JP4070762B2 - Management support system and computer program in hospitalized medical facilities - Google Patents

Description

  The present invention relates to a management support system and a computer used in medical related facilities (referred to as “inpatient medical related facilities” in the present application) such as hospitals, clinics, and clinics equipped with hospitalized facilities such as patient beds or hospital beds and hospital rooms. The present invention relates to the technical field of computer programs that allow a computer to function as such a system.

  Traditionally, in Japan, the “payment of payment system” under medical insurance systems such as social insurance and national health insurance has been adopted for medical fees or medical fees at medical facilities. Recently, in light of the review of the medical compensation system, the introduction of a “comprehensive payment system” for each disease type in the Western style is also being considered in Japan. Here, the “volume payment system” is based on, for example, a point system or a point system called a medical remuneration score or a receipt, and basically, individual medical actions (for example, diagnosis, This is a remuneration system that charges a fee for medical examination, examination, surgery, medication, meals, bed provision, hospital room provision, etc. For example, even when hospitalized for the same disease classification, if the number of days of hospitalization is long or the number of medical treatments performed is large, the medical fee is increased. For each medical practice, points corresponding to the difficulty, labor, labor or labor cost, and further costs such as drug cost, material cost, base material cost, equipment cost, facility cost are set in advance. In the end, a medical fee corresponding to the combined points will be paid.

  On the other hand, the “comprehensive payment system” refers to, for example, “stomach cancer”, when patients with a specific disease classification are hospitalized and treated, regardless of the length of hospitalization, or the size or amount of various medical activities performed. Regardless, it is a remuneration system with a constant medical fee. More specifically, medical remuneration is fixed in advance for each disease type such as DRG (Diagnosis Related Group), and basically the same amount of medical remuneration is charged as long as the type is the same. Will be. According to the comprehensive payment system, especially in hospitalized medical facilities, there is an increased chance of efficient medical treatment and treatment in order to achieve early discharge. Therefore, the comprehensive payment system is expected to play a central role in restoring the entire healthcare economy. In fact, in the United States, a comprehensive payment system for one hospitalization has become widespread, and it has been quite successful in reducing medical fees when hospitalized for the same disease.

  From this background, as a first step in the introduction of the “Comprehensive Payment System” in Japan, there is a new medical compensation system that combines “Comprehensive Payment” and “Price Payment” at limited hospitals. It is conducted on a trial basis. In this specification, for convenience, the medical compensation system in which “comprehensive payment” and “volume payment” are combined in some form is called a “combination medical compensation system”. This is called “combination medical fee”. Specifically, in Japan, the introduction of Japan's own combination medical compensation system called DPC (Diagnosis Procedure Combination), which is based on dividing medical compensation into approximately 1700 groups according to disease types, is being considered. Has been. However, the bill for comprehensive payment in this combination medical fee is not a fixed payment for one hospitalization for each disease type as in the United States, but a fixed payment for one hospitalization day for each disease type, that is, a fixed daily payment. It is said that. Furthermore, the fixed daily payment is relatively high in the predetermined period from the date of hospitalization determined for each disease classification, and the fixed daily payment is relatively low in the predetermined period after the passage. Is a mechanism that does not allow comprehensive payments (that is, flat-rate daily payments) but allows only volume payments. In addition, even in the period in which comprehensive payment (that is, fixed daily payment) is permitted, in addition to this, it is a mechanism that allows partial payment of the volume determined for each disease type.

  Even if such a combination medical compensation system is introduced, there is no fundamental difference in medical practice for patients with specific diseases. However, in actual hospital-related medical facilities, the purpose of “comprehensive payment” is to determine which treatment should be applied to patients who can be treated both at home and at home while incorporating their will. If there is an emphasis on this, there will be a strong sense that there is a demand for active home treatment, and home treatment will be selected exclusively.

  However, if only home treatment is selected in this way under the combination medical remuneration system, depending on the individual illness, it may not be possible to obtain the “payment of payment” as a medical remuneration, or a predetermined period from the aforementioned hospitalization date. When the “in-hospital economy” (that is, profit based on medical fees excluding expenses in individual hospitals) deteriorates by incurring a situation in which low or high fixed daily payments cannot be obtained as medical fees There is also a possibility. However, for patients who can be treated both at home and at home, advising only inpatient treatment may cause inconvenience that patients waiting for admission cannot be hospitalized indefinitely. As a result of the continuation of this, “volume payments” will not always have a positive effect on the hospital economy.

  Conventionally, in Japan that adopts the volume payment system, as a computer system used in medical related facilities and organizations that perform medical calculations, such as "volume payment" for each patient as described above or the point calculation that is the basis for it, A system for automatic calculation by inputting various medical actions performed using codes or the like has already been completed (see, for example, Patent Documents 1 to 5). On the other hand, in Europe and the U.S., etc. that adopt a comprehensive payment system, as a computer system used in medical facilities, etc., search for the above-mentioned DRG, etc., and output the corresponding medical fee on the screen or on paper The system is already ready.

  Furthermore, various types of computer systems have been proposed for medical-related general matters such as medical accounting, medical management management, medical plan creation support, reservation management, order entry, hospital bed management, introduction mail, etc. in hospitals (Patent Document 6). ~ 8).

JP 2004-030356 A JP 2004-005097 A JP 2003-203114 A JP 2002-092153 A Japanese Patent Laid-Open No. 2002-092152 JP 2001-325354 A JP 2001-052073 A Japanese Patent Laid-Open No. 10-187810

  However, in the case of a combination medical compensation system, which treatment, especially for patients who can be both hospitalized and at home, has a negative or positive impact on the in-hospital economy? There is a technical problem that there is no computer system that presents.

  This leads to a situation where the in-hospital economy fluctuates at an unspecified period, and hospitalized medical facilities that are forced to operate harshly under the social demand of reducing medical expenses have a period of so-called “red loss”. It happens frequently. Therefore, even in hospitals and the like that can be established in a long term, they can go bankrupt. The situation where hospitalized medical facilities go bankrupt due to the introduction of such a combination medical compensation system will be fatal to local residents and must be avoided.

  In addition, for patients who can receive both inpatient and home care, whether using computer systems or not, they can adjust hospital admission / exit from the perspective of hospital economy or management, It is not possible to adjust the entrance / exit by reading ahead about the number of patients waiting for hospitalization, the number of vacant beds, the number of vacant rooms, etc. under the volume payment system. However, if the payment is made in volume, no matter who is hospitalized, there is basically no change in hospitalization costs. For example, if doctors, etc. in hospital-related medical facilities decide to enter or leave the hospital from the viewpoint of hospital economy or management, it is inevitable that wasted time and energy will be used for consideration and judgment. There is a danger that the act may be neglected. On the other hand, especially for patients whose admission and discharge matters, there is always an absolute requirement that human life is the top priority. There is also a technical problem that is difficult.

  The present invention has been made in view of the above-mentioned problems, and can provide information to assist in the determination of hospital admission while performing appropriate treatment in an inpatient medical facility that employs a combination medical reward system. It is an object of the present invention to provide a management support system used in hospitalized medical facilities and a computer program that allows a computer to function as such a system.

In order to solve the above-mentioned problem, the management support system in the hospitalized medical facility according to the present invention has a medical remuneration system in which a comprehensive payment for each disease classification set in advance is combined with a payment in advance for each medical action set in advance. A management support system for presenting discharge target data indicating a discharge date, which is a target calendar date, to a single inpatient in an inpatient medical facility to be employed, and (i) each of a plurality of disease classifications A charge amount corresponding to the comprehensive payment amount indicated by the first charge amount data for the virtual inpatient and (ii) a charge amount corresponding to the volume payment indicated by the second charge amount data for the virtual inpatient The cumulative profit / loss with respect to the date axis based on the hospitalization date of the virtual inpatient is calculated based on the above. Storage means for storing period data indicating a period that takes a maximum value on the plus side in association with a plurality of disease classifications that respectively define the amount of charges corresponding to the comprehensive payment, From the input means capable of inputting hospitalization date data indicating the hospitalization date for the one inpatient and disease classification data indicating the disease classification related to the one inpatient, and the period data stored in the storage means, the input Obtaining the one corresponding to the disease classification related to the one inpatient indicated by the disease classification data input via the means, and inputting the period indicated by the acquired period data via the input means. Based on the hospitalization date indicated by the hospitalization date data, the target discharge date for the one hospitalized patient is calculated, and the discharge target data indicating the calculated discharge date is obtained. Generating display data for displaying medical-related data related to one or a plurality of patients including the one inpatient in a predetermined format, and generating the discharge target data generated in the display Display data generating means for generating data included in a part of the data and display means for displaying the generated display data.

  According to the management support system in an inpatient medical facility according to the present invention, in an inpatient medical facility having an inpatient facility such as a hospital, a medical fee system that is a combination of comprehensive payment and volume payment, that is, combination medical care such as the aforementioned DPC. Adopt a compensation system. The management support system is for presenting discharge target data to one inpatient in such an inpatient medical facility.

