Information processing device, information processing method, and program

Abstract

The purpose of the present invention is to realize a practice of medical care that leads to, inter alia, lowering medical expenses and reducing the number of people subject to specific health guidance, on the premise of maintaining and improving treatment outcomes, and to realize provision of optimal health checkup and consultation passes from the results of analyzing medical expenses. An education and enlightenment provision control unit 51 executes control related to a service for providing, to each of one or more employees H, education and / or enlightenment for medical care and / or health. A service effect degree calculation unit 52 calculates an effect degree brought about by provision of the service, on the basis of a difference between medical expenses for each of the one or more employees H in a reference period and medical expenses for each of the one or more employees H in a determination period, where the reference period is a prescribed period before provision of the service, and the determination period is a prescribed period after provision of the service. An incentive determination unit 53 determines, on the basis of the effect degree, an incentive that is granted to a service provider ST of the service, from a heath insurance association KD and an enterprise KG that bear at least some of the abovementioned medical expenses.

Description

[Technical Field]

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

[0002] Conventionally, there is a technology that supports information sharing when a medical facility introduces a patient to another medical system (see, for example, Patent Document 1). [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Japanese Patent Application Laid-Open No. 2008-197742 Summary of the Invention [Problem to be solved by the invention]

[0004] In the prior art including the above-mentioned Patent Document 1, for example, a patient is simply referred from a medical institution such as a hospital where the patient has a family doctor to another medical institution such as a specialized hospital based on the patient's illness, its severity, etc. In contrast, patients have desired not only a referral based on the connection of their family doctor, but also a referral to an appropriate medical institution according to their own situation, etc. While these demands exist, in recent years there have also been demands for medical treatment that reduces medical costs while maintaining and improving treatment outcomes, and for the provision of optimal screening and medical examination paths based on the results of medical cost analysis, and it has not been possible to fully meet these demands.

[0005] The present invention was made in light of these circumstances, and aims to realize medical treatment that leads to reduced medical costs and fewer people requiring specific health guidance, while maintaining and improving treatment outcomes, and to provide optimal screening and medical examination paths based on the results of medical cost analysis. [Means for solving the problem]

[0006] In order to achieve the above object, an information processing device according to one aspect of the present invention comprises: An education and awareness provision control means for controlling a service that provides at least one of education and awareness regarding at least one of medical care and health to each of one or more subjects; a service effectiveness calculation means for calculating the effectiveness of the provision of the service based on the difference between the medical costs for the reference period and the medical costs for the evaluation period for each of the one or more subjects, with a predetermined period before the provision of the service as a reference period and a predetermined period after the provision of the service as an evaluation period; an incentive determination means for determining an incentive to be given to the provider of the service by a health insurance organization that bears at least a portion of the medical costs based on the degree of effectiveness; Equipped with.

[0007] An information processing method and a program according to one aspect of the present invention are a method and a program corresponding to an information processing device according to one aspect of the present invention. [Effects of the Invention]

[0008] According to the present invention, it is possible to realize medical treatment that leads to a reduction in medical expenses and a decrease in the number of people who require specific health guidance, while maintaining and improving treatment outcomes, and it is also possible to provide optimal examination and medical consultation paths based on the results of medical expense analysis. [Brief explanation of the drawings]

[0009] [Figure 1] FIG. 1 is a diagram showing an overview of a service that can be realized by an embodiment of an information processing device of the present invention. [Figure 2] 1 is a diagram illustrating an example of a configuration of an information processing system to which a server according to an embodiment of the information processing device of the present invention is applied. [Figure 3] 3 is a block diagram showing an example of a hardware configuration of a server in the information processing system of FIG. 2. FIG. [Figure 4]4 is a functional block diagram showing an example of a functional configuration of a server of FIG. 3 that configures the information processing system of FIG. 2. [Figure 5] FIG. 10 is a diagram showing an example of a target receipt. [Figure 6] FIG. 10 is a diagram showing an example of calculation of the difference in medical expenses. [Figure 7] FIG. 10 is a diagram illustrating an example of calculation targets and non-targets. [Figure 8] FIG. 10 is a diagram showing an example of how to interpret a prescription period. [Figure 9] FIG. 10 is a diagram showing an example of determining the treatment period. [Figure 10] FIG. 10 is a diagram illustrating an example of a departure determination. [Figure 11] FIG. 10 is a diagram showing an outline of the present service that can be realized by another embodiment of the information processing device of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0010] Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

