have a medical record of treating 12 cases per year at the hospital … (Formula 5) Therefore, DPC hospitals that do not fall under the "University Hospital Group" are assigned to either the "DPC Designated Hospital Group" or the "DPC Standard Hospital Group," but aiming to be selected as a "DPC Designated Hospital Group" with a larger "basic coefficient" will lead to improved management. And to be selected as a "DPC Designated Hospital Group," it is necessary to improve the above "Performance Requirements 1" to "Performance Requirements 4."

[0031] Returning to equation 3, "functional evaluation coefficient I" is a coefficient that evaluates the staffing and overall facility structure of DPC-eligible hospitals, and is the basis for the evaluation of how DPC-eligible hospitals approach medical activities, such as medical safety measures, infection prevention measures, and the deployment of nurses at night.

[0032] The "Functional Evaluation Coefficient II" evaluates incentives for improving efficiency in the entire medical care system through participation in the DPC / PDPS system. The Functional Evaluation Coefficient II is judged based on six items: "insured medical care," "efficiency," "complexity," "emergency medical care," "coverage rate," and "community medical care."

[0033] "Insurance medical treatment" will be evaluated based on efforts such as compiling quality-based DPC survey data, publishing hospital information, and working to improve the quality of health care.

[0034] "Efficiency" is evaluated based on the efforts of each DPC hospital to shorten the length of hospital stay. Specifically, "efficiency" is judged by the "efficiency index," which is an index of the average length of hospital stay assuming that the DPC hospital has the same patient composition as all other DPC hospitals, as shown in the following (Formula 6).

[0035] "Efficiency index" = "Total length of stay after adjusting for patient composition" ÷ "Total number of DPC cases nationwide" =Σ("Average length of stay for each DPC at our hospital" x "Number of cases for each DPC nationwide") ÷Σ("Number of cases for each DPC nationwide") However, the DPCs in question are those that are subject to comprehensive billing and have a medical record of 12 cases per year at the hospital ... (Formula 6) "Complexity" is evaluated based on the number of cases with high comprehensive range output points per hospitalization nationwide, and is judged using the "complexity index" shown above (Equation 5).

[0036] "Emergency medical care" evaluates the discrepancy in the amount of medical resources required to treat patients who require emergency medical care, with a higher ratio of emergency medical cases and a larger amount of medical resources invested leading to a higher rating.

[0037] "Coverage rate" is an evaluation of the comprehensive system that can respond to a wide range of diseases, and is determined by the "coverage rate index" shown in the following (Formula 7). "Coverage rate index" = "Number of DPC types with 12 or more cases per year at your hospital" ÷ "Total number of DPC types" However, the DPCs in question are those that are subject to comprehensive billing and have a medical record of treating 12 cases per year at the hospital … (Formula 7) "Community medical care" evaluates contributions to community medical care, primarily for facilities that fulfill the function of providing necessary medical care in mountainous and remote areas.

[0038] Returning to formula 3, the "sudden change mitigation coefficient" is a coefficient intended to provide relief to hospitals that would be significantly affected financially if the "basic coefficient," "functional evaluation coefficient I," and "functional evaluation coefficient II" were to change drastically when medical fee revisions were made.

[0039] The "coefficients by medical institution" calculated in this way are notified to each DPC-eligible hospital by the Ministry of Health, Labor and Welfare every year, but the data used to calculate the "coefficients by medical institution" is data from the past one-year evaluation period (predetermined period). For example, the evaluation period for calculating the "coefficients by medical institution" for fiscal year 2018 (April 2018 to March 2019) is one year (12 months) from October 2016 to September 2017, taking into account the time required to compile data.

[0040] In addition, when calculating the "coefficient by medical institution," it is stipulated that only "diseases with an average of one case per month (diseases with 12 or more cases per year)" are evaluated, in order to exclude cases with a small number of cases during the evaluation period as outliers.

[0041] The hospital management analysis system 300 then generates a policy proposal for improving the "coefficient by medical institution" determined based on the various indexes described above. In particular, in this embodiment, improvement measures for the "performance requirement 1" and the "performance requirement 4" that lead to an improvement of the "basic coefficient", and improvement measures for the "coverage rate", the "complexity index", and the "efficiency index" that lead to an improvement of the "functional evaluation coefficient II" are generated.

[0042] This approach makes it possible to analyze the medical record of DPC hospitals and propose various measures to improve coefficients for each medical institution, thereby supporting management improvements at DPC hospitals under the DPC / PDPS system.

[0043] The details will be explained below. ==Hospital Management Analysis System== First, the hospital management analysis system 300 will be described.

