JP4783318B2 - Reference index analysis system for certification of long-term care - Google Patents

Description

  The present invention relates to a reference index analysis system used when a secondary judgment is determined by a review board using a primary judgment result based on a certification survey result for a person requiring nursing care certification in nursing care insurance.

  A long-term care insurance system was introduced in April 2000, and “nursing care certification work” is being implemented in each insurer. A patent proposal (for example, see Patent Document 1) has already been made for this nursing care certification task. An outline of this certification for long-term care is described below.

  First, if you wish to use the nursing care service, you must apply to the municipality for certification of nursing care. When an application is made, the person in charge of the municipality or a care support specialist such as a home care support company entrusted by the municipality conducts a certification survey on the physical condition. This accreditation survey is conducted by an investigator visiting a long-term care applicant and selecting an option set for each item for a plurality of preset accreditation survey items. In addition, the investigator makes a free statement as a patent matter that the choices of each item cannot be fully expressed. At the same time, the municipality asks the attending physician to prepare a written opinion.

  The certification survey result is input to a computer, and a standard time required for certification for long-term care is estimated by a predetermined certification program, and the degree of long-term care required based on the estimated standard time for certification for long-term care is output as a primary determination result.

After that, at the nursing care certification committee consisting of health, medical and welfare specialists, the above primary judgment results were used to comprehensively confirm the contents of the doctor's opinion, special notes and reference indicators presented by the Ministry of Health, Labor and Welfare. A secondary determination is made to determine whether care (support) is required, and if care (support) is required, how much care (support) is required. Based on the judgment of the nursing care certification examination committee, the municipality performs nursing care (support required) certification.
JP 2001-5880 A

  The above-mentioned examination committee has to make secondary judgments in a short time for a large number of certifications requiring long-term care, and prompt and efficient work is required. In addition, since the degree of nursing care required is directly related to the nursing care service that can be received by the applicant for nursing care, it must be fair and it is important that the examination results do not vary.

  The previous examination committees have used the primary judgment results and comprehensively confirmed the contents of the doctor's opinion, special notes, and reference indicators presented by the Ministry of Health, Labor and Welfare. There is a risk that estimation will be enormous, and it may take a long time for the examination, or the examination results may vary among examination committees.

  An object of the present invention is to provide a reference index analysis system in certification for long-term care that can provide secondary determination candidates based on a clear reference index analysis when performing a secondary determination by a review board based on a primary determination result. It is in.

  The reference index analysis system for long-term care certification according to the present invention is used when a secondary judgment is determined by a review board using a primary judgment result based on a certification survey result consisting of a plurality of items for a long-term care certification target person in long-term care insurance. It is a reference index analysis system, and it is certified at the highest rate from statistical data of past care-required certification results by the combination of disability independence and dementia independence obtained from the accreditation survey. Independence degree combination distribution analysis means to select the degree of care required as a secondary judgment candidate, and the severity change when the secondary judgment result is high relative to the primary judgment result obtained from the past nursing care certification result and the low case Using the statistical results with minor changes, the primary judgment result of the person to be authorized and the severity selected in advance from the certification survey items for each degree of care required of the primary judgment result or Change analysis means for determining whether or not the primary determination result of the subject person to be changed has been changed based on the survey result of the item related to the degree change, and determining the secondary determination candidate, and the certification target based on the survey result of the certified survey item Using a state image of the person, from a plurality of state image examples for each degree of care required based on the statistical data of the past certification for long-term care required results, extract a plurality of state image examples similar to the state image of the person to be certified, Similar state image example analyzing means for obtaining a secondary determination candidate from the degree of care required to which each of the extracted state image examples belongs, and dividing the accredited investigation items into a plurality of groups, and investigating the authorized person for each group The score of the result is totaled, and the score totaled for each group is compared with the average score of each group in each degree of care required obtained from the statistical data of past certification of long-term care required. The degree of need for nursing care with the most Characterized in that a between evaluation item estimation means.

Moreover, the reference index analysis system in the certification for long-term care described in the present invention represents the characteristics of the degree of long-term care required from among the above-mentioned certification survey items for each degree of long-term care based on statistical data of past certification for long-term care required. Each item is selected, and as a result of the certification survey on the subject of certification, the items that show the problem status are extracted the degree of care required corresponding to all of the selected items, and this is extracted. The survey item trend analysis means may be further added with the highest level of care required among the required levels of care required as a secondary determination candidate.

  According to the present invention, based on the primary determination result, when performing a secondary determination by comprehensively confirming the contents of the doctor's opinion and special instructions and the reference index presented by the Ministry of Health, Labor and Welfare, a clear reference index analysis for the examination Can be provided, so that the examination can be performed quickly and efficiently, and the examination results for each examination committee do not vary, and the examination can be conducted fairly.

  Hereinafter, an embodiment of a reference index analysis system for certification of long-term care according to the present invention will be described in detail with reference to the drawings.

  First, the flow of certification for long-term care will be described with reference to FIG. In FIG. 1, when there is an application for certification for long-term care (step 101), as described above, the person in charge of the municipality or an authorized investigator commissioned by the municipality conducts a certification survey on the physical status of the applicant for certification for long-term care. Perform (step 102). In this accreditation survey, an investigator visits an applicant for certification for long-term care and conducts an investigation by selecting an option set in advance for each item for a plurality of accredited survey items. In addition, the investigator makes a free statement as a patent matter that the choices of each item cannot be fully expressed. At the same time, the municipality asks the attending physician to create a written opinion and obtains the written opinion (step 103).

  The survey result is input to a computer, and a standard time for certification of care required is estimated by a predetermined certification program, and the degree of care required based on the estimated standard time for certification of long-term care is output as a primary determination result (step 104). ).

  After that, at the nursing care certification committee consisting of health, medical and welfare specialists, the above primary judgment results were used to comprehensively confirm the contents of the doctor's opinion, special notes and reference indicators presented by the Ministry of Health, Labor and Welfare. Secondary determination is performed. In this case, first, the contents of the certification survey are confirmed (step 105). That is, it is confirmed whether or not there is any contradiction (inconsistency) among the contents of the authorized survey, the special remarks, and the opinion of the attending physician (step 106). As a result, there is a contradiction (step 107) and no contradiction (step 108). If there is a contradiction, there is no correction (step 109), partial correction (step 110), and reexamination (step 111). Through these, the result of the primary determination is determined (step 111). If there is no contradiction (step 108), the result of the primary determination is determined as it is (step 112).

  Next, using the primary determination result determined in this way, the special remarks and the attending doctor's opinion are used for examination at the nursing certification examination committee, and there is a change to the primary determination (step 113) or no change (step) 114), and the certification required for long-term care and the like are determined (step 115). That is, it is determined whether or not care (support) is required, and if care (support) is required, how much care (support) is required.

  Here, in the examination process after the determination of the primary determination result (step 111), as described above, the primary determination result, the doctor's opinion and special notes are examined as examination materials, but in the present invention, in addition to these, We decided to provide candidates for secondary judgment based on a clear reference index analysis to determine the final category of long-term care required for those requiring long-term care.

  This reference index is created based on the statistical data of past results of certification of long-term care required, and applied to persons requiring certification for long-term care (subjects of examination). That is, since the nursing care insurance system was introduced in April 2000, a large number of certifications requiring long-term care have been performed so far, and data relating to the certification results have been accumulated as electronic data. Therefore, by statistically processing these data and applying the data of the subject of examination to the statistical results, it is possible to provide secondary judgment candidates based on a clear reference index analysis regarding the decision of the subject of examination. it can.

  As this reference index, in this embodiment, the following four reference indices are used.

