JP4548739B2 - Patient-specific cost calculation apparatus and program therefor - Google Patents

Description

  The present invention relates to a patient-specific cost calculation apparatus for calculating the cost of medical practice in a medical institution for each patient, and a program therefor.

  In order to rationally manage and manage medical institutions, it is necessary to manage the cost of how much cost is applied to each patient. If this cost control becomes possible, it will be possible to calculate the profit rate for each patient, increase the profit rate by formulating cost reduction measures, or give priority to the number of treatments of patients with a high profit rate It is possible to plan management improvement measures, such as increasing profits by increasing the number of items. In particular, labor costs and material costs account for more than 80% of the cost, and it is necessary to accurately grasp the sources of these labor costs and material costs in order to improve the accuracy of cost management.

  In view of these points, methods for calculating costs in medical institutions have been proposed. For example, Patent Document 1 discloses a method of calculating income and expenses for each department of a medical institution and outputting the results for each patient. In this method, the expenses spent for providing medical services are divided into direct expenses for direct departments and indirect expenses for indirect departments. The points to assign are disclosed. More specifically, in the department cost calculation processing by clinical department, the user sets an allocation ratio for allocation according to the number of patients and the number of medical practices, and indirectly uses this allocation ratio. Allocate costs.

JP 2004-213236 A

  However, in the method as described in Patent Document 1, the cost is calculated by simply dividing the cost into a direct cost and an indirect cost. With this method, it was difficult to calculate the patient-specific cost accurately. For example, the costs of medicines and medical materials that are classified as direct costs are also the costs that cannot be directly charged to each patient (for example, medicines are administered to a single patient only for a portion of the total purchase unit, and the other parts The cost of purchasing a drug administered to another patient when administered to another patient, and the cost that can be directly charged to each patient (for example, when a drug is administered to one patient for the entire amount of the purchased unit) The purchase cost of the drug) is mixed, and it is not possible to calculate the exact cost by simply imposing the full amount of the direct cost as the patient cost without considering such a cost category. It was. In addition, various data used as the basis for cost calculation is obtained from existing systems such as medical accounting systems, but these existing systems are not intended to perform cost calculation, so they were obtained from these systems. There were circumstances where the data could not be used immediately for cost accounting.

  The present invention has been made in order to solve such problems caused by the prior art, and the direct cost and the direct cost are calculated by a method according to each characteristic, and the cost per patient is accurately calculated. It is an object of the present invention to provide a patient-specific cost calculation apparatus and a program therefor that can be calculated.

In order to solve the above-described problem and achieve the object, the patient-specific cost calculation apparatus according to claim 1 is a patient-specific cost calculation apparatus for calculating the cost of medical practice for each patient. Basic information storage means for storing basic information necessary for calculation; and direct immutable calculation means for calculating a direct immaterial cost that cannot be directly imposed on a patient among the costs, the basic information storing The information of the predetermined item is extracted from the means, and the extracted information is aggregated for each predetermined cost item according to the form of occurrence of the directly-impartable cost, and the roll-up coefficient corresponding to the cost item is acquired by a predetermined method. , The directly-applicable indivisible cost calculation means for calculating the directly-indivisible cost using the aggregated information and the acquired accumulation factor, and the directly-applicable cost that can be directly charged to each patient among the costs The basic information storage hand Direct calculation means that is obtained by extracting and summing up information of predetermined items from the direct items, direct impractical cost calculated by the direct impractical calculation means, and direct calculation obtained by the direct calculation means A cost-by-patient cost calculating means for calculating the cost for each patient by summing the partial costs for each patient, and a costing coefficient calculating means for calculating or setting the costing coefficient, In the case where the cost calculation target is a medical practice belonging to the predetermined first cost item, the calculation means is a ratio that is a ratio of the cost per time of the specific medical practice to the cost per time of the specific medical practice The coefficient is acquired from the basic information stored in the basic information storage means, or information on the cost per time for each medical practice included in the basic information stored in the basic information storage means By doing When the cost calculation target is a cost belonging to a predetermined second cost item, a unit score corresponding to the cost is obtained from the basic information stored in the basic information storage means, and the unit score Is set as the cost factor of the cost calculation object, and the cost calculation object is a medical action belonging to the predetermined third cost item, the medical action is calculated from the basic information stored in the basic information storage means. The total number of implementations is acquired and the total value of the implementations is set as the roll-up coefficient for the cost calculation object .

The patient-specific cost calculation apparatus according to claim 2 is the patient-specific cost calculation apparatus according to claim 1, wherein the basic information storage means stores the cost for each department that stores the cost for each department of each medical practice. A storage means, and a number-of-execution information storage means for storing the number of cases of each medical practice for each patient, wherein the direct-applicable indivisible calculation means has a cost calculation target as the first cost item or the second cost item. The costing factor of the cost calculation object, the costing factor of all the medical activities of the department and subject to which the costing target belongs and all the actual number information stored in the actual number information storage means Calculate the ratio of the sum of products with the number of medical practice performed, and use the calculated ratio to apportion the total cost of the department to which the clinical practice belongs stored in the departmental cost information storage means. By To calculate the cost of per valence calculation target as the straight Division indivisible cost.

The patient-specific cost calculation apparatus according to claim 3 is information on a department code for specifying a department related to the cost calculation object in the patient-specific cost calculation apparatus according to claim 2, A department code for cost calculation, and a number of types of medical practice number creation indicating whether or not the department where each medical practice to be cost-calculated is actually performed can be determined based on the department code for medical cost calculation , Information for identifying the mutual correspondence relationship between the cost department master stored in association with each other, the department code for medical cost calculation, and the department code for cost calculation in the cost calculation apparatus for each patient. Stores the cost department conversion master to be stored, the medical practice name of each medical practice that is the object of cost calculation, and the department name of the department where each medical practice was actually performed, and stores them in association with each other Target machine The basic information storage means stores the department code for calculating the medical expenses of each medical practice that is the cost calculation object and the medical practice name of each medical practice in association with each other. A separate service data storage means is provided, and the department code for calculating the medical expenses of each medical treatment subject to the cost calculation is acquired from the patient-specific service data storage means and corresponds to the acquired department code for calculating the medical expenses. Medical treatment number creation type to be acquired from the cost department master, and based on the acquired medical treatment number creation type, the department in which each medical practice that is the cost calculation target actually performed the medical cost calculation If it is possible to determine whether or not it can be determined based on the department code for medical use, and if it is possible to determine in which department it was actually performed, the acquired department code for calculating medical expenses is the cost part When the conversion master is referred to and converted into the department code for cost calculation, and it is not possible to determine in which department the cost is actually performed, the name of the medical practice of each medical practice that is the cost calculation target is classified by patient A number-of-services data creation unit that acquires from the service data storage means and acquires a department name corresponding to the acquired medical practice name from the medical practice accumulation target master, and the direct charge indivisible calculation means includes the service Based on the department code converted by the separate number data creation unit or the acquired department name, the department of each medical practice that is the cost calculation target is specified.

In addition, the patient-specific cost calculation apparatus according to claim 4 is the patient-specific cost calculation apparatus according to any one of claims 1 to 3, wherein the basic information storage means includes the number of purchases and purchases for each article. The article information storage means for storing unit unit price, minimum unit conversion, and medical unit conversion conversion, and the direct calculation means for the article for cost calculation, the article stored in the article information storage means The sum of products of the number of purchases and the unit price of purchase is divided by the sum of products of the number of purchases of the article stored in the article information storage means, the minimum unit conversion, and the medical unit conversion conversion. By doing so, the actual purchase unit price of the article is calculated.

The patient-specific cost calculation program according to claim 5 causes a patient-specific cost calculation apparatus for calculating the cost of medical practice for each patient to perform cost calculation for each patient for calculating the cost for each patient. The patient-specific cost calculation apparatus includes basic information storage means for storing basic information necessary for calculating the cost, and the patient-specific cost calculation apparatus directly controls the patient out of the costs. Calculating direct inseparable costs that cannot be imposed on the product, extracting information on predetermined items from the basic information storage means, and using the extracted information as predetermined costs according to the mode of occurrence of the direct inseparable costs Directly indivisible calculation that aggregates for each item, acquires a roll-up coefficient according to the cost item by a predetermined method, and calculates the direct-indivisible cost using the aggregated information and the acquired roll-up coefficient And a direct calculation step for acquiring a direct cost that can be directly imposed on each patient among the costs by extracting and summing information of a predetermined item from the basic information storage means, and The patient who calculates the cost for each patient by summing the direct cost and the direct cost obtained in the direct calculation step for each patient. A separate cost calculation step and a cost factor calculation step for calculating or setting the cost factor are executed, and in the cost factor calculation step, the cost calculation object is a medical practice belonging to a predetermined first cost item In this case, a roll-up coefficient, which is a ratio of the cost per one medical treatment to the cost per one medical practice, is stored in the basic information storage means. Obtained from this information, or calculated by aggregating information on the cost per time of each medical practice included in the basic information stored in the basic information storage means, the cost calculation target is a predetermined second When the cost belongs to the cost item, the unit information corresponding to the cost is acquired from the basic information stored in the basic information storage means, and the unit score is set as the accumulation factor of the cost calculation object. When the cost calculation target is a medical practice belonging to the predetermined third cost item, the number of implementations of the medical practice is acquired from the basic information stored in the basic information storage means. The total value is set as the roll-up coefficient for the cost calculation object.

According to the present invention described in claim 1, 5, by calculating the straight Division indivisible cost using the product on coefficients corresponding to cost item, be calculated in the method according to either directly charged indivisible costs to their properties The patient-specific cost can be calculated more accurately. Therefore, the accuracy of cost management in the medical institution can be improved, and rational management management and business management of the medical institution can be further promoted.
In addition, regarding the cost of medical treatment due to personnel costs, material costs, or equipment costs in particular, it is possible to calculate directly indivisible costs, taking into account the ratio with the cost of the standard medical practice. . In particular, by setting a roll-up coefficient that matches the actual situation of the medical institution, it is possible to calculate a directly imposed indivisible cost that matches the actual situation of the medical institution.
In addition, for a given cost, the cost is calculated based on the accumulation factor set based on the number of unit points corresponding to the cost. Therefore, especially for cost items where the number of unit points and the cost correspond to each other. Can calculate direct indivisible costs according to the number of points.
In addition, for a given medical practice, the cost is calculated using the sum of the number of implementations of the medical practice as an increase factor, so cost items where the number of implementations and costs correspond to each other are implemented. Ru can be performed to calculate the either directly charged inseparable costs in accordance with the number.

According to the second aspect of the present invention , since the direct costs cannot be calculated by apportioning the total cost based on the ratio of the coefficient of increase, the directly indivisible cost corresponding to the coefficient of increase is calculated. Can be calculated.

According to the third aspect of the present invention, even if the department code for calculating medical expenses and the department code for calculating costs do not match, the difference between the medical expenses calculation and the cost calculation is corrected, More accurate costing can be performed.

According to the present invention as set forth in claim 4, not only the unit price of goods, but also the direct cost is calculated by a method that takes into account the number of goods purchased, the unit price of purchase, or the minimum unit conversion and medical unit conversion conversion. Since it can be calculated, it is possible to calculate the direct costs that match the actual situation of purchasing goods.

  The best mode for carrying out the present invention will be described below with reference to the accompanying drawings. However, the present invention is not limited by the present embodiment. First, after describing the present embodiment, a modification example of the present embodiment will be described.

