Medical treatment support device and method

Abstract

To further effectively suppress discontinuation of medical treatment by further accurately analyzing factors of the discontinuation of the medical treatment.SOLUTION: Provided is a medical treatment support device 10 for supporting medical treatment of a patient by analyzing factors of discontinuation of the medical treatment of the patient, the medical treatment support device 10 including: a region-specific medical treatment discontinuation factor analysis unit 11 for analyzing regional factors, the medical treatment discontinuation factors originating from a region of a patient and specifying the regional factors affecting discontinuation of the medical treatment; an individual medical treatment discontinuation factor analysis unit 12 for analyzing patient factors, the medical treatment discontinuation factors originating from an individual patient and specifying the patient factors affecting the medical treatment discontinuation; and an output unit 15 for outputting the specified regional factors and the specified patient factors for every region.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to a technology for supporting patients in undergoing medical examinations, and in particular to a technology for suppressing (including preventing or preventing) the interruption or discontinuation of medical examinations. [Background technology]

[0002] Patients undergo tests, diagnoses, and consultations at medical institutions and the like for treatment, etc. (hereinafter referred to as "visits"). Visits can be discontinued for a variety of reasons. Non-Patent Document 1 analyzes that visits are discontinued for a variety of reasons, such as the patient's level of understanding of the examination, necessity, and economic reasons. Non-Patent Document 1 also describes how discontinuing visits can be reduced by taking measures for each factor. For example, it describes how medical guidance, in which patients receive explanations of the disease and home treatment methods from medical professionals other than doctors, such as nurses, is effective in reducing the number of patients who discontinue their visits.

[0003] Furthermore, Patent Document 1 describes an interactive health management system as IT technology for supporting nutritional therapy and health therapy in relation to medical guidance. Specifically, Patent Document 1 addresses the issue of "providing individuals undergoing nutritional and exercise therapy with interactive medical information distribution and support to stimulate awareness and encourage continuation of the nutritional and exercise therapies." To address this issue, Patent Document 1 discloses an interactive health management system in which "a health management program for nutritional management, exercise management, and simple care management is created and distributed to a patient's information terminal device 1; based on the health management program, the patient selects a meal menu for each meal from a selection menu; for difficult meals, the patient manages nutrition by taking photos of the food with a digital camera; and the patient manages exercise by constantly carrying and recording an exercise monitor; and a data management center provides stimuli from a server 4 of the data management center to motivate the patient to continue self-management during the period in which the patient is undergoing nutritional and exercise management." [Prior art documents] [Non-patent literature]

[0004] [Non-Patent Document 1] Working Group for the Comprehensive Guide to Preventing Diabetes Medical Treatment Discontinuation, "Manual for Preventing Diabetes Medical Treatment Discontinuation," May 2016 https: / / human-data.or.jp / wp / wp-content / uploads / 2018 / 07 / dm_jushinchudan_manual_e.pdf [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Laid-Open No. 2002-222266 Summary of the Invention [Problem to be solved by the invention]

[0006] The factors that lead to discontinuing medical consultations are diverse, including patient factors such as physical condition and economic situation, and regional factors attributable to the patient's location, such as the number of medical facilities and the rate of public transportation. These factors are numerous, and there are large regional differences in the types of influencing factors. Furthermore, multiple factors may interact with each other and lead to discontinuing medical consultations. As described above, the factors that lead to discontinuing medical consultations are complex and diverse. For this reason, it is extremely difficult to implement effective measures to prevent discontinuing medical consultations. For example, simply analyzing regional differences in each factor makes it difficult to formulate appropriate measures for each region. [Means for solving the problem]

[0007] In order to solve the above problem, the present invention analyzes, by region, regional factors, which are regional discontinuation factors that affect discontinuation of medical treatment, and patient factors, which are factors specific to individual patients.

[0008] More specifically, this medical consultation support device analyzes the factors that cause patients to discontinue their medical consultations and supports the patients in receiving medical consultations. The medical consultation support device has a regional medical consultation discontinuation factor analysis unit that analyzes regional factors that cause patients to discontinue their medical consultations originating from the patient's region and identifies the regional factors that affect the discontinuation of medical consultations, an individual medical consultation discontinuation factor analysis unit that analyzes patient factors that cause patients to discontinue their medical consultations originating from the individual patient and identifies the patient factors that affect the discontinuation of medical consultations, and an output unit that outputs the identified regional factors and the identified patient factors for each region.

[0009] The present invention also includes a medical examination support method using the medical examination support device, a program for causing the medical examination support device to function as a computer, and a storage medium storing this program. [Effects of the Invention]

[0010] According to the present invention, the causes of discontinuing medical treatment can be analyzed more accurately, and discontinuing medical treatment can be more effectively prevented. [Brief explanation of the drawings]

[0011] [Figure 1] 1 is a system configuration diagram of a medical examination support system 100 according to one embodiment of the present invention. [Figure 2] 1 is a configuration diagram showing an example of implementation of a medical examination support device 10 according to an embodiment of the present invention. [Figure 3] FIG. 10 is a diagram showing a medical institution / attending physician master 108 used in one embodiment of the present invention. [Figure 4] FIG. 2 is a diagram showing a patient management master 109 used in one embodiment of the present invention. [Figure 5] FIG. 2 is a diagram showing a factor setting master 110 used in one embodiment of the present invention. [Figure 6] FIG. 10 is a diagram showing a factor-specific contribution setting table 111 used in one embodiment of the present invention. [Figure 7] FIG. 10 is a diagram showing an interruption prevention measure master 112 used in one embodiment of the present invention. [Figure 8]10 is a flowchart showing a processing flow of regional factor analysis processing in one embodiment of the present invention. [Figure 9] 10 is a flowchart showing the processing flow of patient factor analysis processing in one embodiment of the present invention. [Figure 10] FIG. 10 is a diagram showing an example of a display that displays the largest regional factors in one embodiment of the present invention. [Figure 11] FIG. 10 is a diagram showing an example of a display of a cause of consultation interruption in one embodiment of the present invention. [Figure 12] FIG. 10 is a diagram showing another example of displaying reasons for discontinuing consultation in one embodiment of the present invention. [Figure 13] FIG. 13 is a diagram showing a support screen 1300 for a task of preventing patients from canceling their medical examinations in one embodiment of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0012] In this embodiment, a technology for preventing interruptions to medical consultations is disclosed as an example of supporting patients' consultations at medical institutions. To this end, in this embodiment, a medical consultation support system 100 including a medical consultation support device 10 is provided. This configuration will be described below, and in this embodiment, consultations include not only diagnosis and examinations, but also tests, medical checkups, day care, and rehabilitation. Furthermore, the place of consultation may be a medical institution, or the patient's home, etc.