1. Distribution according to the level of care required by the degree of independence (hereinafter referred to as the first reference index)
2. Indicator of change in need for nursing care (hereinafter referred to as second reference indicator)
3. Example of similar state image (hereinafter referred to as third reference index)
4). Average score of intermediate price items by degree of care required (hereinafter referred to as fourth reference index)
In the first reference index based on the degree of care required distribution by the above-mentioned independence degree combination, first, the combination of the degree of disability independence and the degree of dementia independence obtained by the accreditation survey is obtained as statistical data of past care-required certification results Apply to The combination of the degree of disability independence and the degree of independence of the dementia of the person to be authorized is selected as the degree of care required that is recognized at the highest rate, and this is set as a secondary determination candidate.

  Moreover, in the 2nd reference parameter | index by the parameter | index of a need-for-care level change, the data which took the statistics about the case where a secondary determination result is changed with respect to a primary determination result from the past required-of-care-certification result is used. In other words, when the secondary determination result is high, the change is severe, and when the secondary determination result is lower, the change is minor, and when such a severe change or minor change occurs, Some items that are often selected in a good state are selected for each degree of care required in the primary determination result as items related to the severe or mild change. Based on the primary determination result of the person to be certified and the number of items related to the above-mentioned severe or minor change in the result of the certification survey, it is determined whether or not the primary judgment result of the person to be certified has been changed. The candidate is determined.

  In the third reference index based on similar state image examples, a plurality of state image examples based on past authorization survey results are prepared for each degree of care required using statistical data of past nursing care authorization results. Then, the state image of the person to be authorized based on the current survey result is compared with a plurality of state image examples prepared for each degree of care required, and a predetermined number of similar state image examples are extracted. Further, the degree of care required to which the extracted state image examples belong is counted, and the degree of care required to which the extracted state image examples belong most is set as a secondary determination candidate.

  Furthermore, in the fourth reference index based on the average score of intermediate evaluation items according to the degree of care required, the survey items for certification are divided into multiple groups, and the scores for the survey results of the subjects subject to certification are aggregated for each group. To do. In addition, regarding the statistical data of past care-required certification results, an average score is obtained for each group for each degree of care required. Then, compare the score totaled for each group of people to be certified with the average score of each group for each degree of care required obtained from past statistical data, identify the group whose average score is closest, The degree of care required with the largest number of identified groups is set as a secondary determination candidate.

  FIG. 2 shows a system configuration for obtaining secondary determination candidates based on such four reference index analyses. In FIG. 2, reference numeral 10 denotes data requiring certification for long-term care, which includes a primary determination result 11 and certification survey data 12. This long-term care-required person data 10 is created for each long-term care-required person and is stored in a database for long-term care recipients (not shown). 13 is statistical data of past care-required certification results, each of which includes data on independence level combination 14, severe / mild change index 15, state image example 16 according to degree of care required, and intermediate evaluation item average score 17. Stored as master data in the database.

  Reference numeral 18 denotes a computer that realizes each arithmetic processing means to be described later, and has a self-supporting degree combination analysis means 19, a change analysis means 20, a similar state image example analysis means 21, and an intermediate evaluation item analysis means 22 as functions. Each of these arithmetic processing means performs predetermined arithmetic processing (details will be described later) using the corresponding ones of the various data 11, 12, and 14 to 17, and the first to fourth reference index analyzes described above. A secondary determination candidate is generated. The output unit 24 displays the processing results of the above-described arithmetic processing units 19 to 22, that is, the generated secondary determination candidates by the first to fourth reference index analysis, in a form 25 and a screen 26 in a predetermined display format. To either or both.

  Reference numeral 27 denotes an input operation unit 27 such as a keyboard or a mouse, which is used for calculation commands to the calculation processing means 19, 20, 21, and 22.

  Next, details of the various data 11, 12, 14 to 17 and the arithmetic processing means 19, 20, 21, 22 will be described.

  First, the care recipient data 10 composed of the primary determination result 11 and the authorized survey data 12 will be described with reference to FIGS. 3a to 3d. This data for those requiring nursing care is No. 1 to No. It has up to 300 items. Of these, No. 1 to No. Items up to 32 are items related to basic matters such as an insurer number and an insured number.

  No. 33 to No. 38 is an item related to the implementation of the certification survey such as the survey date.

  No. 39 to No. Items up to 100 are items relating to primary determination such as primary determination results. 41 to No. 49 is an item of the reference time such as certification for long-term care that is directly related to the primary determination result. No. 50 to No. 56 is an item relating to the intermediate evaluation item score from the first group to the seventh group, and the later-described processing in the similar state image example analysis means 21 for generating the third reference index, and the fourth reference index It is used for the later-described processing in the intermediate evaluation item estimation means 22 for generating. No. 66 to No. 97 is an item related to the severe index and the mild index, and is used for a care level change determination process (to be described later) in the change index analysis means 20 for generating the second reference index.

  No. 101 to No. Items up to 111 are items related to secondary determination such as a screening committee.

  No. 112 to No. 232 is an item related to the accreditation survey. 149 to No. 215 is a survey item (67 items) of the first group to the seventh group. 216 to No. 227 is a survey item (12 items) related to special medical care. No. 228, no. 229 is an item relating to the degree of disability independence and the degree of independence of dementia, and is used for the determination process described later in the independence degree combination distribution analysis means 19 for generating the first reference index. Furthermore, no. 230 to No. 232 is a survey item newly added due to the 2006 revision of the law.

  Here, looking at the first group to the seventh group described above, the first group is a group related to “paralysis contracture” and No. 149 to No. This corresponds to the item 159. The second group is related to “movement”. 160 to No. The item of 166 corresponds. The third group is related to “complex operation”. No. 167 to No. The item of 169 corresponds. The fourth group is related to “special care”. 170 to No. The item of 176 corresponds. The fifth group is related to “personal belongings”. 177 to No. The item of 186 corresponds. The sixth group is related to “communication”. No. 187 The item of 196 corresponds. The seventh group is related to “problem behavior”. No. 197 This corresponds to the item 215.

  In each of these items, options such as “No”, “Yes”, “Yes”, “Yes if caught”, “No” are set, and one of these options is selected as a survey result.

  No. In the item of 228 disability independence, one of the four criteria of rank J, A, B, C (November 18, 1991, Minister of Health and Welfare Secretary of Health and Welfare for the Elderly) is selected. No. For 229, any one of ranks I, II, III, IV, and M of five criteria (notified by the Ministry of Health and Welfare, Geriatric Health and Welfare Bureau Director) is selected.

  Description of other items is omitted.

  The processing content of each arithmetic processing means 19, 20, 21, 22 will be described. The calculation results of these calculation processing means 19, 20, 21, and 22 are displayed and output on the form 25 and the screen 26 by the output means 24. Here, the case where the calculation results are output to the form 25 will be described as an example.

  First, the display contents of the form 25 will be schematically described with reference to FIG. In the form (reference index analysis form) 25 shown in FIG. 4, reference numeral 25A denotes a basic information column on which various information items relating to individuals who are subject to certification for long-term care are posted. Reference numeral 25B is a reference index analysis result column, which lists the primary determination result of the person requiring long-term care certification and the secondary determination candidate (degree of care required) analyzed by each arithmetic processing means 19, 20, 21, 22 The

  In the following columns, the analysis contents of each reference index listed in the reference index analysis result column 25B are individually listed. That is, 25C is a distribution column according to the level of care required by the combination of independence, and the analysis contents and analysis results by the independence combination analysis means 19 are posted. Reference numeral 25D denotes an index field for change in nursing care, in which the analysis content and analysis result of the change analysis means 20 are posted. Reference numeral 25E denotes a similar state image example column, in which the analysis contents and analysis results of the similar state image example analysis means 21 are posted. 25F is an average score column of the intermediate evaluation items viewed according to the degree of care required, and the analysis contents and analysis results of the intermediate evaluation item estimation means 22 are posted.