  Here, the “disease classification” according to the present invention means a broadly defined disease classification such as DRG, DPC, etc., and is not limited to a classification based on a detailed disease name, but also a classification that can be a lump sum for making a comprehensive payment. is doing. “Comprehensive payment” according to the present invention is a fixed amount payment for the entire “one hospitalization” for each disease classification and a daily payment for the “one hospitalization date” for each disease classification. Including the case where is a fixed amount. That is, the “inclusive payment” referred to here includes both payment by a single hospitalization fixed amount system for each disease classification and daily payment fixed amount system for each disease classification during the hospitalization period. This includes cases where the length of hospitalization changes in stages depending on the length from the date of hospitalization. For example, within a relatively short hospitalization period based on a standard or recommended hospitalization date, a relatively flat daily payment is made, and after that, a relatively low fixed daily payment is made. This includes cases where As described above, the “comprehensive payment” according to the present invention means general payment of medical fees having a property that the payment amount is determined according to the disease classification.

  The “medical practice” according to the present invention includes not only an act directly applied to a disease or illness such as diagnosis, medical examination, examination, surgery, medication, meal, bed provision, hospital room provision, etc. This means any action that is the subject of a payment in a hospital-related facility. “Travel payment” according to the present invention means that a fixed amount set for each medical practice is paid for each medical practice actually performed. At this time, the volume payment is typically paid after elapse of a period subject to the above-described comprehensive payment. Alternatively, such “volume payment” may be partially paid in addition to the comprehensive payment even within the period covered by the above-mentioned comprehensive payment. For example, within a specific hospitalization period in which comprehensive payment is permitted, 70% of the total medical fee may be billed for comprehensive payment and the remaining 30% may be billed for volume payment.

  The “medical remuneration system” according to the present invention is a medical remuneration system that is a combination of both the comprehensive payment and the volume payment. For example, a medical compensation system that combines DPC-based comprehensive payments with traditional volume payments, which is currently being conducted experimentally in Japan, is one example. Combining both inclusive payment and volume payment in some way makes it very difficult for doctors to determine how to set a discharge date from the hospital economic point of view. It ’s not like anything.

The “one inpatient” is a real or virtual one inpatient who is hospitalized or will be hospitalized or a candidate in an inpatient medical facility. The “discharge target data” according to the present invention is a target relative to the hospitalization date or current date of an actual or virtual one inpatient, or on an absolute time axis such as a calendar. Indicates the discharge date . For example, on the basis of the hospitalization date of one hospitalized patient, the last day of hospitalization that is not covered by the payment period for the volume payment and is covered only by the comprehensive payment request or it from subsequent day, Ru is the discharge date is a target.

  During the operation, display data for displaying medical-related data related to one or a plurality of patients including one inpatient in a predetermined format is generated by a display data generating unit including, for example, a system controller, a CPU, and a memory. The Here, “medical data” refers to data specific to each patient (for example, patient data or medical data linked to a patient such as examination data, medical examination data, vital sign data, etc.), each doctor or each nurse. Specific data (for example, worksheet data or work data related to a plurality of patients), patient data or medical data related to a plurality of or all patients in the entire hospital-related medical facility, worksheet data, work data, bed management system, etc. There may be. Furthermore, it may be various medical accounting data, business analysis data, financial data, medical management management data, reservation management data, order entry data, introduction mail data, etc. in the hospitalized medical facility. In short, general data related to medical care in the hospitalized medical related facility is “medical related data” according to the present invention. In addition, as the display data in the “predetermined format”, for example, various types of medical data for each patient such as a care map or a navigation care map (both registered trademarks of Kameda Medical Information Laboratory Co., Ltd.) described below are classified by date and medical care. It may be display data for display in a medical plan and record table format arranged by item. Or existing worksheets, bed management sheets, appointment management sheets, medical accounting tables, medical management management, electronic medical records, order entry for one or more patients or all patients admitted to the hospital-related medical facility It may be display data for display in a format for use.

Particularly in the present invention, for example, a disease related to one inpatient indicated by disease classification data input via the input means from the period data stored in the storage means by an arithmetic unit comprising, for example, a system controller, CPU, memory, etc. Get the one corresponding to the classification. Further, the target discharge date for one hospitalized patient is calculated by using the period indicated by the acquired period data as a reference for the hospitalization date indicated by the hospitalization date data input via the input means. Then, discharge target data indicating the calculated discharge date is generated.

More specifically, for example, if a disease classification that prescribes comprehensive payment such as DPC is determined, a target discharge date can be uniquely determined in advance with respect to the hospitalization date. That is, it is possible to set a target period in advance for each disease classification or for the one hospitalized patient belonging to each disease classification. Here, the “period” refers to a period other than one day, such as a plurality of days, weeks, months, and hours. For example, for each disease classification, when standard or hypothetical hospitalization treatment is performed, the cumulative profit / loss on the date axis (or time axis) based on the hospitalization date is calculated, and both hospitalization treatment and home treatment are Within the possible hospitalization period, if the day or period when the cumulative profit / loss takes the maximum value on the positive side (ie the day or period when the surplus becomes the largest) is calculated, this can be set as the target period It becomes. In this case, in the case of a fixed amount payment for each hospitalization, it is easy to calculate the cumulative profit / loss for the date axis, and the daily fixed amount payment for each hospitalization day and this change step by step. Even in this case, since the daily payment amount on each day is known, it is possible to calculate the cumulative profit / loss for the date axis.

  Finally, the display data including discharge target data generated in this way is, for example, an LCD (liquid crystal display) device, a PDP (plasma display panel) device mounted on a personal computer device, a mobile device, a large screen display, etc. The image is displayed by display means such as a CRT (cathode ray tube) device or an organic EL (electroluminescence) display device.

Therefore, in the inpatient medical facility, whether any treatment for patients capable of both inpatient treatment and home treatment has an adverse or positive effect on the in-hospital economy, The display means enables visual presentation in the form of display of discharge target data as a part of the display data. In other words, if the actual discharge date is set so that it matches the target discharge date indicated by the discharge target data, without worrying about how much the payment for the comprehensive payment or how much the payment for the volume payment is, It may be considered that it will have a positive impact on the in-hospital economy while providing appropriate in-patient or home care for one in-patient. On the other hand, if the actual discharge date deviates from the target discharge date, the appropriate inpatient treatment or home treatment as planned by the medical fee system is not given to one inpatient. It is likely that it will not have a positive impact on the hospital economy.

  Therefore, doctors who decide which treatment to be able to perform both in-patient treatment and home treatment at the hospital-related medical facility refer to the discharge target data included in the display data as described above. In addition, by setting the actual discharge date so as to follow this, the hospital economy can be stabilized. That is, compared with a case where a doctor or the like determines which treatment is to be performed without any index data, the hospital economy can be remarkably stabilized. Therefore, even in hospitalized medical facilities that are under strict management due to social demands to reduce medical expenses, it is easy to run so-called “surplus” management, and it is established in the long term. If it is possible hospitals, there is almost no risk of going bankrupt at any point, leading to the well-being of local residents.

  In addition, as will be described in detail later, while adopting a medical compensation system that is a combination of comprehensive payment and volume payment, that is, a combination medical compensation system such as the aforementioned DPC, both hospitalization treatment and home treatment are adopted. As a result of adjusting the target time of entry / exit from the viewpoint of the hospital's economy or management, the number of patients waiting for hospitalization, the number of empty beds, the number of empty rooms, etc. It is also possible to present discharge target data reflecting the result of adjusting the time of admission and discharge as part of the display data.

  Therefore, doctors and the like in hospitalized medical facilities hardly need to use wasted time and energy for consideration and judgment in order to decide whether to enter or leave the hospital from the viewpoint of hospital economy or management. On the other hand, doctors, etc., will be able to view the discharge target data provided by setting discharge target data so that the absolute condition of top priority on human life is satisfied, especially for patients whose admission or discharge is a problem. It is possible to decide whether to enter or leave the hospital without concern, and to concentrate on the original work of a doctor or the like. Therefore, it is possible to improve the quality of basic medical care, and ultimately, it becomes possible to promote the health of the local people and the entire population under the management of sound hospitalization related facilities.

In one aspect of the management support system in an inpatient medical facility according to the present invention, the display data generating means includes (i) a billing amount corresponding to the comprehensive payment indicated by the first billing amount data, and (ii) the second billing. Calculate the target discharge date for the hospitalization date based on the billing amount corresponding to the volume payment indicated by the amount data and (iii) the hospitalization date indicated by the hospitalization date data , and the calculated The discharge target data indicating the target discharge date is generated.