[0013] Fig. 1 is a system configuration diagram of a medical examination support system 100 according to this embodiment. In Fig. 1, the medical examination support system 100 has a medical examination support device 10 connected to various devices such as an instructor terminal 20, an administrative terminal 30, and a medical institution terminal 40.

[0014] Each of these devices will be described below. The medical examination support device 10 is a device that executes the main processing of this embodiment, and supports medical examinations, particularly analyzes medical examination discontinuation. To this end, the medical examination support device 10 has a region-specific medical examination discontinuation factor analysis unit 11, an individual medical examination discontinuation factor analysis unit 12, a medical examination discontinuation factor integration analysis unit 13, an input unit 14, an output unit 15, and a memory unit 16.

[0015] First, the regional consultation discontinuation factor analysis unit 11 analyzes regional factors for patients who discontinued their consultation and identifies regional factors that influence consultation discontinuation. Here, regional factors refer to regional discontinuation factors attributable to the patient's region. The patient's region refers to the area related to the patient's consultation and medical visits, including the patient's address, the patient's place of work, the location of the medical institution where the patient visits, and the travel route and means for the visit. Regional factors include the number of medical institutions, the public transportation coverage rate, and the climate, and indicate characteristics that contribute to discontinuation in the region and circumstances such as constraints related to consultation. Furthermore, the individual consultation discontinuation factor analysis unit 12 analyzes patient factors for each patient who discontinued their consultation and identifies patient factors that influence consultation discontinuation. Here, patient factors refer to regional discontinuation factors attributable to the individual patient. Patient factors refer to characteristics that contribute to discontinuation in the individual patient, circumstances such as constraints related to consultation, including financial constraints, physical condition, and examination details.

[0016] Furthermore, the consultation discontinuation factor integration analysis unit 13 integrates the regional factors identified by the regional consultation discontinuation factor analysis unit 11 and the patient factors identified by the individual consultation discontinuation factor analysis unit 12 to calculate integrated factors. More preferably, the consultation discontinuation factor integration analysis unit 13 analyzes the integrated factors and identifies integrated factors that influence consultation discontinuation. Note that "influencing consultation discontinuation" has the same meaning as regional factors and patient factors.

[0017] The input unit 14 also receives and acquires information (e.g., the circumstances that caused the interruption) used in the above-mentioned regional consultation interruption factor analysis unit 11 and individual consultation interruption factor analysis unit 12. This acquisition includes receiving information from other devices and acquiring information based on input from the user. The output unit 15 outputs the processing results of the above-mentioned regional consultation interruption factor analysis unit 11, individual consultation interruption factor analysis unit 12, and consultation interruption factor integrated analysis unit 13. This output includes sending to other devices and displaying to the user.

[0018] Furthermore, the memory unit 16 stores information such as various masters and tables. These are used for processing by the area-specific consultation interruption cause analysis unit 11 and the individual consultation interruption cause analysis unit 12, and are created and updated as a result. This information will be explained later. It is assumed that the consultation support device 10 will be operated and used by medical institutions, governments, and medical treatment guidance institutions. Here, a medical treatment guidance institution is an institution that implements and manages medical treatment guidance for patients.

[0019] The instructor terminal 20 is used by an instructor, such as a public health nurse or pharmacist, who provides medical care guidance. The instructor can use the functions of the medical consultation support device 10 via the instructor terminal 20. For example, the instructor can check the analysis results of the area-specific medical consultation interruption factor analysis unit 11, the individual medical consultation interruption factor analysis unit 12, and the medical consultation interruption factor integration analysis unit 13, and input a report on the results of medical care guidance, including the status of medical consultation interruption. The instructor terminal 20 is implemented as a computer such as a PC, tablet, or smartphone. The instructor terminal 20 and the medical consultation support device 10 may be implemented as a single computer, or may be implemented as a medical care guidance institution system that manages the operations of the medical care guidance institution or a computer that constitutes the system.

[0020] The administrative terminal 30 is also used by a person in charge of health and welfare administration at an administrative agency such as a local government. The health and welfare administration person can use the functions of the medical consultation support device 10 via the administrative terminal 30. For example, the person in charge can check the analysis results of the regional medical consultation discontinuation factor analysis unit 11, the individual medical consultation discontinuation factor analysis unit 12, and the medical consultation discontinuation factor integrated analysis unit 13, and can input measures to promote medical consultations and prevent discontinuation of medical consultations, as well as regional factors and circumstances. The administrative terminal 30 is realized by a computer such as a PC, tablet, or smartphone. The administrative terminal 30 and the medical consultation support device 10 may be realized by a single computer, or may be realized by an administrative agency system for carrying out administrative work at the administrative agency or a computer constituting the same.

[0021] The medical institution terminal 40 is used by medical professionals at the medical institution where the patient is receiving treatment. Medical professionals include the patient's doctor, nurses, pharmacists, and the like. The medical professionals can use the functions of the medical consultation support device 10 via the medical institution terminal 40. For example, they can check the analysis results of the regional consultation interruption factor analysis unit 11, the individual consultation interruption factor analysis unit 12, and the consultation interruption factor integrated analysis unit 13, and input information about the patient's consultation, such as a diagnosis result. The medical institution terminal 40 is implemented as a computer such as a PC, tablet, or smartphone. The administrative terminal 30 and the medical consultation support device 10 may be implemented as a single computer, or may be implemented as a medical institution system for performing tasks such as diagnosis at the medical institution or a computer constituting the system.

