Information processing device, information processing method and program

The information processing apparatus addresses the challenge of estimating patient numbers with attributes outside the target by processing health insurance information based on employee insurance and medical fee data, achieving accurate and comprehensive patient data analysis.

JP2025090496APending Publication Date: 2025-06-17JMDC CO LTD
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Patent Information

Application Number
JP2024101391
Authority / Receiving Office
JP · JP
Patent Type
Applications
Current Assignee / Owner
Filing Date
2024-06-24
Publication Date
2025-06-17

AI Technical Summary

Technical Problem

Existing techniques face challenges in comprehensively obtaining receipt data for all patients, as it is typically provided by individual medical institutions, and health insurance information based on employee insurance has restricted attributes, making it difficult to accurately estimate the number of patients with attributes outside the target.

Method used

An information processing apparatus that acquires and processes health insurance information based on employee insurance to estimate the number of patients with specific attributes, including those outside the target, by utilizing information on medical fees from insurance medical institutions and late-stage elderly medical system information.

Benefits of technology

Enables accurate estimation of the number of patients with various attributes, including those outside the target, when primarily using health insurance information based on employee insurance, thereby improving the comprehensiveness and accuracy of patient data analysis.

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Abstract

To provide a technique capable of accurately estimating the number of patients, including patients with attributes not covered, when using health insurance information based primarily on employee insurance.SOLUTION: An information processing device for estimating the number of prescriptions of medical products, the information processing device comprises: acquisition means for acquiring a first number of patients, the number of patients with a first attribute to whom a medical product has been prescribed, from health insurance information based on employee insurance; estimation means for estimating a second number of patients, the number of patients with a second attribute different from the first attribute to whom the medical product has been prescribed, using the health insurance information; and output means for outputting the sum of the first number of patients and the second number of patients as the number of patients to whom the medical product has been prescribed. Estimating the second number of patients in the estimation means includes estimating the second number of patients with the second attribute to whom the medical product has been prescribed, which should be obtained on the basis of information of medical fees from an insurance medical institution, using the number of patients with the second attribute to whom the medical product has been prescribed, which is obtained on the basis of information of medical fees from a specific insurance medical institution, and the number of patients obtained from insurer information of the medical care system for the latter-stage elderly.SELECTED DRAWING: Figure 3
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Description

Technical Field

[0001] The present invention relates to an information processing apparatus, an information processing method, and a program.

Background Art

[0002] Conventionally, there has been known a technique for grasping the number of patients with a specific disease or estimating medical costs for each region by referring to medical receipt statement (receipt) data (Patent Document 1). A receipt is a statement of charges created by a medical institution or dispensing pharmacy that has provided insured medical care for each patient, separately for outpatient and inpatient services, to an insurer (such as a health insurance association).

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0004] Since receipt data is generally provided by individual medical institutions, it is difficult for a third party to comprehensively obtain receipt data as if it were for all patients. On the other hand, in the case of health insurance information based on employee insurance such as health insurance, it is possible to obtain relatively aggregated information on the number of patients, but the attributes of the subjects covered by the insurance are restricted (for example, subjects aged 75 or older and subjects of regional insurance are not included). Therefore, when mainly using health insurance information based on employee insurance, how to handle the number of patients with attributes outside the target becomes an issue.

[0005] The present invention has been made in view of the above problems, and an object thereof is to realize a technique capable of accurately estimating the number of patients including patients with attributes outside the target when mainly using health insurance information based on employee insurance.

Means for Solving the Problems

[0006] To solve this problem, for example, the information processing apparatus of the present invention is an information processing apparatus for estimating the number of prescriptions of pharmaceuticals, an acquisition unit that acquires a first number of patients, which is the number of patients of a first attribute for whom the pharmaceutical was prescribed, from health insurance information based on employee insurance; an estimation unit that estimates a second number of patients, which is the number of patients of a second attribute for whom the pharmaceutical was prescribed and is different from the first attribute, using the health insurance information; and an output unit that outputs the sum of the first number of patients and the second number of patients as the number of patients for whom the pharmaceutical was prescribed, and estimating the second number of patients in the estimation unit includes estimating the number of patients of the second attribute for whom the pharmaceutical was prescribed, which should be obtained based on information on medical fees by insurance medical institutions, using the number of patients of the second attribute for whom the pharmaceutical was prescribed obtained based on information on medical fees by a specific insurance medical institution and the number of patients obtained from insurer information of the late-stage elderly medical system.

Advantages of the Invention

[0007] According to the present invention, when mainly using health insurance information based on employee insurance, it becomes possible to accurately estimate the number of patients including patients of non-target attributes.

Brief Description of the Drawings

[0008]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Mode for Carrying Out the Invention

[0009] Hereinafter, embodiments will be described in detail with reference to the accompanying drawings. Note that the following embodiments do not limit the invention according to the claims, and not all combinations of the features described in the embodiments are essential for the invention. Two or more of the plurality of features described in the embodiments may be arbitrarily combined. Also, the same or similar configurations are given the same reference numerals, and duplicate explanations are omitted.