[0044] As shown in FIG. 2, the hospital management analysis system 300 is composed of an information processing device such as a computer equipped with a CPU 310, a memory 320, a communication device 330, a storage device 340, an input device 350, an output device 360, and a recording medium reading device 370.

[0045] 2 shows the hardware configuration of the hospital management analysis system 300 and the hardware configuration of the DPC medical record providing device 100 together. Although these hardware configurations are not necessarily the same, they share a basic configuration, so to avoid duplication, these configurations are shown together in FIG. 2.

[0046] The CPU 310 is responsible for the overall control of the hospital management analysis system 300, and realizes the various functions of the hospital management analysis system 300 by reading out the hospital management analysis system control program 730, which is composed of codes for performing various operations related to this embodiment stored in the storage device 340, and various data into the memory 320 and executing or processing them.

[0047] For example, the CPU 310 executes or processes the hospital management analysis system control program 730 and various data, and by working in cooperation with hardware devices such as the memory 320, communication device 330, and storage device 340, various functions such as the medical treatment performance information storage unit 301, method storage unit 302, DPC identification unit 303, and policy proposal generation unit 304 described below are realized.

[0048] The storage device 340 is a non-volatile storage device such as a hard disk drive or a solid state drive (SSD). As shown in Fig. 3, the storage device 340 stores various data such as a hospital management analysis system control program 730 executed by the hospital management analysis system 300, a case-by-case data table 600, an improvement method management table 610, a master table 620, and a disease-specific evaluation data table 630 (details will be described later).

[0049] The recording medium reader 370 reads the hospital management analysis system control program 730 and various data recorded on a recording medium 800 such as a CD-ROM, a DVD, or a USB (registered trademark) memory, and stores them in the storage device 340 .

[0050] The communications device 330 transmits and receives various data and programs to and from the DPC medical result providing device 100 and other computers (not shown) via the network 500. For example, the above-mentioned hospital management analysis system control program 730 and data such as the above-mentioned various tables can be stored in another computer (not shown), and the hospital management analysis system 300 can download these data and the hospital management analysis system control program 730 from this computer. Alternatively, the above-mentioned various tables may be constructed in another computer.

[0051] The input device 350 is a device for inputting data, such as a keyboard or a mouse, while the output device 360 ​​is a device for outputting data, such as a display or a printer.

[0052] The hospital management analysis system 300 may be realized by one computer, or may be realized by a plurality of computers connected to each other so as to be able to communicate with each other. ==DPC medical care record providing device== Next, the DPC medical record providing device 100 will be described.

[0053] As shown in FIG. 2, the DPC medical result providing device 100 is composed of an information processing device such as a computer including a CPU 110, a memory 120, a communication device 130, a storage device 140, an input device 150, an output device 160, and a recording medium reading device 170.

[0054] The CPU 110 is responsible for the overall control of the DPC medical care record providing device 100, and by reading out a DPC medical care record providing device control program 710, which is composed of codes for performing various operations related to this embodiment stored in the storage device 140, and various data into the memory 120 and executing or processing it, it realizes the various functions of the DPC medical care record providing device 100 described in this embodiment.

[0055] As described above, the DPC medical record providing device 100 has a common configuration with the hospital management analysis system 300, so a duplicated explanation will be omitted. ==Table== Next, the case-by-case data table 600, the improvement method management table 610, the master table 620, and the disease-specific evaluation data table 630 will be described with reference to FIGS. <Case-specific data table> The case-based data table 600 is a table that records medical treatment results information for each case that corresponds to the DPC for which treatment was performed at the hospital. An example of the case-based data table 600 is shown in Figure 4. In the example shown in Figure 4, the medical treatment results information includes the facility ID, discharge date, patient ID, discharge date, admission date, DPC code, DPC length of stay, and total comprehensive range fee points, and also includes information on administered medicines. <Master table> The master table 620 is a table that stores aggregated information on medical treatment results at all DPC target hospitals provided by the DPC medical treatment result providing device 100. An example of the master table 620 is shown in Fig. 5. In the example shown in Fig. 5, the master table 620 records information on the DPC code, the national number of cases, the national number of cases after normalization, the national average length of hospitalization, the average comprehensive range fee-for-service points, the comprehensive range fee-for-service points per day, and the comprehensive billing target category.