[0022] The consultation support system 100 analyzes consultation discontinuation using information about patient conditions, such as consultation discontinuation, input from various terminals via the input unit 14 and stored in the memory unit 16. To this end, the regional consultation discontinuation factor analysis unit 11 and the individual consultation discontinuation factor analysis unit 12 analyze the factors that cause consultation discontinuation and identify, for each region, regional factors that contribute significantly to consultation discontinuation and patient factors that contribute specifically to individual patient factors. The output unit 15 then outputs the analysis results. For example, the output unit 15 transmits the analysis results to each terminal, which then displays the results. This enables instructors, welfare officials, and medical professionals to consider policies and measures to prevent consultation discontinuation. While this embodiment allows the consultation support device 10 to be used by medical guidance institutions, government agencies, and medical institutions, these are merely examples; at least one of these may be omitted, or the device may be used by private insurance companies, etc. Furthermore, patient terminals used by patients can also be connected to the consultation support device 10 and used. Furthermore, the instructor terminal 20, administrative terminal 30, medical institution terminal 40, terminals used by insurance companies, and patient terminals shown in FIG. 1 are not limited to one terminal as shown in the figure, and multiple terminals may be provided for each.

[0023] Next, an implementation example of this embodiment will be described with reference to Fig. 2. In this embodiment, the medical examination support device 10 is realized by a server that executes processing according to a program. Therefore, the medical examination support device 10 has a processing device 101, a communication device 102, a main memory device 103, and a sub-memory device 104, which are connected to each other via a communication path.

[0024] Here, the processing device 101 can be realized by a processor such as a CPU, and executes calculations according to various programs described below. The communication device 102 has an interface function for connecting to the network 50, and corresponds to the input unit 14 and output unit 15 in Fig. 1. The network 50 is connected to the instructor terminal 20, administrative terminal 30, and medical institution terminal 40 in Fig. 1, and as a result, the consultation support device 10 can communicate with each of these devices.

[0025] The main storage device 103 can be realized by a so-called memory, and stores programs for calculations by the processing device 101 and information used in the processing of these programs. The secondary storage device 104 can be realized by a storage such as a hard disk drive, and stores programs and various information (masters, tables). In this way, the secondary storage device 104 corresponds to the storage unit 16 in FIG. 1.

[0026] Here, the main storage device 103 stores, as programs, a region-specific analysis program for discontinuation of medical treatment 105, an individual analysis program for discontinuation of medical treatment 106, and an integrated analysis program for discontinuation of medical treatment 107.

[0027] The above-mentioned programs have the following correspondence with the respective units in FIG. Regional Discontinuation Factor Analysis Program 105: Regional Discontinuation Factor Analysis Part 11 Individual consultation discontinuation factor analysis program 106: Individual consultation discontinuation factor analysis part 12 Integrated analysis program for discontinuation of medical consultations 107: Integrated analysis of discontinuation of medical consultations part 13 That is, the processing device 101 executes the processing of the area-specific consultation discontinuation factor analysis unit 11 and the individual consultation discontinuation factor analysis unit 12 according to the area-specific consultation discontinuation factor analysis program 105 and the individual consultation discontinuation factor analysis program 106 .

[0028] Each program is distributed via the network 50 or stored in a storage medium and then installed in the medical examination support device 10. Each program is not an independent program, but each program can be realized by a constituent module.

[0029] In addition, the main memory device 103 stores the following masters and tables, which are information used in this embodiment: a medical institution / attending physician master 108, a patient management master 109, a factor setting master 110, a factor-specific contribution setting table 111, and an interruption prevention measure master 112.

[0030] Each piece of information will be explained below. FIG. 3 is a diagram showing the medical institution / attending physician master 108 used in this embodiment. The medical institution / attending physician master 108 is information about each medical institution and the doctors who work there and who are the patient's attending physician or who could become the patient's attending physician (hereinafter simply referred to as attending physicians), and is master data for identifying the patients under the care of these medical institutions and attending physicians. In this embodiment, as shown in FIG. 3, the medical institution / attending physician master 108 is composed of a medical institution master 108-1 and an attending physician master 108-2, but these may also be composed integrally. Furthermore, the medical institution / attending physician master 108 is composed of a collection of medical institution / attending physician information indicated by each record in FIG. 3. Note that the medical institution / attending physician information can be classified into medical institution information constituting the medical institution master 108-1 and attending physician information constituting the attending physician master 108-2.

[0031] The medical institution master 108-1 and the attending physician master 108-2 will be described below. First, the medical institution master 108-1 is information about medical institutions. In this embodiment, the medical institution master 108-1 has the following items: HID, medical institution name, address, telephone number, and PID. First, the HID is an item that identifies the medical institution. Furthermore, the medical institution name is an item that indicates the name of the medical institution.

[0032] The location and telephone number are items that indicate the location and telephone number of the medical institution, respectively. In addition to these, the email address and identification information of the medical institution terminal 40 used at the medical institution can also be used. The PID is an item that identifies a patient who is receiving treatment at the medical institution.

[0033] Next, the attending physician master data 108-2 is information about the attending physician. Note that although this embodiment targets physicians, the scope can be expanded to include medical professionals. The attending physician master data 108-2 of this embodiment has the following fields: DID, name, affiliation HID, and PID.

[0034] First, the DID is an item that identifies the attending physician in question. The name is an item that indicates the name of the attending physician in question. The affiliation HID is an item that indicates the medical institution where the attending physician in question works. Note that multiple affiliation HIDs may be prepared. The PID is an item that identifies the patients under the care of the attending physician in question. Therefore, the PID of the attending physician master 108-2 is included in the PID of the medical institution master 108-1 that is indicated by its own affiliation ID.