[0010] (Configuration of the Estimation System) First, with reference to FIG. 1, the configuration of the estimation system 10 according to the embodiment of the present invention will be described. The estimation system 10 includes, for example, an information processing apparatus 100 and a communication apparatus 110 used by a user 20 such as a pharmaceutical company. The information processing apparatus 100 is, for example, a server managed by a service company that provides a service for estimating the number of prescriptions of pharmaceuticals. The user 20 checks the number of prescriptions of its own products in a specific period (for example, the recent few months) or checks the trend of the number of prescriptions over time.

[0011] The information processing apparatus 100 estimates the number of patients for whom pharmaceuticals have been prescribed using health insurance information based on employee insurance by means of a prescription number estimation process, the details of which will be described later. Health insurance information based on employee insurance such as health insurance includes, for example, information indicating when an enrollee received what kind of treatment, etc. at which medical institution and what pharmaceuticals were prescribed. Note that the insurer information and national health insurance of the late-stage elderly medical system described later also include the same kind of information. Note that health insurance information based on employee insurance is restricted in the attributes of the subjects who enroll in the insurance, for example, it does not include subjects aged 75 or older or subjects of regional insurance (such as national health insurance).

[0012] In this embodiment, in order to estimate the number of patients including patients with various attributes, information on medical fees by insurance medical institutions and insurer information of the elderly medical insurance system (also simply referred to as elderly information) are used. The information on medical fees by insurance medical institutions includes, for example, information in a medical fee statement (receipt). The information on medical fees by insurance medical institutions may include information on off - hospital prescriptions or be associated with information on off - hospital prescriptions so as to obtain information on prescriptions inside and outside the insurance medical institution. The information on off - hospital prescriptions can be obtained, for example, from DPC survey data. However, it is difficult to obtain information on medical fees by insurance medical institutions from all medical institutions. For example, although the information obtained from large - scale base hospitals is included, there may be a bias in the medical institutions providing information, such as the information from small - scale clinics not being included.

[0013] On the other hand, the elderly information targets people aged 75 or above and is free from biases due to medical institutions or patients' occupations (such as whether they are self - employed or not). Therefore, it is considered that the elderly information can complement the health insurance information based on employee insurance targeting people aged 74 or below. However, the elderly information may have a lower update frequency than other information such as health insurance information (for example, the update frequency is once a year). Therefore, the elderly information may not be suitable as it is for uses such as grasping the trend of the number of prescriptions every few months (by pharmaceutical companies).

[0014] In the prescription number estimation process according to this embodiment, based on the health insurance information based on employee insurance, various processes are performed to utilize the information on medical fees by insurance medical institutions and the elderly information in order to suppress delay and accurately estimate the number of patients.

[0015] In this embodiment, an example will be described in which the information processing apparatus 100 has already acquired health insurance information based on employee insurance (also simply referred to as health insurance information), information on medical fees by insurance medical institutions, health insurance information based on national health insurance (also simply referred to as national health insurance information), and late-stage elderly information inside the information processing apparatus 100. In this case, for example, a service company that manages the information processing apparatus 100 collects the above information from a health insurance association, a medical institution, etc. and stores it inside the information processing apparatus 100.

[0016] Alternatively, the information processing apparatus 100 may appropriately access an external database constructed by collecting the above information from a company other than the above service company from a health insurance association, a medical institution, etc. The health insurance information may be obtained from each of a health insurance association, a mutual aid association, and a mutual aid society. Further, the information on medical fees by insurance medical institutions may include information on insurance medical institutions, and information on medical treatment acts, procedures, prescriptions, examinations, etc. for each patient, such as receipt data and electronic medical record data. From the information on medical fees by insurance medical institutions, information indicating when, at which medical institution, what kind of treatment, etc. the patient received and what kind of medicine was prescribed can be obtained.

[0017] The information processing apparatus 100 can communicate via the communication device 110 and the network 120. In this embodiment, an example will be described in which the information processing apparatus 100 is a server on the cloud. However, the information processing apparatus 100 is not limited to this, and may be realized by a virtual machine, an edge server, a computer placed on a small-scale network, or the like. Further, in this embodiment, an example will be described in which the communication device 110 is a personal computer, for example. However, the communication device 110 is not limited to this, and may be another terminal capable of using a service for estimating the number of prescriptions of pharmaceuticals, such as a smartphone or a tablet-type terminal, using, for example, a browser or a dedicated application.

[0018] (Summary of the Invention) Next, with reference to FIGS. 2 and 3, the outline of the present invention will be described. FIG. 2 shows an example of possible prescription number estimation processing when using health insurance information (health insurance information) based on insured person insurance. The example shown in FIG. 2 shows an example of estimating the number of patients for whom a specific drug has been prescribed. Since the insured person insurance is for persons aged 74 or younger, when extracting the number of patients for whom a specific drug has been prescribed from the health insurance information, an estimated number of patients aged 74 or younger, 204, can be obtained. In this case, for patients aged 75 or older, the accuracy of the estimated number of patients can be improved by complementing the number of patients for whom a specific drug has been prescribed (estimated number of patients aged 75 or older, 205). In the present embodiment, without particular specification, when obtaining various estimated numbers of patients, the information processing apparatus 100 may execute a process of estimating the number of patients nationwide from the number of patients of some subscribers. For example, the information processing apparatus 100 may obtain the estimated number of patients aged 74 or younger, 204, by performing a process of estimating the number of patients nationwide of subscribers of insured person insurance aged 74 or younger from the number of patients of subscribers of insured person insurance aged 74 or younger.