[0056] The DPC code column lists the DPC for which cases were reported at one or more DPC-eligible hospitals. The national number of cases is the number of cases for each DPC combined for all DPC-eligible hospitals. The national number of cases after normalization is the normalized national number of cases for each DPC. The national average length of stay is the average length of stay at all DPC-eligible hospitals. The average comprehensive range volume point is the average comprehensive range volume point at all DPC-eligible hospitals. The comprehensive range volume point per day is the average comprehensive range volume point per day at all DPC-eligible hospitals. The comprehensive billing category indicates whether the item is subject to comprehensive billing or fee-for-service billing. <Disease-specific evaluation data table> The disease-specific evaluation data table 630 is a table generated by the hospital management analysis system 300 using the above-mentioned case-unit data table 600 and master table 620 in accordance with the procedure illustrated in Figure 7, and is a table used when the hospital management analysis system 300 analyzes the medical treatment performance of the DPC target hospital and generates various policy proposals to improve the "medical institution-specific coefficient."

[0057] An example of a disease-specific evaluation data table 630 is shown in Fig. 6. The (1) DPC code, (2) number of cases at the hospital, (3) total number of DPC admissions, and (4) total comprehensive range output points listed in the "Hospital aggregated data" column in Fig. 6 are created by aggregating medical care performance information for a specified data evaluation period listed in the case-by-case data table 600 by DPC.

[0058] The data evaluation period may be one year, in line with the evaluation period (predetermined period) when the Ministry of Health, Labor and Welfare calculates the "coefficient by medical institution," but the user operating the hospital management analysis system 300 can specify or set any period using the input device 350. For example, the user can specify a period in one-month units by inputting the start month and end month. Therefore, when analyzing what the future "coefficient by medical institution" will be, data for less than one year, such as six months, may be used since data for the entire one-year period to be evaluated may not yet be available.

[0059] However, even if a period other than 12 months is specified or set as the data evaluation period, the hospital management analysis system 300 performs processing based on 12 months when generating improvement measures for various indices such as "medical care density" and "complexity index" of this DPC target hospital. For example, the DPC to be calculated for these indices requires 12 cases or more per year, but a DPC with 6 or more cases in a 6-month data evaluation period is converted to 12 or more cases in 12 months, so the hospital management analysis system 300 includes this DPC in the calculation of the index. However, a DPC with only one case in a 6-month data evaluation period is converted to only 2 cases in 12 months, so the hospital management analysis system 300 does not include this DPC in the calculation of the index. The hospital management analysis system 300 determines that at least 11 cases are required in the remaining 6 months to include this DPC in the calculation of the index, and generates improvement measures.

[0060] In addition, the (5) national number of cases, (6) normalized national number of cases, (7) national average length of stay, (8) average comprehensive range output score, and (9) daily comprehensive range output score listed in the “Master Data” column in Figure 6 are the corresponding values ​​listed in the master table 620 stored for each DPC.

[0061] In addition, (10) Evaluation subject, (11) Average length of stay at own hospital, and (12) Difference in average length of stay, written in the “Derived portion” column, are information created by the hospital management analysis system 300 according to the calculation formulas written in the disease-specific evaluation data table 630.

[0062] Note that the information stored in the disease-specific evaluation data table 630 is just an example, and in addition to the information shown in FIG. 6, the disease-specific evaluation data table 630 also stores information used by the hospital management analysis system 300 when generating various policy proposals. <Improvement method management table> The improvement method management table 610 stores information used as a template when the hospital management analysis system 300 generates various measures for improving the "coefficient by medical institution." An example of the improvement method management table 610 is shown in FIG.

[0063] For example, when generating a policy proposal to improve the “density of medical care,” the hospital management analysis system 300 refers to templates for two policy proposals, the medical care density improvement methods (1) and (2), which are described in the improvement method management table 610.

[0064] The template's [Improvement Method] column lists the improvement methods for improving "medical care density." Additionally, the [Calculation Formula] column lists the calculation formula for extracting DPCs that are expected to have an effect of improving "medical care density" from the hospital's medical records. This calculation formula is also used when conducting analysis to improve the hospital's "medical care density." The [Comment] column lists draft comments to be included in the policy proposal.

[0065] First, the hospital management analysis system 300 performs calculations according to the above formula for each DPC listed in the disease-specific evaluation data table 630, and from the calculation results, extracts a predetermined number (three in this embodiment) of DPCs that are expected to improve "medical care density" when improvement methods (1) and (2) are applied to the DPC target hospital in order of effectiveness (largest or smallest calculation result). The hospital management analysis system 300 enters these DPCs in the blank spaces (1), (2), and (3) in the [Comments] column (the spaces marked "..." in Figure 8).

[0066] In addition, the hospital management analysis system 300 calculates each term in the above formula ("normalized number of cases" and "average length of stay at the hospital - national average length of stay") and compiles these values ​​in a graph or table to visually display the state of the hospital's medical record. For example, a graph is created by plotting the values ​​on a two-dimensional coordinate plane.