[I] This Embodiment First, this embodiment will be described.

(Definition)
First, terms used in the description of the present embodiment are defined as follows. However, the meaning of each term is not necessarily limited to the following definition, and may include the meaning that each term normally has as long as it does not contradict the following definition. “Medical costs” is a general term for all costs incurred when a medical practice is performed on a patient. The “direct department” is a department in which medical services for patients are directly recognized, and the “indirect department” is a department in which medical services for patients are not directly recognized. “Service category” is a division of direct departments according to their service type. Here, there are three categories: “inpatient department (ward department)”, “outpatient department (medical department)”, and “central medical department”. Break down.

  In the present embodiment, the medical expenses are calculated by dividing the costs into costs that are directly associated with each patient and costs that are not directly associated with each patient. The former is called “directly charged cost” and the latter is called “directly impossible cost”. Also, in this embodiment, medical expenses are classified into items according to the form in which the medical expenses were incurred (here, the department / subject in which the medical expenses were generated), and the calculation pattern according to the characteristics of each item Cost. This item is referred to as a “cost item”.

  When calculating direct-impossible costs, divide medical expenses for each department that is subject to calculation of direct-impartable costs, and multiply the costs for each department by the coefficient set for each department (weighting for each service). Then, the cost per service unit for each department is calculated. This coefficient is referred to as “rolling coefficient”, and the cost in the service unit thus calculated is referred to as “service unit cost”. More specifically, the roll-up factor is the ratio of the cost per service of a specific service to the cost per service of another service. Note that a coefficient (equivalent coefficient) set by a public institution or the like may be used as the increase coefficient set for the cost of medical practice. Such cost accumulation patterns according to the form of service are referred to as “cost accumulation patterns”, and the information set to uniquely identify each cost accumulation pattern is referred to as “cost accumulation pattern code”. . “Specified insurance medical materials” refers to medical materials whose average amount required to supply medical materials at medical institutions is determined separately from medical fees (abbreviated as “special insurance materials” as necessary) It is. “Article” means an article used in a medical institution, and includes, for example, pharmaceuticals, materials, and foodstuffs. "Purchase unit price" is the price for each purchase unit (1 box, 1 dozen, etc.), and "Purchase purchase price" is the purchase price for each unit of purchase (1 box, 1 dozen, etc.). is there. “Minimum unit conversion” is a coefficient for converting the purchase unit of pharmaceuticals and specified insurance medical materials into the minimum unit in the logistics system 16 described later. In the case of pharmaceuticals, it is fixed at “1” and specified insurance. In the case of a medical material, a number obtained by dividing the purchase unit by the use unit (in the case of 6 purchase units and 1 use unit, the minimum unit conversion = 6) is set. The “medical unit conversion conversion” is a coefficient for converting the unit of quantity information used for pharmaceuticals and specific insurance medical materials into the minimum unit in the medical accounting system 13 described later. In the case of a pharmaceutical product, a number obtained by dividing the purchased unit by the used unit is set (6 purchased units, and the minimum unit conversion = 6 when the used unit is 1).

(Outline of this system)
Next, a patient-specific cost calculation system (hereinafter, this system) constructed using the patient-specific cost calculation apparatus and patient-specific cost calculation program according to the present invention will be outlined. FIG. 1 is an explanatory diagram conceptually showing the overall configuration of the present system.

  This system 1 is a system in which each system 11 to 20 included in the related system group 10, a departmental cost calculation server 30, a maintenance terminal 40, and a plurality of reference terminals 50 are connected to a patient via a network 60 such as a local area LAN or the Internet. It is configured to be connectable to another cost calculation server (hereinafter, this server) 100. The following describes an example in which all of these devices are under the control of one medical institution and only handle information in that one medical institution, but for related systems installed in each of a plurality of medical institutions It is also possible to connect one patient cost calculation server 100 and calculate the patient cost of each of these medical institutions in an integrated or individual manner. In addition, these systems, servers, and terminals do not necessarily need to communicate directly, and may be indirectly connected via known systems and servers (not shown).

(System configuration-related systems)
Next, a specific configuration of the system 1 will be described. The related system group 10 is composed of a plurality of systems that provide basic information necessary for calculating the cost, and is an existing system used in medical practice, and corresponds to the external system in the claims. To do. For example, the systems included in the related system group 10 include an electronic medical record system 11, a nursing PDA system 12, a medical accounting system 13, a financial accounting system 14, a personnel salary system 15, a logistics system 16, a fixed asset system 17, and a purchasing system 18. The surgery management system 19 and the medical examination system 20 can be mentioned.

  An electronic medical record system (order system) 11 performs information processing for transmitting instructions issued by a doctor at a clinical site to medical staff and office staff. The nursing PDA system 12 performs information processing for a nurse to input or output nursing information via a PDA (Personal Data Assistance). The medical accounting system 13 performs information processing for inputting or outputting information related to electronic medical records and accounting. The financial accounting system 14 performs information processing for inputting or outputting information related to financial accounting. The personnel salary system 15 performs information processing for inputting or outputting information related to personnel salary. The physical distribution system 16 performs information processing for inputting or outputting information related to the management of articles. The fixed asset system 17 performs information processing for inputting or outputting information related to fixed assets of medical institutions. The purchase system 18 performs information processing for inputting or outputting information related to the purchase of goods. The surgery management system 19 performs information processing for inputting or outputting information related to surgery management. The medical examination system 20 performs information processing for inputting or outputting information related to the medical examination. Since each of the systems 11 to 20 in the related system group 10 can be configured in the same manner as in the past, detailed description thereof is omitted, but any system 11 to 20 has information managed by the systems 11 to 20. The information stored in the database (corresponding to the primary information storage means in the claims) and the information (corresponding to the primary information in the claims) stored in the database (hereinafter referred to as DB) In accordance with a request from the separate cost calculation server 30 or the patient-specific cost calculation server 100, it has a function of transmitting to the department-specific cost calculation server 30 or the patient-specific cost calculation server 100. However, the configuration of the related system group 10 shown in the present embodiment is an example, and desired data may be acquired from any other system, or the patient-specific cost calculation server 100 may be obtained via the maintenance terminal 40. The administrator may manually input necessary data when necessary. In addition, as for each data described later as acquired from the related system group 10, a part of the data may be omitted unless otherwise specified. In this case, although the cost calculation accuracy is lowered, the cost calculation itself is performed. Is still possible.

(System configuration-departmental cost calculation server)
The divisional cost calculation server 30 is a well-known management information system, and calculates the divisional cost based on the information acquired from each system of the related system group 10, and corresponds to the external system in the claims. To do. Since the departmental cost calculation server 30 can be configured in the same manner as in the past, the detailed description thereof will be omitted. However, the departmental cost calculation server 30 stores information managed by itself in the DB ( (Corresponding to primary information storage means in claims) and information stored in the DB (corresponding to primary information in claims) according to a request from the patient-specific cost calculation server 100 And a function of transmitting to the patient-specific cost calculation server 100.

(System configuration-maintenance terminal and reference terminal)
The maintenance terminal 40 is necessary for an administrator of the patient-specific cost calculation server 100 to input and update data necessary for various processes of the patient-specific cost calculation server 100, and for maintenance operation of the patient-specific cost calculation server 100. It is a terminal for inputting or outputting various information. The reference terminal 50 is a terminal for a user of the patient-specific cost calculation server 100 to display and output information managed by the patient-specific cost calculation server 100. Since the maintenance terminal 40 and the reference terminal 50 can be configured in the same manner as a conventional information processing apparatus (for example, a personal computer having a network connection function, a browsing function, and a local memory), detailed description thereof will be given. Is omitted.

(System configuration-Cost calculation server by patient)
Next, the configuration of the patient-specific cost calculation server 100 will be described. The server 100 is configured by functionally conceptually connecting a storage unit 200, a control unit 300, and a network interface (hereinafter “network IF”) 400 so that they can communicate with each other via a bus 500.

  The storage unit 200 is storage means for storing information and parameters necessary for various processes in the patient cost calculation server 100 in a volatile or non-volatile manner, and is configured by, for example, an HD (Hard Disk). Specifically, the storage unit 200 includes a master DB group 210 and a data DB group 250.

  The master DB group 210 calculates patient-specific primary information provided from the related system group 10 or the departmental cost calculation server 30 by eliminating differences in data formats among the servers of the related system group 10. Correspondence information (master data) or the like for specifying the mutual correspondence between the primary information and the basic information in order to convert the information into basic information in the server 100 (basic information in claims). A DB group to be stored, which corresponds to the correspondence information storage means in the claims. Specifically, the master DB group 210 includes a cost accumulation master DB 211, a cost accumulation pattern master DB 212, a cost accumulation pattern setting master DB 213, a cost department master DB 214, a cost department conversion master DB 215, a cost item conversion master DB 216, Includes specific insurance medical material master DB 217, other system staff master DB 218, medical practice master DB 219, medical practice rollup target master DB 220, roll-up coefficient master DB 221, article master DB 222, other system article master DB 223, and standard medicine master DB 224 It consists of A data configuration example of each of these DBs 211 to 224 will be described later.

  The data DB group 250 is a DB group that stores basic information converted or calculated using the master data of the master DB group 210, and corresponds to basic information storage means in the claims. Specifically, this data DB group 250 includes departmental cost calculation data DB 251, staff information DB 252, staff personnel cost information DB 253, staff time study information DB 254, staff time ratio information DB 255 by staff, patient hospitalization data DB 256, patient Separate operation data DB 257, patient-specific service data DB 258, patient meal number data DB 259, service-specific number data DB 260 (corresponding to the number-of-execution information storage means in claims), service unit cost data DB 261, roll-up target data DB 262 ( Corresponding to the departmental cost information storage means in the claims), patient-specific article consumption data DB 263, patient-specific daily revenue data mart DB 264, patient-specific cost calculation data mart DB 265, patient-specific direct calculation data DB 266, patient-specific Daily data DB26 , And it is configured to include a patient-specific either directly charged data DB268. Each of these DBs 251 to 268 stores information indicated by the names of the respective DBs 251 to 268. For example, the departmental cost calculation data DB 251 stores departmental cost calculation data. A data configuration example of each of these DBs 251 to 268 will be described later.

  The control unit 300 is a control unit that controls each unit of the patient-specific cost calculation server 100, and functionally conceptually includes an I / F acquisition processing unit 301, a service-specific number-of-services data creation unit 302, a product factor calculation unit 303, A direct-impartable calculation unit 304, a direct calculation unit 305, and a patient-specific cost calculation unit 306 are provided. Specific processing contents of these units will be described later. These I / F acquisition processing unit 301, roll-up coefficient calculation unit 303, direct charge indivisible calculation unit 304, direct charge calculation unit 305, and patient-specific cost calculation unit 306 are information acquisition means in the claims, roll-up Corresponding to coefficient calculation means, direct charge indivisible calculation means, direct charge calculation means, and patient-specific cost calculation means. Specifically, the control unit 300 includes a CPU (Central Processing Unit), various programs interpreted on the CPU (control programs such as an OS, programs that define various processing procedures, and the like), and And an internal memory for storing required programs and required data.

  The network IF 400 is a communication control interface for the patient-specific cost calculation server 100 to communicate via the network 60, and is configured as a network board, for example. This network IF 400 corresponds to the receiving means in the claims.