  In the bottom column 25G, the secondary determination candidate estimation logic for each of the reference indices is listed.

  When generating the secondary determination candidate by the reference index analysis, the operator causes the computer 18 to input the data 10 of the person requiring nursing care certification, that is, the primary judgment result 11 and the certification survey data 12 from the input operation unit 27. .

  The independence degree combination distribution analysis means 19 is the No. 1 shown in FIG. 228 and No. 229 data, that is, data on the degree of independence of the person to be certified and the degree of independence of dementia obtained by the certification survey are captured. Moreover, the independence degree combination data 14 is taken in from the statistical data 13 of the past nursing care certification result. Then, the combination of the degree of disability independence and the degree of dementia independence obtained from the accreditation survey is applied to the independence degree combination data 14 of the statistical data 13 of the past nursing care accreditation results, and the combination is certified at the highest rate. Select the level of care required as a candidate for secondary determination.

  For example, assume that the degree of independence of the person to be authorized is B1, and the degree of independence of dementia IIIa. As shown in FIG. 5, the independence degree combination data 14 is divided into a plurality of dementia independence levels (independence and ranks I, II, III, IV, and M). B, C) each has a table that defines the authorization ratio (%) for the degree of care required (independence, support 1 required, equivalent to care 1 required, care required 2, care required 3, care required 4, care required 5) ing. Therefore, the data shown in FIG. 5 are applied with the disability independence degree B1 and the independence degree IIIa of the person to be authorized. In this case, using the data table of the degree of independence of dementia III and looking at the column of the degree of independence of disability B, the degree of need for nursing care with the highest accreditation rate is the need for nursing care 4 with an accreditation rate of 60%. Therefore, in this case, the degree of care 4 is a secondary determination candidate (first reference index).

  In addition, as in the case of dementia independence degree III and the degree of disability independence is B, the degree of need for nursing care with the highest accreditation rate is two, requiring care 4 with an accreditation rate of 50% and requiring care 5. When a plurality of nursing care levels are selected in this way, the selected plurality of nursing care levels are set as secondary determination candidates (first reference indicators).

  The first reference index thus determined (here, “care required level 4”) is stored in a secondary determination candidate database by reference index analysis (not shown).

  In the distribution column 25C according to the degree of care required by the combination of independence of the form 25 shown in FIG. 4, the independence degree B1 and the independence degree IIIa of the person to be certified and the dementia independence shown in FIG. 5 corresponding to this combination Approval rate (%) for each degree of care required in column B of the degree III disability independence degree data table is displayed in a table format. Among them, “Need for care 4” is the highest approval rate. The form is shown inverted.

  The change index analysis means 20 relates to the primary determination result (data of No. 40 in FIG. 3a) from the certification subject for long-term care 10 and the severe or mild change selected in advance from the certification survey items. The item survey results (data from No. 66 to No. 97 in FIG. 3B) are taken in. In addition, a severe / mild change index 15 is taken in as statistical data 13 of past certification for long-term care requirements. This severe / mild change index 15 focuses on the severe change when the secondary determination result is high relative to the primary determination result and the mild change when the secondary determination result is low, based on the past certification for long-term care, and items with the most changes. Is determined for each degree of care required of the primary determination result as a change index. The change index analysis means 20 uses this change index 15 to determine whether or not the primary determination result of the certification target person has been changed from the primary judgment result of the certification target person and the survey results of items related to the severe or mild change of the certification target person. Judgment is made to determine secondary determination candidates.

  That is, as shown in FIG. 6a, the severe / mild change index 15 obtained from the statistical data 13 of the past certification of long-term care required results in the lightest direction when the degree of long-term care required by the primary determination is changed more mildly ( Survey items (items related to minor changes) selected in the “good state” are selected, for example, three items for each degree of care required by the primary determination. In addition, as shown in FIG. 6b, when the degree of care required by the primary determination is changed more severely, the survey items (items related to the severe change) selected most frequently in the heavy direction (bad state) For example, four items are set for each degree of care required by determination.

  The change index analysis means 20 thus sets a predetermined number of items related to the severe change or the minor change for each degree of care required of the primary determination result from the statistical data of the past nursing care authorization result as shown in FIGS. 6a and 6b. The primary determination result (data No. 40 in FIG. 3a) and the certification survey result (data No. 66 to No. 97 in FIG. 3b) are applied to this data table. Then, the number of items corresponding to the item related to the severe change or the minor change is obtained, and the difference between the number of items corresponding to the severe change and the number of items corresponding to the minor change is obtained, and the difference is set in advance. If the value is greater than or equal to the value, the degree of care required in the primary determination result of the person to be authorized is changed by one level to severe or mild and set as a secondary determination candidate.

  For example, the primary determination result (data of No. 40 in FIG. 3A) is “care required 4”, and “daily comprehension” in the survey items (data of No. 66 to No. 97 in FIG. 3B). "Is selected in the light direction (can), and" hold sitting "is selected in the heavy direction (cannot). When these are applied to FIGS. 6a and 6b, in FIG. 6a, when the primary determination is “care required 4”, for the three items set as items related to the minor change, the investigation of the person to be certified As a result, one mild selection (can do) of “understand daily routine” is applicable, and the number of items corresponding to the minor change (number of white circles) is “1”. Further, in FIG. 6B, when the primary determination is “care required 4”, for the four items set as the items related to the severe change, the seriousness selection (not possible) of the survey result “sitting position” of the person to be authorized is not possible. Corresponds to one, and the number of items corresponding to the severe change (number of black circles) is “1”.

  Further, the difference between the number of items corresponding to the severe change (number of black circles) and the number of items corresponding to the minor change (number of white circles) is obtained. In the above example, since “1-1 = 0”, the primary determination result is not changed, and the degree of care required of the primary determination result is directly used as a secondary determination candidate.

  On the other hand, if the difference is a preset value, for example, “3” or more, the degree of care required in the primary determination result of the person to be certified is changed by one step to severe or mild and set as a secondary determination candidate. For example, in the case where 4 items of the survey results of “reserved sitting”, “drinking water”, “meal intake”, and “swallowing” are severely selected (impossible, all assistance, etc.), the primary determination result in FIG. If it is “care-requiring 4”, it corresponds to all four items set as items related to the severe change, and the number of items (the number of black circles) applicable to the severe change is “4”. In this case, the difference between the number of items corresponding to the severe change (number of black circles) and the number of items corresponding to the minor change (number of white circles) is “4-1 = 3”. For this reason, the primary determination result “care required 4” is changed more seriously by one step, and the secondary determination candidate becomes “care required 5”.

  In the column 25D of the change index of the degree of care required in the form 25 shown in FIG. 4, all items related to the mild change selected in advance based on the statistical processing of the certification result of past care required and related to the severe change All of the items to be displayed are displayed. In addition, the corresponding items of the survey results for these items (light changes are “daily comprehension”, severe changes are “sitting position”) and the number (all are “1”), together with the number of differences (“0”) Further, “Need Care 4” which is a secondary determination candidate is displayed.