[0035] Next, FIG. 4 is a diagram showing the patient management master 109 used in this embodiment. The patient management master 109 is information about a patient, and is information that can identify the status of the patient's medical visit. The patient management master 109 is composed of a collection of patient management information indicated by each record in FIG. 4. As shown in FIG. 4, the patient management master 109 has the following fields: PID, patient name, gender, date of birth, address, telephone number, disease, medical visit log, reason for discontinuing medical visit, and HID / DID. First, the PID is a field that identifies the patient. The patient name is a field that indicates the name of the patient. The medical visit log can also be created in cooperation with other information systems, such as electronic medical records held by medical institutions or medical fee billing systems (receipt computers). Alternatively, it can be created using information from medical fee statements (receipts) held by administrative agencies responsible for public medical insurance.

[0036] Furthermore, gender, date of birth, address, and telephone number are examples of patient characteristics. Here, for gender, 1 indicates male, and 0 indicates female. Note that the address may be the place of employment, or may include other characteristics (blood type, etc.). Furthermore, it is desirable to provide patient terminal information, such as an email address, that identifies the patient terminal used by the patient as a characteristic. The patient terminal information may include the medical examination app (program) installed on the patient terminal, or patient identification information on the patient terminal or this app.

[0037] Furthermore, the items "disease," "visit log," "discontinuation cause of visit," and "HID / DID" are examples of items that indicate the visit status of the patient. First, "disease" indicates the patient's illness, which is the reason for the visit. Furthermore, "visit log" is information that records the details of the visit of the patient in chronological order. Furthermore, "patient status" is an item that indicates the environment and situation of the patient, and it is desirable that it is a characteristic that particularly affects the visit.

[0038] The HID / DID are items that identify the medical institution and the patient's doctor. The HID / DID may be separate items, or either one may be used. The consultation log, the reason for discontinuing the consultation, and the HID / DID can be obtained from the medical institution terminal 40, the patient terminal, etc.

[0039] Next, Fig. 5 is a diagram showing the factor setting master 110 used in this embodiment. The factor setting master 110 is information for calculating the factors that caused consultation discontinuation and their contribution. Here, the contribution indicates the degree of contribution or influence of the factor to consultation discontinuation. Therefore, in this embodiment, the factor setting master 110 is composed of a collection of factor setting information indicated by each record shown in Fig. 5, and has the following items: factor classification ID, factor classification name, factor ID, factor name, consultation discontinuation factor, explanatory variable (content), explanatory variable name, and contribution variable name.

[0040] First, the cause classification ID is an item that identifies the classification of the cause of discontinuing medical treatment. The cause classification name indicates the name of the classification of the cause of discontinuing medical treatment. The cause ID is an item that identifies the cause of discontinuing medical treatment. The cause name is the name of the target cause. The cause classification classifies multiple causes of discontinuing medical treatment, and in this embodiment, indicates whether the cause of discontinuing medical treatment is a patient factor derived from the individual patient or a regional factor derived from the patient's region. In the example of Figure 5, the top six records indicate patient factors, and the bottom four records indicate regional factors.

[0041] Furthermore, the consultation discontinuation factor indicates the content of the relevant consultation discontinuation factor. Furthermore, the explanatory variable (content) indicates the content of the explanatory variable required to calculate the contribution of the relevant consultation discontinuation factor and the method for obtaining it. Furthermore, the explanatory variable name indicates the name of the relevant explanatory variable, which identifies the numerical data of the relevant consultation discontinuation factor. For example, for understanding of the disease with factor ID: 1 in Figure 5, a five-level numerical value is identified by an individual survey. Furthermore, the contribution variable name indicates the contribution of the relevant consultation discontinuation factor.

[0042] Next, Fig. 6 is a diagram showing a factor-specific contribution setting table 111 used in this embodiment. The regional consultation interruption factor analysis unit 11 is a table provided for each region in which the calculated consultation interruption factors are recorded, and has the following items for each factor. That is, the factor-specific contribution setting table 111 has the following items: factor name, explanatory variable name, contribution variable name, overall average value, Z value, and region 1 average value to region n average value. The factor-specific contribution setting table 111 is made up of a collection of factor-specific contribution setting information indicated by each record shown in Fig. 6.

[0043] First, the factor name is the name of the target factor, and is the same as the factor name in the factor setting master 110. Also, the explanatory variable name indicates the explanatory variable name of the relevant consultation interruption factor, and is the same as the explanatory variable name in the factor setting master 110. Also, the contribution variable name indicates the contribution of the relevant consultation interruption factor, and is the same as the contribution variable name in the factor setting master 110.

[0044] Additionally, the overall average value indicates the average value of the explanatory variables calculated for the relevant regional factor. The Z-value is the value obtained by dividing the contribution variable name by the standard deviation. By using this Z-value, it is possible to roughly align the magnitude of contribution to the objective variable even if the range of values ​​that the explanatory variables should take differs. As a result, it becomes possible to compare the magnitude of the influence that the explanatory variables have on the objective variable numerically. Here, we will explain the Z-value. For example, the Z-value is calculated as Az[p11] = A[p11] / (standard deviation with x[p11]).

[0045] Furthermore, the region 1 average value to region n average value indicate the average value of the explanatory variables in the sub-regions that make up the target region, respectively. Also, X[p11], which is the overall average value in Figure 6, indicates the average value of x[p11]. Also, X[p11](n), which is the region 1 average value to region n average value, indicates the average value of x[p11](n) (the average value of the explanatory variable x[p11] in region n).

[0046] Next, Fig. 7 is a diagram showing the interruption prevention measure master 112 used in this embodiment. The interruption prevention measure master 112 is composed of a collection of interruption prevention measure information that indicates interruption prevention measures for consultation interruption causes. This interruption prevention measure information corresponds to each record in Fig. 7. The interruption prevention measure master 112 has the following items: cause classification ID, cause classification name, cause ID, cause name, explanatory variable (content), explanatory variable name, prevention measure ID, and prevention measure name. Note that interruption prevention measures are countermeasures against consultation interruptions, and also include preventive measures and prevention measures.