[0067] The hospital management analysis system 300 then generates policy proposals by combining the above information and displays them in the ``Disease evaluation part for medical treatment density calculation'' column and the ``Medical treatment density calculation result evaluation comment part'' column of the output screen shown in Figure 21, thereby presenting specific and useful policy proposals based on the actual medical treatment performance of the DPC target hospital.

[0068] In addition, the hospital management analysis system 300 displays a list of DPCs that are expected to have an improvement effect, extracted using the above formula, including DPCs ranked 4th or lower, as shown in the ``Disease-specific (DPC code) list information display section'' column of Figure 21.

[0069] In this way, it is possible to analyze the medical records of DPC-eligible hospitals and present specific measures to improve the "coefficients by medical institution."

[0070] Although not shown in Fig. 8, templates of proposed measures are also stored for indexes other than "density of medical care" in the improvement method management table 610. The display format for outputting the proposed measures on the screen can be set using HTML (Hyper Text Markup Language) or the like. ==Functional Configuration== 9 shows a functional configuration diagram of the hospital management analysis system 300. The hospital management analysis system 300 according to this embodiment has the functions of a medical record information storage unit 301, a method storage unit 302, a DPC specification unit 303, and a measure proposal generation unit 304.

[0071] Each of these functions is realized by the hardware of the hospital management analysis system 300 executing the hospital management analysis system control program 730.

[0072] The medical performance information storage unit 301 stores medical performance information including information indicating the number of days of hospitalization of the patient, the corresponding DPC, and the comprehensive range output points for each case corresponding to the DPC treated at the DPC target hospital. In this embodiment, the medical performance information storage unit 301 is embodied as a case-by-case data table 600.

[0073] The method storage unit 302 stores methods for improving a predetermined index (such as "medical care density") used in calculating the "coefficient by medical institution." The method storage unit 302 stores methods for improving, for example, the "medical care density," the "corrected complexity index (after severe DPC correction)," the "efficiency index," the "complexity index," and the "coverage rate index." In this embodiment, the method storage unit 302 is embodied as the improvement method management table 610 described above.

[0074] Based on the medical performance information stored in the medical performance information storage unit 301 and the aggregated information that compiles the medical performance at all DPC-targeted hospitals, the DPC identification unit 303 identifies, from among the DPCs that have a medical performance record at DPC-targeted hospitals, a DPC that is expected to improve the index when the above-mentioned method is applied to the DPC-targeted hospital.

[0075] Then, the policy proposal generating unit 304 generates a policy proposal that describes the content of the above method and the DPC that can be expected to have an effect of improving the index.

[0076] For example, when trying to improve "medical care density," the DPC identification unit 303 identifies a predetermined number (e.g., three) of DPCs that are expected to have an effect of improving medical care density, based on the largest product of the average length of stay at a DPC-targeted hospital minus the average length of stay at all DPC-targeted hospitals and the value equivalent to the number of cases at all DPC-targeted hospitals (e.g., the total value or average value), among DPCs with a certain number or more of cases per specified period at a DPC-targeted hospital (e.g., 12 or more cases per year).

[0077] Then, the measure proposal generating unit 304 generates a measure proposal that describes shortening the length of hospital stay of cases that fall under the above-mentioned predetermined number of DPCs as a method for improving the "density of medical care."

[0078] To explain this in more detail with reference to Figures 19, 20 and (Formula 4), we can see that in order to improve "medical care density," it is best to reduce the denominator in (Formula 4), "Σ("average length of stay for each DPC at your hospital" x "number of cases for each DPC nationwide")." However, since the "number of cases for each DPC nationwide" in this denominator is a value (constant) that cannot be changed by the hospital's activities, shortening the "average length of stay for each DPC at your hospital" is a measure to improve "medical care density."

[0079] Therefore, the larger the product of the average length of stay at this DPC hospital minus the average length of stay at all DPC hospitals, and the value equivalent to the number of cases at all DPC hospitals, the greater the improvement effect on "medical care density." Therefore, by focusing improvement measures on such DPCs, it is possible to effectively improve "medical care density."

[0080] In addition, the DPC identification unit 303 may identify, among the DPCs in which the number of cases per specified period at this DPC-targeted hospital is less than a certain number (for example, less than 12 cases per year), DPCs with a specified number (for example, 3 cases) in order of the largest product of the ratio of the medical density at this DPC-targeted hospital to the medical density at all DPC-targeted hospitals and the value equivalent to the number of cases at all DPC-targeted hospitals (such as the total value or average value), as DPCs that are expected to have an improvement effect on medical density.