According to this aspect, the display data generating means firstly (i) a charge amount corresponding to the comprehensive payment amount indicated by the first charge amount data and (ii) a charge amount corresponding to the volume payment amount indicated by the second charge amount data. (iii) A target discharge date is calculated based on the hospitalization date indicated by the hospitalization date data. Furthermore, discharge target data for presenting the discharge date as the target calculated in this way is generated and used as a part of the display data. Therefore, if the first billing amount data, the second billing amount data, and the hospitalization date data are given, the discharge data is automatically generated by the display data generating means and further displayed automatically by the display means. So it is very convenient.

In this aspect, the information processing apparatus further includes an input unit capable of inputting the first billing amount data, the second billing amount data, and the hospitalization date data, and the display data generating unit is input via the input unit. The target discharge date may be calculated based on the first bill amount data, the second bill amount data, and the hospitalization date data. If comprised in this way, if 1st bill amount data, 2nd bill amount data, and hospitalization date data are input via input means, such as a keyboard, a mouse | mouth, a key switch, a voice input device, a receiver, a reader, etc. Since the display data generating means automatically generates discharge target data, it is very convenient.

In order to solve the above problems, the management support system in another hospital-related medical facility according to the present invention combines a comprehensive payment for each disease classification set in advance and a payment for a volume for each medical action set in advance. In a hospital-related medical facility that adopts the system, a management support system for presenting discharge target data indicating a target discharge date or duration to one inpatient, the one inpatient, A charge amount data storage file for storing first charge amount data indicating the charge amount corresponding to the comprehensive payment amount and second charge amount data indicating the charge amount corresponding to the volume payment amount; and (i) a charge amount corresponding to the comprehensive payment amount. And (ii) the target discharge date or period for the hospitalization date of each virtual hospitalized patient of each of a plurality of disease classifications set in advance based on the billing amount corresponding to the volume payment Discharge date or period data indicating the interval, storage means for associating with a plurality of disease classifications each defining the amount of billing corresponding to the comprehensive payment, and storage date data indicating hospitalization date for the one inpatient And input means capable of inputting disease classification data indicating a disease classification related to the one inpatient, and discharge date or period data stored in the storage means based on disease classification data input via the input means The one corresponding to the disease classification related to the one hospitalized patient shown is acquired, and the hospital discharge date or period indicated by the acquired hospital discharge date or period data is determined by the hospitalization date data input via the input means. The discharge date indicating the calculated discharge date or period is calculated by calculating the target discharge date or period for the one inpatient by using the indicated hospitalization date as a reference. An arithmetic unit for generating data,
  Generating display data for displaying medical-related data relating to one or a plurality of patients including the one inpatient in a predetermined format, and including the generated discharge target data in a part of the display data Display data generating means for generating the display data, and display means for displaying the generated display data.

According to the management support system in another hospital-related medical facility of the present invention, the storage means such as a memory is preliminarily based on (i) a charge amount corresponding to a comprehensive payment and (ii) a charge amount corresponding to a volume payment. Discharge date or period data indicating a target discharge date or period for a virtual inpatient hospitalization date of each of a plurality of disease classifications set in advance is stored in association with the plurality of disease classifications. Yes. Such discharge date or period data can be calculated based on the first billing amount data and the second billing amount data in advance. That is, even if there is no actual hospitalization date data, it is stored in advance for each disease classification as discharge date or period data for a virtual hospitalization date of one inpatient. Therefore, when hospitalization date data indicating the hospitalization date for one hospitalized patient and disease classification data indicating the disease classification are input via the input means, the hospital discharge date stored in the storage means or The data corresponding to the disease classification related to one hospitalized patient is acquired from the period data. Furthermore, the discharge date or period indicated by the acquired discharge date or period data is based on the hospitalization date indicated by the hospitalization date data input via the input means, so that one hospitalized patient A target discharge date or period is calculated, and discharge target data is generated. Thereafter, the display data generating means generates display data in which the discharge target data is a part, and the display means automatically displays the display data. Therefore, it is very convenient.
In the management support system in this hospital-related medical facility, for example, the storage means includes, as the discharge date or period data, a charge amount corresponding to the comprehensive payment amount and a charge amount corresponding to the volume payment amount for each of the plurality of disease classifications. The discharge date or period data indicating the discharge date or period with the maximum cumulative profit / loss for the date axis calculated from the above is stored in association with the plurality of disease classifications. The discharge date or period in which the accumulated profit / loss for the date axis is maximized is calculated in advance by a computer, a calculator, manual calculation, mental calculation, or the like.

In one aspect of the management support system in this hospitalized medical facility, the storage means, as the discharge date or period data, claims corresponding to the comprehensive payment amount and the volume payment amount for each of the plurality of disease classifications The discharge date or period data, which is calculated from the amount and indicates the discharge date or period with the maximum cumulative profit / loss with respect to the date axis, is stored in association with the plurality of disease classifications .

According to this aspect, in the calculation unit, the discharge target data is automatically generated by using the discharge date or period data indicating the discharge date or period in which the accumulated profit and loss becomes the maximum, and further, the display means automatically Because it will be displayed, it is very convenient.

In another aspect of the management support system in the hospitalized medical facility according to the present invention, the calculation unit changes the calculated discharge date or period according to the operation status in the hospitalized medical facility, and the display data The generation unit generates the display data so as to move the target discharge date or period with respect to the time axis in accordance with the discharge date or period to which the change has been made .

According to this aspect, the arithmetic unit changes the target discharge date or period in accordance with the operation status in the hospitalized medical facility. The target discharge date or period is moved on the time axis by the generation of display data by the corresponding display data generation means. Here, the “operational status” according to the present invention is typically the current or future number of vacant beds or vacant rooms in the hospital-related medical facility, but the available working hours and overtime hours of doctors, nurses, etc. The operating status may be indirectly or directly indicated by other indicators such as a small amount of space, the availability of a specific facility, and the like. Such “operation status” may be the current operation status, or may be the future or near future operation status. In other words, the target discharge date or period shift may be based on the current operation status, for example, in the near future such as one day, several days later, one week later, several weeks later, one month later, several months later, etc. Alternatively, it may be based on future operating conditions. Furthermore, a change with time of the operating status or a change curve of the operating rate is also included in the operating status referred to here. Thus, the “operation status” is sufficient if it indicates the operation status in the hospitalized medical facility in some sense. For example, a doctor, a hospital director, a medical department manager, etc., in any of a plurality of preset levels, such as the availability is very high, high, low, very low, or standard in the near future For example, it is possible to adopt a configuration in which the operating status is input via the input means in the form of operating status data.

  For example, in an operating situation where the number of vacant beds is large or large, the target discharge date or period is moved toward the future on the time axis. On the other hand, for example, in an operating situation where the number of vacant beds is small or small, or the number of patients waiting for hospitalization is large, the target discharge date or period is moved from the far future to the current direction on the time axis. The

  In this way, for patients who are capable of both in-patient treatment and home treatment, discharge target data corresponding to the operation status is presented as part of the display data from the viewpoint of hospital economy or management. It becomes possible.

In an aspect in which the target discharge date or period is moved according to the operating status, the calculation unit determines the amount of change in the target discharge date or period according to the operating status in the hospitalized medical facility. Regardless of the disease classification related to one hospitalized patient, the amount is determined according to the operation status, and the display data generation means becomes the target corresponding to the discharge date or period when the change is made. The amount of movement of the discharge date or period on the time axis may be a fixed amount that is determined according to the operation status, regardless of the disease classification related to the one inpatient.

  With this configuration, for example, regardless of whether the disease classification is “surgery for gastric cancer” or “brain overflow”, the target discharge date or period such as one day or two days is one. A certain amount determined according to the operation status regardless of the disease classification related to the inpatient is moved away from the future or from the future toward the current direction. Therefore, the moving operation can be performed relatively easily.

Alternatively, in an aspect in which the target discharge date or period is moved according to the operation status, the calculation unit changes the target discharge date or period change amount according to the operation status in the hospitalized medical facility. According to the disease classification related to the one inpatient, the display data generation means corresponds to the discharge date or period to which the change is made, and the time axis of the target discharge date or period. The amount of movement above may be variable according to the disease classification related to the one inpatient.

  With this configuration, the target discharge date or period, for example, two days for “surgery for gastric cancer” and five days for “cerebral spillage” can be made variable according to the disease classification of one hospitalized patient. In addition, it is moved toward the future in the future or from the future toward the present direction. In other words, the in-patients belonging to various disease classifications are moved by different or the same amount of movement. For example, the target discharge date or period is divided into a group that delays relatively large and a group that delays relatively small. Or, it is not limited to two groups, but is divided into three or more groups. Therefore, it is suitable for delaying the discharge date greatly or small, or suitable for greatly increasing or decreasing the discharge date, and relatively suitable for advancing or delaying the discharge date relatively. Inpatients with disease classification can be delayed or advanced in this way, which is very advantageous in practice.

In the aspect in which the target discharge date or period is moved according to the operation status, the calculation unit includes a plurality of inpatients in the hospitalization-related facility according to the operation status in the hospitalization-related facility. Regardless of the type of hospitalized patient, the target discharge date or period is changed, and the display data generating means is configured to correspond to the changed hospital discharge date or period for the plurality of hospitalized patients, You may produce | generate the said display data so that the target discharge date or period may be moved irrespective of the some inpatient.