[0047] First, the factor classification ID identifies the classification of the consultation interruption factor, and is the same as the factor setting master 110 in FIG. 5. The factor classification name indicates the name of the classification of the consultation interruption factor, and is the same as the factor setting master 110 in FIG. 5. The factor ID is an item that identifies the consultation interruption factor, and is the same as the factor setting master 110 in FIG. 5. The factor name is the name of the target factor, and is the same as the factor setting master 110 in FIG. 5. The explanatory variable (content) indicates the content of the explanatory variable required to calculate the contribution of the relevant consultation interruption factor and the method for obtaining it, and is the same as the factor setting master 110 in FIG. 5. The explanatory variable name indicates the name of the relevant explanatory variable, which identifies the numerical data of the relevant consultation interruption factor, and is the same as the factor setting master 110 in FIG. 5. The deterrent measure ID is an item that identifies the deterrent measure for the relevant consultation interruption factor. The deterrent measure name is an item that indicates the name and content of the deterrent measure for the relevant consultation interruption factor.

[0048] This concludes the explanation of the information used in this embodiment, and next we will explain the details of the processing executed in this embodiment. Figure 8 is a flowchart showing the processing flow of the regional factor analysis processing in this embodiment.

[0049] First, in step S11, the regional consultation interruption factor analysis unit 11 acquires consultation interruption factors that cause consultation interruption. To do this, the regional consultation interruption factor analysis unit 11 reads each record recording the consultation interruption factors from the patient management master 109. Here, the regional consultation interruption factor analysis unit 11 may acquire limited consultation interruption requirements according to predetermined conditions (consultation interruption factors for a predetermined target period or specific consultation interruption factors). To do this, the input unit 14 accepts the predetermined conditions from the user. For example, the input unit 14 accepts the target period and specified consultation interruption requirements accepted by the administrative terminal 30 from the person in charge, and the regional consultation interruption factor analysis unit 11 can search the patient management master 109 accordingly to acquire limited consultation interruption requirements.

[0050] Furthermore, in step S12, the regional consultation interruption cause analysis unit 11 sets a target region, which is a region to be analyzed. To do this, the regional consultation interruption cause analysis unit 11 accepts a designation of the region to be targeted from the user via the input unit 14. For example, the input unit 14 accepts a region accepted by the administrative terminal 30 from a person in charge. Then, the regional consultation interruption cause analysis unit 11 identifies the accepted region as the target region.

[0051] Furthermore, in step S13, the regional consultation interruption factor analysis unit 11 calculates regional factors. As an example of regional consultation interruption factors, the regional consultation interruption factor analysis unit 11 calculates the consultation interruption occurrence rate for the entire target region (an example of calculating the contribution), the contribution of each regional factor, and the average value of the explanatory variable (numerical data of consultation interruption factors) for each regional factor. To do this, the regional consultation interruption factor analysis unit 11 executes the following process.

[0052] (1) The regional consultation discontinuation cause analysis unit 11 searches the patient management master 109 using the identified target region as a key, and extracts records (patient management information) that constitute the patient management master 109 for the target region having the corresponding address.

[0053] (2) The regional consultation interruption factor analysis unit 11 determines whether patients in the target region have discontinued consultations based on the consultation logs of the patient management information identified in (1). Next, the regional consultation interruption factor analysis unit 11 identifies the patient status of patients who have discontinued consultations from the patient management master 109. Furthermore, the regional consultation interruption factor analysis unit 11 uses the factor setting master 110 to identify factor setting information including explanatory variables (contents) corresponding to the identified patient status.

[0054] (3) The regional consultation interruption factor analysis unit 11 uses the identified factor design information to calculate the consultation interruption occurrence rate for the entire target region (an example of calculating the contribution), the contribution of each consultation interruption factor, and the average value of the explanatory variable (numerical data of the consultation interruption factor) for each consultation interruption factor.To this end, the following processing is performed. (3)-(a) The area-specific consultation discontinuation factor analysis unit 11 identifies the "contribution degree variable name" of the factor design information identified as the contribution degree. (3)-(b) Furthermore, the area-specific consultation discontinuation factor analysis unit 11 identifies the "explanatory variables" of the factor design information identified as explanatory variables, and calculates the average value thereof. (3)-(c) Then, the regional consultation discontinuation factor analysis unit 11 calculates the consultation discontinuation occurrence rate for the entire target region as follows: First, the regional consultation discontinuation factor analysis unit 11 creates a prediction formula for consultation discontinuation (Equation 1) by regression analysis using explanatory variables, and sets the coefficient as the contribution rate. Rate of discontinuation of medical examination = A[p11]*x[p11]+A[p12]*x[p12]+A[p21]*x[p21]+A[p31]*x[p31]+A[p41]*x[p41]+A[p51]*x[p51]+A[q11]*x[q11]+A[q21]*x[q21]+A[q31]*x[q31]+A[q32]*x[q32]+B … (Equation 1) Here, x[pnm] and x[qnm] are "explanatory variables," and A[pnm] and A[qnm] are "contribution variables." To summarize the above, the regional consultation discontinuation factor analysis unit 11 determines values ​​for p11-p51 for each patient currently receiving treatment, and determines values ​​for q11-q32 for each patient's residential area. Using these values, a prediction formula for consultation discontinuation for the entire region is estimated, and the contribution is calculated as its coefficient.

[0055] Then, the regional consultation interruption factor analysis unit 11 sets the calculated factors in the factor-specific contribution setting table 111 in Fig. 6. That is, the regional consultation interruption factor analysis unit 11 sets, for each regional factor, the average value of the calculated explanatory variables as the "overall average value," the calculated contribution variable name as the "contribution variable name," and the calculated consultation interruption occurrence rate for the entire target region as the "overall average value."