(Processing content)
Next, processing (hereinafter, this processing) performed in the server 100 will be described. This process can be performed as a whole or at an arbitrary part at an arbitrary timing. For example, by automatically starting this process every month, the patient-specific cost for each month can be automatically calculated and stored in the calculation result information DB group. In the following description of each process, when the information acquisition source or acquisition route is not specified, the information is acquired from each system of the related system group 10 or the departmental cost calculation server 30 by a known timing and a known method. Alternatively, the administrator manually inputs via the maintenance terminal 40.

(Processing-Costing pattern)
In this process, FIG. 2 is a diagram showing a cost calculation pattern of this process. This figure shows the cost item, type, roll-up coefficient setting value, service unit cost value, and roll-up method in association with each other.

  Cost items include “medical practice (salary costs)”, “medical practice (material costs)”, “medical practice (equipment costs)”, “medical practice (examination commissions)”, “medical practice (others)”, “ Specific insurance medical materials, “bed area”, “medical chart reference time”, “number of meals”, “number of patients”, “operating time”, “operating room occupancy time”, “medicine and materials”.

  The type is a category indicating either direct charge or indivisible (calculation by accumulation). Here, only the cost item “pharmaceuticals and materials” is directly charged, and other cost items are indivisible.

  The product factor setting value is a value that serves as a reference for setting the product factor. In the present embodiment, the increase coefficient is calculated or acquired by a different method for each group corresponding to the cost item. The first group includes cost items “medical practice (salary expenses)” to “medical practice (others)” (corresponding to the first cost item in the claims). The second group is the cost items “specific insurance medical material” and “bed area” (corresponding to the second cost item in the claims). The third group includes all other cost items that cannot be directly applied (corresponding to the third cost item in the claims). As the increase coefficient setting value, for example, for “medical practice (salary expenses)” to “medical practice (others)”, the “collision coefficient”, for “specific insurance medical material”, “specific insurance medical material score”, “Bed area” for “Bed area”, “Total chart reference time” for “Total chart reference time for each doctor”, “Number of meals” for “Total number of meals for all patients”, “Number of patients” “The number of patients for each department obtained by extracting the number of patients from the service count data DB 260 for each medical practice (salary cost) item” and “operation time” are “total operating time for each staff (surgeon)” “Operating room occupancy time” is “total operating room occupancy time of all patients”.

  The value of the service unit cost is a value that is multiplied by the roll-up coefficient, and is the value of the cost unit in each cost item. The value of the service unit cost is, for example, “unit price per clinical practice” for “medical practice (salary expenses)” to “medical practice (other)”, and “specific each medical insurance material”. "Unit price per insurance medical material", "Bed area" is "Unit price per night for each room", "Medical chart reference time" is "Unit price per minute of medical chart reference time per doctor", "Number of meals" "For unit price per meal", "number of patients" for "unit price per patient per department", for "surgery time" "unit price per minute of operating time per staff (surgeon)" For “operating room occupancy time”, “unit price per operating room occupancy time per hour” is used.

  The roll-up method is a cost calculation method that cannot be directly applied. As a loading method, for example, for “medical practice (salary expenses)” to “medical practice (others)”, the daily clinical practice information for each patient is extracted from the medical statement data, and then the clinical practice rollup target master DB 220. The medical practice extracted for each department is set and the unit price for each medical practice is calculated, and then this unit price is accumulated for each patient.

(Processing-Costing logic)
Next, a cost calculation logic corresponding to each cost calculation pattern will be conceptually described. FIG. 3 is a diagram showing an outline of the cost calculation logic of this process, where (a) is the logic of the direct division indivisible processing, (b) is the logic of the direct division processing, and (c) is the logic of the cost calculation processing by patient. It is.

  As shown in FIG. 3 (a), in the directly-directed inseparable process, “I / F acquisition process”, “number-of-services data creation process”, “rolling coefficient calculation process”, and “directly indivisible part calculation process” Run sequentially. The specific contents of each of these processes may vary depending on each cost item. For example, as the cost factor calculation process, to calculate each cost for the cost items "medical practice (salary expenses)" to "medical practice (others)", execute the "medical practice type" cost coefficient calculation process However, in order to calculate each cost for the cost item “specified insurance medical material” and “bed area”, the cost factor calculation processing of “cost increase factor type” is executed, and each cost of other cost items is calculated. In order to calculate, the “coefficient by service type” roll-up coefficient calculation process is executed. Similarly, for other processes, the same process or different processes are executed according to the characteristics of each cost item, as shown in FIG. By performing processing suitable for the characteristics in this way, it is possible to perform cost calculation in accordance with the generation form of each cost. However, the pattern of the processing is not limited to the 12 patterns of “medical practice (salary cost)” to “operating room occupancy time” shown in FIG. 3A, and the activity of the medical institution in which the system is used Patterns may be added or deleted depending on For example, in the example of FIG. 3 (a), activities related to health examinations are excluded, and therefore a medical institution performing the activities may add a pattern according to the activities.

  As shown in FIG. 3B, the direct division processing sequentially executes “I / F acquisition processing” and “direct calculation processing”. In the present embodiment, the cost that can be directly imposed out of the pharmaceutical cost or the material cost is calculated by the direct charge processing.

  As shown in FIG. 3 (c), in the patient-specific cost calculation process, the direct-indivisible cost calculated in the direct-indivisible process and the direct-in cost calculated in the direct process are added for each patient. Then, calculate and output the cost for each patient.

(Processing content-Directly indivisible processing)
First, the direct indivisible processing for calculating the direct indivisible cost will be described.

(Processing content-Directly indivisible processing-I / F import processing)
First, the specific contents of the I / F acquisition process shown in FIG. This process is mainly executed by the I / F acquisition processing unit 301. Hereinafter, each process included in the I / F acquisition process will be described in order, but is not limited to the following description order, and in any order that can be adopted to obtain a required calculation result, All or only a part necessary is executed (this is the same in other processes described later other than the I / F acquisition process). Even if the information acquisition route is specified in the following description of the I / F acquisition process, the information acquisition route is not limited to the specified acquisition route, but any route as long as information can be acquired theoretically. Information can be acquired. Note that column definitions used in the following processes can be stored in the storage unit 200 in advance, or can be described in a program constituting the control unit 300 (I / F import processing) The same in each process.)

(Processing content-Directly indivisible processing-I / F import processing-Departmental cost calculation processing)
First, the departmental cost calculation process will be described. FIG. 4 is a diagram showing a configuration example and a flow of data of departmental cost calculation processing. In this process, the I / F acquisition processing unit 301 performs mapping work according to a predetermined column definition on the departmental cost calculation data I / F collected from the departmental cost calculation server 30 of the related system group 10. Register in the separate cost calculation data DB 251. Specifically, the item code included in the departmental cost calculation data I / F is converted into the item code in the server 100 with reference to the cost item conversion master DB 216 and included in the departmental cost calculation data I / F. The department code is converted into a department code in the server 100 with reference to the cost department conversion master DB 215, and other information included in the departmental cost calculation data I / F is registered in association with the corresponding item code as it is. If there are a plurality of cost amounts associated with the same PK (Primary Key), the department cost amount, or the indirect department cost amount, an amount obtained by adding these amounts is registered. This completes the departmental costing process.

(Processing content-Directly indivisible processing-I / F acquisition processing-Personnel cost information acquisition processing)
Next, the labor cost information take-in process shown in FIG. FIG. 5 is a diagram showing a data configuration example and flow of personnel cost information fetch processing. In this process, the labor cost master I / F collected from the personnel salary system 15 is mapped in accordance with a predetermined column definition and registered in the staff labor cost information DB 253. Specifically, the date, staff ID, within standards (labor costs within specified standards, the same applies below), nonstandard (personnel costs outside specified standards, apply below), business owners Register the burdens as they are. In addition, add the within-standard, non-standard, and employer burdens and register it as a personnel cost total. The department code is converted into a department code in the server 100 and registered by referring to the cost department conversion master DB 215. The subject code is generated by integrating the data category, job category, staff category, and department code on the departmental cost included in the labor cost master I / F to generate the item code on the patient-specific cost. This completes the labor cost information import process.

(Processing content-Directly inseparable processing-I / F capture processing-Time study information capture processing)
Next, the time study information fetching process shown in FIG. FIG. 6 is a diagram showing a data configuration example and a flow of time study information fetching processing. In this process, the staff time study information I / F manually input by the administrator via the maintenance terminal 40 is mapped in accordance with a predetermined column definition and registered in the staff time study information DB 254. Specifically, the date, staff ID, and time included in the staff time study information I / F are registered in association with each other as they are. Further, the department code included in the staff time study information I / F is converted into a department code in the server 100 and registered with reference to the cost department conversion master DB 215. Also, a course code corresponding to the staff ID is acquired from the staff labor cost information DB 253 and registered. This completes the time study information fetching process.

(Processing content-Directly indivisible processing-I / F acquisition processing-Medical practice master acquisition processing)
Next, the medical practice master take-in process shown in FIG. FIG. 7 is a diagram showing an outline of the medical practice master take-in process. In this process, data whose data classification is “medical practice” is extracted from the score master I / F collected from the medical accounting system 13 (referred to as medical score master I / F if necessary), and this data is the target. As described above, mapping is performed according to a predetermined column definition, and each data is registered in the medical practice master DB 219 as shown in the figure. This completes the medical practice master take-in process.

(Processing content-Directly indivisible processing-I / F acquisition processing-Special protection material master acquisition processing)
Next, the special insurance material (medical material; the same applies hereinafter) master acquisition process shown in FIG. FIG. 8 is a diagram showing an outline of the special medical material master taking-in process. In this process, data whose data classification is “material” is extracted from the medical score master I / F collected from the medical accounting system 13, and mapping work is performed according to a predetermined column definition for this data. Data is registered in the specific insurance medical material master DB 217 as shown. This completes the special medical material master take-in process.

(Processing-Directly inseparable processing-I / F acquisition processing-Bed area acquisition processing)
Next, the bed area taking process shown in FIG. FIG. 9 is a diagram showing an outline of the bed area capturing process. In this process, the costing master I / F manually input by the administrator via the maintenance terminal 40 is mapped according to a predetermined column definition, and each data is stored in the costing master DB 211 as shown in the figure. sign up. This completes the bed area capturing process.

(Processing content-Directly indivisible processing-I / F import processing-Medical statement data capture processing)
Next, the medical statement data take-in process shown in FIG. FIG. 10 is a diagram showing a data configuration example and flow of medical statement data fetch processing. In this process, regarding the medical statement information I / F collected from the medical accounting system 13, the total number of each service for all records is extracted for each daily service and used as a patient-specific service I / F. The patient-specific service I / F is registered in the patient-specific service data DB 258 by performing a mapping operation according to a predetermined column definition. Specifically, the patient number, date, internal code, and quantity included in the medical statement information I / F are registered in association with each other as the patient ID, date, medical internal code, number of times / use number in the patient-specific service data DB 258. To do. In addition, a specific department code is identified according to the combination of entering / exiting (hospital or outpatient identification information; the same applies hereinafter), clinical department code (subject), law-specific number, and medical classification code, and this department code The cost department conversion master DB 215 is referred to and converted into a department code in the server 100 and registered. This completes the medical statement data take-in process.