[0019] The estimated number of patients aged 75 or older, 205, may be obtained from the late-stage elderly information as described above, but the update frequency may be different from that of the health insurance information. For example, when the update frequency of the late-stage elderly information is once a year, it is not possible to grasp the prescription status of drugs that have been on the market for less than one year since the start of sales, or the trends in recent months. On the other hand, the estimated number of patients aged 75 or older, 205, may be obtained from information on medical fees by insurance medical institutions that does not depend on the age of the patients. For example, in the information on medical fees, the ratio of patients aged 75 or older to patients aged 74 or younger can be calculated. By performing a calculation using this ratio of patients aged 75 or older and the estimated number of patients aged 74 or younger, 204, the estimated number of patients aged 75 or older, 205, can be calculated. However, as described above, since it is difficult to obtain information on medical fees from all medical institutions, there is a bias in the medical institutions that are the information providers, which may affect the estimation result of the number of patients.

[0020] If the estimated number of patients aged 75 or above, 205, can be estimated, the total number of patients of all ages (estimated number of patients 202) for whom a specific pharmaceutical product was prescribed can be obtained by calculating the sum of the estimated number of patients aged 74 or below, 204, and the estimated number of patients aged 75 or above, 205 (or the estimated number of patients aged 75 or above, 301, described later). By multiplying the estimated number of patients 202 by a predetermined number of prescriptions per patient (number of prescriptions per patient 203), the total number of prescriptions (estimated total number of prescriptions 201) can be estimated.

[0021] Next, with reference to FIG. 3, the prescription number estimation process according to this embodiment will be described. In the prescription number estimation process according to this embodiment, various processes for more accurately calculating the estimated number of patients aged 75 or above, 205, described with reference to FIG. 2, are added. In particular, in this embodiment, the ratio of patients aged 75 or above (75 - year - old or above correction coefficient) is accurately calculated and multiplied by the estimated number of patients aged 74 or below obtained from the insured person's insurance information, thereby accurately calculating the estimated number of patients aged 75 or above. Note that 201 - 204 described with reference to FIG. 2 are the same in the description of FIG. 3.

[0022] In this embodiment, the information processing apparatus 100 extracts the number of patients aged 75 or above, 303, for whom a specific pharmaceutical product was prescribed from the medical reimbursement information collected from a specific insurance medical institution. The specific insurance medical institution is a part of a number of insurance medical institutions and is an insurance medical institution for which information acquisition has been made possible through a contract or the like. The specific insurance medical institution includes, for example, relatively large - scale insurance medical institutions such as a base hospital or a university hospital. Also, the information processing apparatus 100 extracts the number of patients aged 74 or below, 304, for whom a specific pharmaceutical product was prescribed from the medical reimbursement information collected from a specific insurance medical institution. At this time, since the medical reimbursement information collected from the specific insurance medical institution includes or is associated with the information of off - hospital prescriptions, the information processing apparatus 100 can calculate the number of patients aged 75 or above, 303, for whom a specific pharmaceutical product was prescribed, including in - hospital and off - hospital prescriptions, and the number of patients aged 74 or below, 304, for whom a specific pharmaceutical product was prescribed (that is, these numbers of patients can be calculated more accurately in line with the actual situation).

[0023] Next, the information processing apparatus 100 calculates a patient number ratio 305 between the number of patients in a specific insurance medical institution and the number of patients in other insurance medical institutions. The information processing apparatus 100 calculates a patient number ratio 305-1 for patients aged 75 or older using the late-stage elderly information. On the other hand, the information processing apparatus 100 calculates a patient number ratio 305-2 for patients aged 74 or younger using the health insurance information based on employee insurance. The late-stage elderly information includes information indicating when, at which insurance medical institution, and which pharmaceutical product each patient aged 75 or older was prescribed. The health insurance information also includes information indicating when, at which insurance medical institution, and which pharmaceutical product each patient aged 74 or younger was prescribed. Therefore, the information processing apparatus 100 can calculate the patient number ratio 305-1 between the patients prescribed a specific pharmaceutical product at a specific insurance medical institution and the patients prescribed the same specific pharmaceutical product at other insurance medical institutions among the patients included in the late-stage elderly information. That is, by using the late-stage elderly information, the patient number ratio 305-1 according to the actually aggregated number of patients in a specific insurance medical institution and the number of patients in other insurance medical institutions can be obtained. By doing so, even when using the medical remuneration information collected from a specific insurance medical institution, the number of patients considering the number of patients in other insurance medical institutions can be calculated, so that the accuracy of the estimated number of patients 301 aged 75 or older can be improved. In the case where a specific pharmaceutical product is a new product, due to the low update frequency, there may be no information on the specific pharmaceutical product in the late-stage elderly information. To cope with such a case, instead of extracting the number of patients prescribed a specific pharmaceutical product in the insurer information of the late-stage elderly medical system, the information processing apparatus 100 can extract the number of patients prescribed a pharmaceutical product in the same category (for example, the same drug efficacy) as the specific pharmaceutical product and calculate the patient number ratio 305-1.