[0056] In step S14, the area-specific consultation discontinuation factor analysis unit 11 divides the target area set in step S12 into a plurality of sub-areas (areas 1 to n). For example, the target area can be a prefecture, and the sub-areas can be cities, towns, and villages.

[0057] Furthermore, in step S15, the regional consultation discontinuation factor analysis unit 11 calculates the consultation discontinuation rate, contribution rate, and average value of the regional factors of the sub-region, and sets these to the factor-specific contribution rate setting table 111. For this purpose, the regional consultation discontinuation factor analysis unit 11 extracts any sub-region from among the multiple sub-regions, and calculates the consultation discontinuation rate and average value of the regional factors for the extracted sub-region in the same manner as in step S14. Here, in steps S13 and S15, the regional consultation discontinuation factor analysis unit 11 extracts regional factors that affect consultation discontinuation from the calculated regional factors of contribution rate. "Affecting consultation discontinuation" means that the contribution rate is large and is equal to or greater than a predetermined threshold, or that the contribution rate is a predetermined high rank.

[0058] Next, in step S16, the regional consultation interruption factor analysis unit 11 determines whether the calculation in step S15 has been performed for each sub-region. As a result, if the calculation has been performed for each sub-region (Y), the process proceeds to step S18. On the other hand, if the calculation has not been performed for each sub-region, that is, if there is a sub-region for which the calculation has not been performed (N), the process proceeds to step S17.

[0059] In step S17, the regional consultation interruption factor analysis unit 11 sets sub-regions that have not been calculated in order to execute the calculation process in step S15. Then, the process proceeds to step S15, where calculation process of regional consultation interruption factors for the set sub-regions is executed.

[0060] Furthermore, in step S18, the regional consultation interruption factor analysis unit 11 outputs the regional consultation interruption factors calculated in step S15 via the output unit 15. The regional consultation interruption factors may be output by display on the consultation support device 10 or may be sent to a terminal such as the administrative terminal 30. In the latter case, the regional consultation interruption factors will be displayed on the terminal.

[0061] Next, the analysis process of patient factors in this embodiment will be described. FIG. 9 is a flowchart showing the process flow of the analysis process of patient factors in this embodiment. Note that this analysis process of patient factors also includes creating countermeasures (interruption prevention measures) against these factors. First, in step S21, the individual consultation interruption cause analysis unit 12 creates an interruption prevention measure master 112. That is, a prevention measure ID and a prevention measure name are set for each consultation interruption cause. To this end, the individual consultation interruption cause analysis unit 12 receives a cause ID, a prevention measure ID, and a prevention measure name from a terminal device such as the instructor terminal 20 to the medical institution terminal 40 via the input unit 14. Then, the individual consultation interruption cause analysis unit 12 records the received prevention measure ID and the prevention measure name in the record corresponding to the received cause ID.

[0062] Furthermore, in step S22, the individual consultation interruption factor analysis unit 12 sets the target patient for the patient factors to be analyzed from the patient management master 109. To this end, the individual consultation interruption factor analysis unit 12 receives the designation of the target patient from a terminal such as the administrative terminal 30 via the input unit 14. Here, the target patient is designated as a patient who is currently or has previously discontinued consultation, and the individual consultation interruption factor analysis unit 12 identifies the target patient using the consultation log.

[0063] Furthermore, in step S23, the individual consultation interruption factor analysis unit 12 calculates the contribution of each patient factor to the subject's consultation interruption. To this end, the individual consultation interruption factor analysis unit 12 identifies the subject's patient status from the patient management master 109. Next, the individual consultation interruption factor analysis unit 12 identifies factor setting information corresponding to the identified patient status, i.e., patient factors, from the factor setting master 110. Then, the individual consultation interruption factor analysis unit 12 calculates the contribution of each patient factor to consultation interruption using the identified patient factors and the factor-specific contribution setting table 111. To this end, the individual consultation interruption factor analysis unit 12 calculates the contribution of each factor by calculating the following (Equation 2) to (Equation 7) for each factor name. Patient understanding: A[p11]*(x[p11]-X[p11])…(Number 2) Medical treatment content: A[p12]*(x[p12]-X[p12])…(Number 3) Physical condition: A[p21]*(x[p21]-X[p21])…(Number 4) Secure time: A[p31]*(x[p31]-X[p31])…(Number 5) Economic constraint: A[p41]*(x[p41]-X[p41])…(Number 6) Means of transportation: A[p51]*(x[p51]-X[p51])…(Number 7) Here, the individual consultation interruption factor analysis unit 12 extracts patient factors that affect consultation interruption from these contribution degrees. Influencing consultation interruption can mean that the contribution degree is large, equal to or greater than a predetermined threshold, or that the contribution degree is one of the higher predetermined levels.

[0064] Furthermore, in step S24, the individual consultation interruption factor analysis unit 12 outputs the contribution degree calculated in step S23, the cause name of the patient cause, and the interruption prevention measure via the output unit 15. To this end, the individual consultation interruption factor analysis unit 12 identifies interruption prevention measure information corresponding to the cause name of the contribution degree calculated in this step from the interruption prevention measure master 112. Then, the individual consultation interruption factor analysis unit 12 extracts the name of the prevention measure from the identified interruption prevention measure information.

[0065] This output may be displayed on the medical examination support device 10 or transmitted to a terminal such as the administrative terminal 30. In the latter case, the calculation results are displayed on the terminal. Here, it is desirable that the display in this step be arranged in descending order of the degree of contribution.

[0066] This concludes the explanation of Figure 9. In this embodiment, an integration process is performed to integrate the results of the analysis processes in Figures 8 and 9, and the integrated factors can be calculated. For this purpose, the consultation interruption factor integration analysis unit 13 receives the designation of the main factors from a terminal such as the administrative terminal 30 via the input unit 14. In this embodiment, the number of medical institutions, the public transportation penetration rate, climate (high temperature), and climate (snowfall), which are regional factors, are used as the main factors. Furthermore, the consultation interruption factor integration analysis unit 13 calculates the contribution degree of the main factors. This calculation may use the results of the contribution degree calculation in step S13 or step S23.