[0081] The policy proposal generation unit 304 then generates a policy proposal that describes increasing the number of cases per specified period corresponding to the above-mentioned specified number of DPCs to above the above-mentioned fixed number as a method for improving the "density of medical care."

[0082] In other words, among the DPCs with fewer than 12 cases per year at this DPC-eligible hospital, by extracting DPCs where the "hospital's own practice density" is greater than the "national practice density" and where the number of cases is relatively large among all DPC-eligible hospitals, and by increasing the number of cases at such DPCs to 12 or more per year, the "practice density" can be effectively improved.

[0083] Next, a case where the "complexity index" is improved will be described. When trying to improve the "complexity index," the DPC specification unit 303 specifies a predetermined number of DPCs in descending order of the value (total value, average value, etc.) equivalent to the comprehensive range output score per hospitalization in all DPC-targeted hospitals, among DPCs in which the number of cases per predetermined period in DPC-targeted hospitals is a certain number or more (for example, 12 cases or more per year), as DPCs that can be expected to improve the complexity index.

[0084] Then, the measure generating unit 304 generates a measure describing increasing the number of cases that fall under the above-mentioned predetermined number of DPCs as a method for improving the "complexity index."

[0085] To explain this in more detail with reference to Figures 13 and 14 and (Formula 5), ​​it can be seen that in order to improve the "complexity index," it is best to increase Σ ("number of cases of each DPC at the hospital" x "comprehensive range output points per hospitalization for each DPC nationwide"), which is the numerator of (Formula 5). However, since the "comprehensive range output points per hospitalization for each DPC nationwide" in this numerator is a value (constant) that cannot be changed by the activities of the hospital, it is necessary to take measures to improve the "complexity index" by adjusting the "number of cases of each DPC at the hospital." The denominator of (Formula 5) is also a value (constant) that cannot be changed by the activities of the hospital.

[0086] Therefore, among DPCs with a certain number of cases per given period at DPC-eligible hospitals, the DPCs with a larger value equivalent to the comprehensive range volume points per hospitalization at all DPC-eligible hospitals have a greater effect on improving the "Complexity Index." Therefore, by focusing on improvement measures for such DPCs, it is possible to more effectively improve the "Complexity Index."

[0087] Furthermore, the DPC specification unit 303 may specify a certain number of DPCs in which the number of cases per specified period at the DPC-targeted hospital is equal to or greater than a certain number (for example, 12 cases or more per year), in ascending order of values ​​(such as total values ​​or average values) corresponding to the comprehensive range output points per hospitalization at all DPC-targeted hospitals, as DPCs that are expected to have an effect of improving the complexity index. In this case, the policy proposal generation unit 304 generates the policy proposal that describes reducing the number of cases corresponding to the above-mentioned certain number of DPCs as a method for improving the "complexity index." This aspect also makes it possible to effectively improve the "complexity index."

[0088] As for the "adjusted complexity index (after correction for severe DPC)," it is the same as the explanation of the "complexity index" above, except that it targets DPCs with an average length of stay longer than the average length of stay at all DPC-targeted hospitals and DPCs with a comprehensive range volume performance score per day higher than the average, so a detailed explanation will be omitted.

[0089] Next, a case where the "efficiency index" is improved will be described. When trying to improve the "efficiency index," the DPC identification unit 303 identifies a predetermined number (e.g., three) of DPCs in which the number of cases per predetermined period at a DPC-targeted hospital is equal to or greater than a certain number (e.g., 12 or more cases per year), in order of the largest product of the average length of stay at this DPC-targeted hospital minus the average length of stay at all DPC-targeted hospitals and the value equivalent to the number of cases at all DPC-targeted hospitals (such as the total or average value), as DPCs that can be expected to improve the efficiency index.

[0090] Then, the policy proposal generating unit 304 generates a policy proposal that describes shortening the length of hospital stay for cases that fall under the above-mentioned predetermined number of DPCs as a method for improving the "efficiency index."

[0091] To explain this in more detail with reference to Figures 10, 11 and (Formula 6), we can see that in order to improve the "efficiency index," it is best to reduce "Σ("average length of stay for each DPC at your hospital" x "number of cases for each DPC nationwide")," which is the numerator in (Formula 6). However, since the "number of cases for each DPC nationwide" in this numerator is a value (constant) that cannot be changed by the activities of your hospital, shortening the "average length of stay for each DPC at your hospital" is a measure to improve the "efficiency index."

[0092] Therefore, the larger the product of the average length of stay at this DPC hospital minus the average length of stay at all DPC hospitals and the value equivalent to the number of cases at all DPC hospitals, the greater the improvement effect on the "efficiency index." Therefore, by focusing improvement measures on such DPCs, it is possible to more effectively improve the "efficiency index."