  The similar state image example analysis means 21 obtains the investigation results of the authorization investigation items (data from No. 149 to No. 215 in FIGS. 3c and 3d) from the nursing care authorization subject data 10, and from the first group to the seventh The state image of the person to be authorized based on the survey results of 67 items constituting the group is grasped. Moreover, the state image example 16 classified by the degree of care required is taken in from the statistical data 13 of the past care-required authorization result, and the state image example similar to the state image of the person to be authorized is obtained from the plurality of state image examples of each degree of care required. A predetermined number is extracted. Then, the degree of care required to which the extracted state image examples most frequently belong is set as a secondary determination candidate.

  Here, the state image example 16 according to the level of long-term care required is based on the statistical data 13 of the past required long-term care authorization results, as shown in FIG. In addition, for the need for nursing care 3, the need for nursing care 4, and the need for nursing care 5), a plurality of (10 in this embodiment) state image examples are prepared for 67 items constituting the first group to the seventh group. FIG. 7 shows the last five out of 10 state examples of the care-required 4 (care-required 4-6, care-required 4-7, care-required 4-8, care-required 4-9, care-required 4-10. ) Shows an example of a state image.

  The similar state image example analysis means 21 compares the state image of the person to be authorized with each of the prepared state image examples (60 in total), and the state image of the person to be authorized is obtained from the 60 state image examples. A predetermined number of similar state image examples (for example, the top 10) are extracted.

  This extraction algorithm compares the state image of the person to be certified with the 60 state image examples individually for the 67 items forming the state image examples, and obtains the number of items whose data contents match for each state image example. The top 10 state image examples whose number of matches is equal to or greater than a preset number (threshold value) are extracted as similar state image examples. Then, the degree of need for nursing care having the largest number of degree of care required to which the extracted similar state image example belongs is set as a secondary determination candidate.

  In the example of the similar state image example column 25E of the form 25 of FIG. 4, as the state image example similar to the current state image of the person to be authorized (the state image example in which the number of matching items is, for example, 40 or more threshold values), From the state image examples, four state image examples “4-9,” “4-6,” “4-8,” “4-7,” and “5, need 5” Three state image examples “required 5-7”, “required 5-10”, and “required 5-8” are extracted.

  The number of extractions is originally the top ten. However, in the above example, there are only seven state image examples with the number of matches equal to or more than the threshold value: 40. Yes.

  Then, the degree of care required to which the extracted similar state image examples most frequently belong is set as a secondary determination candidate. In the above example, four state image examples “Necessary 4-9”, “Necessary 4-6”, “Necessary 4-8”, “Necessary 4-7” belong to “Necessary care 4”. Since “−7”, “Necessary 5-10”, and “Necessary 5-8” are more than “Needing care 5”, “Necessary nursing 4” is a secondary determination candidate.

  Here, in the first group to the seventh group, the score of the intermediate evaluation item score is assigned so that the maximum of 100 points and the minimum of 0 points are assigned to each of the choices of the respective items constituting them. Yes. Therefore, the total score of each group can be obtained by counting the survey results (selected options) of the items constituting each group. The total score for each group is shown in No. 3 of FIG. 50 to No. 56.

  Therefore, the similar state image example analyzing means 21 uses No. 3 in FIG. 50 to No. The data of 56, that is, the intermediate evaluation item scores of the first group to the seventh group are taken in, and the image data of the radar chart in which the scores of these groups are drawn in a radial pattern is created. This radar chart shows the extracted state image examples "4-9", "4-6", "4-8", "4-7", "5-7", "5-10", " “5-8” can also be made in the same manner by dividing 67 basic survey items into 7 groups and totaling the score of each item for each group.

  In the example of the similar state image example column 25E of the form 25 in FIG. 4, the extracted similar state image examples “required 4-9” and “required 4” together with the current state image (seven groups of radar chart images) of the person to be authorized. Similar state image examples (seven groups of radar chart images) of “−6”, “4-8”, “4-7”, “5-7”, “5-10”, and “5-8” are displayed respectively. ing.

  By displaying each of the seven groups of radar charts in this way, it is possible to visually confirm the similarity of the shape of the radar chart as well as the number of coincidence of items, and to make the similarity determination of the state image example more reliable. be able to.

  In addition, the extraction algorithm for extracting the similar state image example in the similar state image example analyzing unit 21 is not limited to the determination based on the number of matches of the 67 items forming the state image example.

For example, the similarity between the pattern of each state image example (60 in total) obtained from the statistical data 13 of the past certification for long-term care result and the pattern of the state image of the person to be certified is represented by 67 pieces forming each pattern. Using the score of the authorized survey item, the following equation (1) is used to calculate by the least square method. Then, a state image example in which the calculated similarity is equal to or less than a preset value (the difference in pattern is small) is extracted as a similar state image example, and the degree of care required to which the extracted similar state image example belongs most frequently is extracted. It is good also as a next determination candidate.

In the above equation (1), the pattern similarity is calculated by the least square method for 67 items forming the state image example. As shown in the following equation (2), attention is paid to the aforementioned seven groups of radar charts. The similarity may be calculated by the least square method. That is, the degree of similarity is calculated by the least-squares method for the intermediate evaluation item score of the person to be authorized and the intermediate evaluation item scores of the 60 patterns of state image examples for all the 1 to 7 groups.

  The intermediate evaluation item estimation means 22 divides 67 basic survey items into seven groups, and uses the intermediate evaluation item scores obtained by collecting the survey results for each item for each group. No. of FIG. 50 to No. 56 data are captured. On the other hand, the intermediate evaluation item average score 17 is taken in as the statistical data 13 of the past nursing care certification result. As shown in FIG. 8, the intermediate evaluation item average score data 17 indicates the degree of care required (independence, support 1 required, equivalent to care 1, care required 2, care required 3, care required 4, care required 5). The average score of each group in each 10 state image examples is summarized. The intermediate evaluation item estimation means 22 compares the score for each group of the person to be authorized with the average score of each group in each degree of care required obtained from the state image example, and the group with the closest average score is determined for each degree of care required. Estimate the degree of need for nursing care with the largest number of estimated groups as the secondary determination candidate.

  In the example of the average score column 25F of the intermediate evaluation items seen according to the degree of care required in the form 25 of FIG. 4, the current score of each group, which is the survey result of the person to be certified, and each degree of care required obtained from the state image example The average score of each group is displayed and output in a tabular format. In the figure, the average score closest to the current score of the first group is support 1 required, the average score closest to the current score of the second group is 5 requiring care, and the current score of the third group The average score closest to is the need for long-term care 5, the average score closest to the current score of the fourth group is the need for long-term care 3, and the average score closest to the current score of the fifth group is the need for long-term care 5 In other words, the average score closest to the current score of the sixth group is 5 requiring care, and the average score closest to the current score of the seventh group is 3 requiring care. As a result, the degree of care required with the largest number of groups of average scores closest to the current score of the person to be certified is “care required 5”, which is set as a secondary determination candidate.

  In this way, the secondary determination candidates obtained by the respective arithmetic processing means 19, 20, 21, and 22 are accumulated in the secondary determination candidate database by reference index analysis (not shown) as described above, and are output by the output means 24. It is output to the form 25 or the screen 26 shown in FIG.

  The output unit 24 stores the secondary determination candidates for the degree of care required by the respective indexes obtained by the respective arithmetic processing units 19, 20, 21, and 22 in the secondary determination candidate column 25B in the form 25 of FIG. And output. That is, as a result of the arithmetic processing described above, the secondary determination candidate based on the independence degree combination that is the first reference index is “care-required 4”, and the secondary determination candidate based on the change index that is the second reference index is “ The secondary determination candidate based on the similar reference image example as the third reference index is “care required 4”, and the secondary determination candidate based on the intermediate evaluation item as the fourth reference index is “necessary. “Care 5” is displayed.

