JP3301976B2 - Summary table issuing device, summary table issuing method, and medium storing a summary program - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical office processing apparatus for calculating a medical score and a patient's contribution by inputting a medical practice.

[0002]

2. Description of the Related Art In a medical institution such as a hospital, specific data such as the name and address of a patient under medical treatment and medical insurance to be used are registered. A business processing device to be registered is used. Such a device calculates the insurance points in response to the input of the medical treatment contents, calculates the patient contribution and the insurance claim amount, and stores them together with the medical treatment data. Then, at the beginning of the next month, a medical remuneration statement (hereinafter referred to as a “recept”) in which medical data for one month is compiled is issued for each patient. The medical institution submits it to the insurance institution and claims it. In addition, tabulation by drug or tabulation such as volume for each category is output on a daily or monthly basis using the medical treatment data stored in the apparatus and used. The operation of outputting such an aggregation table is called an aggregation operation.

When the contents of medical treatment given to a patient are input to the apparatus, the medical treatment is naturally performed based on the medical treatment described in the medical chart. Then, individual medical actions such as medical examination, medication, treatment, etc. are input using medical codes unique to each device. The device calculates the insurance points for each medical practice.

[0004] By the way, at the time of medical treatment for infants and the elderly with chronic diseases, a series of consultations, medications, examinations, injections, treatments, etc. are all tied up, and the medical fees such as pediatric outpatient medical fees and general medical fees for elderly people with chronic diseases are provided. It is also performed collectively.

[0005] For example, a pediatric outpatient medical fee is a medical institution advocating pediatrics and reported to the prefectural governor, and is calculated for each day of medical treatment for outpatients under 3 years of age. It is supposed to. In this case, except for the predetermined addition, the costs related to the medical treatment as described above are all included in the predetermined number of the pediatric outpatient medical fees.

[0006] For example, the outpatients with chronic diseases for the elderly are instructed and treated by an insurance medical institution that has notified the prefectural governor that they have met the facility standards. If they do, they will be calculated up to twice a month for each patient. In this case, the guidance and the cost of the examination, medication, and injection for the main illness of the patient in the month in which the guidance and medical treatment are performed are included in the predetermined score.

[0007] In addition, the long-term long-term hospital care management fee for inpatients is hospitalized in a bed for accommodating specific long-term inpatients at an insurance medical institution that has been notified to the prefectural governor that the facility standards have been met. For long-term inpatients of the elderly, it is calculated per day of hospitalization.
It is alleged to include nursing, examination, medication, injection, and prescribed treatment.

[0008] Therefore, in such medical institutions, instead of inputting individual medical treatments performed on patients one by one, for example, a pediatric outpatient medical fee and a long-term hospitalization medical management fee for the elderly, which include them, are calculated. Can be done.

[0009]

However, there is a case in which the calculation is made by inputting a series of such medical treatments,
The calculated insurance points do not always match those calculated by inputting each actual medical practice actually performed. Therefore, we would like to compare the insurance points when calculating a comprehensive medical code such as pediatric outpatient medical fees and the insurance points when calculating individual medical codes without including them, and confirm the difference between the actual and actual insurance codes. There is a request. In such a case, conventionally, a comprehensive medical treatment code is input to the patient and calculated, while an imaginary patient different from the patient is temporarily registered, and the individual medical treatment performed actually is performed. Was calculated for a fictitious patient. Then, the insurance points of the fictitious patients were separately tabulated and compared with the actual figures.

As described above, conventionally, it is necessary to register an imaginary patient who does not exist, which is very troublesome. Also, in order to count the actual volume, only the fictitious patients must be selected and counted, which is troublesome.

[0011]

SUMMARY OF THE INVENTION According to the present invention, data on medical treatment performed on a patient is input and stored, and based on the stored medical data, the volume of medical treatment, medication, injection, etc. is classified. In a tabulation table issuing device that compiles a plurality of pieces of medical data, comprehensive medical data that can be calculated in place of the plurality of medical data, and individually calculated comprehensive medical data that are included in the comprehensive medical data are stored. In such a case, information for identifying each medical treatment data and information indicating comprehensive medical treatment data including the medical treatment data are stored in each medical treatment data, and the totalization of the comprehensive medical treatment data and the comprehensive The above-mentioned problem is solved by issuing the tally of the comprehensive medical treatment data.