[0093] Furthermore, the DPC specification unit 303 may specify, among the DPCs in which the number of cases per predetermined period at the DPC-targeted hospital is less than a certain number (for example, less than 12 cases per year), a certain number of DPCs in descending order of the value obtained by subtracting the average length of stay at the DPC-targeted hospital from the average length of stay at all DPC-targeted hospitals, as DPCs that are expected to have an effect of improving the efficiency index. In this case, the policy proposal generation unit 304 generates a policy proposal that describes increasing the number of cases per predetermined period corresponding to the certain number of DPCs to the certain number or more (12 or more), as a method for improving the "efficiency index". This embodiment also makes it possible to effectively improve the "efficiency index".

[0094] Next, a case where the "coverage rate" is improved will be described. When trying to improve the "coverage rate", the DPC specification unit 303 specifies a predetermined number (e.g., three) of DPCs in descending order of the number of cases at a DPC-targeted hospital among DPCs in which the number of cases per predetermined period is less than a certain number (e.g., less than 12 cases per year) as DPCs that can be expected to improve the coverage rate.

[0095] Then, the policy proposal generation unit 304 generates a policy proposal that describes increasing the number of cases per specified period that correspond to these DPCs to the above-mentioned certain number (12 or more) as a method for improving the "coverage rate."

[0096] To explain this in more detail with reference to Figures 16 and 17 and (Formula 7), it can be seen that in order to improve the "coverage rate", it is good to increase the "number of DPC types at your hospital that are 12 cases or more per year", which is the numerator in (Formula 7). Therefore, increasing the "number of DPC types at your hospital that are 12 cases or more per year" is a measure to improve the "coverage rate". Therefore, increasing the number of cases for DPCs that are just a few cases away from reaching 12 cases, to 12 cases or more, is an effective way to improve the "coverage rate".

[0097] Furthermore, the DPC specification unit 303 may specify a predetermined number (e.g., three) of DPCs in descending order of the value (total value, average value, etc.) corresponding to the number of cases in all DPC-targeted hospitals as DPCs that can be expected to improve the coverage rate, among the DPCs in which the number of cases in a predetermined period in this DPC-targeted hospital is less than a certain number (e.g., less than 12 cases per year). In this case, the policy proposal generation unit 304 generates a policy proposal that describes increasing the number of cases in a predetermined period corresponding to these DPCs to the above-mentioned certain number or more (12 or more), as a method for improving the "coverage rate."

[0098] In this case, if there is a DPC where the number of cases at one's hospital is low but other hospitals nationwide have a high number of cases, it is believed that the number of cases can be increased relatively easily if the cause of the low number of cases at one's hospital can be eliminated, and therefore it can be said to be effective in improving the "coverage rate." ==Process flow== Next, the flow of processing by the hospital management analysis system 300 according to this embodiment will be described with reference to the flowchart in FIG.

[0099] First, the hospital management analysis system 300 performs a process of aggregating the medical records of its own hospital by disease (S1000). Specifically, the hospital management analysis system 300 aggregates the medical records of each case recorded in the case-by-case data table 600 by DPC (by disease) and records them in the disease-by-disease evaluation data table 630.

[0100] Next, the hospital management analysis system 300 cross-references this data with the national medical records (S1010). Specifically, the hospital management analysis system 300 enters the aggregated information on the medical records of all DPC-targeted hospitals entered in the master table 620 in the disease-specific evaluation data table 630. As a result, the disease-specific evaluation data table 630 contains the medical records information of the hospital itself and the aggregated information on the medical records of all DPC-targeted hospitals.

[0101] Next, the hospital management analysis system 300 executes disease-specific evaluation processing (S1020). Specifically, based on the medical record information of the hospital itself and the aggregated information of the medical record of all DPC-targeted hospitals, the hospital management analysis system 300 identifies, from among the DPCs for which the DPC-targeted hospital has a medical record, a DPC that can be expected to have an improvement effect when the improvement method of the medical institution-specific coefficient stored in the improvement method management table 610 is applied to the DPC-targeted hospital.

[0102] Then, the hospital management analysis system 300 derives an evaluation comment (S1030). Specifically, the hospital management analysis system 300 generates a policy plan that describes the content of the method stored in the improvement method management table 610 and the DPC where the above improvement effect can be expected.

[0103] Then, the hospital management analysis system 300 displays this proposed measure on the screen in a format such as those exemplified in FIG. 12, FIG. 15, FIG. 18, FIG. 21, etc. (S1040).