(Processing content-Directly inseparable processing-I / F capture processing-Patient hospitalization data capture processing)
Next, the patient hospitalization data taking process shown in FIG. FIG. 11 is a diagram showing a configuration example and a flow of data of the patient hospitalization data take-in process. In this process, the patient hospitalization information I / F collected from the medical accounting system 13 is mapped according to a predetermined column definition and registered in the patient hospitalization data DB 256. Specifically, the patient number, the room code, the hospitalization date, the discharge date, the transfer date, and the transfer date included in the patient hospitalization information I / F, the patient ID, the hospital code, the hospitalization date, the discharge date in the patient hospitalization data DB 256, Register as transfer date and transfer date. Also, the ward code is converted into a department code in the server 100 with reference to the cost department conversion master DB 215 and registered, and the attending doctor is converted into the attending doctor code in the server 100 with reference to the other system staff master DB 218. sign up. This completes the patient hospitalization data capture process.

(Processing content-Directly indivisible processing-I / F uptake processing-Patient time ratio uptake processing by doctor)
Next, the doctor-specific patient time ratio capture process shown in FIG. 3A will be described. FIG. 12 is a diagram illustrating a configuration example and a flow of data of a doctor-specific patient time ratio capturing process. In this process, the doctor-specific patient time ratio information I / F collected from the electronic medical record system 11 is mapped in accordance with a predetermined column definition and registered in the staff-specific patient time ratio information DB 255. Specifically, the patient ID, date, and reference time included in the doctor-specific patient time ratio information I / F are registered in association with each other as the patient ID, date, and reference time in the staff-specific patient time ratio information DB 255. . Also, the department code is converted and registered in the department code in the server 100 with reference to the cost department conversion master DB 215, and the staff ID is converted into the staff ID in the server 100 with reference to the other system staff master DB 218. And register. This completes the doctor-specific patient time ratio capture processing.

(Processing content-Directly inseparable processing-I / F acquisition processing-Patient-specific operation data acquisition processing)
Next, the patient-specific operation data take-in process shown in FIG. FIG. 13 is a diagram showing an outline of the patient-specific operation data fetching process. In this process, the patient-specific operation data I / F collected from the operation management system 19 is mapped according to a predetermined column definition, and each data is registered in the patient-specific operation data DB 257 as shown. This completes the patient-specific operation data fetching process.

(Processing content-Directly indivisible processing-I / F acquisition processing-Number of meals acquisition processing)
Next, the meal number taking process shown in FIG. FIG. 14 is a diagram showing an outline of the meal number taking process. In this processing, the hospitalization calendar I / F collected from the medical accounting system 13 is mapped according to a predetermined column definition, and each data is registered in the patient meal number data DB 259 as shown. This completes the meal number taking process, and all the I / F taking processes are finished.

(Processing content-Directly inseparable processing-Service count data creation processing by service)
Next, the specific contents of the service-specific number data creation processing shown in FIG. This process is mainly executed by the service number data creation unit 302 by service.

(Processing content-Directly indivisible processing-Number-of-services data creation processing by service-First data creation processing)
First, the first data creation process will be described. 15 and 16 are diagrams showing a data configuration example and flow of the first data creation process. In this process, the medical treatment accumulation target is extracted from the patient-specific service data DB 258 and output to the service-specific number-of-services data DB 260.

  Here, in the present embodiment, the medical practice that can be determined based on the department code of the patient-specific service data DB 258 and in which department the medical practice is actually performed. It is roughly classified into medical practice that cannot be determined based on the department code of the patient-specific service data DB 258. That is, as shown in FIG. 10, the department code is a code acquired from the medical statement information I / F collected from the medical accounting system 13, but the medical accounting system 13 has its original purpose as a cost. Since it is not for calculation but for medical cost calculation, the department specified by the department code may not always match the department for cost calculation. For example, when a patient sees a medical doctor, the medical expenses corresponding to the medical examination should be recorded in the internal medicine in the medical accounting system 13 and should also be recorded in the internal medicine for cost calculation. The department specified by the system 13 matches the department in cost accounting. On the other hand, when a patient receives a prescribed medical practice belonging to the central medical department (image diagnosis in the radiology department, various operations in the operating room, etc.) under the direction of the physician, the medical expenses corresponding to the medical practice are medical accounting. Although it is recorded in the internal medicine in the system 13 (because the department for calculating medical expenses is limited to the medical department and the ward department and not the central medical department), the cost is calculated in the central medical department (radiology department or operating room). Should be accounted for. Therefore, in the present embodiment, for a medical practice that can determine which department is actually performed based on the department specified by the medical accounting system 13, the department is determined based on the department code, and is classified by service. Record the number of cases. This process is shown in FIG. On the other hand, for a medical practice in which it is not possible to determine which department is actually performed based on the department specified by the medical accounting system 13, the correspondence between the department and the medical practice is stored in advance in the medical practice accumulation target master DB 220. The department is identified by referring to this medical practice accumulation target master DB 220 (without using the department identified by the medical accounting system 13), and the number of cases by service is recorded. This process is shown in FIG. By performing such processing, it is possible to correct the difference between the medical cost calculation and the cost calculation and perform a more accurate cost calculation.

  Specifically, in the process of FIG. 15, the patient ID, date, department code, medical internal code, number of times / use number included in the patient-specific service data DB 258 are converted into the patient ID, date, department code in the service-specific number data DB 260. , Output as costing code and number of cases. Further, the cost department master DB 214 is referred to based on the department code of the patient-specific service data DB 258, and it is determined whether or not the type of medical practice number creation type corresponding to the department code is “department reference”. ”(In the case of a predetermined medical practice in which it is possible to determine which department was actually performed based on the medical internal code), the department corresponding to the department code of the patient-specific service data DB 258 Is converted into a department code in the server 100 with reference to the cost department conversion master DB 215, and the target medical practice is extracted. Further, the cost accumulation name corresponding to the medical internal code of the patient-specific service data DB 258 is specified by sequentially referring to the medical practice accumulation target master DB 220 and the medical practice master DB 219, and is output to the service-specific number data DB 260.

  On the other hand, in the process of FIG. 16, the cost department master DB 214 is referred to based on the department code of the patient-specific service data DB 258, and the number of medical practice number creation types corresponding to the department code is not “department reference”. (In the case of a medical practice in which it is impossible to determine which department was actually performed based on the department specified by the medical accounting system 13) Extract the subject's medical practice. That is, in this case, the number-of-services data is created using the department stored in the medical practice accumulation target master DB 220 without using the department code of the patient-specific service data DB 258. For example, even if the department corresponding to “medical practice = image diagnosis” in the patient-specific service data DB 258 is “department = internal medicine” or “department = ward 1”, the medical practice accumulation target master DB 220 When the department corresponding to “medical practice = image diagnosis” is “department = radiation”, the “division = radiation” is made to correspond to “clinical practice = image diagnosis” and the number-of-services data is created. This completes the first data creation process. In addition, since information (corresponding relationship information between departments and medical practices) in the medical practice accumulation target master DB 220 may vary depending on each medical institution, each medical institution conducts interviews, etc. It is preferable to set the medical treatment accumulation target master DB 220 having contents that match the actual situation of the institution.

  In each of these processes of FIGS. 15 and 16, the cost accumulation pattern setting master DB 213 is referred to, and data is created only for what is specified as a medical practice in the cost accumulation pattern setting master DB 213. This point is the same in the following second, fourth, fifth, sixth, and seventh service-specific number data creation processes.

(Processing content-Directly inseparable processing-Number-of-services data creation processing by service-Second data creation processing)
Next, the second data creation process will be described. FIG. 17 is a diagram showing a data configuration example and flow of the second data creation processing. In this process, specific insurance medical materials are extracted from the patient-specific service data DB 258 and output to the service-specific number-of-services data DB 260. Specifically, the patient ID, date, department code, and medical internal code included in the patient-specific service data DB 258 are output in association with each other as the patient ID, date, department code, and costing code in the service-specific number data DB 260. To do. Also, the specific insurance medical material master DB 217 is referred to based on the medical internal code of the patient-specific service data DB 258, and the special insurance medical material code corresponding to the medical internal code is output to the service-specific number data DB 260 as a costing name. To do. This ends the second data creation process.

(Processing content-Directly inseparable processing-Number-of-services data creation processing by service-Third data creation processing)
Next, the third data creation process will be described. FIG. 18 is a diagram illustrating a data configuration example and flow of the third data creation process. In this process, the patient's daily room information is extracted from the patient hospitalization data DB 256 and output to the service-specific number data DB 260. Specifically, the patient ID, department code (ward), and hospital room code included in the patient admission data DB 256 are output in association with each other as the patient ID, department code, and costing code in the service-specific number data DB 260. Also, the floor area information for each room is referred to based on the room code of the patient hospitalization data DB 256, and the room name corresponding to the room code is output to the service-specific number data DB 260 as a cost-accumulated name. Also, the hospitalization date and transfer date of the patient hospitalization data DB 256 are expanded by date and output to the service count data DB 260 as the date. The number of cases by service data DB 260 is fixed to 1. As the floor area information for each room, for example, the floor area information for each hospital manually input by the administrator via the maintenance terminal 40 is mapped according to the column definition and registered in the cost accumulation master DB 211. This completes the third data creation process.

(Processing content-Directly indivisible processing-Number-of-services data creation processing by service-Fourth data creation processing)
Next, the fourth data creation process will be described. FIG. 19 is a diagram illustrating a data configuration example and flow of the fourth data creation process. In this process, the patient chart reference time is extracted from the staff-specific patient-specific time ratio information DB 255 and is output to the service-specific number-of-services data DB 260. Specifically, the patient ID, date, department code, and staff ID included in the time ratio information by patient by doctor are associated with each other as the patient ID, date, department code, and costing code in the service count data DB 260. Output. Further, the staff name corresponding to the staff ID of the doctor-by-patient time-ratio information is acquired from the staff information DB 252 and the staff name is output as a costing name. This completes the fourth data creation process.

(Processing content-Directly indivisible processing-Number-of-services data creation processing by service-Fifth data creation processing)
Next, the fifth data creation process will be described. FIG. 20 is a diagram illustrating a data configuration example and flow of the fifth data creation process. In this process, the patient operation time is extracted from the patient-specific operation data DB 257 and output to the service-specific number-of-services data DB 260. Specifically, the patient ID, date, and staff ID included in the patient-specific operation data DB 257 are output in association with each other as the patient ID, date, and costing code in the service-specific number data DB 260. Moreover, the staff name corresponding to the staff ID of the patient-specific surgery data DB 257 is acquired from the staff information DB 252 and the staff name is output as a cost-accumulated name. The department code in the service-specific number data DB 260 is fixed to a predetermined department code assigned to the operating room. This completes the fifth data creation process.

(Processing content-Directly indivisible processing-Number-of-services data creation processing by service-Sixth data creation processing)
Next, the sixth data creation process will be described. FIG. 21 is a diagram showing a data configuration example and flow of the sixth data creation process. In this process, the patient operation occupancy time is extracted from the patient operation data DB 257 and output to the service number data DB 260. Specifically, the patient ID and date included in the patient-specific surgery data DB 257 are output in association with each other as the patient ID and date in the service-specific number-of-services data DB 260. Further, the integrated value of the operation time in the patient-specific operation data DB 257 is output as the number of cases (here, “number of cases” is actually a time value). Further, the cost accumulation code and cost accumulation name of the cost accumulation master DB 211 are output as the cost accumulation code and cost accumulation name in the service-specific number data DB 260. The cost accumulation code in the service-specific number data DB 260 is fixed to a predetermined department code assigned to the operating room. This completes the sixth data creation process.