[0012]

FIG. 1 is a block diagram showing the configuration of a tabulation table issuing apparatus according to an embodiment. This device is installed in a medical institution,
This is to input and save data relating to the medical treatment received by the patient, calculate the insurance claim amount from the medical treatment data, and issue a claim. In addition, based on these medical treatment databases, daily or monthly turnovers can be tabulated for each type of consultation fee, medication fee, injection fee, treatment fee, examination fee, etc., and a tabulation table can be issued. . In the figure, reference numeral 20 denotes a processing apparatus main body, which includes a file device 10 such as a hard disk device, a display device 25 such as a CRT, input means 26 such as a keyboard and a mouse device, and a printer 27.

The file device 10 includes a patient database 11 that stores patient-specific data such as a patient's name and address, medical insurance used by the patient, and the like, and a medical care database 12 that stores medical treatments received by the patient for each patient. And an issuance condition file 13 for storing issuance conditions of the tabulation sheet. Then, inside the processing device main body 20, a calculation processing unit 21 that receives a medical code input from the keyboard 26 and calculates an insurance score, and data from the patient database 11 and the medical database 12 stored in the file device 10 are stored. A tabulation business processing unit 22 that reads out and creates a total table such as a daily total table or a monthly total table, and a condition setting processing unit 2 that sets the issue conditions of the total table under the control of the total business table 22
3 and a form issuance processing unit 24 for issuing a summary table from the printer 27 while referring to the set issuance conditions.

Next, the operation of the present apparatus will be described. First, the input of medical treatment data will be described with reference to FIGS.
FIG. 3 shows a medical data input screen 30 displayed by the calculation processing unit 21. The patient information column 31 at the top of the screen displays the date of the day “September 11, 1998” and the patient's readout from the patient database 11. The name "Ichiro Suzuki" and the date of birth "October 14, 1997" are displayed, and it is also displayed that this patient is an "infant" younger than three years on the day of the medical treatment. The lower part of the screen is an input field 33. In response to the respective medical care codes being input from the keyboard 26, the calculation processing section 21 enters the name and insurance points corresponding to the codes into the medical care action field 32 at the center of the screen. Is displayed on the screen.

In the medical practice column 32, medical data of 12 lines are currently displayed. The data from the oral prescription on the first line to the examination judgment fee on the eleventh line is obtained by inputting the actual medical treatment performed on the patient based on the medical record. And since the medical institution is a registered medical institution, the “pediatric outpatient consultation fee” that covers these medical practices
On the twelfth line. At the right end of the medical practice column, the insurance score of each medical practice is displayed. The internal prescription on the first line prescribed 7 days of medicine, so "5 (points) x 7"
(Day) ". The rest is the insurance score for one medical practice on the day. However, in this case, since a pediatric outpatient medical fee that includes a series of medical treatments has been entered, only 640 points of the pediatric outpatient medical fee are calculated for the receipt of this patient. The medical treatment data of the 1st to 11th lines are stored in the medical treatment database 12 by the calculation processing unit 21, but are not calculated.

FIG. 4 shows a record configuration of the medical care database 12 storing the medical care contents of the patient shown in FIG. Each record includes a patient code 41 for distinguishing a patient, a medical treatment date 42, a prescription number 43 assigned to each medical treatment, and a prescription to which the medical treatment is applied when the medical treatment is included. A comprehensive target prescription number 44 indicating whether the item is included, a representative category 45, and an insurance score of 4
6 and other information 47. From this, the medical practice with the prescription number 43 from “1001” to “1007” has the comprehensive target prescription number 44 of “1001”.
Since it is 8 ", it is understood that the medical treatment of the prescription number" 1008 ", that is, the pediatric outpatient medical fee is included and is not calculated on the receipt. Conversely, medical data in which the prescription number 43 matches the comprehensive target prescription number 44 is always calculated on the receipt. In the illustrated example, the prescription number “10” is used.
A pediatric outpatient fee of “08” corresponds to this. Here, a medical practice included in other medical data is referred to as comprehensive data, and a medical practice including them is referred to as comprehensive data. In addition, the medical data that can be individually calculated without having a comprehensive / included relationship has the comprehensive target prescription number 44 set to zero. This includes medical data of general patients who are neither elderly nor infants.