[0011] First, with reference to FIG. 1, an overview of a service (hereinafter referred to as "this service") that can be realized by an embodiment of an information processing device of the present invention will be described. FIG. 1 is a diagram showing an overview of the present service that can be realized by an embodiment of an information processing device of the present invention.

[0012] The following provides an overview of this service, but this explanation is an example and is not intended to be limiting.

[0013] This service is intended to realize medical treatment that leads to reduced medical costs and fewer people requiring specific health guidance, while maintaining and improving treatment outcomes, and to provide optimal screening and medical examination paths based on the results of medical cost analysis.

[0014] In addition, this service is realized by the service provider ST, who provides this service, approaching multiple stakeholders, including multiple companies KG, multiple affiliated medical institutions TK, and health insurance organizations KD.

[0015] Specifically, this service is an approach by service provider ST that enables employees H (insured persons, etc.) belonging to company KG to receive advice on appropriate health checkup contents based on the results of an analysis of medical expenses by health insurance group KD, as well as advice on how to receive treatment and access affiliated medical institutions TK. This service also allows employees H (insured persons, etc.) to have effective educational and enlightenment opportunities via the service provider ST.

[0016] Furthermore, this service is an approach taken by service provider ST that enables multiple affiliated medical institutions TK to receive various management support, such as guidance on how to provide online medical consultations that increase convenience for employee H, while complying with guidelines set by the government (this will make it easier for employee H working for company KG to visit the hospital, create a system that allows him to continue treatment, and prevent the various illnesses of employee H who visit the hospital from worsening).

[0017] In addition, this service is an approach by service provider ST that enables employee H of company KG to obtain correct information about various diseases through various educational content (for example, information provided on the Internet, email newsletters, video content, etc.).

[0018] Furthermore, this service is an approach taken by service provider ST that enables employee H of company KG to receive medical treatment and monitoring from a doctor via online consultations, utilizing free time at work, etc. (This allows the prescription period for medication to be extended (such as the legally permitted 90 days), and as a result, employees can receive the medication they need for treatment without having to visit the hospital frequently).

[0019] This service also provides various management support to multiple affiliated medical institutions TK, and builds a medical institution network that sympathizes with providing medical care that does not incur unnecessary medical fees. For example, a medical treatment pass for employee H of company KG is set up for the built medical institution network.

[0020] In addition, this service improves employee H's access to medical institutions that provide treatment at appropriate medical costs, with the premise of maintaining and improving treatment outcomes (medical institutions that optimize prescription medications, frequency of visits, disease management, etc., while utilizing online medical consultations, etc.).

[0021] Furthermore, this service allows the service provider ST to receive a portion of the medical expenses that have been appropriately reduced through the series of activities described above from the health insurance organization KD (health insurance association, health insurance union, etc.) as an incentive (e.g., performance-based compensation, etc.) (other examples are not limited to this and will be described later with reference to Figure 11).

[0022] In this service, the process of reducing medical expenses as described above follows the following flow (not shown). In other words, by utilizing data from the health insurance organization KD, we will first understand at an individual level whether or not it is possible to reduce (lower) medical expenses. Next, at the individual level, in order of the person's potential for improvement, intervention is carried out through direct guidance, emails, letters, video distribution, etc., to guide employee H (insured person, etc.) to medical institutions (multiple affiliated medical institutions TK) that provide highly efficient medical care. Next, the medical expenses of the induced employee H are tracked, and a portion of the savings (reduction amount) is claimed from, for example, a health insurance group KD as an incentive (for example, not limited to, performance-based compensation or fixed costs) to the service provider ST (this is not limited to a health insurance group KD, but could also be a company KG, a local government, etc.).