[0104] In this way, it will be possible to analyze the medical treatment records of DPC-eligible hospitals and present various policy proposals for improving the "medical institution coefficient."

[0105] The hospital management analysis system 300, the control method and the program for the hospital management analysis system 300 according to the present embodiment have been described above, and the above-described aspects can support the formulation of various policy plans for providing higher quality medical services under the DPC / PDPS system and improving the management efficiency of hospitals, particularly the formulation of policy plans for improving the medical institution coefficients stipulated in the DPC / PDPS system, and can support the management of DPC-targeted hospitals.

[0106] For example, in this embodiment, the contents of the policy proposal are output in natural language, so even if you do not have deep knowledge of the medical system, you can easily judge the quality of your hospital's medical record data, understand the issues your hospital faces, develop solutions to those issues, and set goals.

[0107] The above-described embodiment is for the purpose of facilitating understanding of the present invention, and is not intended to limit the present invention. The present invention may be modified or improved without departing from the spirit of the present invention, and equivalents thereof are also included in the present invention. [Explanation of symbols]

[0108] 100 DPC medical record providing device 300 Hospital Management Analysis System 301 Medical record information storage unit 302 Method storage section 303 DPC Specification Department 304 Policy proposal generation department 310 CPU 320 Memory 330 Communication Equipment 340 Storage device 350 Input Device 360 Output Device 370 Recording medium reader 500 Network 600 Case-specific data table 610 Improvement Method Management Table 620 Master Table 630 Disease-specific evaluation data table 710 DPC medical record providing device control program 730 Hospital Management Analysis System Control Program 800 Recording media 900 Reports 1000 Whole System

Claims

1. A hospital management analysis system capable of generating a policy plan for improving a medical institution coefficient of a DPC target hospital, A medical care performance information storage unit stores medical care performance information including information indicating the number of days of hospitalization of a patient, the corresponding DPC, and the comprehensive range fee-for-service score for each case corresponding to the DPC treated at the DPC-targeted hospital; A method storage unit that stores a method for improving a predetermined index used in calculating the coefficient by medical institution; a DPC identification unit that identifies, based on the medical record information and aggregate information of medical records at all DPC-targeted hospitals, from among DPCs that have a medical record at the DPC-targeted hospital, a DPC that is expected to have an improvement effect on the specified index when the method is applied to the DPC-targeted hospital; A measure proposal generating unit that generates the measure proposal describing the content of the method and the DPC in which the improvement effect can be expected; A hospital management analysis system that includes:

2. The hospital management analysis system according to claim 1, The predetermined index includes at least one of a medical density used to calculate a basic coefficient constituting a breakdown of the coefficient by medical institution, and an efficiency index used to calculate a functional evaluation coefficient II constituting a breakdown of the coefficient by medical institution, The DPC specifying unit is Among the DPCs in which the number of cases per predetermined period at the DPC-targeted hospital is equal to or greater than a certain number, a predetermined number of DPCs are identified as DPCs that can be expected to have an effect of improving the medical density or the efficiency index, in descending order of the product of the average length of stay at the DPC-targeted hospital minus the average length of stay at all DPC-targeted hospitals and a value corresponding to the number of cases at all DPC-targeted hospitals; The policy proposal generation unit generates the policy proposal, which describes shortening the length of hospital stay of cases corresponding to the predetermined number of DPCs as the method. Hospital management analysis system.

3. The hospital management analysis system according to claim 1, The predetermined index includes a medical density used to calculate a basic coefficient constituting a breakdown of the coefficient by medical institution, The DPC specifying unit is Among the DPCs in which the number of cases per predetermined period at the DPC-targeted hospital is less than a certain number, a certain number of DPCs are identified as DPCs that can be expected to have an effect of improving the medical density, in descending order of the product of the ratio of the medical density at the DPC-targeted hospital to the medical density at all DPC-targeted hospitals and a value equivalent to the number of cases at all DPC-targeted hospitals; The policy proposal generation unit generates the policy proposal, which describes, as the method, increasing the number of cases per the specified period corresponding to the specified number of DPCs to the certain number or more. Hospital management analysis system.

4. The hospital management analysis system according to claim 1, The predetermined index includes at least one of a corrected complexity index used to calculate a basic coefficient that constitutes a breakdown of the coefficient by medical institution, and a complexity index used to calculate a functional assessment index II that constitutes a breakdown of the coefficient by medical institution, The DPC specifying unit is Among the DPCs with a certain number or more of cases per predetermined period in the DPC-targeted hospitals, a certain number of DPCs are identified in descending order of value corresponding to the comprehensive range volume score per hospitalization in all DPC-targeted hospitals as DPCs that can be expected to have an improvement effect on the corrected complexity index or the complexity index, The policy proposal generation unit generates the policy proposal, which describes, as the method, increasing the number of cases corresponding to the predetermined number of DPCs. Hospital management analysis system.