Next, the task of issuing a tabulation report will be described. When a tabulation job is designated from the keyboard 25, the tabulation job processing unit 22 starts. Next, when the issuance condition setting of the aggregation table is designated, the aggregation business processing unit 22 causes the condition setting processing unit 2
3 is started, a condition setting screen 50 shown in FIG. 5 is displayed on the screen of the display device 25. In the figure, reference numeral 51 denotes a form type designation field for designating a daily total table or a monthly total table. Here, a daily total ledger, which is one of the daily total tables, is designated. Since the issuance period below it contains zero and is not specified, the daily ledger is issued on the day. The insurance unit is specified as the summation unit 52, and under the selection conditions below, the outpatient / hospitalization distinction is specified as outpatient, and the department and doctor are not specified. Then, in the comprehensive count 53,
Specify whether to compile the comprehensive data described in the receipt or to compile the included data included in them. Therefore, in the example of FIG. 5, for the outpatient on September 11, it is specified that the comprehensive medical data is to be tabulated by insurance. These conditions are stored in the issuance condition file 13.

Next, the tabulation business processing unit 22 activates the form issuance processing unit 24, so that the form issuance processing unit 24 reads out the totaling conditions from the issuance condition file 13 and issues a totaling table meeting the conditions. I do. That is, the medical data is read from the medical database 12, and the insurance points are totaled for each category according to the designation of the condition of inclusion or inclusion. The procedure will be described according to the flow of FIG.

First, the medical data is read one record at a time from the medical database 12 (step S1), and it is determined whether or not the "inclusive prescription number" of the record is zero (step S3). If the value is zero, the medical data is individually computable and has no comprehensive / included relationship, so the process proceeds to step S7 without exception and the points are totaled. If it is not zero, it is next determined whether the designation of the comprehensive count 53 in FIG. 5 is “inclusive”, that is, whether the total data calculated in the receipt is total or the comprehensive “included” data is totaled. (S4). If it is "inclusive", the process proceeds to step S5, and the "prescription number" of the read record is compared with the "inclusive prescription number". Since the match is equivalent to the "inclusive", the insurance points are totaled separately for the representative section 45 stored in the record (S7). Specifically, it is tabulated by consultation fee, medication fee, injection fee, treatment fee, surgery fee, examination fee, imaging fee, and other categories. The consultation fee includes the guidance fee. Thereafter, the process returns to step S1 to read the next record, and performs the same processing. If it is determined in step S2 that the processing has been performed up to the last record, the process branches to step S8, and the printer 27 prints and issues a summary table.

Here, in the example of the record shown in FIG.
Only the record with the prescription number 44 of “1008” is to be counted as “inclusive”. This medical care data is classified into guidance fees as can be seen from FIG. FIG. 6A shows an example of the printed totaling table. In this case, since neither the initial consultation fee nor the re-examination fee has been calculated, only c and the number of patients are 1. (E) 640 points of outpatient pediatric outpatient fees are included in the insurance coverage, all of which are included in the category of medical consultation fees. As mentioned above, the guidance fee is included in the consultation fee,
The 640 points of the pediatric outpatient medical fees classified as guidance on the screen of FIG. 3 are totaled as a medical consultation fee as a result of the totaling.

On the other hand, if the tallying of the "inclusive" data has been designated, step S4 in FIG.
It will branch to 6. Then, the “prescription number” and “comprehensive target prescription number” of the read record are compared, and if they do not match, the insurance points are totaled for each representative category stored in the record (S7). FIG. 6B shows an example of a tally table obtained as a result of tallying all records. In this case, records whose prescription numbers 44 shown in FIG. 4 are “1001” to “1007” are totaled. The points in the insurance are a total of 1146 points of each record. The breakdown is 75 points for the prescription fee and 1071 points for the test fee. Since neither initial consultation fee, re-examination fee nor guidance fee has been calculated,
Unlike the figure (a), the consultation fee is zero.

As described above, in the present embodiment, it is possible to specify whether “total” or “total” data should be totaled as a condition for preparing the totaling table. Can easily be obtained. By outputting each tabulation, the medical institution outputs volume by category when calculating a medical code that encompasses a series of medical treatments, and volume when calculating individual medical codes without including it. Can be compared.

[0023]

According to the present invention, it is possible to easily obtain a total when the medical treatment contents are included and a total when the medical treatment contents are not included. At this time, there is no need to register a dummy patient, and there is no need to select only the dummy patient and collect the total, so that it is possible to save much trouble compared to the related art.

[Brief description of the drawings]

FIG. 1 is a block diagram illustrating a configuration of an embodiment.

FIG. 2 is a diagram showing a processing procedure in the embodiment.

FIG. 3 is a display example of a medical care data input screen in the embodiment.

FIG. 4 is a diagram showing an example of a record configuration of a medical care database in the embodiment.

FIG. 5 is a display example of a condition setting screen in the embodiment.