[0023] Next, with reference to FIG. 2, a description will be given of the configuration of an information processing system that realizes the provision of the above-described service, that is, an information processing system to which a server according to an embodiment of the information processing device of the present invention is applied. FIG. 2 is a diagram showing an example of the configuration of an information processing system to which a server according to an embodiment of the information processing device of the present invention is applied.

[0024] The information processing system shown in FIG. 2 is configured to include a server 1, an affiliated medical institution terminal 2, a health insurance organization terminal 3, a company terminal 4, and insured person terminals 5-1 to 5-n (n is an integer value of 1 or more). The server 1, affiliated medical institution terminal 2, health insurance organization terminal 3, company terminal 4, and insured person terminals 5-1 to 5-n are interconnected via a network N such as the Internet.

[0025] The server 1 is an information processing device managed by the service provider ST of this service (Fig. 1). The server 1 executes various processes to realize this service while appropriately communicating with the affiliated medical institution terminal 2, the health insurance organization terminal 3, the company terminal 4, and the insured person terminals 5-1 to 5-n. The affiliated medical institution terminal 2 is an information processing device managed by the affiliated medical institution TK, and is configured with a smartphone, tablet, personal computer, or the like. The health insurance organization terminal 3 is an information processing device managed by a health insurance organization KD (health insurance association, health insurance union, etc.), and is configured by a smartphone, tablet, personal computer, or the like.

[0026] The company terminal 4 is an information processing device managed by the company KG to which the employee H (insured person, etc.) belongs, and is configured by a smartphone, tablet, personal computer, etc. Each of the insured person terminals 5-1 to 5-n is an information processing device managed by each of the multiple employees H (insured persons, etc.), and is configured with a smartphone, tablet, personal computer, etc. When referring to the insured person terminals 5-1 to 5-n collectively, the part after the hyphen may be omitted.

[0027] FIG. 3 is a block diagram showing an example of a hardware configuration of a server in the information processing system of FIG.

[0028] The server 1 includes a CPU (Central Processing Unit) 11, a ROM (Read Only Memory) 12, a RAM (Random Access Memory) 13, a bus 14, an input / output interface 15, an input unit 16, an output unit 17, a memory unit 18, a communication unit 19, and a drive 20.

[0029] The CPU 11 executes various processes according to a program recorded in the ROM 12 or a program loaded from the storage unit 18 into the RAM 13 . The RAM 13 also stores data and the like necessary for the CPU 11 to execute various processes.

[0030] The CPU 11, ROM 12, and RAM 13 are connected to one another via a bus 14. An input / output interface 15 is also connected to this bus 14. An input unit 16, an output unit 17, a storage unit 18, a communication unit 19, and a drive 20 are connected to the input / output interface 15.

[0031] The input unit 16 is configured with, for example, a keyboard and is used to input various information. The output unit 17 is configured with a display such as a liquid crystal display, a speaker, etc., and outputs various information as images and sounds. The storage unit 18 is configured with a DRAM (Dynamic Random Access Memory) or the like, and stores various data. The communication unit 19 communicates with other devices (for example, the affiliated medical institution terminal 2, the health insurance organization terminal 3, the company terminal 4, and the insured person terminals 5-1 to 5-n in FIG. 2) via a network N including the Internet.

[0032] Removable media 30, such as a magnetic disk, optical disk, magneto-optical disk, or semiconductor memory, is appropriately attached to the drive 20. A program read from the removable media 30 by the drive 20 is installed in the storage unit 18 as needed. Furthermore, the removable medium 30 can also store various data stored in the storage unit 18 in the same manner as the storage unit 18.