  The examiner looks at the output content of the secondary determination candidate column 25B, and sets the degree of care required that is output most frequently as the secondary determination candidate as the final secondary determination result. In the above example, three “care-required 4” are output as secondary determination candidates and one “care-required 5” is output, so the secondary determination result is “care-required 4”.

  Thus, it is shown that the secondary determination candidate of three reference indices among the four reference indices is “Need Care 4” for the primary determination result “Nursing Care 4”. From this, it is possible to quickly and fairly determine the secondary determination result as “care required 4”. In other words, these four reference indicators are objective reference indicators because they are based on data obtained by statistically processing a huge amount of past nursing care certification results. , There is a possibility that it can be surely suppressed that the examination results vary from one examination committee to another.

  Further, the output means 24 displays the disability independence degree and the dementia independence of the person to be authorized used in the independence degree combination distribution analysis means 19 shown in FIG. And the numerical value of the accreditation ratio of each degree of care required for the degree of independence and the degree of independence of the corresponding dementia are output in a table format. By outputting in this way, it becomes clear what combination of independence the secondary determination candidate has become “care-required 4”.

  Further, the output means 24 displays all items related to the mild change selected from the basic survey items based on the statistical results and all the items related to the severe change in the index field 25D of the change in care required in FIG. Each item is displayed. Among the items related to the mild change, the display form is changed for the items for which the basic survey result for the authorized person selects a good state such as “independence” or “can”. In addition, among items related to severe changes, the display status is also changed for items for which the basic survey results for the subject of certification have selected problematic states such as “watch, etc.”, “partial assistance”, “impossible”, etc. . Then, the difference between the number of items whose display state has changed due to the minor change and the number of items whose display state has changed due to the severe change is displayed numerically, and the degree of care required changed based on this difference is displayed as a secondary determination candidate. ing.

  By displaying in this way, it is possible to clearly grasp what causes the severe change or the minor change due to the cause, and the certification work can be ensured.

  Further, the output unit 24 extracts the state image of the person to be authorized created by the similar state image example analysis unit 21 shown in FIG. 2 in the similar state image example column 25E and each state extracted as similar to this state image. The number of matching items in the image example and the radar chart are displayed. For this reason, in addition to the degree of similarity based on the number of matching items, the judging committee can determine the degree of similarity in consideration of the shape of the seven groups of radar charts.

  Moreover, the output means 24 displays the average score of 1-7 groups in the state image example in the form of a table for each degree of care required in the average score column 25F of the intermediate evaluation items viewed according to the degree of care required. And among the displayed average scores of each group, the display form of the average score that is closest to the score of each group that is the survey result of the authorized person is changed, and there are the most average scores that have changed this display. The degree of care required is changed as a secondary determination candidate.

  By displaying in this way, it is possible to know the score of the intermediate evaluation items in each group of the certification target person, the average score of the intermediate evaluation items in the state image example, and the corresponding status according to the degree of care required. It is possible to determine the degree of care required for the secondary determination candidate after grasping the above.

  In the above embodiment, four reference indicators are provided, but in addition to this, a trend of survey items may be provided as a fifth reference indicator. FIG. 9 shows an example of the system configuration in this case, and FIG. 10 shows an example of the output form 35.

  In this case, as shown in FIG. 9, the data 30 of the characteristic item for each degree of care required is used as the statistical data 13 of the past recognition result of need for care. As shown in FIG. 11, the feature item 30 according to the level of care required is basically for each level of care required (support 1, need 1 need, need 2, need 3, need 4, need 5). From the survey items, items representing the characteristics of the degree of care required are selected from the statistical results. Moreover, the trend analysis means 31 is provided as a calculation processing means.

  The output form 35 is configured as shown in FIG. In the form 35, reference numeral 35A denotes a basic information column on which various information items related to the individual requiring care are posted. 35B is a reference index analysis result column, and the primary determination result of the person requiring nursing care and the secondary judgment candidate (degree of nursing care required) analyzed and generated by each arithmetic processing means 19, 20, 21, 22, 31 Are consolidated and posted.

  In the following columns, the analysis contents of each reference index listed in the reference index analysis result column 35B are individually listed. 35C is a distribution column according to the level of care required by the combination of independence levels, and the analysis contents and analysis results by the independence level combination analysis unit 19 are posted in the same manner as the distribution column 25C according to the level of care required shown in FIG. 35D is an index column for change in care required, and the analysis content and analysis result of the change analysis means 20 are posted in the same manner as the column 25D in FIG. 35E is a similar state image example column, and the analysis contents and analysis results of the similar state image example analysis means 21 are numerically displayed in tabular form for the state image example, the number of matching items, and the similarity. 35F is an average score column of the intermediate evaluation items viewed according to the degree of care required, and the analysis contents and analysis results of the intermediate evaluation item estimation means 22 are posted as in the column 25F of FIG.

  35H is a trend column of survey items, and the analysis contents and analysis results by the trend analysis means 31 are posted.

  In the lowermost column 35G, secondary determination candidate estimation logic for each of the reference indices is listed.

  In the above configuration, the trend analysis means 31 captures the certification survey data 12 from the long-term care-required subject data 10 and also captures the data 30 of the characteristic item for each degree of care required in the analysis data 13 of the past long-term care-required certification result. As a result of the basic survey on the subject of certification, an item for which an option indicating a problem other than “independence” or “capable” is selected corresponds to an item that represents the characteristics set for each degree of care required. Judge whether to do.

  The survey item trend column 35H in FIG. 10 represents this determination state. In other words, items selected in advance as items representing their characteristics are listed in tabular form according to the degree of care required (support 1, need 1 need, need 2, need 3, need 4, need 5). ing. Among these items, as a result of the basic survey on the subject of certification, the presence or absence of items indicating a problem condition other than “independence” or “capable” is examined. It is output in different display forms as characters.

  In the example in the figure, the three items selected to represent the characteristics of “Need Support 1” are the survey results for the subject of authorization, all of which are options that represent a problem state other than “independence” or “capable” Is selected, the item is a black and white character. In “Need Care 3”, the two items selected to represent the characteristics are the survey results for the person to be certified, and there are options that indicate problem states other than “independence” or “capable”. Is selected. In other words, “support 1 required” and “care required 3” have selected problems with all items selected to represent features.

  On the other hand, with regard to the other care-requiring levels, all items selected as representing characteristics are not selected as problematic. The jury who looked at the output result of such a form, if all the selected items are selected as problematic and the level of care required is high, in this case "care required 3" Are secondary determination candidates in the fifth reference index (investigation of survey items).

  Since the output means 24 performs the above-described output to the survey item trend field 35H shown in FIG. 10, the trend analysis means 31 shown in FIG. As shown in Fig. 8, for each degree of care required, the items selected from the basic survey items as the characteristics of the degree of care required are displayed in a table format corresponding to the corresponding degree of care required. ing. Among the displayed items, for the items for which the results of the basic survey for the subject of certification are selected as having problems other than “independence” or “capable”, the display state is changed to black characters. ing.

  By displaying in this way, the judging committee can grasp the tendency of the overall survey items including the degree of care required other than the secondary determination result, and can perform an appropriate examination.

  Thus, the secondary determination candidate of the fifth reference index obtained by the trend analysis unit 31 is not shown together with the secondary determination candidates obtained by the other arithmetic processing units 19, 20, 21, and 22. The data is accumulated in the secondary determination candidate database by reference index analysis, and is output to the form 35 or the screen 26 shown in FIG.