FIG. 6 is a diagram illustrating an output example of a tally table in the embodiment.

[Explanation of symbols]

10 File device 11 Patient database 1
2 Medical treatment database 13 Issuance condition file 20 Processing device body 2
DESCRIPTION OF REFERENCE NUMBERS 1 Calculation processing part 22 Total business processing part 23 Condition setting processing part 2
4 Form Issuance Processing Unit 25 Display Device 26 Input Means 27 Printer

Claims (5)

(57) [Claims] 1. A method for inputting and storing data representing a medical treatment performed on a patient, and performing data processing based on the stored medical treatment.
This is a tally table issuing device that tallies up the amount of medical treatments that can be individually calculated
Comprehensive data representing medical treatments that can be calculated in addition to the comprehensive data representing medical treatments included in the comprehensive data
And neither the comprehensive data nor the comprehensive data
Medical treatment database that stores medical treatment data representing medical treatment
And the medical treatment database includes information for each of the data.
Information that identifies individual medical practices (hereinafter referred to as prescription numbers and
Call) and the prescription of comprehensive data covering the medical practice
Stores the information indicating the number (hereinafter referred to as the comprehensive prescription number)
Stored in the medical care database in accordance with a user's instruction.
Based on the prescription number and comprehensive prescription number
And the volume of the comprehensive data or the comprehensive
Aggregate the volume of the included data,
At that time, medical treatment data that is neither comprehensive data nor comprehensive data
Is a collection that is aggregated together at the time of any of the above volume aggregations.
And a total business processing unit . 2. The medical treatment database according to claim 1 , wherein
Data is the same as the prescription number in the comprehensive data.
And store it in the comprehensive data or the comprehensive data.
The comprehensive prescription number of the medical care data to a predetermined value and store it
Are those, wherein aggregation business processing unit, storage of the medical database
The prescription number of the stored data matches the comprehensive prescription number
Or the number of medical treatments for which the comprehensive prescription number is the specified value
The total volume of the comprehensive data.
The tabulation table issuing device according to claim 1. 3. The medical data processing unit according to claim 1 , wherein
The generic prescription number of the data stored in the base is
Value or, if not a given value, its prescription number
And the medical treatment actions that do not match the comprehensive prescription number
A contract that aggregates the volume of inclusive data
A tally table issuing device according to claim 2. 4. Recording of data representing a medical treatment performed on a patient.
Medical database to remember and medical practice
Collection with a totalization processing unit that totals the volume based on
The spreadsheet issuing device collects multiple medical treatments that can be calculated individually and substitutes them for
Comprehensive data representing medical practices that can be calculated
Comprehensive data representing the medical practice included in the data
And a medical practice that is neither comprehensive data nor comprehensive data
Is stored in the medical care database, and
At that time, the prescription number and its identification to identify each medical practice
Comprehensive data showing the prescription number of the comprehensive data
And a prescription number for each of the data.
The same value as the prescription number of the data is stored and stored in the medical data that is not the comprehensive data or the comprehensive data.
The comprehensive prescription number is stored as a predetermined value, and is stored in accordance with the volume totaling instruction for the comprehensive data.
Comprehensive prescription number of the data that has been
Aggregate medical treatments that match or have a predetermined value
And, on the other hand,
The comprehensive prescription number of the stored data is a predetermined
If it is a value or is not the prescribed value,
Volume for medical treatments that do not match the generic prescription number
Aggregate table issuance method characterized by counting. 5. Data of medical treatment performed on a patient is input.
Program that aggregates the volume based on the medical practice
A set of medical treatments that can be individually calculated
Comprehensive data representing medical practices that can be calculated
Comprehensive data representing the medical practice included in the data
And a medical practice that is neither comprehensive data nor comprehensive data
The medical data and the medical data representing the are stored in the database,
Prescription number for identifying each medical practice and its practice
Comprehensive prescription number indicating prescription number of comprehensive data
Is stored for each of the data, and for the comprehensive data, the
The same value as the prescription number of the data is stored and stored as medical data that is neither the comprehensive data nor the comprehensive data.
The comprehensive prescription number is stored as a predetermined value and stored according to the volume totaling instruction for the comprehensive data.
Comprehensive prescription number of the data that has been
Aggregate medical treatments that match or have a predetermined value
And, on the other hand,
The comprehensive prescription number of the stored data is a predetermined
If it is a value or is not the prescribed value,
Volume for medical treatments that do not match the generic prescription number
Media that stores the program to be counted.