[0024] On the one hand, the information processing apparatus 100 calculates the patient number ratio 305-2 between the patients who were prescribed a specific drug at a specific insurance medical institution and the patients who were prescribed the specific drug at other insurance medical institutions among the patients included in the health insurance information (aged 74 or younger). Also in this case, by using the health insurance information, the patient number ratio 305-2 according to the actually measured number of patients at a specific insurance medical institution and the number of patients at other insurance medical institutions can be obtained. Note that the update frequency of the health insurance information may be higher than that of the late-stage elderly information, and the update frequencies of the respective information may be different. For this reason, instead of extracting the number of patients who were prescribed the specific drug in the health insurance information, the information processing apparatus 100 can extract the number of patients who were prescribed a drug in the same category as the specific drug and calculate the patient number ratio 305-2. By doing so, the calculation methods of the patient number ratios 305-1 and 305-2 can be made consistent.

[0025] The information processing apparatus 100 applies the patient number ratio 305-1 (for example, multiplies) to the number 303 of patients aged 75 or older who were prescribed the specific drug. Thereby, the number of patients aged 75 or older who were prescribed the specific drug, which should be obtained based on the medical reimbursement information by the insurance medical institutions (including the specific and other insurance medical institutions), can be acquired. Similarly, the information processing apparatus 100 applies the patient number ratio 305-2 (for example, multiplies) to the number 304 of patients aged 74 or younger who were prescribed the specific drug. Thereby, the number of patients aged 74 or younger who were prescribed the specific drug, which should be obtained based on the medical reimbursement information by the insurance medical institutions (including the specific and other insurance medical institutions), can be acquired.

[0026] Through these processes, the number of patients aged 75 or older who were prescribed the specific drug and the number of patients aged 74 or younger who were prescribed the specific drug are obtained. The information processing apparatus 100 calculates the ratio of these numbers of patients (that is, the correction coefficient 302 for those aged 75 or older). The information processing apparatus 100 can estimate the estimated number of patients aged 75 or older by applying the correction coefficient 302 for those aged 75 or older to the above-mentioned estimated number 204 of patients aged 74 or younger (for example, multiplying).

[0027] In other words, taking the example of FIG. 3, the information processing apparatus 100 estimates the number of patients aged 75 or older for whom a medicine has been prescribed, which should be obtained based on the medical reimbursement information of insurance medical institutions, by using the number of patients aged 75 or older for whom a medicine has been prescribed, which is obtained based on the medical reimbursement information of a specific insurance medical institution, and the number of patients obtained from the insurer information of the late-stage elderly medical insurance system. Further, the information processing apparatus 100 estimates the number of patients aged 74 or younger for whom a medicine has been prescribed, which should be obtained based on the medical reimbursement information of insurance medical institutions, by using the number of patients aged 74 or younger for whom a medicine has been prescribed, which is obtained based on the medical reimbursement information of a specific insurance medical institution, and the number of patients obtained from the health insurance information based on the employee insurance. At this time, the insurance medical institutions include a specific insurance medical institution and other insurance medical institutions. Therefore, the information processing apparatus 100 adjusts the number of patients aged 75 or older obtained based on the medical reimbursement information of a specific insurance medical institution by using the number of patients obtained from the insurer information of the late-stage elderly medical insurance system, so as to estimate the number of patients aged 75 or older (the number of patients aged 75 or older prescribed in all insurance medical institutions) that should be obtained based on the medical reimbursement information of the specific insurance medical institution and other insurance medical institutions.

[0028] (Configuration of Information Processing Apparatus) Next, a functional configuration example of the information processing apparatus 100 will be described with reference to FIG. 4. Each of the functional blocks to be described may be integrated or separated, and the functions to be described may be realized by other blocks. Also, what is described as hardware may be realized by software, and vice versa.

[0029] The communication unit 401 includes a communication circuit that communicates with various devices via a network. The communication unit 401 receives the information processed by the control unit 404 from a communication partner device (for example, the communication device 110), or transmits the information processed by the control unit 404 to the communication partner device. The power supply unit 402 is a power supply that provides the power required for the operation of the information processing apparatus 100.