  If configured in this way, the target discharge date or period will be uniform in the future, without discrimination between hospitalized patients, such as postponing one day or two days for all hospitalized patients, or It moves from the future toward the present direction. Therefore, the moving operation can be performed relatively easily.

In the aspect in which the target discharge date or period is moved in accordance with the operation status, the calculation unit is configured to perform a certain period of time based on the present among a plurality of inpatients including the one inpatient in the inpatient medical facility. It has means for extracting a specific inpatient who is scheduled to continue hospitalization, and for the extracted specific inpatient, the target discharge date or period is changed , and among the plurality of inpatients For the patients other than the extracted specific inpatients, the target discharge date or period may not be changed .

  If comprised in this way, about hospitalization patients other than the specific hospitalization patient whose discharge was approaching soon, it can avoid causing confusion by not moving the target discharge date or period. At the same time, for specific inpatients whose discharge is not approaching, the target discharge date or period is moved according to the operating status. As a result, it is possible to present discharge target data that changes depending on the operation status as part of the display data from the viewpoint of the in-hospital economy or the management viewpoint while taking care not to cause confusion for the inpatients.

  It is also possible to move the target discharge date or period (for example, extend the discharge date) for hospitalized patients other than specific hospitalized patients whose discharge is approaching soon. It is also possible to improve internal management.

In the aspect in which the target discharge date or period is moved in accordance with the operation status, the calculation unit is capable of specifying home treatment among a plurality of inpatients including the one inpatient in the inpatient medical facility. With respect to the extracted specific inpatients, the means for extracting the inpatients, and the non-extracted specific inpatients other than the extracted specific inpatients do not change the target discharge date or period at least in advance. The target discharge date or period may be changed .

  With this configuration, home treatment is not possible, that is, for an inpatient who needs hospitalization, no change in the plan regarding the date of hospitalization is required. On the other hand, for specific inpatients who can be treated at home, by changing the target discharge date or period, the hospital's economic perspective is taken into consideration so as not to have any adverse effect on the treatment of all inpatients. Or the discharge target data which changes according to an operation condition can be shown as a part of display data from a management viewpoint.

Furthermore, in the aspect in which the target discharge date or period is moved according to the operation status, the calculation unit includes the total number of patient beds in the hospitalized medical facility and the number of empty beds, the total number of hospital rooms and the number of empty hospital rooms, In addition, based on at least one numerical value of the number of patients waiting for hospitalization, an operating rate index indicating the operating status is calculated, and the target discharge date or period is changed according to the calculated operating rate index. Also good.

  If comprised in this way, the operating rate parameter | index which shows the actual operating condition in the said hospitalization medical related facility is calculated by the display data generation means. For example, an operation rate index such as a vacant bed rate, a vacant room rate, and a hospitalization rate is calculated from the number of vacant beds and vacant rooms in the current or near future, or the current total number of patients waiting for hospitalization. At this time, it is preferable to move the target discharge date or period so that the operation status approaches a certain level, that is, the operation rate index approaches a preset or desirable value. For example, move the target discharge date or period so that the occupancy rate of the patient bed or room is 95 to 97% (in other words, the vacant bed rate or vacant room rate does not exceed 3-5%) It is preferable to do so. In this case, for example, the target discharge date or period for all inpatients may be uniformly delayed by 5% regardless of the disease classification. Alternatively, it may be delayed by a different percentage by hospitalized patient or disease classification.

  As specific operations, for example, if the vacancy in the patient bed or hospital room is likely to increase in the near future, the target discharge date or period is moved (delayed), or, for example, scheduled to be hospitalized If the number of patient candidates increases, the target discharge date or period will be moved (accelerated), and all patients including those waiting for hospitalization will be moved so that there will be no inconvenience for treatment. .

  In another aspect of the management support system for hospitalized medical related facilities of the present invention, the display data generating means generates the display data for displaying the medical related data in time series as the predetermined format, and the discharge target. Data is generated so as to be displayed at a location corresponding to the target discharge date or period on the time axis related to the time series.

  According to this aspect, the medical data is displayed in time series by the display data generating means and the display means, for example, in the manner such as the care map described above, and the discharge target data is related to such time series. It is displayed on the time axis at a location corresponding to the target discharge date or period. Therefore, the doctor or the like can see the discharge target data displayed by, for example, a predetermined type of bar, mark, icon, text, or the like at a corresponding position on the time series. Therefore, it is possible to visually quickly and accurately recognize where the target discharge date or period is in time. In the aspect in which the target discharge date or period is made variable in accordance with the operation status described above, the discharge target data is appropriately moved in the direction along the time axis and displayed, which is easier to understand.

In the aspect in which the medical related data is displayed in time series, the display data generating means is based on the first and second billing amount data input through the input means. (Ii) The display data may be generated so that a period in which the claim by comprehensive payment is not allowed is displayed so as to be distinguishable from each other.

If comprised in this way, the 1st and 2nd billing amount data into which the period when the claim by comprehensive payment is recognized by the display data generation means and the display means, and the period when this is not recognized are input via the input means. Are displayed in a distinguishable manner. For example, these periods can be distinguished by applying different colors, hatching, shading, and the like. Alternatively, a predetermined type of mark, bar, or the like indicating the boundary between these periods is displayed at a location corresponding to the boundary. That is, by displaying in this way, it is easy to understand what billing is permitted within each period or the current day. At this time, the target discharge date and the end date of the period during which the payment by comprehensive payment is permitted may or may not match.

  In the aspect in which the medical related data is displayed in time series, the display data generation unit displays the current date data indicating the current date at least at a location corresponding to the current date on the time axis. As described above, the current date data may be generated as a part of the display data. According to this configuration, the current day (that is, today) and each day around the current day (that is, today) due to the presence of current day data such as a predetermined type of bar or mark displayed as a part of the display data ( For example, it can be easily understood what billing is possible within a period when tomorrow, the day after tomorrow, etc.).

In an aspect in which the medical related data is displayed in time series, the calculation unit may calculate the time axis when the charge by comprehensive payment is a charge for a fixed amount for daily payment that changes stepwise according to the number of days from the hospitalization date. The display data generation means may generate the display data so that the specified before and after are displayed so as to be distinguishable from each other at least before and after the daily payment fixed amount changes.

  If comprised in this way, the display data production | generation means and a display means will display so that a period with a relatively high daily payment fixed amount in comprehensive payment can be distinguished from a low period. For example, these periods can be distinguished by applying different colors, hatching, shading, and the like. Alternatively, a predetermined type of mark, bar, or the like indicating the boundary between these periods is displayed at a location corresponding to the boundary. That is, by displaying in this way, it is possible to easily understand what comprehensive payment is permitted for each day or the current day.

In the aspect of displaying the medical-related data in time series, the calculation unit is configured to: (i) a charge corresponding to the comprehensive payment or (ii) a sum of a charge corresponding to the comprehensive payment and a charge corresponding to the volume payment A density of the forehead with respect to the time axis is calculated to further calculate billing amount density data indicating the calculated density , and the display data generation unit converts the generated billing amount density data into the display data It may be generated as a part.

  If comprised in this way, the doctor etc. can recognize the density of the charge amount in the period from the hospitalization date to the scheduled discharge date about one hospitalized patient on a display means. Thereby, the present evaluation about this one inpatient can be performed from a viewpoint of management in a hospital, for example, and it can be used for subsequent treatment. For example, when the density of the charge amount is too low, the comprehensive payment amount may be set too low. Therefore, it is considered that it will greatly contribute to the improvement of the current medical compensation system based on, for example, experimental DPC.

  The period of density in this way is from various days such as from the date of admission to the current date, from the date of admission to the target discharge date or period, from the date of admission to the last day of the period during which the claim for comprehensive payment is allowed. It's okay. In addition, when the charge by comprehensive payment is a request for a fixed amount for daily payment that changes stepwise according to the number of days from the date of hospitalization, it may be a period from the date of hospitalization to the date when the fixed amount for daily payment changes. Furthermore, the day on which the period for obtaining the density is started is not limited to the hospitalization day, but may be the current day (that is, today).

In another aspect of the management support system in an inpatient medical facility according to the present invention, the calculation unit calculates a break-even point of the profit and loss for the billing amount corresponding to the comprehensive payment , and a branch point indicating the calculated break point The data is generated, and the display data generation means generates the generated branch point data as a part of the other display data.