(Processing content-Directly indivisible processing-Number-of-services data creation processing by service-Seventh data creation processing)
Next, the seventh data creation process will be described. FIG. 22 is a diagram illustrating a data configuration example and flow of the seventh data creation process. In this process, the daily meal number information of the patient is extracted from the patient meal number data DB 259 and is output to the service-specific number data DB 260. Specifically, the number of meals for each day is specified based on the date, patient ID, and each meal number data included in the patient meal number data DB 259, and for each day, the month, the patient ID, and each day. Output the number of meals in relation to each other. That is, each data of the patient meal number data DB 259 includes, for each month, the first record in the first record, the second meal in the second record, and the last record in the last record. Since the number of meals corresponding to the end of the month is stored, this is expanded into data for each month and day. Further, the department code corresponding to the patient ID in the patient meal number data DB 259 is acquired from the service-specific number data DB 260 output in the third data creation process and is output to the service-specific number data DB 260 in this process. Further, the cost accumulation code and cost accumulation name of the cost accumulation master DB 211 are output as the cost accumulation code and cost accumulation name in the service-specific number data DB 260. This completes the seventh data creation process.

(Processing content-Directly indivisible processing-Number-of-services data creation processing by service-Eighth data creation processing)
Next, the eighth data creation process will be described. 23 to 25 are diagrams illustrating a data configuration example and a flow of the eighth data creation process. In this process, as in FIG. 10, the medical statement information I / F collected from the medical accounting system 13 is mapped in accordance with a predetermined column definition and registered in the patient-specific service data DB 258. 15 and 16, patient medical practice data is extracted from the patient-specific service data DB 258 by referring to the medical practice accumulation target master DB 220 and the medical practice master DB 219 and registered in the service-specific case data DB 260. . Next, as shown in FIG. 23, the service-specific number-of-services data DB 260 is totaled excluding the cost accumulation code. Further, the cost accumulation code and cost accumulation name of the cost accumulation master DB 211 are output as the cost accumulation code and cost accumulation name in the service-specific number data DB 260. The number of cases is fixed at 1. Using the service-specific case data (hereinafter referred to as intermediate service-specific data) created in this way, the medical technology-related patient-specific case-by-service data and the hospital-wide patient-specific case-by-service data create. For data for medical technology, as shown in FIG. 24, the cost department master DB 214 is referred to, the department code corresponding to the department type “ward” is specified, and the number of data for each intermediate service including this department code is obtained. It is created by extracting and totaling the extracted number of cases by intermediate service, excluding department codes. The department code is fixed to the medical technology system. As for data common to hospitals, as shown in FIG. 25, data on the number of cases by intermediate service is totaled excluding the department code. The department code is fixed for all hospitals. Thus, the eighth data creation process is completed, and all the service count data creation processes for all services are completed.

(Processing content-Directly indivisible processing-Rolling coefficient calculation processing)
Next, the specific content of the calculation coefficient calculation process shown in FIG. This process is mainly executed by the product factor calculation unit 303. This processing is roughly divided into three types: medical practice type processing, cost increase factor type processing, and number-of-services type processing. In the medical practice type process and the cost increase coefficient type process, the increase coefficient calculation is performed by referring to the weight set in advance in the master, whereas in the service type number type process, the weight set in the master in advance is calculated. Does not exist, calculates the roll-up coefficient using the number of cases by service. However, the medical practice type process and the cost increase coefficient type process are different from each other because the master to be referred to is different and the process of whether to refer to the consignment category is different.

(Processing content-Directly indivisible processing-Rolling coefficient calculation processing-Medical practice type processing)
First, the medical practice type process will be described. FIG. 26 is a diagram illustrating a configuration example and a flow of data of medical practice type processing. Here, as a premise, in the increase coefficient master DB 221, as an increase coefficient corresponding to at least a part of each medical practice, an increase coefficient determined for each medical institution in which the system 1 is used, or a public coefficient It is assumed that an equivalent coefficient determined by an engine or the like is stored in advance. In this medical practice type processing, for a medical practice in which the roll-up coefficient is not yet set in the roll-up coefficient master DB 221 (for example, a predetermined medical practice (examination, image diagnosis, surgery) performed in the central medical department). Only the increase coefficient is calculated, and this increase coefficient is registered in the increase coefficient master DB 221.

  Specifically, the roll-up coefficient master DB 221 is referred to based on the department code and cost accumulation code of each record included in the service-specific number data DB 260, and the records corresponding to these department code and cost accumulation code are accumulated. It is determined whether or not the coefficient master DB 221 already exists. When such a record exists, the increase coefficient is already registered in the record, and therefore, no registration of the increase coefficient is necessary.

  On the other hand, when such a record does not exist, the department code and the cost accumulation code included in the service-specific number data DB 260 are output in association with each other as the department code and the cost accumulation code in the accumulation coefficient master DB 221. . In addition, the medical practice master DB 219 is referred to based on the costing code included in the service-specific number data DB 260, and the code table number and score of the record that holds the costing code as the medical practice code are acquired. Based on the table number and the score, the product coefficient is calculated and registered in the product coefficient master DB 221.

(Processing content-Directly indivisible processing-Rolling coefficient calculation processing-Medical practice type processing-Rolling coefficient identification processing)
FIG. 27 shows a flowchart of the increase coefficient specifying process in FIG. In this process, a roll-up coefficient is calculated based on the code table number acquired from the medical practice master DB 219. Specifically, referring to the consignment category in the medical practice master DB 219, when the cost accumulation pattern is the inspection consignment cost (step SA-1, Yes), and the consignment category is “consignment” ( (Step SA-2, Yes), the accumulation coefficient = the score of the medical practice (Step SA-3), and when the commissioning category is not “consignment” (when “in-hospital”) (Step SA-2, No) ), The product coefficient is set to 0 (step SA-4). Further, when the cost accumulation pattern is other than the inspection commission cost (step SA-1, No), when the commission category is "consignment" (step SA-5, Yes), the cost coefficient = 0. (Step SA-4), and when the entrustment classification is not “consignment” (Step SA-5, No), the increase coefficient = the score of the medical practice (Step SA-3). This is because the inspection consignment cost when the inspection consignment fee is outsourced to the hospital and the inspection consignment fee when other expenses are outsourced are actually zero. After specifying the increase coefficient in this way, the increase coefficient is registered in the increase coefficient master DB 221 and the increase coefficient calculation process is completed. Then, as shown in FIG. 26, the increase coefficient specified in the increase coefficient calculation process is registered in the increase coefficient master DB 221, and the medical practice type process is completed.

  In the medical practice type processing of FIG. 26, it has been described that the increase coefficient is stored in advance in the increase coefficient master DB 221. However, the increase coefficient is newly calculated or the initial value is set as the initial value. It is also possible to update the roll-up coefficient. For example, as shown in FIG. 28, the calculation coefficient of the medical action to be calculated (here, operation A) is the cost per operation of the operation A per specific service serving as the calculation standard. It is calculated by dividing by the cost (cost based on the cost factor). The cost per operation A is calculated by totaling various costs (for example, salary costs and equipment-related costs) used to perform the operation A.

  The salary cost per operation A is calculated by multiplying the average required time of each medical person involved in the operation A by the hourly wage of the medical person. For example, when three people, a doctor, a nurse, and an engineer, are involved as medical personnel, salary cost = (average doctor operating time x doctor hourly salary) + (average nurse salary) 1 operation time x nurse's hourly wage) + (average time required per engineer x hourly wage of the technician).

  The equipment-related costs per operation A are the medical equipment and equipment depreciation expenses, medical equipment and equipment rent, medical equipment and equipment repair costs, and medical equipment and equipment maintenance fees per operation A. And it is calculated by totaling the equipment and equipment insurance premiums. For example, the depreciation cost for medical instrument equipment per operation A is calculated by adding up the depreciation expenses for medical instrument equipment per operation for all medical devices used in operation A. The The medical instrument equipment depreciation cost per medical device is calculated as the sum of the cost amortization costs for each medical device service used for the operation A. The total cost amortization cost for each medical device used for this operation A is calculated by equation (1) in FIG. The information used for each calculation can be acquired from the related system group 10 or the service-specific number data DB 260 registered so far, or can be calculated based on the information acquired in this way. For example, a doctor's hourly wage can be acquired from the personnel salary system 15 of the related system group 10, and an average doctor's operating time per operation can be acquired from the surgical management system 19, and medical instrument equipment depreciation The cost can be acquired from the fixed asset system 17. By calculating the increase coefficient in this way, it is possible to perform cost calculation that reflects the difference in weight for each medical practice from the viewpoint of cost.

(Processing-Directly Indivisible Processing-Rolling Factor Calculation Processing-Cost Rolling Factor Type Processing)
Next, the cost accumulation coefficient type process shown in FIG. FIG. 29 is a diagram illustrating a data configuration example and a flow of cost increase coefficient type processing (in the case of specific insurance medical materials), and FIG. 30 is a data configuration example and flow of cost increase coefficient type processing (in the case of bed area) FIG. In this process, the cost coefficient is calculated based on the coefficient of the cost price master DB 211.

  Specifically, when calculating the increase coefficient of the specific insurance medical material, as shown in FIG. 29, the department code included in the service-specific number-of-services data DB 260 is set as the department code of the increase coefficient master DB 221. Further, the special insurance medical material master DB 217 is referred to based on the cost accumulation code included in the service-specific number data DB 260, and the special insurance medical material code and unit score of the record holding the cost accumulation code as the special insurance medical material code. Are registered in the product factor master DB 221 as the cost product code and product factor.

  When calculating the roll-up coefficient of the bed area, as shown in FIG. 30, the department code included in the service-specific number data DB 260 is set as the department code of the roll-up coefficient master DB 221. Further, the cost accumulation master DB 211 is referred to based on the cost accumulation pattern code and the cost accumulation code included in the service-specific number data DB 260, and the cost accumulation of records holding these cost accumulation pattern code and cost accumulation code is referred to. The upper pattern code, the cost increase code, and the cost increase coefficient are acquired, and these are registered in the increase coefficient master DB 221 as the cost increase pattern code, the cost increase code, and the increase coefficient. This completes the costing factor type processing.

(Processing-Directly indivisible processing-Rolling coefficient calculation processing-Number-of-services processing by service)
Next, the number-of-services type process by service shown in FIG. FIG. 31 is a diagram illustrating a configuration example and a flow of data of the number-of-services type processing. In this process, the roll-up coefficient is calculated based on the number of cases in the service-specific case number data DB 260. Specifically, the cost accumulation pattern code, department code, and cost accumulation code included in the service-specific number data DB 260 are set as the cost accumulation pattern code, department code, and cost accumulation code in the accumulation coefficient master DB 221. . Also, the total number of cases included in the number-of-services data DB 260 is registered in the product factor master DB 221 as a product factor. The reason why the total number of cases is used as the increase factor is as follows. In other words, the reciprocal of the total is a product factor, but if the reciprocal is used, the error in calculation processing becomes large. Therefore, the total value is obtained here, and the total value is calculated in the service unit cost calculation process described later. Is used as the denominator of division. This completes the number-of-services type process for each service, and all the roll-up coefficient calculation processes are completed.

(Processing content-Directly indivisible processing-Directly indivisible calculation processing)
Next, the specific contents of the direct charge indivisible calculation process shown in FIG. This process is mainly executed by the direct impregnable calculation unit 304.