[0030] The storage unit 403 includes a non-volatile storage medium such as a hard disk or a semiconductor memory, and includes various programs executed by the control unit 404 of the information processing apparatus 100, various data used by the control unit 404, and a DB. The various programs include, in addition to the program for executing the prescription number estimation process according to the present embodiment, an operating system, a framework, a library, and the like. The various data include, for example, the setting values of the information processing apparatus 100. Further, the storage unit 403 includes the insured person insurance information 431, the insurance medical institution information 432, the late-stage elderly information 433, and the national health insurance information 434. The insured person insurance information 431 is the health insurance information based on the above-described insured person insurance. As described above, the health insurance information includes information indicating when the subscriber received treatment such as what kind of treatment at which medical institution and what kind of medicine was prescribed. The insurance medical institution information 432 includes the medical fee information by the above-described insurance medical institution. The late-stage elderly information 433 includes the above-described late-stage elderly information. The national health insurance information 434 includes information indicating when the subscribers who subscribe to the national health insurance under 74 years old received treatment such as what kind of treatment at which medical institution and what kind of medicine was prescribed.

[0031] The control unit 404 includes a CPU 410 which is a central processing unit and a RAM 411. The control unit 404 controls the operations of each part inside the control unit 404 and the operations of each part of the information processing apparatus 100 by expanding and executing the programs stored in the storage unit 403 in the RAM 411. Further, the control unit 404 executes the prescription number estimation process using each part in the control unit 404.

[0032] The RAM 411 includes a volatile storage medium such as a DRAM, and temporarily stores parameters, processing results, etc. for the control unit 404 to execute programs.

[0033] The information acquisition unit 420 acquires necessary information (for example, various patient numbers shown in FIG. 3 etc.) from the insured person insurance information 431, the insurance medical institution information 432, the late-stage elderly information 433, and the national health insurance information 434 stored in the storage unit 403.

[0034] The patient number estimation unit 421 performs the calculations of the patient number ratios 305-1 and 305-2, the operations using these patient number ratios, the calculation of the correction coefficient 302 for 75 years old and above, the estimation of the estimated patient number 301 for 75 years old and above, etc., as described with reference to FIG. 3. Further, the patient number estimation unit 421 can calculate the estimated patient number 202 from the estimated patient number 204 for 74 years old and below and the estimated patient number 301 for 75 years old and above.

[0035] The prescription number estimation unit 422 multiplies the estimated patient number 202 by a predetermined number of prescriptions per patient (the number of prescriptions per patient 203) to estimate the estimated total number of prescriptions 201 for a specific pharmaceutical product. Further, the prescription number estimation unit 422 can transmit the estimated estimated total number of prescriptions 201 to the communication device 110 via the communication unit 401. Note that the estimated total number of prescriptions 201 may be estimated for each length of various periods. The prescription number estimation unit 422 can estimate six estimated total number of prescriptions 201 for each two-month period. In this way, the transition of the number of prescriptions for one year's worth of pharmaceuticals can be shown every two months.

[0036] (Configuration of the communication device) Furthermore, a configuration example of the communication device 110 will be described with reference to FIG. 5. FIG. 5 shows a functional configuration example of the communication device 110 of the present embodiment. Note that each of the functional blocks to be described may be integrated or separated, and the functions to be described may be realized by other blocks. Also, what is described as hardware may be realized by software, and vice versa.

[0037] The communication unit 501 includes, for example, a communication circuit, etc., and performs transmission and reception of necessary data by communicating with the information processing device 100 via mobile communication such as LTE or by communicating with the information processing device 100 via wireless communication such as WiFi.

[0038] The operation unit 503 includes a keyboard and a touch panel, and accepts operations on various operation screens displayed on the display unit 505. The display unit 505 includes a display panel such as an LCD or an OLED, and displays GUIs for various operations. For example, the display unit 505 receives information indicating the estimated total number of prescriptions 201 calculated by the information processing apparatus 100, and causes it to be displayed on the display unit 505 via, for example, a web browser or a dedicated application.

[0039] The recording unit 506 includes a non-volatile memory such as a semiconductor memory, and stores set user information, programs executed by the control unit 502, and the like.

[0040] The control unit 502 includes a CPU 510 and a RAM 511. For example, when the CPU 510 executes a program recorded in the recording unit 506, the control unit 502 controls the operations of each functional block within the control unit 502 and each unit within the communication device 110.

[0041] (Another example of prescription number estimation processing) Next, with reference to FIG. 6, another example of the prescription number estimation processing according to the present embodiment will be described. In the example described with reference to FIG. 3, the number of patients for whom a specific pharmaceutical product was prescribed was extracted from the health insurance information based on employee insurance, and the estimated number of patients under 74 years old 204 was calculated. Therefore, the calculated estimated number of patients under 74 years old 204 does not include the number of patients who are enrolled in the National Health Insurance, which is a regional insurance. Therefore, when calculating the estimated number of patients under 74 years old 204, the number of patients 601 obtained from the health insurance information based on employee insurance and the number of patients 602 obtained from the health insurance information based on the National Health Insurance are added together. Thereby, the estimated number of patients under 74 years old 204 can be calculated more accurately, taking into account the number of patients enrolled in the National Health Insurance.