  In the secondary determination candidate column 35B in the form 35 of FIG. 10, secondary determination candidates for the degree of care required by each index obtained by the respective arithmetic processing means 19, 20, 21, 22, 31 are displayed by the output means 24. It is output together with the judgment result. That is, in the example of the figure, the temporary determination result is “Need Care 4”. Further, the secondary determination candidate based on the combination of independence that is the first reference index, which is the result of the arithmetic processing described above, is “care-required 4”, and the secondary determination candidate based on the change index that is the second reference index. Is “Need Care 4”, the secondary reference candidate based on the similar state image example that is the third reference index is also “Need Care 4”, and the secondary reference candidate based on the intermediate table appearance that is the fourth reference index Is “care required 5”, and the tendency of the survey item, which is the fifth reference index, to be “care required 3” is displayed in a table format.

  In the embodiment described with reference to FIG. 4, secondary determination candidates based on each reference index are displayed in the secondary determination candidate field 25 </ b> B, respectively, and the judging committee sees the output contents and outputs the most as secondary determination candidates. Although the degree of care required was the final secondary determination result, in this embodiment, after selecting and displaying the one closest to the primary determination as the secondary determination candidate by each reference index as described above, As the final secondary determination candidate, the secondary determination candidate closest to the primary determination result is selected from the most frequently output secondary determination candidates.

  For this reason, the output unit 24 displays the primary determination result and the secondary determination candidate of the degree of care required by each index obtained by the respective arithmetic processing units 19, 20, 21, 22, 31, and these secondary determinations Among candidates, the degree of care required closest to the primary determination result is output as a final secondary determination candidate.

  In the example of the figure, the primary determination result is “care required 4”, and the secondary determination candidates based on the five indexes are three types of “care required 3”, “care required 4”, and “care required 5”. In this case, since there are the most secondary determination candidates of “care required 4”, this “care required 4” is the final secondary determination candidate.

  In the above example, if there is no “care required 4” as the secondary determination candidate by each reference index, but only “care required 3” and “care required 5”, these are the primary determination results “care required 4”. Each difference is one rank, and no difference occurs. In such a case, for example, a rule may be set such that, for example, a higher rank is used as a final secondary determination candidate.

  In this way, even if the degree of care required closest to the primary determination result is the final secondary determination candidate, the secondary determination candidate based on each reference index is still an enormous amount of past past care needs. Since it is based on data obtained by statistically processing the certification results, it is an objective reference index. Even if the examination committees are different, a certain result is obtained, and it is possible to reliably prevent the examination results from being blurred for each examination committee.

  In the above description, the secondary determination candidate for the degree of care required by each index obtained by each arithmetic processing means 19, 20, 21, 22, 31 has been described as being output to the form 25 or 35 by the output means 24. However, by providing the output means 24 with a known screen control function, an image can be displayed on the screen 26. The screen display content may be an image equivalent to the form described with reference to FIGS. 4 and 10, but can be displayed with a unique screen configuration utilizing the characteristics of the screen.

  For example, FIG. 12 shows the basic screen for the examination committee, and the display area 40 at the top of the screen displays the primary determination result (the numerical value 3 in the example of the figure means “care required 3”) together with the basic information on the person to be certified. 2) and secondary determination candidates (numerical values indicating the degree of care required) by each reference index are displayed within a thick frame, and a display section for a final secondary determination result is provided next to the thick frame. The display area 41 other than this is a display section for basic survey (authorization survey) results, patent matters, opinion documents, and the like. In the example of the figure, the basic survey is selected, the score of the 67 groups survey items in 7 groups (the score for each item allocated so that the total score for each group is 100 points maximum and 0 points respectively), and special medical care 12 survey items and survey results of other survey items are displayed in a horizontal bar graph format.

  The display part of each secondary determination candidate in the thick frame functions as a button for calling a corresponding reference index screen.

  For example, when the “state image” button is operated, a screen related to a similar state image example shown in FIG. 13 is displayed. On this screen, the processing result of the similar state image example analysis means 21 shown in FIGS. 2 and 9 is displayed.

  As described above, the similar state image example analysis means 21 obtains the survey results of the basic survey items (data from No. 149 to No. 215 in FIG. The state image of the person to be authorized is grasped based on the investigation results of 67 items constituting the first group to the seventh group. Moreover, it shows in FIG. 7 about each degree of care required from the statistical data 13 of the past required care certification result (support 1, need 1 need, need 2, need 3, need 4, need 5). As described above, a total of 60 state image examples are fetched by 10 based on the investigation results of 67 items from the first group to the seventh group. Then, a plurality of state image examples similar to the state image examples of the person to be certified are extracted from the 60 state image examples for each degree of care required, and from the degree of care required to which each of the extracted state image examples belongs. Find secondary decision candidates.

  That is, the state image of the person to be authorized is compared with the 60 state image examples based on the statistical data 13 of the past nursing care authorization result, and the top 10 similar state images similar to the state image of the person to be authorized are compared. Extract examples. This extraction algorithm compares the state image of the person to be certified with the 60 state image examples individually for the 67 items forming the state image, and determines the number of items whose data contents match for each state image example. The top 10 state image examples whose number of matches is equal to or greater than a preset number (threshold) are extracted as similar state image examples.

  In the screen of FIG. 13, the display area 42 on the upper right side is a portion showing the top ten similar state examples. In the example of the figure, since there are only seven cases of threshold abnormality, seven state examples, that is, four state image examples “required 4-9”, “required 4-6”, “required 4- The three status image examples “5-7”, “5-10”, and “5-8” of “8”, “4-7”, and “care-required 5” are calculated separately and the number of matching items. Are displayed in tabular form along with similarities. When the displayed similar state image examples are counted according to the level of care required, “Need Care 4” is more frequent, so the display color of the corresponding state image example is changed, and “Need Care 4” becomes a secondary determination candidate. It represents that.

  Further, since the first group to the seventh group forming the state image can obtain intermediate evaluation item scores that are 100 points maximum and 0 points minimum for the survey results of those survey items. Evaluation item scores are obtained for the status image of the person to be certified and the 60 status image examples to be compared.

  In the screen of FIG. 13, the lower display area 43 is a part that displays the intermediate evaluation item scores between the status image of the authorized person and the 60 status image examples to be compared in a tabular format. Since it is difficult to display the intermediate evaluation item scores of the 60 state image examples at the same time, a plurality of state examples are sequentially displayed by scrolling or the like.

  Further, an upper left area 44 in FIG. 13 is a display portion of a radar chart formed by the above-mentioned seven groups of intermediate evaluation item scores. In other words, the radar chart a of the authorized person and the state image example b designated from the 60 state image examples can be displayed in a superimposed manner. By this display, it is possible to compare the degree of similarity of the state image example patterns by both radar charts. The state image example b to be compared is configured to be arbitrarily selected from a plurality of state image examples displayed in the lower display area 43 in a table format.

  By displaying in this way, the similarity of the shape of the radar chart can be visually confirmed together with the number of matching items, and the similarity determination of the state image example can be made more reliable.

  Further, when the “trend” button in FIG. 12 is operated, a screen related to the trend of survey items shown in FIG. 14 is displayed. On this screen, the processing result of the trend analysis means 31 shown in FIG. 9 is displayed.

  As described above, the trend analysis means 31 is selected in advance as an item representing its characteristics according to the degree of care required (support 1, need 1 need, need 2, need 3, need 4, need 5). The feature item 30 according to the degree of care required, which is the master data, is applied to the result of the basic survey for the person to be authorized, and the investigation item of the person to be authorized corresponding to the item representing the characteristic of the selected degree of care required is , It is determined whether a problem state other than “self-supporting” or “capable” is selected.