(Processing content-Directly indivisible processing-Directly indivisible calculation processing-Service unit cost calculation processing)
First, the service unit cost calculation process shown in FIG. 32 and 33 are diagrams showing a configuration example and a flow of data of service unit cost calculation processing. In this process, as shown in FIG. 32, the service refers to the cost accumulation pattern setting master DB 213, and services based on the cost coefficient according to each cost accumulation pattern for each department item of the cost accumulation pattern setting. Create unit costs. Specifically, the coefficient calculation classification corresponding to the costing pattern code included in the costing pattern setting master DB 213 is acquired from the costing pattern master DB 212. Further, the service count data DB 260 is referred to based on the department code and costing pattern code included in the costing pattern setting master DB 213, and the number of records from the records that match the combination of these department code and costing pattern code is obtained. In addition to the acquisition, the acquisition coefficient corresponding to the cost increase code included in this record is acquired from the increase coefficient master DB 221.

  Next, as shown in FIG. 33, referring to the product data DB 262 based on the department code and costing pattern code included in the costing pattern setting master DB 213, the combination of these department code and costing pattern code Get the accumulated amount from the record that matches.

  Thereafter, as shown in FIG. 3 (a), according to the coefficient calculation classification acquired from the cost accumulation pattern master DB 212, the medical practice type and the cost accumulation coefficient type process, the time study reference process, the accumulation object data reference process The service unit cost is calculated by performing any one of the processes. Among these, in the medical practice type and the cost increase coefficient type process, the increase coefficient stored in the increase coefficient master DB 221 by the medical action type process (FIG. 26) and the cost increase coefficient type process (FIG. 29) is used. Perform costing. In the time study reference process and the roll-up target data reference process, cost calculation is performed using the roll-up coefficient stored in the roll-up coefficient master DB 221 by the number-of-services type process (FIG. 31). Those that can be simply costed by accumulating are those that are costed as data to be processed for reference, and cannot simply be calculated ("Correction of data to be added" described later is required) Cost calculation is performed as a time study reference process.

(Processing content-Directly indivisible processing-Directly inseparable calculation processing-Medical practice type and cost increase factor type processing)
First, the medical practice type and cost increase coefficient type processing will be described. FIG. 34 is a diagram showing a configuration example and a flow of the medical practice type and cost increase coefficient type processing. In this process, referring to the cost accumulation pattern setting master DB 213, the service unit cost is calculated on the basis of the accumulation coefficient for each medical activity in which the coefficient calculation classification of the cost accumulation pattern is the medical activity type and the cost accumulation coefficient type. create. Specifically, the service unit cost for the medical treatment A to be calculated = the accumulated amount of the department code and the subject code to which the medical practice A belongs × the increase coefficient of the medical practice A / (the department to which the medical practice A belongs The cumulative coefficient for each medical practice × the number of implementations for each medical practice is a value obtained by adding up all the medical practices in the department to which the medical practice A belongs).

  For example, as shown in FIG. 35, the department is an operating room, and the operating room has an accumulated amount of 1 million yen, and the medical practice belonging to the department includes wound treatment, skin / subcutaneous tumor extraction, hernia surgery, bone marrow When transplantation is performed, and each of these factors is 1.50, 0.50, 1.00, 2.00, and the number of implementations for each is 20, 30, 45, and 5 The service unit costs are calculated as 15,000 yen, 5,000 yen, 10,000 yen, and 20,000 yen. The service unit cost calculated in this way and the increase coefficient used for the calculation are stored in the service unit cost data DB 261 as the service unit cost and the calculated time increase coefficient.

(Processing content-Directly inseparable processing-Directly inseparable calculation processing-Time study reference processing)
Next, the time study reference process shown in FIG. 36 and 37 are diagrams showing a configuration example and a flow of the time study reference process. In this process, with reference to the cost accumulation pattern setting master DB 213, a service unit cost is created on the basis of the accumulation coefficient for a pattern whose cost calculation pattern coefficient calculation classification is the service count type (see time study). Specifically, as shown in FIG. 36, when the cost calculation pattern coefficient calculation classification is the chart reference time, all the cost increase codes extracted by the increase coefficient calculation processing by a predetermined calculation formula are used. A service unit cost is created for each (staff ID). That is, the staff ID and the amount corresponding to the department code and subject code included in the costing pattern setting master DB 213 are acquired from the staff time study information DB 254, and are included in the acquired staff ID and costing pattern setting master DB 213. Acquire the increase coefficient corresponding to the department code and the cost increase pattern code from the increase coefficient master DB 221 and divide the amount (personnel cost) acquired from the staff time study information DB 254 by the acquired increase coefficient. Thus, the service unit cost is calculated. The service unit cost calculated in this way and the increase coefficient used for the calculation are stored in the service unit cost data DB 261 as the service unit cost and the calculated time increase coefficient.

  However, if it cannot be processed by the above calculation method, as shown in FIG. 37, after correcting the data to be accumulated, the service unit cost is calculated by the above-mentioned medical practice type and cost accumulation factor type processing. . The case where the above calculation method cannot be used is a case where “correction of data to be accumulated” may be necessary. That is, when personnel expenses are incurred but are not recorded in the medical accounting system 13 (for example, salary is paid to the trainee, labor costs are incurred, It is not counted in the medical accounting system 13). Here, whether or not this is the case is specified by referring to the product factor master DB 221 and the staff time study information DB 254. If these are the case, the costing code (staff ID) corresponding to the department code and costing code included in the costing pattern setting master DB 213 is acquired from the costing coefficient master DB 221, and the acquired staff ID and The amount corresponding to the department code and subject code included in the cost accumulation pattern setting master DB 213 is acquired from the staff time study information DB 254. Then, the acquired amount is corrected by subtracting the acquired amount from the accumulated amount corresponding to the year, month, subject code, and department code in the staff time study information DB 254. Then, the service unit cost is calculated by performing the above-described medical practice type and cost increase factor type processing based on the corrected data to be added DB 262, and the calculated service unit cost and the product used for the calculation are calculated. The upper coefficient is stored in the service unit cost data DB 261 as the service unit cost and the calculated time accumulation coefficient.

(Processing content-Directly inseparable processing-Directly inseparable calculation processing-Reference data reference processing)
Next, the accumulation target data reference process shown in FIG. FIG. 38 is a diagram illustrating a configuration example and a flow of the loading target data reference processing. In this process, with reference to the cost accumulation pattern setting master DB 213, a service unit cost is created on the basis of the accumulation coefficient for a pattern whose cost calculation pattern coefficient calculation type is the number-by-service type (see data to be accumulated) To do. Specifically, the amount of money corresponding to the department code and item code of the cost accumulation pattern setting master DB 213 is acquired from the accumulation object data DB 262. Further, the costing pattern setting master DB 213 acquires the department code and the costing coefficient corresponding to the costing pattern code from the costing coefficient master DB 221. Then, the service unit cost is calculated by dividing the acquired accumulated amount by the acquired accumulation factor. The service unit cost calculated in this way and the increase coefficient used for the calculation are stored in the service unit cost data DB 261 as the service unit cost and the calculated time increase coefficient. This completes the direct impossibility calculation process, and all the direct impossibility calculations end.

(Processing content-Direct processing)
Next, the direct charge processing for calculating the direct charge in FIG. 3B will be described. However, for the processing without special mention, the same processing as the direct-indivisible processing can be performed.

(Processing content-Direct processing-I / F import processing)
First, the specific contents of the I / F acquisition process shown in FIG. This process is mainly executed by the I / F acquisition processing unit 301. Hereinafter, each process included in the I / F acquisition process will be sequentially described.

(Processing content-Direct processing-I / F acquisition processing-Article master acquisition processing)
First, the article master take-in process will be described. 39 and 40 are diagrams showing a configuration example and a flow of data of the article master take-in process. In this process, the article master I / F collected from the logistics system 16 is mapped in accordance with a predetermined column definition and registered in the article master DB 222 and the other system article master DB 223. Further, matching of articles is performed on the collected articles from the medical score master I / F collected from the medical accounting system 13, and the medical billing amount is registered in the article master DB 222. Specifically, as shown in FIG. 39, each data of the article master I / F is registered in the article master DB 222. However, for the item code of the article master I / F, the cost item to be registered is determined, and the item code corresponding to the determined cost item is registered. This determination is performed using a correspondence table (not shown) of classification codes and cost items set in advance for each type (for example, pharmaceuticals or materials) to be taken in, and corresponds to the classification code of the article master I / F. The cost item is specified with reference to the corresponding table. For medical unit conversion conversion, only a predetermined number of digits of the internal code of the medical score master I / F is extracted and registered. As shown in FIG. 40, among the data included in the article master DB 222 thus registered, the system type and the article name are registered as the system type and the other system article name in the other system article master DB 223. The article code of the article master DB 222 is registered as the other system article code and the article code in the other system article master DB 223, and the other system type and other system unit conversion are fixed to the surgical management system and 1, respectively. This completes the article master take-in process.

(Processing content-Direct processing-I / F acquisition processing-Other system article master acquisition processing)
Next, the other system article master taking process will be described. 41 and 42 are diagrams showing a configuration example and a flow of data of another system article master take-in process. In this process, the medical score master I / F collected from the medical accounting system 13 is mapped in accordance with a predetermined column definition and registered in the other system article master DB 223. Specifically, in the case of a medicine, as shown in FIG. 41, data whose data classification is medicine is extracted from the medical score master I / F, and the internal code, display name, The input unit is registered as the other system article code, the other system article name, and the other system unit. The other system type and other system unit conversion of the other system article master DB 223 are fixed to “medical DPC system” and “1”, respectively. The system type of the other system article master DB 223 is fixed to the medicine management system. In the article code of the other system article master DB 223, the individual medicine code of the medical score master I / F is registered. In the case of materials, the system type of the other system article master DB 223 is fixed to the medical DPC system and the article code of the other system article master DB 223 is set as shown in FIG. Registers the internal code of the medical score master I / F. This completes the article master taking process, and all the I / F taking processes are finished.

(Processing content-Direct processing-Direct calculation processing)
First, the specific contents of the direct calculation process shown in FIG. This process is mainly executed by the direct calculation unit 305. Hereinafter, each process included in the direct calculation process will be sequentially described.

(Processing content-direct processing-purchase price calculation processing)
First, the purchase price calculation process will be described. In this process, a purchase price is calculated for an article registered in the article master DB 222. Here, when the calculation target article is a drug, the purchase price is calculated for each individual drug code, and data is generated in the article master DB 222 for each individual drug code. On the other hand, when the article to be calculated is a material, the purchase price is calculated for each medical code, and data is generated in the article master DB 222 for each medical code.

  FIG. 43 is a diagram illustrating a configuration example and a flow of data of a drug purchase price calculation process. Specifically, for drugs already registered in the article master DB 222, since the JAN (Japanese Article Number) code of the drug is set in “other codes 1 to 5”, “other codes 1” to “other codes” In order up to “5”, individual drug codes corresponding to each JAN code are acquired from the standard drug master DB 224. Then, the purchase price of each individual drug unit is calculated for each acquired individual drug code unit, and data is added to the article master DB 222. At this time, the individual pharmaceutical code is registered as an article code. Further, the article code is fixed to a predetermined code (here, a medicine management system). The calculation of the purchase price of an individual drug unit is performed by the sum of (number of purchases × unit price of purchase unit) / (sum of purchases × minimum unit conversion × medical unit conversion) of the drug. When the total number of purchases of the drug is 0, the purchase number is calculated as 1. By performing such a calculation, it is possible to calculate a unit price (purchased unit price in the scope of claims) according to the purchase record of the medicine.