[0067] Then, the consultation interruption factor integration analysis unit 13 corrects the calculated contribution rate based on the demand and calculates the integrated factor. Specifically, the consultation interruption factor integration analysis unit 13 calculates the following (Equation 8) to (Equation 11). Balance of number of medical institutions: x[q11](n) / (x[p51](n) / habitable area of ​​district n)...(Number 8) Transportation accessibility balance: x[q21](n) / (x[p51](n) / habitable area of ​​district n) ... (Equation 9) Climate (hot) balance: ((365-[q31](n)) / 365) / (x[p51](n) / habitable area of ​​district n) ... (Number 10) Climate (snowfall) balance: ((365-[q32](n)) / 365) / (x[p51](n) / habitable area of ​​district n) ... (Math 11) In addition, the consultation interruption factor integration analysis unit 13 corrected these integrated factors using transportation means (demand) as a patient factor, but the patient factors used for correction are not limited to this, and patient factors such as those described above can be used.

[0068] Next, the consultation interruption factor integrated analysis unit 13 outputs the contribution degree, which is the calculation result, via the output unit 15. At this time, the factor name may also be output in addition to the contribution degree. This output may be displayed on the consultation support device 10 or transmitted to a terminal such as the administrative terminal 30. In the latter case, the calculation result is displayed on the terminal. Here, it is desirable that the display in this step be arranged in descending order of contribution degree. Furthermore, the output in this step may also output the results of steps S18 and S24, or may output, particularly display, at least one of these so that it is selectable. Below, the display of patient factors, regional factors, and integrated factors will be explained using Figures 10 to 13.

[0069] First, Fig. 10 is a diagram showing an example of a display displaying the largest regional factors in this embodiment. Here, the largest regional factors refer to the factors that contribute the most to consultation discontinuation in a region and its constituent sub-regions. Display screen 1000 in Fig. 10 is a display screen on output unit 15 or each terminal, and has a region classification selection area 1001, a patient factor area 1002, a regional factor area 1003, and a factor display area 1004.

[0070] The area division selection area 1001 is an area for selecting the target area, and FIG. 10 shows options such as city, town, medical district, and other options. In addition, FIG. 10 shows the selections to display the largest factors for each city, town, and village. The patient factor area 1002 and the area factor area 1003 each show a legend for the largest factors. Specifically, the patient factor area 1002 shows a design in which the largest patient factors are understanding of the disease, medical treatment details, physical condition, time availability, financial constraints, and transportation. The area factor area 1003 shows a design in which the largest area factors are the number of medical institutions, the penetration rate of public transportation, climate (high temperature), and climate (snowfall). Furthermore, the factor display area 1004 displays the largest factors for each city, town, and village selected in the area division selection area 1001, i.e., for each region, in map format according to the legends (patient factor area 1002 and area factor area 1003).

[0071] Next, Fig. 11 is a diagram showing an example of a display of consultation interruption factors in this embodiment. A display screen 1100 in Fig. 11 has a factor selection area 1101, a region classification selection area 1105, and a factor display area 1106. First, the factor selection area 1101 is an area for selecting the factor classification to be displayed, and has a patient factor selection area 1102, a region factor selection area 1103, and a patient / region integration selection area 1104.

[0072] Here, the patient factor selection area 1102 is an area for selecting a patient factor as a factor classification, and the factor names corresponding to the factor classification ID p in FIG. 5 are displayed as options. That is, the patient factors displayed as options are understanding of the disease, medical treatment details, physical condition, securing time, financial constraints, and means of transportation. In the example of FIG. 11, understanding of the disease is selected. Furthermore, means of transportation indicates the difficulty the patient has in going out. In contrast, the public transportation penetration rate in the regional factors is different from what is common to multiple patients in the region.

[0073] The regional factor selection area 1103 is an area for selecting patient factors as a factor classification, and displays as options the factor names corresponding to the factor classification ID p in FIG. 5. That is, the number of medical institutions, the public transportation coverage rate, climate (high temperature), and climate (snowfall) are displayed as options for regional factors. Furthermore, the patient / region integration selection area 1104 is an area for selecting integration factors as a factor classification. That is, the balance of the number of medical institutions, the balance of public transportation coverage rate, climate (high temperature), and climate (snowfall) are displayed as options for integration factors.

[0074] Furthermore, the area classification selection area 1105 is an area for selecting the target area, and in Fig. 11, options such as city, town, village, medical district, and others are shown. Furthermore, in Fig. 11, each city, town, village is selected to be displayed in the factor display area 1106 in a format according to its contribution to understanding of the disease specified in the patient factor selection area 1102. Furthermore, the factor display area 1106 is displayed in a format according to the factor selected in the factor selection area 1101, by city, town, village (selected in the area classification selection area 1105), that is, by region. For example, in the factor display area 1106 in Fig. 11, each city, town, village is displayed distinctly using a color, shade, size, or a combination of these according to its contribution.

[0075] Next, Fig. 12 is a diagram showing another example of displaying reasons for discontinuing consultation in this embodiment. Fig. 12 is a display screen having the same area as Fig. 11, but the factors displayed in the factor display area 1106, that is, the selected factors, are different. That is, in Fig. 12, the balance of the number of medical institutions is selected in the patient / region integration selection area 1104, and each city, town, or village (selected in the area classification selection area 1105) is displayed in map form in the factor display area 1106 in a format corresponding to the balance of the number of medical institutions.