[0033] Although not shown, the affiliated medical institution terminal 2, health insurance organization terminal 3, company terminal 4, and insured person terminals 5-1 to 5-n in Fig. 2 can also have basically the same hardware configuration as that shown in Fig. 3. Therefore, a description of the hardware configuration of the affiliated medical institution terminal 2, health insurance organization terminal 3, company terminal 4, and insured person terminals 5-1 to 5-n will be omitted.

[0034] The various hardware and software components constituting the information processing system of FIG. 2, including the server 1 of FIG. 3, work together to execute various processes for providing the present service of FIG.

[0035] FIG. 4 is a functional block diagram showing an example of the functional configuration of the server of FIG. 3 that constitutes the information processing system of FIG.

[0036] As shown in FIG. 4, in the CPU 11 of the server 1, an education / enlightenment provision control unit 51, a service effectiveness degree calculation unit 52, an incentive determination unit 53, and an incentive acquisition unit 54 function. In addition, an area of ​​the storage unit 18 of the server 1 stores an education and awareness provision information DB 71, a service effectiveness degree calculation information DB 72, and an incentive determination and acquisition information DB 73.

[0037] The education and awareness provision control unit 51 executes control relating to a service of providing at least one of education and awareness regarding at least one of medical care and health to each of one or more employees H (insured persons, etc.). Specifically, the education and awareness provision control unit 51 controls services to provide correct information about various diseases to each of multiple employees H (insured persons, etc.) belonging to company KG through various awareness content (e.g., information provided on the Internet, email newsletters, video content, etc.). The information to be provided to each of the plurality of employees H (insured persons, etc.) is stored in the education and awareness provision information DB 71.

[0038] The education and awareness provision control unit 51 allows the service provider ST to approach each of multiple employees H (insured persons, etc.) who understand the dangers of the disease but are not currently aware of any particular symptoms and are therefore not very proactive about treatment, as well as each of multiple employees H (insured persons, etc.) who are too busy with their daily work to find time to visit a medical institution. For example, the education and awareness provision control unit 51 can provide guidance and educational information regarding lifestyle-related diseases, thereby increasing, for example, the medical literacy of each of the multiple employees H (insured persons, etc.).

[0039] In addition to the above, the education and awareness provision control unit 51 provides various management support to the multiple affiliated medical institutions TK. Information on the various management support is stored in the education and awareness provision information DB 71. By providing various management support, we will build a network of medical institutions that share the view that medical treatment should be performed without unnecessary medical fees. We will also establish a medical treatment pass for employee H, who belongs to company KG.

[0040] The service effectiveness calculation unit 52 uses a predetermined period before the provision of this service as a reference period and a predetermined period after the provision of this service as a judgment period, and calculates the effectiveness of providing this service based on the difference (e.g., the amount of reduction) between the medical costs in the reference period and the medical costs in the judgment period for one or more employees H (insured persons, etc.). The difference itself may be used as the degree of effectiveness. The medical costs mentioned above include medical expenses as well as medical fee points. In the case of medical fee points, the cost per point is assumed to be predetermined. The medical costs mentioned above are costs for diseases specified by the service provider ST or the company KG. The calculated effectiveness degree is stored in the service effectiveness degree calculation information DB 72 in association with information that can identify the employee H (insured person, etc.).

[0041] The service effectiveness calculation unit 52 allows the service provider ST to approach each of multiple employees H (insured persons, etc.) and calculate the service effectiveness obtained at the health insurance group KD (health insurance association, health insurance union, etc.). Such a service effectiveness calculation unit 52 makes it possible to determine whether medical treatment that leads to a reduction in medical expenses and a decrease in the number of people who require specific health guidance, etc., is being implemented, assuming that treatment outcomes are maintained and improved, and also makes it possible to determine whether optimal checkup and medical examination paths are being provided, based on the results of medical expense analysis.