  FIG. 44 is a diagram illustrating a data configuration example and flow of the material purchase price calculation processing. Specifically, for the material registered in the article master DB 222, since the medical code of the material is set in “other code 1”, the purchase price is calculated for each medical code and the article master DB 222 is used. Add data to the. At this time, the medical code is registered as an article code. The article code is fixed to a predetermined code (here, medical DPC system). The calculation of the purchase price for each medical code is the same as that for the above-mentioned pharmaceutical. By performing such a calculation, it is possible to calculate a unit price corresponding to the purchase record of the material (a purchase record unit price in the scope of claims). This completes the purchase price calculation process.

(Processing-Direct processing-Conversion source material cost calculation processing)
Next, the conversion source material cost calculation process shown in FIG. FIG. 45 is a diagram showing a data configuration example and flow of conversion source material cost calculation processing. In this process, the material of each department system is matched with the material for purchase, and the purchase price of the patient-specific article consumption data DB 263 is updated. Specifically, the other system type and other system article code corresponding to the system type and article code of the article master DB 222 are obtained from the other system article master DB 223, and the obtained other system type and other system article code are patient-specific items. The system type and article code in the consumption data DB 263 are registered. Also, the item code of the item code is registered as the item code in the patient-specific item consumption data DB 263. Further, based on the purchase unit purchase price of the article master DB 222 and the other system unit conversion of the other system article master DB 223, the purchase price = the purchase unit purchase price / the other system unit conversion is calculated. Register in the consumption data DB 263. The patient-specific article consumption data DB 263 to be updated includes the date, patient number, detailed examination section, and detailed amount acquired from the medical statement information I / F in FIG. It is registered as an ID, an article code (converted with reference to the score master I / F), and a purchase price. However, if there is a system that can more accurately acquire the consumption information of the article, it is preferable to acquire the detailed amount from the system. This completes the conversion source material cost calculation process.

(Processing-Cost calculation by patient)
Finally, the specific contents of the cost calculation process for each patient shown in FIG. This processing is mainly performed by the patient-specific cost calculation unit 306, and data obtained by extracting data necessary for the analysis of patient-specific costs from the direct and indivisible parts calculated by the previous processing. The patient-specific cost calculation data mart DB 265 as a set is created. Then, for this patient-specific cost calculation data mart DB 265, various data are aggregated and output from an arbitrary viewpoint (axis).

(Processing-Cost calculation processing by patient-Cost calculation data mart creation processing by patient)
First, patient-specific cost calculation data mart creation processing will be described. 46 to 52 are diagrams showing a configuration example and a flow of data of the cost calculation data mart creation processing by patient. In this process, the data created in each of the direct cost calculation and direct calculation is added to the patient-specific cost calculation data mart DB 265.

  Specifically, as shown in FIG. 46, the cost accumulation pattern code, patient ID, date, department code, cost accumulation code, and number of cases in the case-by-service number data DB 260 created by direct indivisible cost calculation are classified by patient. The cost calculation data mart DB 265 adds the cost accumulation pattern code, patient ID, date axis key, department code, cost accumulation code, and number of cases. In addition, the service unit cost corresponding to the combination of the cost accumulation pattern code, the department code, and the cost accumulation code in the service count data DB 260 is acquired from the service unit cost data DB 261, and the acquired service unit cost and service The revenue amount is calculated by multiplying the number of cases acquired from the separate number data DB 260 and added to the patient-specific cost calculation data mart DB 265. Hospitalization days are set to zero. Note that “concat_key_domain” in FIG. 46 indicates the character string processing when setting the acquisition source information in the patient-specific cost calculation data mart DB 265, and combines the character string of the hospital domain and the acquisition source character string. For example, a hospital domain character string and a date character string are combined and set as a date axis key (the same applies to FIGS. 50 to 52 described later).

  As shown in FIG. 47, the cost department conversion master DB 215 and the cost item conversion master DB 216 are referred to from the related system group 10, the departmental cost calculation server 30, or the patient direct data I / F collected by manual input. The patient-specific direct data DB 268 is created.

  Then, as shown in FIG. 48, a record is added to the patient-specific direct calculation data 266 based on the patient-specific direct data DB 268. In addition, the date, patient number, detailed examination section, and detailed amount acquired from the medical details information I / F in FIG. 10 are displayed as the date, patient ID, and item code (point master I / F in the patient-specific item consumption data DB 263). Register as purchase price).

  Further, as shown in FIG. 49, a record is added to the patient-specific direct calculation data DB 266 while referring to the other system item master 223 based on the patient-specific item consumption data DB 263.

  Next, as shown in FIG. 50, the cost calculation pattern code, date, patient ID, subject code, department code, system type, direct content code, number, and direct charge amount of the direct calculation data DB 266 for each patient, Additional cost calculation data Mart DB 265 is added as cost accumulation pattern code, date axis key, patient ID, item code, department code, system type, cost accumulation code, number of cases, and cost amount. The number of hospitalization days is set to zero.

  Further, as shown in FIG. 51, the date, patient ID, and revenue of the patient-specific daily revenue data mart DB 264 are added as the date axis key, patient ID, and revenue amount of the patient-specific cost calculation data mart DB 265. The number of hospitalization days is set to zero. The patient-specific daily revenue data mart DB 264 is created by mapping data extracted from the medical statement information I / F collected from the medical accounting system 13 according to the column definition.

  Further, as shown in FIG. 52, the date, patient ID, staff ID, diagnosis group classification number, and number of hospitalization days of the patient-specific daily data DB 267 are converted into the date axis key, patient axis key of the patient-specific cost calculation data mart DB 265, It adds as staff ID, diagnosis group classification number, hospitalization days. This completes the patient-specific cost calculation data mart creation process. Hospitalization days are set to zero. The patient-specific daily data DB 267 is created by mapping data extracted from the patient hospitalization data DB 256, the staff-specific patient time ratio information DB 255, and the patient diagnosis group classification data according to the column definition. The patient diagnosis group classification data is created by mapping the patient diagnosis group classification application information I / F collected from the medical accounting system 13 according to the column definition.

(Processing-Cost calculation by patient-Cost output by patient)
Finally, the patient-specific cost output process shown in FIG. Here, by inputting an arbitrary key at an arbitrary timing through the reference terminal 50, the data added to the patient-based cost calculation data mart DB 265 is targeted for two-dimensional or three-dimensional data. Extraction is performed, and the extracted data is transmitted to the reference terminal 50 in a predetermined format and output by an output device such as a monitor of the reference terminal 50.

  The details of the two-dimensional or three-dimensional data extraction and format conversion can be omitted because known processing can be used. For example, FIG. 53 shows an MDC (Major Diagnostic) of a diagnostic group whose cost is to be referred to. Indicates the output result when the Category) code and diagnostic classification code are entered as keys. In this case, all records corresponding to the diagnosis group classification number including the MDC code and diagnosis classification code input as keys are extracted from the patient-specific cost calculation data mart DB 265, and the predetermined records included in the extracted records are included. Information (here, diagnosis group classification number, patient ID, length of hospitalization, cost (cost amount), revenue (revenue amount)) and information (here, diagnosis group classification) acquired or calculated by a predetermined method based on these information The name of the disease acquired from the predetermined DB based on the number, the profit and the profit rate calculated based on the cost and the profit) are output. This ends the patient-specific cost output process, and all patient-specific cost calculation processes are completed.

[II] Modifications to Embodiments Although the embodiments of the present invention have been described above, the specific configuration and method of the present invention are within the scope of the technical idea of each invention described in the claims. Can be arbitrarily modified and improved. Hereinafter, such a modification will be described.

(About problems to be solved and effects of the invention)
The problems to be solved by the invention and the effects of the invention are not limited to the above-described contents, and the present invention solves the problems not described above or produces the effects not described above. In addition, only a part of the described problems may be solved or only a part of the described effects may be achieved.

(About configuration and control)
Further, all or any part of the control described as being automatically performed in each of the above embodiments may be performed manually, and conversely, all or any of the control described as being performed manually is performed. A part may be automated based on a known technique or the idea described above. Moreover, you may comprise a part or all of each functional block of each component shown in the said embodiment with a hard wired logic.

(About distribution and integration)
Each electrical component described above is functionally conceptual and does not necessarily need to be physically configured as illustrated. In other words, the specific form of distribution / integration of each part is not limited to the one shown in the figure, and all or a part thereof may be functionally or physically distributed / integrated in arbitrary units according to various loads and usage conditions. Can be configured. For example, a part of the functions of the related system group 10 may be provided in the patient-specific cost calculation server 100, or the functions of the patient-specific cost calculation server 100 may be distributed to a plurality of server groups.

(About the roll-up coefficient)
In the above embodiment, the increase coefficient is sequentially calculated in the system 1, but when a standard increase coefficient (equivalent coefficient) for each medical practice is provided by a public institution or the like, The equivalent coefficient may be stored in advance in the storage unit 200 as an equivalent coefficient DB, and the equivalent coefficient acquired from the equivalent coefficient DB may be used as a product coefficient as necessary. In addition, the standard roll-up coefficient stored in advance is used in the initial stage of the introduction of the system 1, and the roll-up coefficient is increased when the accumulation of various data increases as the system 1 is operated. May be sequentially updated and replaced with a product coefficient specific to the system 1. By updating the roll-up coefficient in this way, it is possible to calculate patient-specific costs using the roll-up coefficient that reflects the characteristics of the medical institution where the system 1 is introduced, and patients that match the actual conditions of each medical institution A separate cost can be acquired.

(Regarding the calculation method of the roll-up coefficient)
The method for calculating the coefficient of increase is not limited to the method described above. For example, even for a medical practice belonging to a predetermined first cost item, if the number of cases corresponds to the cost, the increase coefficient may be calculated by the number-of-services type process. On the contrary, even if it is a medical practice that belongs to the predetermined third cost item, if the specific gravity of personnel expenses or the like is large, the increase factor may be calculated by a medical practice type process.