[0076] Next, FIG. 13 is a diagram showing a support screen 1300 for the work of preventing consultation interruptions in this embodiment. In FIG. 13, the support screen 1300 shows the analysis results of consultation interruptions for a patient (Mr. / Ms. xxxx) performed by the individual consultation interruption cause analysis unit 12. For this reason, the support screen 1300 has the following items: cause name, cause of consultation interruption, and confirmation item (necessary preventive measures). First, the cause name indicates the name of the cause of consultation interruption for the patient in question. Furthermore, the consultation interruption cause indicates a patient factor among the causes of consultation interruption for the patient in question. Furthermore, the confirmation item (necessary preventive measures) indicates preventive measures for preventing consultation interruption for the patient in question. This preventive measure is an example of a discontinuation preventive measure, and is identified from the interruption preventive measure master 112.

[0077] In the example of FIG. 13 , the individual consultation interruption factor analysis unit 12 displays a support screen 1300 for patient factors in step S24. However, this embodiment is not limited to patient factors. That is, regional factors and integrated factors can also be displayed on the support screen 1300. In this case, the individual consultation interruption factor analysis unit 12 and the consultation interruption factor integrated analysis unit 13 execute the analysis process of FIG. 9 to display the support screen 1300 including interruption prevention measures corresponding to regional factors and integrated factors. While this support screen 1300 can be displayed on each terminal, it is preferable to display it on the instructor terminal 20. In this case, the instructor can confirm and implement interruption prevention measures as part of medical care guidance. As described above, in this embodiment, the regional consultation interruption factor analysis unit 11 and the individual consultation interruption factor analysis unit 12 can identify factors that affect consultation interruption, for example, factors with a high contribution rate. In other words, factors that contribute to consultation interruption can be analyzed with greater accuracy. The consultation interruption factor integrated analysis unit 13 may also analyze factors that affect consultation interruption, for example, factors with a high contribution rate. As described above, a major factor can be one whose contribution is equal to or greater than a predetermined threshold value or one whose contribution is among the higher levels determined in advance.

[0078] As described above, according to this embodiment, it is possible to perform a detailed analysis of discontinuation of medical consultations and to propose measures to prevent such discontinuation. Furthermore, the present invention is not limited to this embodiment and includes various modifications and application examples. For example, a configuration may be adopted in which one or a combination of two of patient factors, regional factors, and integrated factors are analyzed and output. Furthermore, the factors are not limited to the factors exemplified in FIG. 5, and at least some of them may be omitted. Furthermore, the identification of discontinuation prevention measures and the display of the support screen 1300 may be omitted. Furthermore, the medical consultation support device 10 may be used and operated by medical institutions, administrative agencies, or medical guidance institutions. [Explanation of symbols]

[0079] 10... medical consultation support device, 11... area-specific consultation interruption factor analysis unit, 12... individual consultation interruption factor analysis unit, 13... consultation interruption factor integrated analysis unit, 14... input unit, 15... output unit, 16... memory unit, 20... instructor terminal, 30... administrative terminal, 40... medical institution terminal, 50... network, 100... medical consultation support system

Claims

1. A consultation support device that analyzes the cause of a patient's discontinuation of consultation and supports the patient in consultation, A region-specific consultation interruption factor analysis unit that analyzes regional factors that are factors that cause consultation interruption originating from the patient's region and identifies regional factors that affect the consultation interruption; an individual consultation interruption factor analysis unit that analyzes patient factors that are factors that cause consultation interruption originating from the individual patient and identifies patient factors that affect the consultation interruption; A medical examination support device having an output unit that outputs the identified regional factors and the identified patient factors for each region.

2. 2. The consultation support device according to claim 1, The regional consultation discontinuation factor analysis unit calculates the consultation discontinuation occurrence rate in the region, the contribution of each regional factor, and the average value of the explanatory variables for each regional factor, The individual consultation interruption factor analysis unit is a consultation support device that calculates the contribution of each patient factor for the patient.

3. 3. The consultation support device according to claim 2, The region-specific consultation interruption factor analysis unit is a consultation support device that calculates the consultation interruption occurrence rate, the contribution rate, and the average value of the explanatory variable for each sub-region that makes up the region.

4. 3. The consultation support device according to claim 2, The individual consultation interruption factor analysis unit identifies an interruption prevention measure for the identified patient factor, The output unit is a medical examination support device that outputs the interruption prevention measure.

5. 2. The consultation support device according to claim 1, The consultation support device further includes a consultation interruption factor integration analysis unit that integrates the identified regional factors and the identified patient factors to calculate an integrated factor.

6. A consultation support method executed by a consultation support device that analyzes a cause of a patient's consultation discontinuation and supports the patient in consultation, comprising: A regional consultation discontinuation factor analysis unit analyzes regional factors that are factors that cause consultation discontinuation originating from the patient's region, and identifies regional factors that affect the consultation discontinuation; an individual consultation discontinuation factor analysis unit analyzes patient factors that are factors that cause consultation discontinuation originating from the individual patient, and identifies patient factors that affect the consultation discontinuation; The examination support method, wherein an output unit outputs the identified regional factors and the identified patient factors for each region.

7. The consultation support method according to claim 6, The regional consultation discontinuation factor analysis unit calculates the consultation discontinuation occurrence rate in the region, the contribution of each regional factor, and the average value of the explanatory variables for each regional factor, The consultation support method, in which the individual consultation interruption factor analysis unit calculates the contribution of each patient factor for the patient.

8. The consultation support method according to claim 7, A medical consultation support method in which the regional medical consultation interruption factor analysis unit calculates the medical consultation interruption occurrence rate, the contribution rate, and the average value of the explanatory variables for each sub-region that makes up the region.

9. The consultation support method according to claim 7, The individual consultation interruption factor analysis unit identifies an interruption prevention measure for the identified patient factor, A medical examination support method in which the output unit outputs the interruption prevention measure.

10. The consultation support method according to claim 6, The consultation support device further includes a consultation interruption factor integration analysis unit, The consultation support method, in which the consultation interruption factor integration analysis unit integrates the identified regional factors and the identified patient factors to calculate an integrated factor.

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