  According to this aspect, “the break-even point of the profit and loss for the invoiced amount corresponding to the comprehensive payment” is a point (date) on the time axis at which the profit is maximized when focusing only on the comprehensive payment. Such a DPC branch point exists when the fixed daily payment per hospitalization day changes step by step as in the comprehensive payment in the combination medical compensation system. If the comprehensive payment per hospitalization or the fixed daily payment per hospitalization day does not change, such a DPC branch point has little meaning. For example, for the fixed amount of daily payment that changes in stages for each disease classification, the cumulative profit or loss on the time axis based on the hospitalization date is calculated, and the date or period when the cumulative profit or loss takes the maximum value on the plus side, The break-even point of profit and loss can be calculated. When displaying medical-related data in time series as a predetermined format, if such branch point data is displayed with a bar or mark at a location corresponding to the branch point on the time axis, the branch This is very convenient because the points can be easily understood visually.

In another aspect of the management support system in the hospitalized medical facility according to the present invention, the calculation unit calculates a break-even point of the profit and loss for the sum of the charge amount corresponding to the comprehensive payment amount and the charge amount corresponding to the volume payment amount , Branch point data indicating the calculated branch point is generated, and the display data generation unit generates the generated branch point data as part of the display data.

  According to this aspect, the “breaking point for the sum of the invoiced amount for the comprehensive payment and the invoiced amount for the volume payment” is the time when the profit is maximized when focusing on the comprehensive payment and the volume payment. Means a point (date) on an axis. For example, the cumulative amount of profit / loss on the time axis based on the date of hospitalization is calculated by adding the volume paid to the daily fixed amount for each disease classification that changes in stages, and the cumulative profit / loss is the maximum value on the positive side. The break-even point can be calculated as the date or period of taking When displaying medical-related data in time series as a predetermined format, if such branch point data is displayed with a bar or mark at a location corresponding to the branch point on the time axis, the branch This is very convenient because the points can be easily understood visually.

  In order to solve the above-mentioned problems, the computer program of the present invention causes a computer to function as a management support system (including various aspects thereof) in the above-described hospitalized medical facility of the present invention.

  According to the computer program of the present invention, the computer program is read from a recording medium such as a ROM, a CD-ROM, a DVD-ROM, a hard disk or the like for storing the computer program, and executed. Alternatively, the computer program Can be executed after being downloaded to a computer via a communication means or the like, for example, the management support system in the hospitalized medical facility of the present invention described above can be realized relatively easily.

  Incidentally, the computer program of the present invention can also adopt various aspects in response to the various aspects of the management support system in the hospitalization related facility of the present invention described above.

  These effects and other advantages of the present invention will become apparent from the embodiments described below.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

(First embodiment)
First, the configuration of the first embodiment will be described with reference to FIGS. FIG. 1 is a block diagram of a management support system in an inpatient medical facility as a first embodiment of the present invention, and FIGS. 2 and 3 are respectively in the storage device according to the management support system of the first embodiment. It is a conceptual diagram which illustrates the specific example of the table stored in the file constructed | assembled. FIG. 4 is a characteristic diagram showing the payment amount (in other words, the billing amount) in the combination medical compensation system employed in the present embodiment with respect to the date axis.

  In FIG. 1, the management support system 1 presents discharge target data for each inpatient in an inpatient medical facility that employs a combination medical compensation system based on DPC, which is a combination of comprehensive payment and volume payment. Is. That is, the management support system 1 in hospitalized medical facilities includes a computer such as a known personal computer, workstation, medium-sized computer, large-sized computer, mobile computer (portable information terminal), electronic notebook, etc. as a hardware resource. The storage device 2 includes an input device 3, a processing unit 4, a display device 5, a printing device 6, a communication unit 7, a reading device 8, and a system clock 9.

  The storage device 2 includes a well-known storage device that can be randomly accessed, such as a hard disk device, an IC (Integrated Circuit) memory, a magnetic disk device, a magneto-optical disk device, and an optical disk device.

  The storage device 2 includes discharge target data 501 for each DPC as shown in FIG. 2 in addition to a plurality of files for storing various medical-related data by patient, doctor, nurse, department, etc. The file 2a for storing the table 2 and the file 2b for storing the table including the discharge target data 502 for each patient as illustrated in FIG. 3 are logically constructed.

  As shown in FIG. 2, the table constructed in the file 2a is the first period data indicating the first period in which a relatively high daily fixed amount is recognized immediately after the date of hospitalization in the comprehensive payment for each DPC. (Ii) the second period data indicating the second period following the first period, in which a relatively low daily payment fixed amount is permitted in the comprehensive payment, (iii) the high amount applied in the first period, This includes high-price data indicating the daily fixed amount, (iv) low-value data indicating the second daily fixed amount, which is a low amount applied in the second period, and (v) discharge target data 501 and the like. The discharge target data 501 indicates the discharge target by the number of days from the hospitalization date. That is, by referring to the table stored in the file 2a, it is possible to quickly and surely identify the day that is set in advance for each DPC and is the discharge target date based on the hospitalization date. it can.

  As shown in FIG. 4, the first period is, for example, a period of hospital days from a few days to a dozen days starting from the hospitalization date (the number of days is determined by the corresponding DPC). Within each day, a claim for a high daily payment fixed amount M1 (= the first daily payment fixed amount shown in FIG. 2), which is 15% higher than the reference daily payment fixed amount M0, is permitted in the combination medical compensation system. . The second period is, for example, a period of hospital days from several days to ten or more days following the first period (note that this number of days is determined by the corresponding DPC). Claims for a low daily payment fixed amount M2 (= the second daily payment fixed amount shown in FIG. 2) which is minus 15% of the fixed amount M0 are allowed in the system. In addition, in the third period following the second period, comprehensive payment is not permitted, and only the payment of the volume payment M13 according to the implemented medical practice is permitted in the system. In the first and second periods as well, claims for volume payments M11 and M12 according to the implemented medical practice are partially approved in the system. For example, in the aforementioned first and second periods, 70% of the total medical fee is a claim for a comprehensive payment (ie, fixed amount M1 or M2), and the remaining 30% is a claim for a volume payment (ie, volume) Payment M11 or M12). For example, the first and second periods may be statistically determined based on the period during which 25% of patients are discharged as actual results of inpatients related to each DPC. Whether or not to set is an artificial matter. In the combination medical compensation system, such first and second periods may be collectively referred to as “specific hospitalization period”.

  As shown in FIG. 3, the table constructed in the file 2b includes, for each patient, that is, for each patient ID (identification number), (i) DPC data indicating the DPC of the patient, (ii) the actual hospitalization of the patient. Hospitalization date data indicating the date, (iii) discharge target data 502 of the patient, and (iv) discharge date data indicating the discharge date currently set for the patient. The discharge target data 502 indicates a discharge target by a calendar date. That is, by referring to the table stored in the file 2b, it is possible to quickly and reliably specify the year, month, and day of the discharge target date on the calendar for each patient.

  Returning to FIG. 1 again, the input device 3 is composed of a keyboard, a numeric keypad, a mouse, a trackball, an input pen, an input tablet, a voice input device, etc., and can input medical related data and other various data and commands. Furthermore, an arbitrary position on the image displayed on the display device 5 can be designated.

  The processing unit 4 includes a CPU (Central Processing Unit), and includes a calculation unit 4a and a display data generation unit 4b. The configurations and operations of the calculation unit 4a and the display data generation unit 4b will be described in detail later with reference to the drawings (see FIGS. 5 to 13).

  The display device 5 is a well-known display device such as a CRT device, an LCD device, or a PDP device, and displays medical-related data display in a predetermined format on the screen based on the display data generated by the processing unit 4. To do. Further, the input device 3 is configured so that an arbitrary position on the screen can be designated.

  The printing device 6 is a known printing device such as a laser beam printer or an ink jet printer, and may be a color or monochrome type. The printing device 6 is configured to print an arbitrary screen displayed on the display device 5 by inputting a predetermined print command from the input device 3.

  The communication unit 7 includes, for example, a modem for exchanging various files and data including the file 2a and the file 2b with other computers. The communication unit 7 is connected to other management support systems 1 and 202 via a network 201 such as a wired, wireless, dedicated line, general line, telephone line, and the Internet.

  The reading device 8 includes, for example, a CD drive, a DVD drive, an FD (floppy (registered trademark) disk) drive, and the like, and reads a computer program recorded on a recording medium 8a such as a CD, DVD, or FD. The computer program read by the machine in this manner causes a computer that is a hardware resource of the management support system 1 to function as the management support system. In addition, instead of reading from the storage medium 8a, such a computer program is carried on a carrier wave transmitted from an external server device, thereby using the communication unit 7 via the network 201 such as the Internet. It may be configured to download.

  The system clock 9 has a calendar function and always measures the current date and time regardless of whether the main power supply of the management support system 1 is turned on or off. When updating the display of the medical related data, the date and time measured by the system clock 9 is referred to. In place of such a system clock 9, a clock device outside the system that outputs a signal in a predetermined format indicating the current date and time at a constant cycle is referenced, and the processing unit 4 obtains the current date and time based on this signal. You may comprise as follows.