It is explanatory drawing which shows notionally the whole structure of the cost calculation system classified by patient which concerns on embodiment of this invention. It is a figure which shows the cost calculation pattern which concerns on embodiment. It is a figure which shows the outline | summary of the cost calculation logic which concerns on embodiment, (a) is the logic of a direct part indivisible process, (b) is the logic of a direct part process, (c) is the logic of the cost calculation process according to a patient. is there. It is a figure which shows the structural example and flow of data of the cost calculation process according to department. It is a figure which shows the structural example and flow of data of a labor cost information taking-in process. It is a figure which shows the structural example and flow of data of a time study information taking process. It is a figure which shows the outline | summary of a medical treatment master acquisition process. It is a figure which shows the outline | summary of a special medical material master taking-in process. It is a figure which shows the outline | summary of a bed area taking-in process. It is a figure which shows the structural example and flow of data of medical statement data taking-in processing. It is a figure which shows the structural example and flow of data of a patient hospitalization data taking-in process. It is a figure which shows the structural example and flow of data of the doctor time ratio acquisition process according to doctor. It is a figure which shows the outline | summary of the operation data acquisition process classified by patient. It is a figure which shows the outline | summary of a meal number taking-in process. It is a figure which shows the structural example and flow of data of a 1st data creation process. It is a figure which shows the structural example and flow of data of a 1st data creation process. It is a figure which shows the structural example and flow of data of a 2nd data creation process. It is a figure which shows the structural example and flow of data of a 3rd data creation process. It is a figure which shows the structural example and flow of data of a 4th data creation process. It is a figure which shows the structural example and flow of data of a 5th data creation process. It is a figure which shows the structural example and flow of data of a 6th data creation process. It is a figure which shows the structural example and flow of data of a 7th data creation process. It is a figure which shows the structural example and flow of data of an 8th data creation process. It is a figure which shows the structural example and flow of data of an 8th data creation process. It is a figure which shows the structural example and flow of data of an 8th data creation process. It is a figure which shows the structural example and flow of data of a medical practice type | mold process. It is a flowchart of an increase coefficient specific process. It is a figure which shows the calculation method of a coefficient of increase. It is a figure which shows the structural example and flow of data of a cost increase coefficient type | mold process (in the case of specific insurance medical material). It is a figure which shows the structural example and flow of data of a cost increase coefficient type | mold process (in the case of a bed area). It is a figure which shows the example of a structure and flow of data of the number type process according to service. It is a figure which shows the structural example and flow of data of a service unit cost calculation process. It is a figure which shows the structural example and flow of data of a service unit cost calculation process. It is a figure which shows the structural example and flow of a medical treatment type | mold and cost increase coefficient type | mold process. It is a figure which shows the example of calculation of a service unit cost. It is a figure which shows the structural example and flow of a time study reference process. It is a figure which shows the structural example and flow of a time study reference process. It is a figure which shows the structural example and flow of a roll-up object data reference process. It is a figure which shows the structural example and flow of data of an article | item master taking-in process. It is a figure which shows the structural example and flow of data of an article | item master taking-in process. It is a figure which shows the structural example and flow of the data of other system goods master taking-in process. It is a figure which shows the structural example and flow of the data of other system goods master taking-in process. It is a figure which shows the structural example and flow of data of the purchase price calculation process of a pharmaceutical. It is a figure which shows the structural example and flow of data of the purchase price calculation process of material. It is a figure which shows the structural example and flow of data of the conversion source material cost calculation process. It is a figure which shows the structural example and flow of the data of cost calculation data mart preparation processing classified by patient. It is a figure which shows the structural example and flow of the direct calculation data classified by patient. It is a figure which shows the structural example and flow of the direct calculation data classified by patient. It is a figure which shows the structural example and flow of the direct calculation data classified by patient. It is a figure which shows the structural example and flow of the data of cost calculation data mart preparation processing classified by patient. It is a figure which shows the structural example and flow of the data of cost calculation data mart preparation processing classified by patient. It is a figure which shows the structural example and flow of the data of cost calculation data mart preparation processing classified by patient. It is a figure which shows the example of a data output.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Cost calculation system classified by patient 10 Related system group 11 Electronic medical record system 12 Nursing PDA system 13 Medical accounting system 14 Financial accounting system 15 Personnel pay system 16 Logistics system 17 Fixed asset system 18 Purchasing system 19 Surgery management system 20 Medical examination system 30 Department Separate cost calculation server 40 Maintenance terminal 50 Reference terminal 60 Network 100 Patient-specific cost calculation server 200 Storage unit 210 Master DB group 211 Cost accumulation master DB
212 Costing pattern master DB
213 Costing pattern setting master DB
214 Cost Department Master DB
215 Cost department conversion master DB
216 Cost item conversion master DB
217 Specified insurance medical material master DB
218 Other system staff master DB
219 Clinical practice master DB
220 Target DB for medical treatment accumulation
221 Rolling coefficient master DB
222 Article Master DB
223 Other system article master DB
224 Standard Drug Master DB
250 data DB group 251 departmental cost calculation data DB
252 Staff Information DB
253 Personnel cost information DB
254 Staff Time Study Information DB
255 Time ratio information DB by patient by staff
256 Patient hospitalization data DB
257 Patient-specific surgery data DB
258 Patient-specific service data DB
259 Patient meal data DB
260 Number data DB by service
261 Service unit cost data DB
262 Data DB for loading
263 Patient consumption data DB by patient
H.264 Patient Revenue Daily Data Mart DB
265 Cost accounting data mart DB by patient
266 Patient Direct Calculation Data DB
267 Patient-specific daily data DB
268 Direct data DB by patient
DESCRIPTION OF SYMBOLS 300 Control part 301 I / F taking-in process part 302 Number-of-services data preparation part according to service 303 Increase coefficient calculation part 304 Directly indivisible part calculation part 305 Direct part calculation part 306 Cost calculation part by patient 400 Network interface 500 Bus

Claims (5)

A patient-specific cost calculation device for calculating the cost of medical practice by patient,
Basic information storage means for storing basic information necessary for calculating the cost;
Among the costs, a direct-impartable inseparable calculation means for calculating a direct-indivisible cost that cannot be directly imposed on the patient, extracting information on a predetermined item from the basic information storage means, and extracting the extracted information Aggregate for each predetermined cost item according to the form of occurrence of the directly imposed inseparable cost, acquire a roll-up coefficient according to the cost item by a predetermined method, using the tabulated information and the acquired roll-up coefficient A direct indivisible calculation means for calculating the direct indivisible cost;
A direct calculation means for acquiring a direct charge that can be directly imposed on each patient among the costs, by extracting and totaling information on predetermined items from the basic information storage means; and
The cost is calculated for each patient by totaling the direct costs that are calculated by the direct costs and the direct costs that are obtained by the direct costs for each patient. Cost accounting means by patient,
A rolling coefficient calculating means for calculating or setting the rolling coefficient,
The roll-up coefficient calculation means is
In the case where the cost calculation target is a medical practice belonging to the predetermined first cost item, a cost factor that is a ratio of the cost per treatment of the specific medical practice to the cost per treatment of the specific medical practice is Obtained from the basic information stored in the basic information storage means, or calculated by totaling information on the cost of each medical practice included in the basic information stored in the basic information storage means And
When the cost calculation object is a cost belonging to a predetermined second cost item, a unit score corresponding to the cost is obtained from the basic information stored in the basic information storage means, and the unit score is calculated as the cost. Set as the factor of calculation for calculation,
When the cost calculation target is a medical practice belonging to the predetermined third cost item, the number of implementations of the medical practice is acquired from the basic information stored in the basic information storage means, and the total number of implementations Is set as the cost factor for the cost object,
Cost calculation device by patient. The basic information storage means includes
Department-specific cost information storage means for storing department-specific costs for each medical practice;
A number-of-implementation information storage means for storing the number of cases of each medical practice for each patient;
The direct charge indivisible calculation means is:
When the cost accounting object belongs to the first cost item or the second cost item,
For the costing factor of the cost calculation object, the number of cases of all the medical practices stored in the costing factor and the actual number information storage means of all the medical practices of the department and subject to which the cost accounting object belongs And calculate the ratio of the sum of products with
By using the calculated ratio to apportion the total cost of the department to which the clinical practice belongs stored in the departmental cost information storage means, To calculate as inseparable costs,
The cost calculation apparatus classified by patient according to claim 1. Information related to a department code for identifying a department related to the cost calculation object, which is a department code for medical cost calculation and a department in which each medical practice that is the cost calculation object is actually performed A cost department master that stores and stores the number of types of medical treatment cases indicating whether or not it can be determined based on a department code for calculation;
A cost department conversion master that stores information for specifying the correspondence between the department code for calculating medical expenses and the department code for cost calculation in the cost calculation apparatus for each patient;
The medical treatment accumulation target master that stores the medical treatment name of each medical treatment subject to the cost calculation and the department name of the department where each medical treatment was actually performed in association with each other,
The basic information storage means stores the service code storage means for each patient that stores the medical treatment cost department code of each medical practice that is the object of cost calculation and the medical practice name of each medical practice in association with each other. With
The department code for calculating the medical expenses of each medical practice to be cost-calculated is obtained from the patient-specific service data storage means, and the number of types of medical practice creation corresponding to the acquired department code for medical expenses is Acquired from the cost department master, and based on the acquired number of types of medical treatments, the department where each medical practice that is the cost calculation target actually performed based on the acquired medical cost calculation department code If it is possible to determine whether or not it is actually performed in which department, the department for cost calculation can be determined by referring to the cost department conversion master for the acquired department code for calculating medical expenses. If it is not possible to determine in which department it was actually converted into a code, the name of the medical practice of each medical practice that is the cost calculation target is stored in the service data storage means for each patient. Tokushi, and a service-specific number data generating unit for acquiring the department name corresponding to the acquired intervention name from the intervention costing target master,
The direct charge indivisible calculation means, based on the department code converted by the number-of-services data creation unit or the acquired department name, identifies the department of each medical practice that is the cost calculation target,
The cost calculation apparatus classified by patient according to claim 2. The basic information storage means includes article information storage means for storing the number of purchases, purchase unit unit price, minimum unit conversion, and medical unit conversion conversion for each article,
The direct calculation means stores, in the article information storage means, the sum of products of the number of purchases of the goods and the unit price of purchase stored in the article information storage means for the articles to be cost-calculated. The actual purchase price of the article is calculated by dividing by the sum of products of the purchased number of the article, the minimum unit conversion, and the medical unit conversion conversion.
The patient-specific cost calculation apparatus according to any one of claims 1 to 3. A program for causing a patient-specific cost calculation device for calculating the cost of medical practice for each patient to perform cost calculation for each patient for calculating the cost for each patient,
The patient-specific cost calculation apparatus includes basic information storage means for storing basic information necessary for calculating the cost,
In the patient cost calculation apparatus,
Of the costs, a step of calculating a directly imposed inseparable cost that cannot be directly imposed on a patient, extracting information of a predetermined item from the basic information storage means, and extracting the extracted information into the directly imposed inseparable cost Aggregate for each predetermined cost item according to the form of cost generation, acquire a roll-up coefficient according to the cost item by a predetermined method, and use the aggregated information and the acquired roll-up coefficient to calculate the directly imposed indivisible cost A direct inseparable calculation step to calculate
A direct calculation step of acquiring a direct charge that can be directly imposed on each patient among the costs by extracting and totaling information on predetermined items from the basic information storage means,
For each patient, the cost is calculated for each patient by totaling the direct cost that was calculated in the direct cost calculation step and the direct cost that was acquired in the direct cost calculation step for each patient. A costing step;
A calculation step for calculating or setting the increase coefficient is performed, and
In the step of calculating the rolling coefficient,
In the case where the cost calculation target is a medical practice belonging to the predetermined first cost item, a cost factor that is a ratio of the cost per time of the particular medical practice to the cost per time of the specific medical practice is Obtained from the basic information stored in the basic information storage means, or calculated by summing up information related to the cost of each medical practice included in the basic information stored in the basic information storage means Let
When the cost calculation object is a cost belonging to a predetermined second cost item, the unit information corresponding to the cost is acquired from the basic information stored in the basic information storage means, and the unit score is calculated as the cost. Let it be set as the calculation factor for calculation,
When the cost calculation target is a medical practice belonging to the predetermined third cost item, the number of implementations of the medical practice is acquired from the basic information stored in the basic information storage means, and the total value of the implementations Is set as the roll-up factor for the cost object,
Patient costing program.

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