5. The hospital management analysis system according to claim 1, The predetermined index includes at least one of a corrected complexity index used to calculate a basic coefficient that constitutes a breakdown of the coefficient by medical institution, and a complexity index used to calculate a functional assessment index II that constitutes a breakdown of the coefficient by medical institution, The DPC specifying unit is Among the DPCs with a certain number or more of cases per specified period in the DPC-targeted hospitals, a certain number of DPCs are identified in order of decreasing value corresponding to the comprehensive range volume score per hospitalization in all DPC-targeted hospitals as DPCs that can be expected to have an improvement effect on the corrected complexity index or the complexity index, The policy proposal generation unit generates the policy proposal, which describes a method for reducing the number of cases corresponding to the predetermined number of DPCs as the method. Hospital management analysis system.

6. The hospital management analysis system according to claim 1, The predetermined index includes an efficiency index used to calculate the functional evaluation coefficient II that constitutes the breakdown of the coefficient by medical institution, The DPC specifying unit is Among the DPCs in which the number of cases per predetermined period in the DPC-targeted hospital is less than a certain number, a certain number of DPCs are identified in order of increasing value obtained by subtracting the average length of stay in the DPC-targeted hospital from the average length of stay in all DPC-targeted hospitals as DPCs that can be expected to have an effect of improving the efficiency index; The policy proposal generation unit generates the policy proposal, which describes, as the method, increasing the number of cases per the specified period corresponding to the specified number of DPCs to the certain number or more. Hospital management analysis system.

7. The hospital management analysis system according to claim 1, The predetermined index includes a coverage rate used to calculate the functional evaluation coefficient II, which is a breakdown of the coefficient by medical institution, The DPC specifying unit is Among the DPCs in which the number of cases per predetermined period at the DPC-targeted hospital is less than a certain number, a certain number of DPCs in descending order of the number of cases at the DPC-targeted hospital are identified as DPCs in which an improvement effect on the coverage rate can be expected; The policy proposal generation unit generates the policy proposal, which describes, as the method, increasing the number of cases per the specified period corresponding to the specified number of DPCs to the certain number or more. Hospital management analysis system.

8. The hospital management analysis system according to claim 1, The predetermined index includes a coverage rate used to calculate the functional evaluation coefficient II, which is a breakdown of the coefficient by medical institution, The DPC specifying unit is Among the DPCs in which the number of cases per predetermined period at the DPC-targeted hospital is less than a certain number, a certain number of DPCs are identified in descending order of the value corresponding to the number of cases at all DPC-targeted hospitals as DPCs that can be expected to have an effect of improving the coverage rate, The policy proposal generation unit generates the policy proposal, which describes, as the method, increasing the number of cases per the specified period corresponding to the specified number of DPCs to the certain number or more. Hospital management analysis system.

9. A method for controlling a hospital management analysis system capable of generating a policy plan for improving a medical institution coefficient of a DPC target hospital, comprising: The hospital management analysis system comprises: For each case corresponding to the DPC for which medical treatment was performed at the DPC-targeted hospital, medical treatment performance information including information indicating the number of days of hospitalization of the patient, the corresponding DPC, and the comprehensive range of performance points is stored; storing a method for improving a predetermined index used in calculating the coefficient by medical institution; Based on the medical record information and the aggregated information of the medical records at all DPC-targeted hospitals, a DPC that can be expected to improve the specified index when the method is applied to the DPC-targeted hospital is identified from among the DPCs that have a medical record at the DPC-targeted hospitals; A control method for a hospital management analysis system, which generates the policy proposal describing the content of the method and the DPC for which the improvement effect can be expected.

10. A program for generating a policy plan for improving a medical institution coefficient of a DPC target hospital, On the computer, A function for storing medical record information including information indicating the number of days of hospitalization of a patient, the corresponding DPC, and the comprehensive range fee-for-service score for each case corresponding to the DPC for which medical care was provided at the DPC-targeted hospital; A function of storing a method for improving a predetermined index used in calculating the coefficient by medical institution; A function of identifying DPCs that have a medical record at the DPC-targeted hospital based on the medical record information and aggregated information of the medical record at all DPC-targeted hospitals, among the DPCs that have a medical record at the DPC-targeted hospital, which can be expected to improve the specified index when the method is applied to the DPC-targeted hospital; A function of generating the proposed measures that describes the content of the method and the DPC that can be expected to have the improvement effect; A program to achieve this.

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