  Next, in this embodiment, various examples of medical related data displayed by the display device 5 based on display data including discharge target data generated by the calculation unit 4a and the display data generation unit 4b of the processing unit 4. Are shown in FIGS. FIG. 5 to FIG. 7 show examples of displaying medical related data in a predetermined format that can be displayed in the first embodiment.

  In FIG. 5, medical practice data as an example of medical-related data is displayed in the form of a medical plan and a record table called a care map or a navigation care map (both are registered trademarks of Kameda Medical Information Laboratory Co., Ltd.). Yes.

  That is, as shown in FIG. 5, the medical practice data is stored in the format of the medical plan and record table 10 with the date on the horizontal axis 12 and the type of medical practice on the vertical axis 11 (see FIG. 1). It is displayed on the screen. Further, the patient name corresponding to the medical plan and the record table 10 is displayed in the text data column 631, and the DPC to which the patient belongs is displayed in the DCP column 632. In this case, the display data generation unit 4b (see FIG. 1) displays the medical plan including the various medical practice data and the record table 10 in each cell 10a, and the day width of the date column (horizontal axis 12). The current date / time mark 611 indicating the current date / time position in the case of 24 hours conversion is displayed, and the discharge target mark 612 corresponding to the discharge target data is displayed at the corresponding location on the horizontal axis 12 (ie, the date axis). In this way, display data is generated and supplied to the display device 5. Further, in the column of each date constituting the horizontal axis 12 as the date axis, a unique color and hatching that each date belongs to the first period 601 (in FIG. 5, the first sick day to the fifth sick day). Indicated by shading, etc., and indicating that each date belongs to the second period 602 (in FIG. 5, the sixth sick day to the eighth sick day) by a unique color, hatching, shading, etc. Is configured to generate display data so as to indicate that it belongs to the third period 603 (in FIG. 5, the ninth to twelfth sick days) by a unique color, hatching, shading, or the like. The meanings of the first period 601, the second period 602, and the third period 603 are as already described with reference to FIG. These first period 601, second period 602, and third period 603 are uniquely determined in a form corresponding to the DPC shown in the DPC column 632, for example, in the table illustrated in FIG. A period corresponding to DPC can be obtained from a DPC master file constructed in a certain storage device 2.

  In FIG. 5, the current date and time mark 611 can easily understand visually which date the current day is located in the medical plan and record table 10, and the discharge date to be targeted is The discharge plan mark 612 makes it easy to visually understand where the medical plan and the record table 10 are located.

  In FIG. 6, medical practice data as an example of medical-related data is displayed in the form of a daily medical plan list. In other words, a plurality of medical practices for which the execution times are set are arranged in the order of the execution times (in the example of FIG. 6, the medical practices included in the category of each medical practice on the same day in the order of the dates). It is displayed in the format of the list arranged in time order. In the case of this format, the part corresponding to the unit of date in the medical plan list 110 may be displayed with a page break, or may be displayed while scrolling up and down. Particularly in the present embodiment, the display data generation unit 4b (see FIG. 1) displays a display column 110a for displaying “discharge target data” as text and “expected discharge date data” currently set for the patient. Display data is generated and supplied to the display device 5 so that the display field 110b for displaying text is displayed in a predetermined area (upper right in FIG. 6) in the medical plan list 110. ing.

  In FIG. 7, the medical doctor data and the nurse data as an example of medical related data are displayed in a patient-specific list format. That is, the name and ID of the doctor in charge and the name and ID of the nurse in charge are displayed in a list format for each patient ID of each inpatient. Particularly in the present embodiment, the display data generation unit 4b (see FIG. 1) displays the discharge target data in the column 120 of the “discharge target date” in the list and further sets the current status for the patient. The display data is generated and supplied to the display device 5 so that the scheduled discharge date is displayed as text in the column “scheduled discharge date” in the list.

  As described above, according to the present embodiment, the display data generation unit 4b (see FIG. 1) is discharged from each hospitalized patient calculated by the calculation unit 4a (see FIG. 1) as described later or externally input. The target data is generated by including it as a part of the display data, and the display device 5 displays the generated display data. Therefore, if the medical-related data displayed in various formats on the display device 5 while adopting the combination medical reward system (see FIGS. 5 to 7), it is possible to achieve both inpatient treatment and home treatment. It can be easily understood visually in the form of the display of “discharge target data” which treatment is adversely affected or has a positive effect on the in-hospital economy. And, for example, if the scheduled discharge date (or the actual discharge date) is set so that it matches the discharge date indicated by the discharge target data, the appropriate inpatient treatment or home treatment is given to the one inpatient, It will have a positive impact on the economy.

  Next, the flow of processing according to various methods for generating discharge target data in this embodiment will be described with reference to FIGS. 8 to 13. FIG. 8 is a flowchart showing the discharge target data display process in the first embodiment, and FIGS. 9 and 10 are flowcharts showing the discharge target data display process in the modification. FIGS. 11 to 13 are flowcharts showing various specific examples of discharge target data changing processing in the first embodiment.

  In FIG. 8, first, period data indicating the first and second periods in which comprehensive payment (that is, daily fixed amount) for each DPC is permitted, and charge amount data indicating the charge amount chargeable in each of the first and second periods. Then, various data such as billing amount data indicating a billing amount corresponding to the volume paid, hospitalization date data indicating the hospitalization date, and the like are input (step S11). Subsequently, discharge target data is calculated based on these various input data (step S12). For example, for each DPC, when standard or hypothetical hospitalization treatment is performed, the cumulative profit / loss on the date axis (or time axis) based on the hospitalization date is calculated, and both hospitalization treatment and home treatment are possible Within a long hospitalization period, a day or period in which the cumulative profit / loss takes the maximum value on the positive side (that is, the day or period when the surplus becomes the largest) is determined, and this is set as the target discharge date or period. Here, the discharge target data 501 (see FIG. 2) based on the hospitalization date for the virtual inpatient may be calculated, or the discharge target data 502 on the calendar for the actual inpatient (see FIG. 3). May be calculated.

  Next, display data having a predetermined format as shown in FIGS. 5 to 7 including the discharge target data calculated in this way is generated (step S13), and the display is appropriately performed (step S14).

  After that, whether or not the discharge target data should be updated depends on, for example, the input of a command to change or update the discharge target data according to the operating rate in the hospitalized medical facility or the arrival of periodic update timing The determination is made by inputting a command for updating the discharge target data (step S40). Here, when not updating (step S40: No), a series of display processes are finished as it is.

  On the other hand, when updating (step S40: Yes), data indicating the number of vacant beds and vacant rooms that are the basis for the operation rate in the hospitalized medical facility, data indicating the availability of doctors and nurses, waiting for hospitalization Various data necessary for changing or updating discharge target data such as data indicating the number of patients is acquired (step S41). Subsequently, the operation rate is calculated based on these various data (step S42), and the discharge target data corresponding to the calculated operation rate is changed or updated (step S43). For example, the “occupancy rate” is an operation rate in the future or the near future. For example, depending on the operation rate indicating that the number of vacant beds is large, the target discharge date or period is on the time axis in the future. Moved. On the other hand, the target discharge date or period is moved from the future to the current direction on the time axis according to the operation rate that the number of vacant beds decreases or the number of patients waiting for hospitalization increases. The Thus, discharge target data indicating the discharge date as a target adjusted on the time axis according to the operation rate is generated. Preferably, it is preferable to move the target discharge date or period so that the operation rate calculated in this way approaches a certain level. For example, as an example of the operation rate, the rate of occupancy of patient beds and hospital rooms will be 95 to 97%, in other words, the rate of empty beds and empty rooms should not exceed 3 to 5%. Move days or periods.

  Next, display data having a predetermined format as shown in FIGS. 5 to 7 including the discharge target data thus changed or updated is generated (step S44), and the display is appropriately performed (step S45).

  Thereafter, it is determined whether or not the discharge target data should be updated (step S46). When not updating here (step S46: No), a series of display processing is ended as it is. On the other hand, when updating (step S46: Yes), it returns to step S41 and a series of display processes are performed again.

  As a result of the above, in the hospital-related medical facility, what kind of treatment will be adversely affected or positively affected by hospital treatment for patients who are capable of both hospitalization and home care? Can be visually presented in the form of the display of discharge target data as a part of the display data as shown in FIGS. In particular, by the processing of steps S40 to S46, the results of adjusting the target admission / exit time from the viewpoint of the in-hospital economy or management from the viewpoint of hospital hospitalization and home treatment, and further progress Thus, it is possible to present discharge target data that reflects the result of adjusting the time of admission and discharge by reading the operating status in the hospital-related medical facility as part of the display data.

  Next, with reference to FIGS. 9 and 10, two modified examples of the discharge target data display process shown in FIG. 8 will be described. In FIG. 9 and FIG. 10, the same steps as those in FIG. 8 are given the same step numbers, and the description thereof will be omitted as appropriate.