  In the screen of FIG. 14, items selected in advance as items representing the characteristics according to the degree of care required (support 1, need 1 need, need 2, need 3, need 4, need 5). Is displayed in tabular form. Among these items, the display color is changed for items for which a problem state other than “independence” or “capable” is selected as a result of the basic survey on the person to be certified.

  In the example in the figure, the display colors of the items selected as representing features from “support 1 required” to “care required 3” surrounded by a thick frame are changed. This is a result of the survey on the person to be certified, and all indicate that a problem state other than “independence” or “capable” is selected. On the other hand, as for the degree of other care required, some items are not selected as problematic.

  In this case, all the selected items are the level of care required that has been selected as problematic, and the highest level of need for care, in this case “Need Care 3”, is the fifth reference indicator (trend of survey items) ) As a secondary determination candidate.

  By displaying in this way, the judging committee can grasp the tendency of the overall survey items including the degree of care required other than the secondary determination result, and can perform an appropriate examination.

  When the “middle point” button in FIG. 12 is operated, a screen relating to the intermediate evaluation item score shown in FIG. 15 is displayed. On this screen, the processing result of the intermediate evaluation item estimation means 22 shown in FIGS. 2 and 9 is displayed.

  As shown in FIG. 8, the intermediate evaluation item estimation means 22 has each degree of care required obtained from statistical data of past care-required certification results (independence, support 1 required, equivalent to care 1, care required 2, care required 3, using the average score of each group in need of nursing care 4, need of nursing care 5), and comparing this with the score for each group of the survey results of the subject of certification, the number of groups with the closest average score for each degree of care required Estimate the degree of need for nursing care with the largest number of estimated groups as the secondary determination candidate.

  The screen of FIG. 15 shows the score of each group that is the current survey result of the person to be certified, and the average score of each group in each degree of care required described above obtained from the statistical data on the results of certification of long-term care required. It is displayed in the format. In the example of the figure, the average score closest to the current score of the first group is support 1 required, the average score closest to the current score of the second group is 5 requiring care, and the current time of the third group The average score closest to the score of 5 is the need for long-term care, the average score closest to the current score of the fourth group is the need for long-term care 3, and the average score closest to the current score of the fifth group is the need for long-term care 5 indicates that the average score closest to the current score of the sixth group is 5 requiring care, and the average score closest to the current score of the seventh group is 3 requiring care. As a result, the degree of care required with the largest number of groups of average scores closest to the current score of the person to be certified is “care required 5”, which is set as a secondary determination candidate.

  By displaying in this way, it is possible to know the correspondence status of the intermediate evaluation items in each group of certified subjects and the average score of past intermediate evaluation items by the degree of care required. It is possible to determine the degree of care required for the secondary determination candidate after grasping the above.

  When the “independence degree” button in FIG. 12 is operated, a screen related to the independence degree combination shown in FIG. 16 is displayed. On this screen, the processing result of the independence degree combination distribution analysis means 19 shown in FIGS. 2 and 9 is displayed.

  As described above, the independence degree combination distribution analysis means 19 takes in the independence degree combination data table 14 shown in FIG. 5 from the statistical data 13 of the past nursing care authorization result, and obtains the person to be authorized obtained by the basic survey. By applying the combination of the degree of disability independence and the degree of independence of dementia, select the degree of care required that is certified at the highest rate and select it as a secondary determination candidate.

  In the screen of FIG. 16, the upper display area 45 displays that the disability independence of the person to be authorized is B1 and the independence degree of dementia IIIa. In the lower display area 46, the analysis state using the data table of the degree of independence of dementia III shown in FIG. 5 corresponding to this combination of independence is displayed. That is, the degree of care required for each degree of disability independence in Dementia Independence III (independence and ranks J, A, B, and C) (independence, support 1 required, equivalent to care 1 equivalent, care required 2, care required 3, Approval ratio (%) of care required 4 and care required 5) is displayed, and among them, the degree of disability independence of the person being certified is B rank, so the accreditation for each degree of care required in the disability independence degree B column Among the percentages (%), “Necessary care level 4” is the highest certified percentage.

  By displaying in this way, it is possible to clearly grasp what causes the severe change or the minor change due to the cause, and the certification work can be ensured.

  Further, when the “change” button in FIG. 12 is operated, a screen for displaying the processing result of the change analysis means 20 shown in FIGS. 2 and 9 is displayed. Although this screen is not particularly presented, for example, a screen that realizes the display content having the same meaning as that of the column 25D of the nursing care change index in the form 25 of FIG. 4 may be used.

  In any of the above-described embodiments, the care-required person data 10 and the statistical data 13 of the past care-required certification results are stored in a database, and these data are captured by the computer 18 and predetermined computations are performed by the respective computation processing means. However, the present invention is not limited to such a configuration.

  For example, the above-described various data (primary determination data, certification survey data, etc.) are held in a file (for example, CSV), and this file is input to a computer, whereby secondary determination candidates based on reference index analysis are stored in a file (also for example, (CSV). In this way, since the obtained secondary determination candidates based on the reference index analysis can be managed as a file, it can be used in any form.

It is a flowchart explaining the flow of general nursing care certification. It is a system block diagram showing one embodiment of a reference index analysis system in certification for long-term care according to the present invention. It is a data block diagram which shows the basic item, primary determination result part, etc. in the nursing care certification target person data used for this invention. It is a data block diagram which shows the primary determination result part etc. in the nursing care target subject data used for this invention. It is a data block diagram which shows the investigation item part etc. in the nursing care target person data used for this invention. It is a data block diagram which shows another investigation item part etc. in the nursing care target subject data used for this invention. It is a figure which shows an example of the form output by this invention. It is a figure which shows an example of the independence degree combination data table used by this invention. It is a figure which shows an example of the data structure of the mild change parameter | index used by this invention. It is a figure which shows an example of a data structure of the seriousness change parameter | index used by this invention. It is a figure which shows a part of data structure of the state image example according to a nursing care level used by this invention. It is a figure which shows an example of a data structure of the intermediate evaluation item average score used by this invention. It is a system block diagram showing one embodiment of a reference index analysis system in certification for long-term care according to the present invention. It is a figure which shows the other example of the form output by this invention. It is a figure which shows an example of a data structure of the feature item according to the degree of care required used by this invention. It is a screen figure which shows the basic screen output by this invention. It is a screen figure which shows the similar state example screen output by this invention. It is a screen figure which shows the tendency screen of the investigation item output by this invention. It is a screen figure which shows the intermediate evaluation item score screen output by this invention. It is a screen figure which shows the independence degree combination screen output by this invention.

Explanation of symbols

10 Persons requiring certification for long-term care 11 Primary determination results 12 Basic survey data 13 Statistical data of past results of certification for long-term care 14 Independence degree combination data table 15 Severe / light change indicators 16 Examples of status according to the degree of care required 17 Average of intermediate evaluation items Point 18 Computer 19 Independence degree combination distribution analysis means 20 Change index analysis means 21 Similar state image example analysis means 22 Intermediate evaluation item estimation means 24 Output means 25, 35 Form 26 Screen 27 Input operation unit 30 Characteristic items according to the degree of care required 31 Trend Analytical means

Claims (18)