[0042] The incentive determination unit 53 determines an incentive (e.g., performance-based compensation) to be granted to the service provider ST of this service (Figure 1) from the health insurance organization KD (health insurance association, health insurance union, etc.) or company KG, which bears at least a portion of the above-mentioned medical costs, based on the degree of effectiveness of providing this service calculated by the service effectiveness calculation unit 52. The incentives are linked to information that can identify the health insurance group KD (health insurance association, health insurance union, etc.) or the company KG, and are stored in the incentive determination / acquisition information DB 73. The incentive determination / acquisition information DB 73 also stores coefficients, etc., which will be described later.

[0043] Here, performance-based compensation is used as an example of an incentive (a specific example of performance-based compensation will be described later), but the incentive may also be, for example, fixed costs determined based on a predetermined payment system between the service provider ST and, for example, a company KG.

[0044] The incentive acquisition unit 54 manages the acquisition of the incentives determined by the incentive determination unit 53. Information about the acquired incentives is stored in the incentive determination and acquisition information DB 73 .

[0045] Next, calculation of performance compensation, which is an example of an incentive, will be described with reference to FIGS. FIG. 5 is a diagram showing an example of a target medical receipt.

[0046] Receipt A, receipt B, and receipt C shown in FIG. 5 are, for example, receipts for person A in different months (not limited to this, but may also be, for example, receipt A for person A, receipt B for person B, and receipt C for person C). A receipt refers to a detailed statement of medical fees that, for example, an affiliated medical institution TK bills a health insurance organization KD (health insurance association, health insurance union, etc.) for insured medical treatment received by an employee H (insured person, etc.).

[0047] Receipt A in Figure 5 shows that it includes the target disease decided between service provider ST and company KG (marked with a circle), and does not include any other disease than the target disease (marked with an x). Because receipt A includes the target disease, it is subject to aggregation (marked with a circle). Receipt B indicates that it includes the target disease (marked with a circle) and also includes diseases other than the target disease (marked with a circle). Receipt B includes diseases other than the target disease, but since it includes the target disease, it is included in the calculation (marked with a circle). Receipt C does not include the target disease (marked with an x), and conversely, it includes a disease other than the target disease (marked with a circle). Receipt C does not include the target disease, so it is excluded from the calculation (marked with an x). For example, this will be determined with the company KG to which this service is provided, but target diseases include "diabetes," "hyperlipidemia," and "high blood pressure." Non-target diseases include "malignant neoplasms." In this case, hospitalization fees are not included in the calculation.

[0048] FIG. 6 is a diagram showing an example of calculation of the difference in medical expenses. Here we show an example of how the system calculates the difference in medical expenses (monthly average) before and after the system is introduced on an individual basis to determine the billing amount.

[0049] FIG. 6 includes a column indicating "month," a column indicating "Mr. A," a column indicating "determination period," and a column indicating "claim month." In the "Month" column, the month in which the system providing this service was introduced is set to "M1," and each month from that month is displayed to the right, from "M1" to "M24." Conversely, going back in time, each month is displayed, from "-M1" to "-M12."

[0050] In the column for "Mr. A," "Y" indicates the month of the first visit to the target clinic (affiliated medical institution TK) for the target disease, which will be called the "index month." Note that the "index month" will be different for each individual. In the case of "Mr. A," the "Index month" is "M3." The baseline period (hereinafter referred to as the BL period) in FIG. 6 corresponds to the past 12 months ("M2 to -M10") that do not include "M3" which is the "Index month." In the column for "Mr. A," "R" indicates whether or not there was a medical visit that was eligible for tallying. During the BL period, there were six medical visits that were eligible for tallying. In the column showing "Mr. A," "M" indicates the prescription period for the drug. During the BL period, there is one month that corresponds to the prescription period for the drug. The prescription period indicated by "M" will be described later with reference to Figure 8. The "BL treatment period" in Figure 6 corresponds to the period from the earliest month of diagnosis of the target disease to the latest month of diagnosis of the target disease during the BL period plus the prescription period indicated by "M."

[0051] In the case of "Mr. A," the one year period from "M3," which is the "Index month," i.e., "M3 to M14," is the "first year of the calculation period." Note that in the "first year of the calculation period," there is no dropout determination, which will be described later, so the incentive equivalent to that shown in Figure 1 is claimed, for example, every three months (claiming every three months is just one example). The "billing months" for the "first year of the calculation period" will be "M3," "M6," "M9," and "M12."