  In FIG. 9, first, discharge date or period data corresponding to one inpatient is acquired. This acquisition is acquired from the table illustrated in FIG. 2 as discharge date or period data corresponding to the DPC related to one inpatient (step S21). Next, discharge target data that is a part of the display data is generated based on the discharge date or period data acquired in this way, and display data including a predetermined format as shown in FIGS. 5 to 7 is generated. (Step S22) and the display is appropriately performed (Step S14). Thereafter, steps S40 to S46 are executed in the same manner as in the case of FIG. 8, and a series of display processing is completed.

  In FIG. 10, first, input of discharge target data indicating a discharge date or period as a target, which is calculated in advance by a computer or a computer, manual calculation, etc. corresponding to one inpatient, is input device 3 (FIG. 10). 1)) (step S31). Next, display data of a predetermined format as shown in FIGS. 5 to 7 including the discharge target data input in this way is generated (step S13), and the display is appropriately performed (step S14). Thereafter, steps S40 to S46 are executed in the same manner as in the case of FIG. 8, and a series of display processing is completed.

  Next, with reference to FIG. 11 to FIG. 13, various specific examples of the discharge target data changing process in the first embodiment will be described. The discharge target data changing process is performed, for example, as the discharge target data changing process shown as step S43 in FIGS. Also, in FIG. 12 and FIG. 13, the same steps as those in FIG.

  In the change process of FIG. 11, when changing discharge target data according to the operation status, the movement amount on the discharge target date on the time axis is made variable according to the DPC related to each inpatient. . For example, hospitalized patients with DPC = aaa are delayed by 2 days, hospitalized patients with DPC = bbb are delayed by 5 days, and so on. That is, in FIG. 11, first, a DPC for one inpatient among one or a plurality of inpatients to be displayed in a predetermined format is acquired (step S51). Next, the discharge target data for the one inpatient is changed by the movement amount corresponding to the acquired DPC (step S52). Thereafter, it is determined whether or not it is the last patient among one or a plurality of inpatients to be displayed in a predetermined format (step S53), and if it is the last (step S53: Yes), a series of change processing is finished. On the other hand, if it is not the last (step S53: No), the object of the said change process is moved to the next inpatient (step S54), and it returns to step S51 and a series of change processes are performed again.

  It should be noted that the amount of movement of the discharge target data may be a fixed amount that is determined according to the operation status without depending on the DPC. For example, for an in-patient with an arbitrary DPC, the patient is uniformly delayed by 3 days according to the operating status.

  In the change process of FIG. 12, for patients other than the specific inpatient whose discharge has just approached, the discharge is not imminent without changing the discharge target data so as not to cause confusion. It is intended to improve the hospital economy by making changes to the discharge target data for specific inpatients. That is, in FIG. 12, whether or not one inpatient among one or more inpatients to be displayed in a predetermined format is a specific inpatient who is scheduled to continue hospitalization for a certain period of time or more based on the current time. Is determined (step S61). Here, if it is a specific inpatient (step S61: Yes), the discharge target data about the said one inpatient will be changed (step S52). In other words, the change of discharge target data for a specific inpatient other than the inpatient who refrained from the discharge date is executed. Thereafter, it is determined whether or not it is the last patient among one or more hospitalized patients to be displayed in a predetermined format (step S53). On the other hand, if the result of determination in step S61 is not a specific inpatient (step S61: No), the process proceeds directly to step S53. In other words, in the case of an inpatient who is ahead of the discharge date, the discharge target data is not changed. If the result of determination in step S53 is the last (step S53: Yes), the series of change processing is finished. On the other hand, if it is not the last (step S53: No), the object of the change process is moved to the next inpatient (step S54), and the process returns to step S61 to perform a series of change processes again.

  However, even in the case of an inpatient other than a specific inpatient who is about to be discharged (Step S61: No), it is possible to move the target discharge date or period (for example, to extend the discharge date). Yes, this makes it possible to improve hospital management with immediate effect. In addition, instead of selectively changing specific hospitalized patients who are not approaching discharge in this way, for example, all hospitalized patients are postponed by one day or postponed by two days, regardless of the time until discharge. You may change it uniformly.

  In the changing process of FIG. 13, whether or not home treatment is possible for each inpatient is added to one of the criteria for changing the discharge target data, and then the discharge target data is changed. is there. In other words, for hospitalized patients who have no choice but to choose only hospitalization treatment, no adjustment is made on the discharge date while giving priority to hospitalization treatment as much as possible regardless of the availability in the hospitalized medical facility. On the other hand, for other inpatients, the goal is to improve the hospital economy by changing the discharge target data. That is, in FIG. 13, it is first determined whether or not one inpatient among one or a plurality of inpatients to be displayed in a predetermined format is an inpatient that can be treated at home (step S71). Here, if the patient is an inpatient who can also be treated at home (step S71: Yes), the discharge target data for the one inpatient is changed (step S52). That is, the change in discharge target data is executed for inpatients who can perform both home treatment and hospitalization treatment. Thereafter, it is determined whether or not it is the last patient among one or more hospitalized patients to be displayed in a predetermined format (step S53). On the other hand, as a result of the determination in step S71, if the patient is not an inpatient capable of home treatment (step S71: No), the process proceeds to step S53 as it is. That is, in the case of an inpatient who needs hospitalization treatment, the change of discharge target data is not executed. If the result of determination in step S53 is the last (step S53: Yes), the series of change processing is finished. On the other hand, if it is not the last (step S53: No), the object of the change process is moved to the next inpatient (step S54), and the process returns to step S61 to perform a series of change processes again.

(Second Embodiment)
A second embodiment will be described with reference to FIGS. 14 and 15. FIG. 14 shows an example of display of medical related data in a predetermined format displayed by the management support system in the hospitalized medical related facility as the second embodiment of the present invention, and FIG. 15 shows the display in the second embodiment. It is a flowchart which shows the display process of discharge target data. The hardware configuration in the second embodiment is the same as that of the first embodiment shown in FIG. 1, and the software configuration is different in the second embodiment. In FIGS. 14 and 15, the same components as those in FIGS. 5 and 8 are given the same reference numerals, and the description thereof will be omitted as appropriate.

  In FIG. 14, as shown in FIG. 4, the DPC branch point calculated by the calculation by the comprehensive payment (daily payment fixed amount) according to the DPC that changes stepwise according to the number of days from the hospitalization date is the DPC branch point bar 621. It is displayed as. Here, the “DPC branch point” is a point (date) on the time axis where the profit by the comprehensive payment is maximized when attention is paid only to the comprehensive payment. Such a DPC branch point exists when the fixed daily payment per hospitalization day changes step by step as in the comprehensive payment in the combination medical compensation system. For example, for the daily payment fixed amount for each DPC that changes in stages (see Fig. 4), the cumulative profit / loss on the date axis (or time axis) based on the hospitalization date is calculated, and the cumulative profit / loss is maximized on the positive side. The DPC branch point can be calculated as the day or period when the value is taken (that is, the day or period when the surplus becomes the largest). If one hospitalized patient is discharged before the DPC breakpoint, the maximum return on comprehensive payments will not be obtained due to the loss of a fixed daily payment (ie, comprehensive payments). It will be. Conversely, if one hospitalized patient is discharged after the DPC fork, the maximum return on comprehensive payments will not be obtained due to the subsequent implementation of low-margin medical practices.

  Further, in FIG. 14, not only the comprehensive payment as in the DPC branch point is taken into consideration, but in addition to this, the period for which the comprehensive payment is allowed (ie, the first and second periods shown in FIG. 4). Considering the amount of money that can be charged in part, and the amount of money that can be charged in the period in which the claim for comprehensive payment is not allowed (that is, the third period shown in FIG. 4) The break-even point obtained by the above calculation is displayed as a break-even point bar 622. Here, the “break-even point” means a point (date) on the time axis when paying attention to the comprehensive payment and the volume payment, that is, the total profit becomes the maximum. For example, taking into account the amount paid for the daily payment for each DPC that changes in stages (see Fig. 4), calculate the cumulative profit / loss on the date axis (or time axis) based on the hospitalization date, The break-even point can be calculated as the day or period when the cumulative profit / loss takes the maximum value on the plus side (that is, the day or period when the surplus becomes the largest). If one hospitalized patient was discharged before the break-even point, the maximum profit would not be obtained due to the loss of medical compensation thereafter, and conversely, the patient was discharged after the break-even point. If this is the case, the maximum profit will not be obtained due to the subsequent implementation of medical practices with low profit margins.

  As shown in FIG. 15, first, after inputting various data (step S11), the calculation of the DPC breakpoint and the breakeven point as described above is performed in the calculation unit 4a of the processing unit 4 (see FIG. 1) (step 1). S81). Subsequently, discharge target data is generated in the calculation unit 4a of the processing unit 4 (see FIG. 1) based on at least one of these calculated DPC breakpoints and breakeven points (step S82). Thereafter, display data including the DPC breakpoint bar 621 and the breakeven point bar 622 is generated (see FIG. 1) in the display data generation unit 4b of the processing unit 4 (step S83), and displayed in the format as shown in FIG. Is executed (step S84).