[0042] Although FIG. 6 shows a simple example, various calculations can be performed to more appropriately estimate each of the number of patients 601 and the number of patients 602. The information processing apparatus 100 extracts, for example, from the national health insurance information, the ratio of patients (national health insurance patient ratio) to whom a specific pharmaceutical product has been prescribed among the subscribers of the national health insurance. The information processing apparatus 100 can extract the number of patients who have been prescribed a pharmaceutical product in the same category as the specific pharmaceutical product and use it as the national health insurance patient ratio. In this way, even when the update frequency of the national health insurance information is low, by multiplying the national health insurance patient ratio by the number of subscribers to the national health insurance, the number of patients (i.e., the number of patients 602) in the latest national health insurance information can be estimated. Further, the information processing apparatus 100 can also calculate the number of patients 602 obtained from the health insurance information based on the national health insurance using the number of patients 601 obtained from the health insurance information based on the employee insurance. Specifically, the information processing apparatus 100 can estimate the number of patients 602 obtained from the health insurance information based on the national health insurance by applying (for example, multiplying) a correction coefficient to the number of patients 601 obtained from the health insurance information based on the employee insurance. This correction coefficient represents the ratio between the number of patients nationwide in the national health insurance information and the number of patients nationwide based on the employee insurance. The information processing apparatus 100 can estimate the latest number of patients 602 among the subscribers to the national health insurance by multiplying the previously obtained correction coefficient by the number of patients based on the latest employee insurance. Note that the number of patients nationwide in the national health insurance information can be calculated by multiplying the number of subscribers nationwide to the national health insurance by the ratio of the number of patients (to whom a specific pharmaceutical product has been prescribed) in the national health insurance information. Also, the number of patients nationwide in the health insurance information based on the employee insurance can be calculated by multiplying the number of subscribers nationwide to the health insurance based on the employee insurance by the ratio of the number of patients (to whom a specific pharmaceutical product has been prescribed) in the health insurance information. In this way, by further taking into account the national health insurance information, it is possible to estimate the number of patients with less delay and high accuracy even for the estimated number of patients 204 aged 74 or younger.

[0043] (A series of operations of the prescription number estimation process in the information processing apparatus) Next, a series of operations of the prescription number estimation process in the information processing apparatus will be described with reference to FIG. 7. Each operation described in this series of operations is realized by the control unit 404 causing each part of the control unit 404 to function by expanding and executing a program stored in the storage unit 403 in the RAM 411.

[0044] In S701, the information acquisition unit 420 acquires the number of patients with the first attribute (for example, 74 years old or younger) from the health insurance information based on the insured person's insurance. This process corresponds to acquiring the estimated number of patients under 74 years old 204 described above.

[0045] In S702, the patient number estimation unit 421 calculates the ratio of the number of patients in a specific insurance medical institution to the number of patients in other insurance medical institutions using the insurer information of the late-stage elderly medical system. This process corresponds to the calculation of the patient number ratio 305-1 described above.

[0046] In S703, the patient number estimation unit 421 calculates the ratio of the number of patients in a specific insurance medical institution to the number of patients in other insurance medical institutions using the health insurance information based on the insured person's insurance. This process corresponds to the calculation of the patient number ratio 305-2 described above.

[0047] In S704, the patient number estimation unit 421 estimates the number of patients with the first attribute and the number of patients with the second attribute (for example, 75 years old or older) in the specific and other insurance medical institutions using the ratio of the number of patients in the specific insurance medical institution to the ratio of the number of patients in other insurance medical institutions. This process corresponds to the estimation of the number of patients in the specific and other insurance medical institutions described above.

[0048] In S705, the patient number estimation unit 421 estimates the number of patients with the second attribute using the number of patients with the first attribute and the ratio of the number of patients with the second attribute to the number of patients with the first attribute. This process corresponds to the estimation of the estimated number of patients 75 years old or older using the 75-year-old or older correction coefficient 302 described above.

[0049] In S706, the prescription number estimation unit 422 estimates the total number of prescriptions using the total number of patients (the sum of the number of patients with the first attribute and the number of patients with the second attribute) and the number of administrations per patient. This process corresponds to the process of estimating the estimated total number of prescriptions 201 described above. When the control unit 404 outputs the total number of prescriptions, it ends the series of operations of the prescription number estimation process.

[0050] As described above, in the present embodiment, the number of patients under 74 years old for whom a medicine has been prescribed is obtained from the health insurance information based on the insured person insurance, and the number of patients 75 years old or older for whom a medicine has been prescribed is estimated using the health insurance information. At this time, the number of patients 75 years old or older that should be obtained based on the medical remuneration information of the insurance medical institution is estimated using the number of patients 75 years old or older based on the medical remuneration information of a specific insurance medical institution and the number of patients obtained from the insurer information of the late-stage elderly medical system. In this way, by using the late-stage elderly information, it is possible to calculate based on the ratio of the number of patients of a specific insurance medical institution actually measured and the number of patients using the number of patients of other insurance medical institutions, so that the number of patients 75 years old or older can be estimated more accurately. In other words, when mainly using the health insurance information based on the insured person insurance, it becomes possible to accurately estimate the number of patients including patients with attributes that are not the target.