[0052] In the "billing month" of "M3," as shown by T1-1, "M3 to M5" are determined to be the treatment period, and the monthly average difference between the "BL treatment period" or "BL period" and the treatment periods "M3 to M5" is calculated. That is, the service effectiveness calculation unit 52 calculates the effectiveness of the provision of this service. For the "billing month" of "M6," "M3 to M8" is determined to be the treatment period as shown in T1-2, and the monthly average difference is calculated between the "BL treatment period" or "BL period" and the treatment period of "M3 to M8." For the "billing month" of "M9," as shown in T1-3, "M3 to M11" is determined to be the treatment period, and the monthly average difference is calculated between the "BL treatment period" or "BL period" and the treatment period of "M3 to M11." For the "billing month" of "M12," "M3 to M14" is determined to be the treatment period, and the monthly average difference is calculated between the "BL treatment period" or "BL period" and the treatment period of "M3 to M14."

[0053] Although not particularly limited, the coefficient used to determine the incentive is 1 / 2 in the "first year of the calculation period," and the incentive is determined by multiplying the difference by this coefficient 1 / 2. In the "second year of the calculation period," 1 / 3 is used, and the incentive is determined by multiplying the difference by this coefficient 1 / 3. Furthermore, in the "third year of the calculation period," 1 / 5 is used, and the incentive is determined by multiplying the difference by this coefficient 1 / 5.

[0054] FIG. 7 is a diagram illustrating an example of calculation targets and non-targets. In Example 1 in Figure 7, since the patient started receiving treatment at affiliated medical institution TK after the introduction of this service, Example 1 is subject to calculation of the degree of effectiveness, etc., as described above. Additionally, since Example 3 also began receiving treatment at affiliated medical institution TK after the introduction of this service, Example 3 is subject to the calculation of the above-mentioned degree of effectiveness, etc. Note that, since Example 3 had no history of treatment before the introduction of this service, the average medical expenses for the baseline period (BL period) are compared with the medical expenses for the assessment period. On the other hand, in Example 2, there were no visits to affiliated medical institution TK after the introduction of this service, so Example 2 is not included in the calculation.

[0055] FIG. 8 is a diagram showing an example of how to interpret the prescription period. Here, the number of prescription days is calculated as the most frequent "number of prescriptions" on the receipts for the most recent month of diagnosis of the target disease during the target period, extracted from the baseline period (BL period) and the assessment period, and the number of months that this number of days spans is calculated as the prescription period during the target period. In other words, the treatment period is considered to extend up to the month in which prescription dates overlap.

[0056] FIG. 9 is a diagram showing an example of determining the treatment period. In FIG. 9, the 7 months from "-M10 to -M4" in the baseline period (BL period) is determined as the BL treatment period. 9, "M1 to M3" are determined as the treatment period T1-1. "M1 to M6" are determined as the treatment period T1-2. "M1 to M9" are determined as the treatment period T1-3. "M1 to M12" are determined as the treatment period T1-4.

[0057] FIG. 10 is a diagram illustrating an example of the separation determination. As shown in Figure 10, if there is no diagnosis of the target disease at the affiliated medical institution TK at least once during the six months including the most recent month in the claim period when the target disease was diagnosed at the affiliated medical institution TK, it is determined that the patient has discontinued treatment. If it is determined that treatment has been discontinued, the patient will be excluded from the calculation from the month of claim in which the decision to discontinue treatment was made. If it is determined that treatment has been discontinued, if there is a month in which the target disease was diagnosed at the next affiliated medical institution TK after the billing month in which treatment was discontinued, the month in which that target disease was diagnosed will become the new "index month."

[0058] As explained above with reference to FIGS. 5 to 10, it is possible to perform calculations relating to performance compensation, which is an example of an incentive.

[0059] FIG. 11 is a diagram showing an outline of this service that can be realized by another embodiment of the information processing device of the present invention. 11, this service is designed so that incentives are given to the service provider ST by, for example, a company KG or a local government (not shown), etc. In other words, the incentives given to the service provider ST are not limited to those shown in FIG. 1, but may be, for example, those shown in FIG. 11.

[0060] Although one embodiment of the present invention has been described above, the present invention is not limited to the above-described embodiment, and modifications, improvements, etc. within the scope of achieving the object of the present invention are considered to be included in the present invention.

[0061] Furthermore, the system configuration shown in FIG. 2 and the hardware configuration of the server 1 shown in FIG. 3 are merely examples for achieving the object of the present invention, and are not particularly limited.

[0062] Furthermore, the functional block diagram shown in Fig. 4 is merely an example and is not particularly limited. That is, it is sufficient if the information processing system in Fig. 2 is provided with functions that can execute the various processes described above as a whole, and the functional blocks and databases used to realize these functions are not particularly limited to the example in Fig. 4.

[0063] Furthermore, the locations of the functional blocks and databases are not limited to those shown in FIG. 4 and may be arbitrary. For example, at least some of the functional blocks and databases located on the server 1 side may be provided on the affiliated medical institution terminal 2, health insurance organization terminal 3, company terminal 4, and insured person terminals 5-1 to 5-n side, or on other information processing devices not shown.

[0064] The above-described series of processes can be executed by hardware or software. Furthermore, one functional block may be configured as a single piece of hardware, a single piece of software, or a combination thereof.

[0065] When a series of processes is executed by software, the programs that make up the software are installed into a computer or the like from a network or a recording medium. The computer may be a computer built on dedicated hardware. The computer may also be a computer capable of executing various functions by installing various programs, such as a server, a general-purpose smartphone, or a personal computer.

[0066] The recording medium containing such a program may be composed not only of a removable medium (not shown) that is distributed separately from the device main body in order to provide the program to the user, but also of a recording medium that is provided to the user in a state that is pre-installed in the device main body.

[0067] In this specification, the steps describing the program to be recorded on the recording medium include not only processes that are performed in chronological order, but also processes that are not necessarily performed in chronological order but are performed in parallel or individually.

[0068] In other words, the information processing device to which the present invention is applied is sufficient as long as it has the following configuration, and can take on a variety of different embodiments. That is, an information processing device to which the present invention is applied (for example, the server 1 in FIG. 2) an education and awareness provision control means (e.g., education and awareness provision control unit 51 in FIG. 4) that executes control regarding a service (e.g., "education and awareness" in FIG. 1) that provides at least one of education and awareness regarding at least one of medical care and health to each of one or more subjects (e.g., employee H (insured person, etc.) in FIG. 1); a service effectiveness calculation unit (e.g., service effectiveness calculation unit 52 in FIG. 4 ) that calculates the degree of effectiveness (the difference itself may be the degree of effectiveness) of providing the service based on the difference between the medical costs (e.g., a concept including medical expenses as well as medical fee points) for the reference period for each of the one or more subjects and the medical costs for the judgment period, with a predetermined period before the provision of the service being a reference period (e.g., a baseline period, a BL treatment period, etc. in FIG. 9 ) and a predetermined period after the provision of the service being a judgment period (e.g., a judgment period, etc. in FIG. 9 ); Incentive determination means (e.g., incentive determination unit 53 in FIG. 4) for determining an incentive (e.g., "incentive" in FIG. 1, such as performance-based compensation or fixed costs) to be given to the provider of the service by a health insurance organization (e.g., health insurance organization KD (health insurance association, health insurance union, etc.) in FIG. 1) that bears at least a part of the medical costs based on the degree of effectiveness; Equipped with. According to the present invention, it is possible to realize medical treatment that leads to a reduction in medical expenses and a decrease in the number of people who require specific health guidance, while maintaining and improving treatment outcomes, and it is also possible to provide optimal examination and medical consultation paths based on the results of medical expense analysis.

[0069] In addition, an information processing device to which the present invention is applied (for example, the server 1 in FIG. 2) At least some of the one or more subjects belong to a predetermined organization (for example, the company KG in FIG. 1 or a local government not shown), The incentive determination means further determines an incentive to be given by the predetermined organization to the provider of the service. According to the present invention, incentives to be given can be determined not only by the health insurance organization but also by a predetermined organization to which the subject belongs.

[0070] In addition, an information processing device to which the present invention is applied (for example, the server 1 in FIG. 2) The difference is the difference in the medical costs for the disease designated by the predetermined organization. According to the present invention, the degree of effectiveness of providing a service can be calculated based on the difference in medical costs for diseases designated by a predetermined organization.

[0071] In addition, an information processing device to which the present invention is applied (for example, the server 1 in FIG. 2) The provider of the service is affiliated with a designated medical institution; The medical costs are costs incurred at the specified medical institution when each of the one or more subjects uses the specified medical institution. According to the present invention, it is possible to more accurately calculate the degree of effectiveness of providing a service. [Explanation of symbols]

[0072] 1...Server, 2...Affiliated medical institution terminal, 3...Health insurance organization terminal, 4...Company terminal, 5...Insured person terminal, 11...CPU, 18...Memory unit, 19...Communication unit, 51...Education and awareness provision control unit, 52...Service effectiveness degree calculation unit, 53...Incentive determination unit, 54...Incentive acquisition unit, 71...Education and awareness provision information DB, 72...Service effectiveness degree calculation information DB, 73...Incentive determination and acquisition information, ST...Service provider, KG...Company, H...Employee

Claims

1. an education and awareness provision control means for controlling a service that provides at least one of education and awareness regarding at least one of medical care and health to each of one or more subjects; a service effectiveness calculation means for calculating the effectiveness of the provision of the service based on the difference between the medical costs for the reference period and the medical costs for the evaluation period for each of the one or more subjects, the predetermined period before the provision of the service being a reference period and the predetermined period after the provision of the service being an evaluation period; an incentive determination means for determining an incentive to be given to the provider of the service by a health insurance organization that bears at least a portion of the medical costs based on the degree of effectiveness; An information processing device comprising:

2. At least a portion of the one or more subjects belong to a predetermined organization; The incentive determination means further determines an incentive to be granted by the predetermined organization to the provider of the service. The information processing device according to claim 1 .

3. The difference is a difference in the medical costs of a disease designated by the specified organization. The information processing device according to claim 2 .

4. The provider of the service is affiliated with a designated medical institution; The medical costs are costs incurred at the specified medical institution when each of the one or more subjects uses the specified medical institution. The information processing device according to claim 1 .

5. An information processing method executed by an information processing device, an education and awareness provision control step for executing control regarding a service that provides at least one of education and awareness regarding at least one of medical care and health to each of one or more subjects; a service effectiveness calculation step of calculating the effectiveness of the provision of the service based on a difference between the medical costs for the reference period and the medical costs for the evaluation period for each of the one or more subjects, where the predetermined period before the provision of the service is set as a reference period and the predetermined period after the provision of the service is set as an evaluation period; an incentive determination step of determining an incentive to be given to the provider of the service from a health insurance organization that bears at least a part of the medical costs based on the degree of effectiveness; An information processing method including:

6. On the computer, an education and awareness provision control step for executing control regarding a service that provides at least one of education and awareness regarding at least one of medical care and health to each of one or more subjects; a service effectiveness calculation step of calculating the effectiveness of the provision of the service based on a difference between the medical costs for the reference period and the medical costs for the evaluation period for each of the one or more subjects, where the predetermined period before the provision of the service is set as a reference period and the predetermined period after the provision of the service is set as an evaluation period; an incentive determination step of determining an incentive to be given to the provider of the service from a health insurance organization that bears at least a part of the medical costs based on the degree of effectiveness; A program that executes control processing including:

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