  In addition to or instead of the break-even point for DPC and the break-even point as shown in FIG. 14, the point (date) at which the accumulated profit / loss changes from plus (black) to minus (red) for each inpatient is calculated. It is also possible to obtain the result and display it as a bar or mark at the corresponding position on the date axis. Thereby, for example, it is easily understood whether each patient is in black or red at each time point (date) in the present or future.

(Third embodiment)
A third embodiment will be described with reference to FIGS. 16 and 17. FIG. 16 shows an example of display of medical related data in a predetermined format displayed by the management support system in the hospitalized medical related facility as the third embodiment of the present invention, and FIG. 17 shows the display in the third embodiment. It is a flowchart which shows the display process of discharge target data. The hardware configuration in the third embodiment is the same as that in the first embodiment shown in FIG. 1, and the software configuration is different in the third embodiment. In FIGS. 16 and 17, the same components as those in FIGS. 5 and 8 are given the same reference numerals, and the description thereof will be omitted as appropriate.

  In FIG. 16, as shown in FIG. 4, the first to third densities obtained by the calculation by the comprehensive payment (daily payment fixed amount) according to the DPC that changes stepwise according to the number of days from the hospitalization date Displayed as first to third density indicators 701 to 703, respectively. Furthermore, a scheduled discharge date mark 700 indicating the currently set scheduled discharge date is displayed at the end of the third density indicator 703. The scheduled discharge date mark 700 is displayed by a predetermined type of icon at a corresponding position on the date axis of the medical plan and record table 10. Here, the “first density” means a remuneration amount density obtained by dividing the total amount of medical remuneration up to today indicated by the current date and time mark 611 by the period from the hospitalization date to today. The “second density” means a reward amount density obtained by dividing the total amount of medical remuneration up to the discharge target date indicated by the discharge target mark 612 by the period from the hospitalization date to the discharge target date. “Third density” means the total amount of remuneration obtained by dividing the total amount of medical remuneration up to the scheduled discharge date indicated by the scheduled discharge date mark 700 by the period from the hospitalization date to the scheduled discharge date. Each of the first to third density indicators 701 to 703 is displayed in a color close to green if the reward amount density is high, and is displayed in a color close to red if the reward amount density is low. Alternatively, if the remuneration amount density is high, the color is displayed with a relatively high density, and if the remuneration amount density is low, the color is displayed with a relatively low density. Eventually, if the discharge date is set so that the third density indicating the compensation amount density on the scheduled discharge date becomes high, the hospital economy for the one inpatient will be the maximum, but the actual schedule The discharge date is determined by doctors, etc. depending on various factors such as the medical condition, hope, and convenience of the inpatient. When determining this, the 1st to 3rd densities should be taken into account in the hospital economy. It will give you useful information visually.

  As shown in FIG. 17, first, after inputting various data (step S11), the calculation of the first to third densities as described above is performed in the calculation unit 4a of the processing unit 4 (see FIG. 1) (step S91). ). Subsequently, discharge target data is generated in the calculation unit 4a of the processing unit 4 (see FIG. 1) (step S92). Thereafter, display data including the first to third density indicators 701 to 703 and the scheduled discharge date mark 700 is generated (see FIG. 1) in the display data generation unit 4b of the processing unit 4 (step S93), and is shown in FIG. Display in such a format is executed (step S94).

  In addition, when taking the remuneration amount density, in addition to or instead of calculating the period, the hospitalization date may be the current date (that is, today).

  As described above in detail, according to each embodiment of the present invention, it is possible to present information that assists in determining whether to enter or leave a hospital while performing appropriate treatment in an inpatient medical facility that employs a combination medical reward system.

  Note that the discharge target data can be shared by a plurality of management support systems 1 via the network 201 shown in FIG. 1, and the discharge target data can be used by another system 202. Alternatively, collective management and collective generation of discharge target data in a plurality of hospitalized medical facilities are performed by the management support system 1 arranged in the center apparatus, and provided to each of the hospitalized medical facilities. Is also possible. Further, for example, the management support system 1 can be constructed so as to obtain discharge target data in accordance with the current or near future operation rate in each inpatient medical facility and provide them via the network 201, respectively. is there.

  The present invention is not limited to the above-described embodiment, and can be changed as appropriate without departing from the spirit or idea of the invention that can be read from the claims and the entire specification, and a management support system with such a change Computer programs are also included in the technical scope of the present invention.

It is a block diagram of the management support system in the hospitalization medical related facility as 1st Embodiment of this invention. FIG. 3 is a conceptual diagram illustrating a specific example of a table stored in a file constructed in the storage device according to the management support system of the first embodiment. FIG. 6 is a conceptual diagram illustrating another specific example of a table stored in a file constructed in the storage device according to the management support system of the first embodiment. It is a characteristic view which shows the payment amount in the combination medical compensation system employ | adopted by 1st Embodiment with respect to a date axis. FIG. 3 is a plan view showing an example of display of medical related data in a predetermined format that can be displayed in the first embodiment. FIG. 6 is a plan view showing another example of displaying medical related data in a predetermined format that can be displayed in the first embodiment. FIG. 6 is a plan view showing another example of displaying medical related data in a predetermined format that can be displayed in the first embodiment. 5 is a flowchart showing a discharge target data display process in the first embodiment. It is a flowchart which shows the display process of the discharge target data in the modification of 1st Embodiment. It is a flowchart which shows the display process of the discharge target data in the other modification of 1st Embodiment. 6 is a flowchart showing a specific example of a change process of discharge target data in the first embodiment. 6 is a flowchart showing another specific example of discharge target data change processing in the first embodiment. 6 is a flowchart showing another specific example of discharge target data change processing in the first embodiment. It is a top view which shows the example of a display of the medical relevant data in the predetermined format displayed by the management support system in the hospitalization medical relevant facility as 2nd Embodiment of this invention. It is a flowchart which shows the display process of the discharge target data in 2nd Embodiment. It is a top view which shows the example of a display of the medical relevant data in the predetermined format displayed by the management support system in the hospitalization medical relevant facility as 3rd Embodiment of this invention. It is a flowchart which shows the display process of the discharge target data in 3rd Embodiment.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Management support system 2 ... Storage device 3 ... Input device 4 ... Processing part 4a ... Operation part 4b ... Display data generation part 5 ... Display device 6 ... Printing device 7 ... Communication part 9 ... System clock 201 ... Network

Claims (5)

The target calendar for a single inpatient in an inpatient medical facility that employs a medical compensation system that combines a pre-set comprehensive payment for each disease category and a pre-set payment for each medical practice. A management support system for presenting discharge target data indicating a discharge date as a date,
(i) indicated by the charge amount corresponding to the comprehensive payment amount indicated by the first charge amount data for the virtual inpatient of each of the plurality of disease classifications; and (ii) indicated by the second charge amount data for the virtual inpatient. Calculated on the basis of the billing amount corresponding to the volume paid , and the cumulative profit / loss with respect to the date axis based on the hospitalization date of the virtual inpatient is calculated for both inpatient treatment and home treatment for the virtual inpatient. Storage means for storing period data indicating a period that takes a maximum value on the plus side in association with a plurality of disease classifications that respectively define the billing amount corresponding to the comprehensive payment,
An input means capable of inputting hospitalization date data indicating hospitalization date for the one hospitalized patient and disease classification data indicating disease classification related to the one hospitalized patient;
From the period data stored in the storage means, the one corresponding to the disease classification related to the one hospitalized patient indicated by the disease classification data input via the input means is acquired, and the acquired period data By calculating the target discharge date for the one hospitalized patient by using the hospitalization date indicated by the hospitalization date data input via the input means as the reference period, the calculated discharge date is calculated. A calculation unit for generating discharge target data indicating a discharge date;
Generating display data for displaying medical-related data relating to one or a plurality of patients including the one inpatient in a predetermined format, and including the generated discharge target data in a part of the display data Display data generation means for generating
A management support system in a hospital-related medical facility, comprising: display means for displaying the generated display data.   The display data generating means generates the display data for displaying the medical related data in time series as the predetermined format, and the discharge target data is used as the target discharge on the time axis related to the time series. The management support system in an inpatient medical facility according to claim 1, wherein the management support system is generated so as to be displayed at a location corresponding to a day.   The display data generating means is based on the first and second billing amount data input through the input means, and (i) a period during which the comprehensive payment is allowed and (ii) the comprehensive payment. 3. The management support system in an inpatient medical facility according to claim 2, wherein the display data is generated so that a period in which the period is not recognized is displayed so as to be distinguishable from each other.   The display data generating means displays the current date data indicating the current date obtained by referring to the system clock so that the current date data is displayed at least at a location corresponding to the current date on the time axis. 4. The management support system in an inpatient medical facility according to claim 2, wherein the current date data is generated as a part of data.   A computer program for causing a computer to function as a management support system in an inpatient medical facility according to any one of claims 1 to 4.

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