[0051] In the above-described embodiment, in the prescription number estimation process, the case where the number of patients under 74 years old for whom a medicine has been prescribed and the number of patients 75 years old or older for whom a medicine has been prescribed are calculated respectively has been described as an example. However, the prescription number estimation process may estimate the number of patients for whom a medicine has been prescribed by calculating the number of patients under 64 years old for whom a medicine has been prescribed and the number of patients 65 years old or older for whom a medicine has been prescribed respectively. Hereinafter, the prescription number estimation process using this method will be described.

[0052] The health insurance information based on employee insurance includes information on employees aged 65 or older and 74 or younger. Generally, it is assumed that those who are insured under employee insurance at this age are in good health enough to continue working. On the other hand, it is also assumed that information on patients aged 65 or older and 74 or younger who are undergoing treatment such as hospitalization may not be included in the health insurance information. That is, among the health insurance information, the information on employees aged 65 or older and 74 or younger may include a bias in health status.

[0053] Therefore, by calculating the number of patients under 64 years old for whom a drug has been prescribed and the number of patients 65 years old or older for whom a drug has been prescribed respectively, the estimation accuracy of the number of patients is improved. In particular, in the following process, the ratio of patients 65 years old or older (65-year-old or older correction coefficient) is calculated accurately, and this is multiplied by the estimated number of patients under 64 years old obtained from the employee insurance information to accurately calculate the estimated number of patients 65 years old or older. Note that 201-204 described in FIG. 2 are the same in this description.

[0054] The information processing device 100 extracts the number 803 of patients 65 years old or older for whom a specific drug has been prescribed from the medical reimbursement information collected from a specific insurance medical institution. In addition, the information processing device 100 extracts the number 804 of patients under 64 years old for whom a specific drug has been prescribed from the medical reimbursement information collected from a specific insurance medical institution. The specific insurance medical institution is an insurance medical institution that has become able to obtain information through a contract or the like, similar to the above example, and the medical reimbursement information includes or is associated with information on off-campus prescriptions.

[0055] Next, the information processing apparatus 100 calculates a patient number ratio 805 between the number of patients in a specific insurance medical institution and the number of patients in other insurance medical institutions. The information processing apparatus 100 calculates a patient number ratio 805-1 for patients aged 75 or older using the late-stage elderly information. Here, the reason for using the patient number ratio 805-1 for patients aged 75 or older is that the ratio between the number of patients in a specific insurance medical institution and the number of patients in other insurance medical institutions is based on little difference by age (for example, the difference between patients aged 75 or older and patients aged 65 or older). Therefore, for the purpose of calculating the 65-and-older correction coefficient, the late-stage elderly information can also be utilized to calculate the patient number ratio between the number of patients in a specific insurance medical institution and the number of patients in other insurance medical institutions. Similar to the above-described embodiment, the information processing apparatus 100 can calculate the patient number ratio 805-1 by extracting the number of patients who have been prescribed a drug in the same category (for example, the same drug efficacy) as the specific drug instead of extracting the number of patients who have been prescribed the specific drug in the insurer information of the late-stage elderly medical system.

[0056] On the other hand, the information processing apparatus 100 calculates a patient number ratio 805-2 for patients aged 64 or younger using the health insurance information based on employee insurance. That is, by using the health insurance information, the information processing apparatus 100 can obtain a patient number ratio 805-2 for patients aged 64 or younger according to the number of patients in a specific insurance medical institution and the number of patients in other insurance medical institutions. The information processing apparatus 100 can calculate the patient number ratio 805-2 by extracting the number of patients who have been prescribed a drug in the same category as the specific drug instead of extracting the number of patients who have been prescribed the specific drug in the health insurance information. By doing so, the calculation methods of the patient number ratios 805-1 and 805-2 can be made consistent. Next, the information processing apparatus 100 applies (for example, multiplies) the patient number ratio 805-1 to the number 803 of patients aged 65 or older for whom a specific pharmaceutical product has been prescribed. Thereby, it is possible to obtain the number of patients aged 65 or older for whom the specific pharmaceutical product has been prescribed, which should be obtained based on the medical remuneration information of the insurance medical institutions (including the specific and other insurance medical institutions). Similarly, the information processing apparatus 100 multiplies the patient number ratio 805-2 by the number 804 of patients aged 64 or younger for whom the specific pharmaceutical product has been prescribed. Thereby, in the specific insurance medical institution and other insurance medical institutions, it is possible to obtain the number of patients aged 64 or younger for whom the specific pharmaceutical product has been prescribed.

[0057] Furthermore, the information processing apparatus 100 calculates the ratio of the number of patients aged 65 or older to the number of patients aged 64 or younger for whom the specific pharmaceutical product has been prescribed (that is, the correction coefficient 802 for 65 years old and above). The information processing apparatus 100 can estimate the number of patients aged 65 or older by applying (for example, multiplying) the correction coefficient 802 for 65 years old and above to the above-described estimated number 806 of patients aged 64 or younger.

[0058] In this way, for the estimated number of patients aged 64 or younger, the information of the insured persons aged 64 or younger in the insured person insurance information including information on the highly reliable age group is used to calculate the estimated number of patients aged 64 or younger. On the other hand, for the number of patients aged 65 or older, the information of the insured persons aged 65 or older and 74 or younger included in the insured person insurance information is not used. Instead, the correction coefficient 802 for 65 years old and above based on the medical remuneration information of the insurance medical institutions and the like is used to calculate the estimated number of patients aged 65 or older. Even in this way, when mainly using the health insurance information based on the insured person insurance, it becomes possible to accurately estimate the number of patients including patients with attributes not covered.

[0059] The invention is not limited to the above-described embodiments, and various modifications and changes are possible within the scope of the gist of the invention.

Explanation of Reference Numerals

[0060] 100... Information processing apparatus, 110... Communication apparatus, 420... Information acquisition unit, 421... Patient number estimation unit, 422... Prescription number estimation unit

Claims

1. An information processing device for estimating the number of patients to whom a medicine is prescribed, an acquisition means for acquiring a first number of patients, which is the number of patients with a first attribute to whom the medicine is prescribed, from health insurance information based on employee insurance; an estimation means for estimating a second number of patients to whom the medicine is prescribed, the second number being the number of patients having a second attribute different from the first attribute, using the health insurance information; an output means for outputting the sum of the first number of patients and the second number of patients as the number of patients to whom the medicine is prescribed, An information processing device characterized in that estimating the second number of patients in the estimation means includes estimating the number of patients of the second attribute to whom the drug has been prescribed, which should be obtained based on information on medical fees from an insurance medical institution, using the number of patients of the second attribute to whom the drug has been prescribed, obtained based on information on medical fees from a specific insurance medical institution, and the number of patients obtained from insurer information of the Long-Term Care Insurance System.

2. The information processing device described in claim 1, characterized in that estimating the second number of patients in the estimation means further includes estimating the number of patients of the first attribute to whom the drug has been prescribed, which should be obtained based on information on medical fees from an insurance medical institution, using the number of patients of the first attribute to whom the drug has been prescribed, obtained based on information on medical fees from the specific insurance medical institution, and the number of patients obtained from health insurance information based on the employee insurance.

3. The insurance medical institution includes the specific insurance medical institution and other insurance medical institutions, 2. The information processing device of claim 1, wherein estimating the second number of patients in the estimation means includes estimating the number of patients with the second attribute that should be obtained based on information on medical fees from the specific insurance medical institution and the other insurance medical institutions by adjusting the number of patients with the second attribute obtained based on information on medical fees from the specific insurance medical institution using the number of patients obtained from insurer information of the Long-Term Care Insurance System.

4. The information processing device according to claim 3, characterized in that the number of patients obtained from the insurer information of the Long-Term Care Insurance System includes the number of patients to whom prescriptions have been prescribed by the specific insurance medical institution and the number of patients to whom prescriptions have been prescribed by the other insurance medical institution.

5. The information processing device according to claim 1, characterized in that the number of patients obtained from the insurer information of the Long-Term Care Insurance System for the Elderly includes the number of patients in the insurer information of the Long-Term Care Insurance System who have been prescribed a drug of the same category as the drug.

6. The estimation means estimates the second number of patients by applying a predetermined coefficient to the first number of patients; The information processing device according to claim 1, characterized in that the specified coefficient includes a ratio between the number of patients of the first attribute to whom the drug is prescribed and the number of patients of the second attribute, which should be obtained based on information on medical fees from the insurance medical institution, adjusted using the number of patients obtained from insurer information of the Long-Term Care Insurance System for the Elderly.

7. The information processing device according to claim 1, characterized in that the acquisition means acquires the first number of patients by adding the number of patients with the first attribute to whom the medicine has been prescribed, which is obtained from health insurance information based on national health insurance.

8. 2 . The information processing device according to claim 1 , wherein the first number of patients is the number of patients aged 74 or younger to whom the medicine has been prescribed, and the second number of patients is the number of patients aged 75 or older to whom the medicine has been prescribed.

9. 2 . The information processing device according to claim 1 , wherein the first number of patients is the number of patients aged 64 or younger to whom the medicine has been prescribed, and the second number of patients is the number of patients aged 65 or older to whom the medicine has been prescribed.

10. An information processing method for estimating the number of prescriptions for medicines, which is executed by an information processing device, an acquisition step of acquiring a first number of patients, which is the number of patients with a first attribute to whom the medicine is prescribed, from health insurance information based on employee insurance; an estimation step of estimating a second number of patients to whom the medicine is prescribed, the second number being the number of patients having a second attribute different from the first attribute, using the health insurance information; an output step of outputting the sum of the first number of patients and the second number of patients as the number of patients to whom the medicine is prescribed, An information processing method in which estimating the second number of patients in the estimation step includes estimating the number of patients with the second attribute to whom the drug has been prescribed, which should be obtained based on information on medical fees from an insurance medical institution, using the number of patients with the second attribute to whom the drug has been prescribed, obtained based on information on medical fees from a specific insurance medical institution, and the number of patients obtained from insurer information of the Long-Term Care Insurance System.

11. A program for causing a computer to function as each of the means of the information processing device according to any one of claims 1 to 9.

Citation Information

Patent Citations

  • Server, method, and program for assisting cooperation of local health care

    JP2010231652A