A reference index analysis system used when a secondary judgment is decided by a review board using a primary judgment result based on a certification survey result consisting of a plurality of items for a subject requiring certification for long-term care insurance,
Based on the combination of disability independence and dementia independence obtained by the above-mentioned accreditation survey, the degree of long-term care required that is certified at the highest rate is selected from the statistical data of past accreditation of long-term care required. Independence degree combination distribution analysis means as a determination candidate,
Using the statistical results of the severe change when the secondary determination result is high and the mild change when the secondary determination result is low compared to the primary determination result, obtained from the past certification for long-term care, the primary determination result of this person and the primary determination Secondary determination by determining whether or not the primary determination result of the person to be certified is changed from the survey result of the item related to the severe or mild change previously selected from the certified survey items for each degree of care required Change indicator analysis means for determining candidates,
Using the status image of the person to be certified based on the survey results of the certification survey items, the status image of the person to be certified from a plurality of status image examples for each degree of care required based on the statistical data of the past nursing care certification results Similar state image example analysis means for extracting a plurality of similar state image examples and obtaining secondary determination candidates from the degree of care required to which each of the extracted state image examples belongs,
The accredited survey items are divided into a plurality of groups, and the scores of the survey results of the persons to be accredited are totaled for each group, and the scores obtained for each group and the statistical data of the past certification results requiring care are obtained. Intermediate evaluation item estimation means that compares the average score of each group in each degree of care required and sets the degree of care required with the largest number of groups with the closest average score as a secondary determination candidate,
Reference index analysis system for certification of long-term care, which is characterized by having   From the statistical data of past nursing care certification results, for each degree of nursing care, select the items representing the characteristics of the degree of nursing care required from the above certification survey items. The level of care required is extracted from the items that have resulted in the status of the above, and the highest level of need for care among the extracted levels of need for care is selected as a secondary determination candidate. The reference index analysis system for certification of long-term care according to claim 1, further comprising a trend analysis means for survey items.   The independence degree combination distribution analysis means, for a plurality of dementia independence degree, using a data table that defines the authorization ratio of the degree of care required in each disability independence degree, the degree of disability independence of the person to be certified, dementia independence degree The reference index analysis system for certification of long-term care according to claim 1, wherein the degree of long-term care requiring the highest certification ratio is set as a secondary determination candidate.   The change index analysis means selects a predetermined number of items related to the severe change or mild change from the items of the certification survey for each degree of care required of the primary determination result from the statistical data of the results of certification of care required in the past. Using the data table, the primary determination result of the person to be authorized and the result of the authorized investigation are applied to the data table to obtain the number of items corresponding to the item related to the severe change or the mild change, and correspond to the severe change Find the difference between the number of items to be applied and the number of items that correspond to the mild change, and if the difference is greater than or equal to the preset value, change the level of care required for the primary judgment result of the person to be certified by one step, severe or mild The reference index analysis system in certification for long-term care according to any one of claims 1 to 3, wherein the reference index analysis system is a secondary determination candidate.   The similar state image example analyzing means prepares a plurality of state image examples for each degree of care required from statistical data of past care required authorization results, and each of the prepared state image examples and the status of the person to be authorized And the number of matches of each of the authorized survey items forming the state image and the state image example are obtained, and the state image examples in which the number of matches is equal to or greater than a preset number are extracted as similar state image examples. The reference index analysis system for certification of need for nursing care according to any one of claims 1 to 4, wherein the degree of need for care to which the extracted similar state image examples most frequently belong is a secondary determination candidate.   The similar state image example analysis means, for each of the status image of the person to be authorized and each of the extracted state image examples, categorize the certification survey items into a plurality of groups, total the scores of each item for each group, 6. The reference index analysis system for certification of need for nursing care according to claim 5, wherein image data of a radar chart is created based on the total score.   The similar state image example analysis means prepares a plurality of state image examples for each degree of care required based on statistical data of past care-required certification results, and patterns of each of these state image examples and the status image of the person to be certified The degree of similarity with the pattern is calculated by the least-squares method using the scores of the authorized survey items forming each pattern, and the state images whose calculated similarity is equal to or less than a preset value are extracted as similar state image examples The reference index analysis system for certification of need for nursing care according to any one of claims 1 to 4, wherein the degree of need for care to which the extracted similar state image examples most belong is set as a secondary determination candidate. .   The similar state image example analysis means prepares a plurality of state image examples for each degree of care required based on statistical data of past care-required certification results, and patterns of each of these state image examples and the status image of the person to be certified The degree of similarity with the pattern is calculated by the least square method using the score for each group obtained by dividing the authorized survey items forming each pattern into a plurality of groups, and the calculated similarity is a preset value. The following state image examples are extracted, and the degree of care required to which the extracted state image examples most frequently belong is set as a secondary determination candidate. 5. Care required according to any one of claims 1 to 4 Reference index analysis system for accreditation.   9. The apparatus according to claim 1, further comprising an output unit that outputs each secondary determination candidate of the degree of care required obtained by each unit together with the primary determination result to a screen or a form. Reference index analysis system for certification of long-term care.   When there are multiple secondary determination candidates for the degree of care required obtained by each means in each reference index, the one close to the primary determination or the primary determination itself among them is selected as a single secondary determination candidate The reference index analysis system for certification of need for nursing care according to any one of claims 1 to 9, further comprising output means for performing output on a screen or a form.   Each secondary determination candidate of the degree of care required obtained by each means, and the output that outputs the most frequent secondary determination candidates among those secondary determination candidates as a final secondary determination candidate to a screen or a form The reference index analysis system for certification of long-term care according to any one of claims 1 to 8, further comprising means.   When there are a plurality of secondary determination candidates having the largest number of secondary determination candidates among the secondary determination candidates of the degree of care required obtained by each means, the one closer to the primary determination or between them 9. The reference in certification of need for nursing care according to any one of claims 1 to 8, further comprising output means for outputting the primary determination itself as a single final secondary determination candidate to a screen or a form. Indicator analysis system.   The certification of need for nursing care according to any one of claims 1 to 8, further comprising output means for outputting an analysis result related to a secondary determination candidate for the degree of need for care obtained by each means in a file format. Reference index analysis system.   The output means is a numerical value of a certification ratio of each nursing care degree in the degree of independence and dementia independence of the person to be authorized used in the independence degree combination distribution analysis means, and in the degree of independence and dementia independence 14. The reference index analysis system for certification of need for nursing care according to any one of claims 9 to 13, characterized by:   The output means selects and displays all items related to mild change and all items related to severe change from among the authorized survey items, and displays the items related to the displayed mild change. Among the items related to the serious change in the displayed items, change the display mode for the items indicating the good condition such as “independence” or “done” as the result of the certification survey for the subject of certification. Change the display status for items that have a problem such as “watch, etc.”, “partial assistance”, or “cannot do”, and change the display status depending on the number of items whose display status has changed due to minor changes and severe changes. The difference between the number of items displayed is displayed numerically, and the degree of care required changed based on the difference is displayed as a secondary determination candidate. Reference index analysis system in need of nursing care certification described.   The output means is configured to display a radar chart for the state image of the authorized person created by the similar state image example analysis means and each state image example extracted as being similar to the state image. The reference index analysis system in the certification for long-term care according to any one of claims 9 to 13.   The output means displays the average score of each group obtained by classifying the basic survey items in the statistical data of past certification for long-term care results into a plurality of groups in a tabular form according to the degree of long-term care required. Among the average scores of each group, the display form of the average score that is closest to the score of each group that is the survey result of the certification subject is changed, and the degree of care required in which the display-changed average score is the most present is changed. The reference index analysis system for certification of need for nursing care according to any one of claims 9 to 13, wherein the display is changed as a secondary determination candidate.   From the items of the certification survey, the trend analysis means of the survey item represents the characteristics of the degree of care required for each degree of care required based on the statistical data of the results of certification of long-term care required. The selected items are displayed in a table format corresponding to the degree of care required, and among the displayed items, the display status of items that indicate a problem is changed as a result of the basic survey on the subject of certification. The reference index analysis system for certification of need for nursing care according to any one of claims 9 to 13, wherein: