JP2006018532A - System and method for analyzing hospital management information, computer readable storage medium and computer program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a hospital management information analysis system for statistically refining unprofitable medical treatment which may exert influence on hospital earnings and expenses at the time of introducing DPC evaluation to the hospital in each DPC. <P>SOLUTION: The hospital management information analysis system 10 is provided with a hospital data management system 11 for respectively inputting medical accounting data and clinical history data and managing hospital data integrated as data per hospitalization in each patient. The hospital management information analysis system 10 is also provided with a terminal 12a having a program for executing a procedure for determining a DPC as a DPC code, defining patient data which are the data of one patient from the hospital data and coding the DPC code in the patient data and a procedure for calculating medical treatment fees respectively on the basis of piece evaluation and DPC evaluation by using the patient data in which the DPC code is coded and analyzing and displaying hospital management at the time of introducing the DPC evaluation from the calculated results. The hospital data management system 11 is connected to the terminal 12a through a LAN 18. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a hospital management information analysis system, a hospital management information analysis method, a computer readable storage medium, and a computer program for analyzing the management status of the hospital at the time of introduction of DPC evaluation from medical accounting data and medical history data possessed by the hospital. .

  In the information analysis system that can analyze and analyze medical accounting data and medical history data existing in the hospital, useful information is extracted from the information stored in the medical accounting database and medical history database and managed by the integrated database To do. In this way, by managing information with the integrated database, it is possible to analyze information in a hospital without giving a load to a business information system (see, for example, Patent Document 1).

  In addition, due to medical reform, it is based on DPC (diagnosis group classification: Diagnosis Procedure Combination), which is the basis of the one-day comprehensive payment method at specific function hospitals in Japan (national university hospital, main hospital and national center hospital). A comprehensive evaluation was attempted. Today, DPC evaluation has expanded its scope, and from April 2004, general hospitals other than specific function hospitals have been tried.

  DPC means a combination of diagnosis and treatment, but differs from DRG (Diagnosis Related Group) / PPS (Prospective Payment System) that has been used in the following two points.

  The first difference is that Western-style DRGs first classify diseases according to the presence or absence of surgical treatment, while DPCs select the operation and treatment based on the name of the wound, and finally the severity. It is a point classified according to the presence or absence of. Therefore, the classification is closer to the thinking process of medical care in the clinical field.

  Next, the second difference is that the conventional DRG / PPS is based on a fixed amount payment per hospitalization, while the DPC has a fixed amount payment method per day. In DRG / PPS, regardless of the length of hospitalization, there is no dissatisfaction by the patient for the same payment amount, and even if hospitalization exceeds the average length of stay, the hospital does not take out the amount. However, in DRG / PPS, the same short-term addition / long-term subtraction mechanism as that for conventional hospitalization costs is incorporated into the number of comprehensive points per day, and an incentive to reduce the length of hospital stays is working.

  FIG. 29 is a diagram for explaining a DPC comprehensive portion and a volume portion constituting a medical fee for DPC evaluation.

  FIG. 29 shows, as main medical practice classifications, examination fees, medications, injection costs, treatment subtotals, surgical subtotals, examination subtotals, diagnostic imaging subtotals, other costs, hospitalization costs, and dietary medical expenses. The medical fee based on DPC evaluation is composed of a comprehensive part which is a hospitality item and a volume part which is a doctor fee item. When the medical practice classification is, for example, an examination fee, the cost of home medical care and the instruction management fee are distributed in the volume part of the examination fee, but the other examination fee is distributed in the comprehensive part. For example, in the case of a treatment subtotal, treatment costs of 1000 points or more of the treatment subtotals are arranged in the volume portion, but those exceeding 1000 points are arranged in the comprehensive portion.

  The introduction of the DPC evaluation system to general hospitals is positioned as one of the reforms aimed at reducing medical expenses, but for the hospital management, it is necessary to maintain medical quality and medical treatment fees while clarifying unprofitable medical care. Reducing costs is an urgent issue.

  When a DPC evaluation system is introduced to a general hospital, it is unclear how the management status of the hospital changes compared to before the introduction of the DPC evaluation system.

  Therefore, if the medical fee after the introduction of the DPC evaluation system can be simulated with the current hospital data at the hospital, the balance of the hospital after the introduction of the DPC evaluation system can be predicted. Moreover, unprofitable medical practice can be clarified by analyzing the relationship between the medical practice and the balance of the hospital.

In addition, if you can simulate the medical fee after introducing the DPC evaluation system in the hospital balance of operation of a specific function hospital where the DPC evaluation system has been introduced and the general hospital after the DPC evaluation system has been introduced, I can grasp.
JP 2002-24479 A

  However, there is no tool for simulating medical fees after the introduction of the DPC evaluation system. One reason for this is that the coding policy is not visible. DRG and ICD (International Classification of Diseases) coding are inseparable, but ICD coding is not widespread. For this reason, for example, different DPC codes may be assigned even for the same wound name, and the medical fee for each wound name cannot be simulated on a DPC basis.

  Furthermore, in order to simulate medical fees after the introduction of the DPC evaluation system, it is not possible to use the integrated database extracted from medical accounting data and medical history data existing in the hospital as it is. You need to build a managed database.

  The present invention has been made in consideration of the above-mentioned circumstances, and for each DPC of the hospital, the medical fee can be compared with the case where the DPC evaluation is not introduced and the hospital balance when the DPC evaluation is introduced is affected. It is an object of the present invention to provide a hospital management information analysis system, a hospital management information analysis method, a computer-readable storage medium, and a computer program that can statistically narrow down unprofitable medical treatments to be given.

  In addition, the second object of the present invention is to analyze the hospital management information that can statistically narrow down the patients who have received unprofitable medical treatment that affects the hospital balance at the time of DPC evaluation introduction for each DPC in the hospital. A system, a hospital management information analysis method, a computer-readable storage medium, and a computer program are provided.

  Furthermore, the third object of the present invention is to compare the medical fee between the case where DPC evaluation is performed for a patient who has been transferred at the hospital as one hospitalization, and the case where the DPC evaluation is performed using each DPC code determined for each hospitalization To provide a hospital management information analysis system, a hospital management information analysis method, a computer-readable storage medium, and a computer program.

  In order to solve the above-described problems, the hospital management information analysis system according to the present invention is an information analysis system capable of statistically analyzing and analyzing medical accounting data and medical history data existing in a hospital. The hospital data management system for managing the hospital data integrated as data per hospitalization for each patient, taking in the medical history data, and the patient data as one patient data from the hospital data while determining the DPC as the DPC code The procedure for coding the DPC code in the patient data and the patient fee in which the DPC code is coded are used to calculate the medical fee by the volume evaluation and the DPC evaluation, and the DPC evaluation is introduced from the calculation result. A program to execute procedures for analyzing and displaying hospital management at the time And a terminal having a beam connected through a network.

  In addition, the hospital management information analysis system according to the present invention is an information analysis system that can analyze and analyze medical accounting data and medical history data existing in the hospital, and each of the medical accounting data and the medical history data, Hospital data management system for managing hospital data integrated as data per hospitalization for each patient and DPC as DPC code, while determining patient data as one patient data from the hospital data. The procedure for coding the DPC code in the data and the patient fee in which the DPC code is coded are used to calculate the medical treatment fee by the volume evaluation and the DPC evaluation, and from this calculation result, the hospital management at the time of introducing the DPC evaluation is analyzed and And a computer having a program for executing the displaying procedure The display device that displays various screens used in the analysis of the hospital management, and were connected to a terminal having an operation unit capable of selection operation according to the screen to be displayed on the display device via the network.

  In order to solve the above-described problems, the hospital management information analysis method according to the present invention is an information analysis method capable of statistically analyzing medical accounting data and medical history data existing in a hospital, wherein the medical accounting data and Hospital data management process in which the hospital history data is managed and hospital data integrated as data per hospitalization for each patient is managed, and a patient whose DPC is determined as a DPC code and is one patient data from the hospital data After the data is confirmed, the DPC coding process for coding the DPC code in the patient data, and the medical fee is calculated from the cost for each diagnostic action classification included in the patient data in which the DPC code is coded. The analysis and display of hospital management at the time of DPC evaluation introduction from the calculation results And a Nau data analysis and display process.

  According to the hospital management information analysis system, hospital management information analysis method, computer-readable storage medium, and computer program according to the present invention, statistically narrow down the unprofitable medical practices that affect the hospital balance at the time of DPC evaluation introduction Can do.

  Further, according to the hospital management information analysis system, the hospital management information analysis method, the computer-readable storage medium and the computer program according to the present invention, the hospital balance at the time of introducing the DPC evaluation for each DPC in the hospital. It is possible to statistically narrow down patients who have been given profitable medical care.

  Furthermore, according to the hospital management information analysis system, the hospital management information analysis method, the computer-readable storage medium and the computer program according to the present invention, when a patient who has been transferred to the hospital is evaluated as a single hospitalization, The medical fee can be compared with the case where the DPC evaluation is performed with each DPC code determined in the above.

  Embodiments of a hospital management information analysis system, a hospital management information analysis method, a computer-readable storage medium, and a computer program according to the present invention will be described with reference to the accompanying drawings.

  FIG. 1 is a block diagram showing a first embodiment of a hospital management information analysis system, a computer-readable storage medium, and a computer program according to the present invention.

  FIG. 1 shows a medical accounting data management system 8 that manages medical accounting data (monthly medical accounting information) in a predetermined hospital, a medical history data management system 9 that manages medical history data (discharge summary), and a per-patient hospitalization. A hospital management information analysis system 10 that manages data and analyzes and displays the hospital management at the time of DPC evaluation introduction from the data is shown.

  The hospital management information analysis system 10 incorporates medical accounting data and medical history data on a monthly basis, integrates it as patient data per hospitalization per patient, and manages this patient data as hospital data for multiple patients. Base), the hospital management information storage system 11 and the patient fee included in the hospital data managed by this hospital management information storage system 11 can be used to calculate the medical treatment fee per patient in the volume evaluation and DPC evaluation, respectively. There is provided a computer 12, such as a PC (Personal Computer) 12a, which performs calculation and executes analysis and display of hospital management at the time of introducing DPC evaluation from the calculation result.

  The medical accounting data management system 8, the medical history data management system 9, the hospital management information storage system 11 and the terminal 12a are connected to each other via a network capable of data communication, for example, a LAN (Local Area Network) 18 in the hospital.

  The medical accounting data management system 8 is provided with a medical accounting DB (not shown) for managing medical accounting data. This medical accounting DB includes medical practice classifications such as medical examination fees, medication charges, and injection costs for each patient. , Treatment subtotal, surgical subtotal, inspection subtotal, surgical subtotal, inspection subtotal, diagnostic imaging subtotal, other expenses, hospitalization expenses and meal medical expenses, and details of each medical fee are managed.

  The medical history data management system 9 is provided with a medical history DB (not shown) for managing medical history data, and this medical history DB includes, for example, hospitalization date, department in charge, name of injured disease, name of operation, and outcome for each patient. Medical history details are managed.

  In the hospital management information storage system 11 of the hospital management information analysis system 10, medical accounting data and medical history data read monthly from the medical accounting data management system 8 and the medical history data management system 9 are stored per patient per hospital. A hospital DB 27 that integrates as data and centrally manages this patient data as hospital data for each of a plurality of patients, and a control unit 28 for communicating with an external business information system via the LAN 18 are provided. The hospital management information storage system 11 receives data of information systems other than the medical accounting data management system 8 and the medical history data management system 9, for example, cost data (accounting cost and management cost in profit / loss data) of the accounting system. Next, it can be read and managed by the hospital DB 27 as data per hospitalization for each patient.

  FIG. 2 is a table showing hospital data managed by the hospital DB 27.

  The hospital data shown in FIG. 2 is obtained by integrating medical accounting data and medical history data read monthly from the medical accounting data management system 8 and medical history data management system 9 as patient data per patient per hospital. Consists of patient data for each patient.

  Patient data per hospitalization is monthly for each hospitalization and medical treatment classification (examination fee, medication fee, injection cost, treatment subtotal, surgical subtotal, examination subtotal, diagnostic imaging subtotal, other costs, hospitalization costs, dietary expenses, etc.) Information obtained from medical accounting data of expenses (income), and information obtained from medical history data such as hospital admission date, department in charge, names of wounds, and names of operations.

  The terminal 12a of the hospital management information analysis system 10 shown in FIG. 1 includes a ROM (Read Only Memory) 31, a CPU (Central Processing Unit) 32, a RAM (Random Access Memory) 33, and an external storage device. 34, an operation device 35, a display device 36, a storage medium drive device 37, and a communication device 38 are provided. ROM 31, CPU 32, RAM 33, external storage device 34, operation device 35, display device 36, storage medium drive The device 37 and the communication device 38 are connected to each other by a bus 39.

  The ROM 31 stores in advance a basic program for operating the terminal 12a. The RAM 33 is used as a work area for the CPU 32.

  The storage medium drive device 37 operates the recording medium 40. The recording medium 40 is composed of, for example, a CD (Compact Disk) -ROM. In this CD-ROM, DPC (DPC: Diagnosis Procedure Combination) is determined as a DPC code on the terminal 12a, while medical accounting data and medical history data existing in the hospital are integrated as data per hospitalization for each patient. The patient data, which is the data of one patient, is determined from the hospital data, the procedure for coding the DPC code in this patient data, and the medical fee is calculated using the patient data in the volume evaluation and the diagnosis group classification evaluation. A hospital management information analysis execution program or the like for executing a procedure for analyzing and displaying the hospital management at the time of introducing the DPC evaluation from the calculation result is recorded. The storage medium drive device 37 is composed of a CD-ROM drive or the like, reads a hospital management information analysis execution program or the like from the recording medium 40 under the control of the CPU 32, and stores the hospital management information analysis execution program or the like as needed. Bridge to be installed on 34.

  Note that the storage medium 40 is not limited to a CD-ROM, and is a DVD, FD, or the like when a DVD (Digital Versatile Disk) drive, an FD (Floppy Disk) drive, or the like is provided as the storage medium drive device 35. May be.

  The external storage device 34 is composed of, for example, an HDD (Hard Disk Drive). As described above, the hospital management information analysis execution program is installed in the external storage device 34, and various computer programs are installed in advance by a general method.

  The CPU 32 reads a basic program and the like from the ROM 31 and reads a hospital management information analysis execution program from the external storage device 34 to execute data processing and the like for performing the hospital management information analysis. The ROM 31 may store a hospital management information analysis execution program in addition to the basic program. In this case, the CPU 32 reads out the basic program and the hospital management information analysis execution program from the ROM 31 and stores the hospital management information analysis execution program. Data processing for information analysis is executed.

  The operation device 35 includes a keyboard and a mouse. Various commands and the like according to the operation of the operator are input.

  The display device 36 includes a CRT (Cathode Ray Tube), a liquid crystal display device, or the like. Various screens used in the hospital management information analysis are displayed on the display device 36 under the control of the CPU 32.

  Next, a hospital management information analysis system 10, a hospital management information analysis method using a computer-readable storage medium and a computer program will be described using the flowchart shown in FIG. 3.

  First, medical accounting data and medical history data are taken into the hospital management information storage system 11 of the hospital management information analysis system 10 every month from the medical accounting data management system 8 and the medical history data management system 9, respectively. As shown in FIG. 2, the patient data is managed as hospital data for each of a plurality of patients (step S1).

  Subsequently, the CPU 32 provided in the terminal 12a of the hospital management information analysis system 10 executes a hospital management information analysis execution program and the like. When the hospital management information analysis execution program is executed, the CPU 32 first determines the DPC as the DPC code, while determining the patient data as one patient data from the hospital data, and codes the DPC code in the patient data. (Step S2). For example, first, the CPU 32 displays a mode selection screen (shown in FIG. 4) on which the operator can select a mode (surgery name mode or injury name mode) on the display device 36 (step S2a). Then, on the mode selection screen, the CPU 32 determines whether the operation name 35 and the name of the disease are based on whether the operator uses the operation device 35 and clicks the “operation name mode” or clicks on the “injury name mode”. It is determined which of the modes has been selected (step S2b).

  If the CPU 32 determines that the operation name mode has been selected in step S2b, the CPU 32 determines each element of the MDC (“MDC [disease”) in order to determine the MDC (Major Diagnosis Category) constituting the DPC code. Name] ”) is displayed on the display device 36 (step S2c).

  Thereafter, until step S2h, the MDC constituting the DPC code (information held in the first and second digits from the left end of the DPC code) is determined as MDC <06>, and the surgical classification constituting the DPC code (9 and 10 digits from the left end of the DPC code) The information that the eye has) is determined as the surgical category <04>, and the DPC code <0335> is selected by selecting the injury category <0335> as the injury category (information from the 3rd to 6th digits from the left end of the DPC code) constituting the DPC code. The case of determining 0603353x04x00x> and <0603353x04x01x> will be described below, but is not limited to the case of determining DPC codes <0603353x04x00x> and <0603353x04x01x>.

  5 to 7 are diagrams illustrating an example of the DPC classification definition selection (operation name mode) screen.

  FIG. 5 is a screen of DPC classification selection (operation name mode) in which “MDC [disease name]” of the MDC is displayed by, for example, a pull-down menu (drop-down menu) method.

  Here, as "MDC [disease name]", "MDC01 [neurological disease]", "MDC02 [ophthalmic disease]", "MDC03 [otolaryngology disease]", "MDC04 [respiratory system disease]" , "MDC05 [cardiovascular disease]", "MDC06 [digestive system disease, liver, biliary tract / pancreatic disease]", "MDC07 [musculoskeletal disease]", "MDC08 [skin and subcutaneous tissue disease]", "MDC09 [breast disease]", "MDC10 [endocrine / nutrition / metabolic disease]", "MDC11 [renal / urinary tract disease and male reproductive system disease]", "MDC12 [female reproductive system disease and postpartum disease]・ Abnormal pregnancy and delivery], “MDC13 [Diseases of blood, hematopoietic organs, immune organs]”, “MDC14 [Newborn diseases, congenital malformations]”, “MDC15 [pediatric diseases]” and “MDC16 [trauma, burns, poisoning] , Foreign bodies, other diseases] ” It is.

  Like the DPC classification definition selection (surgery name mode) screen shown in FIG. 5, the operator uses the operation device 35 such as a mouse and selects from among a plurality of “MDC [disease name]” displayed on the menu. The required “MDC [disease name]” “MDC 06 [digestive system disease, liver, biliary tract / pancreatic disease]” is selected. When “MDC06 [digestive system disease, liver, biliary tract / pancreatic disease]” is selected, the CPU 32 determines MDC as MDC <06> (step S2d).

  Subsequently, in order to determine the surgical segment constituting the DPC code, the CPU 32 displays each element (“surgical name”) of the surgical segment on the display device 36 (step S2e). In the display on the display screen 36, “Surgery name” corresponding to “MDC06 [digestive system disease, liver, biliary tract / pancreatic disease]” selected in step S2d is displayed.

  FIG. 6 is a DPC classification definition selection (operation name mode) screen in which the “operation name” of the operation classification is displayed by, for example, a pull-down menu (drop-down menu) method.

  Like the DPC classification definition selection (operation name mode) screen shown in FIG. 6, the operation device 35 is used by the operator, and a required “operation name” from among a plurality of “operation names” displayed on the menu. "Laparoscopic cholecystectomy" is selected. When “laparoscopic cholecystectomy” is selected, the CPU 32 determines the surgical section as the surgical section <04> (step S2f).

  When the operation category is determined in step S2f, the CPU 32 displays each element (“injury and disease name”) of the injury and disease category on the display device 36 in order to determine the injury and disease category constituting the DPC code (step S2g). In the display screen 36, “MDC06 [digestive system disease, liver, biliary tract / pancreatic disease]” selected in step S2d and “laparoscopic cholecystectomy” selected in step S2f are displayed. "Injury name" shall be displayed.

  FIG. 7 is a DPC classification definition selection (operation name mode) screen in which the “injury and disease name” of the injury and disease classification is displayed in a list, for example.

  Like the DPC classification definition selection (surgery name mode) screen shown in FIG. 7, the operation device 35 is used by the operator, and a required “DPC code” is selected from a plurality of “DPC codes” displayed in a list. Some DPC codes <0603353x04x00x> and <0603353x04x01x> are selected. When the DPC codes <0603353x04x00x> and <0603353x04x01x> are selected, the CPU 32 determines DPC codes <0603353x04x00x> and <0603353x04x01x>, which are required DPC codes (step S2h). Here, when selecting the DPC codes <0603353x04x00x> and <0603353x04x01x>, the operator needs to see a plurality of “injury names” shown on the DPC classification definition selection (operation name mode) screen shown in FIG. It is performed by selecting “Gall bladder edema, cholecystitis, etc.” which is the “injury name”.

  When “gallbladder edema, cholecystitis, etc.” is selected while looking at a plurality of “injury and disease names” shown on the DPC classification definition selection (surgical name mode) screen shown in FIG. 7, the CPU 32 selects “gallbladder edema, cholecystitis, etc.” DPC code <0603353x04x00x> when the element ("Yes / No") of the minor injury category (information held in the 13th digit from the left end of the DPC code) is "No" In this case, the DPC code <0603353x04x01x> is determined.

  In addition, when “laparoscopic cholecystectomy” is determined as the “surgical name” and “gallbladder edema, cholecystitis, etc.” is determined as the “sickness and disease name”, two types of DPCs differ depending only on the secondary wound disease category. Confirm the code. However, in the case of other “surgery name” and “injury / disease name”, the treatment, etc. constituting the DPC code is classified into 1 division (information held in the 11th digit from the left end of the DPC code), and the treatment is divided into 2 divisions (12 from the left end of the DPC code). A plurality of DPC codes are determined by a combination of the information in the digit), the minor injury category and the severity classification (information in the 14th digit from the left end of the DPC code).

  On the other hand, if the CPU 32 determines in the determination in step 2b that the operation name mode is selected, the display device 36 displays all “operation names” included in the hospital data managed by the hospital DB 27 of the hospital management information storage system 11. (Step S2i).

  Hereinafter, the case where the operation name is confirmed as laparoscopic cholecystectomy will be described up to step S21, but is not limited to the case where laparoscopic cholecystectomy is confirmed.

  8 to 10 are diagrams illustrating examples of the hospitalization analysis cumulative data (operation name mode) screen.

  FIG. 8 is a diagram showing an initial screen of accumulated data for hospitalization analysis (surgery name mode) in which a search condition for surgery names is displayed by, for example, a pull-down menu method.

  Here, even in an equivalent surgical technique, there may be a difference in the names of the surgery stored in the medical history data management system 9 and the hospital management information storage system 11 due to the difference in the name of the surgery by a doctor or the like. Therefore, the cumulative data for hospitalization analysis (surgery name mode) screen shown in FIG. 8 can be subjected to an OR search according to a multiple search condition. In addition, as in the hospitalization analysis cumulative data (operation name mode) screen shown in FIG. 8, a “keyword” of an operation name may be input so that patient data having this keyword can be searched.

  FIG. 9 shows the search condition of the operation name displayed in, for example, a pull-down menu method. In the hospitalization analysis cumulative data (operation name mode) screen for searching patient data having “laparoscopic cholecystectomy” selected from the menu. FIG. 10 is a diagram for explaining an example of a selection operation of “laparoscopic cholecystectomy”.

  As shown in the cumulative data for hospitalization analysis (operation name mode) screen shown in FIG. 9, the operation device 35 is used by the operator, and a plurality of “operation names” displayed on the first search condition menu are required. “Laparoscopic cholecystectomy”, which is the “surgical name”, is selected.

  When the search condition is selected, the CPU 32 confirms the operation name as laparoscopic cholecystectomy (step S2j), and from the hospital DB 27 of the hospital management information storage system 11 on the accumulated data for hospitalization analysis (operation name mode) screen The patient data corresponding to the laparoscopic cholecystectomy selected in is searched. The CPU 32 displays the “injury name” included in the retrieved patient data having a laparoscopic cholecystectomy on the display device 36 for each patient (step S2k).

  FIG. 10 is a hospitalization analysis cumulative data (operation name mode) screen in which the operation name selection results are displayed in a list, for example.

  As shown in the DPC classification definition selection (operation name mode) screen shown in FIG. 10, patient data having the operation name “laparoscopic cholecystectomy” is displayed for each patient, and “injury name” for each patient is displayed. Listed. The operation device 35 is used by the operator, and a required “injury name” is selected from a plurality of “injury and disease names” displayed in a list, so that the CPU 32 performs an operation used for data analysis from the hospital data. Patient data having the name “laparoscopic cholecystectomy” and the required “injury name” are determined (step S2l).

  Subsequently, the CPU 32 matches the patient data determined in step S21 with the DPC code determined in step S2h. Then, the DPC code determined in step S2h is coded in the patient data determined in step S2l (step S2m).

  In the operation of step S2 shown in FIG. 3, after the DPC code is confirmed in step S2h, the patient data is confirmed in step S2l and both are matched. However, the patient is matched in steps S2i to 2l. After determining the data, the DPC code may be determined in steps S2c to 2h to match both.

  The patient data includes information on the name of the operation and injury / sickness per hospitalization, as well as the presence / absence of treatment 1 required for coding, the presence / absence of treatment 2 and the like, the presence / absence of minor injury and disease severity, and the like. Therefore, the CPU 32 automatically assigns DPC codes corresponding to the presence / absence of the treatment 1 for each patient data, the presence / absence of the treatment 2, the presence / absence of a minor injury, and the presence / absence of severity. For example, patient data having the operation name “laparoscopic cholecystectomy” and the name of injury or injury “other gallbladder <sac> gallbladder <flame> calculus with inflammation” has information on the presence or absence of treatment 2 and the presence or absence of secondary injury Therefore, the DPC code <0603353x04x00x> or <0603353x04x01x> determined in step S2h is automatically assigned depending on the presence / absence of treatment 2 and the like and the presence / absence of a minor injury.

  Therefore, the DPC codes <0603353x04x00x> and <0603353x04x01x> are determined in step S2h, the operation name “laparoscopic cholecystectomy” is determined in step S2j, and the wound name “other gallbladder <sac> gallbladder <flame> with inflammation> > If ”stone” is selected, the patient data for surgery name “laparoscopic cholecystectomy” and wound name “other gallbladder <sac> gallbladder with inflammation <sac> stone”, and minor injury “none” The DPC code <0603353x04x00x> is coded. Similarly, the patient data for surgery name “laparoscopic cholecystectomy” and wound name “other gallbladder <sac> gallbladder <flame> calculus with inflammation” and minor wound “Yes” include DPC code <0603353x04x01x> Coded.

  The CPU 32 calculates the medical fee by the volume evaluation and the DPC evaluation using the patient data in which the DPC code is coded in step S2. Data analysis and display are performed using the data of the calculation result (step S3).

  First, the CPU 32 displays the DPC determined in step S2h as a DPC code on the display device 36 as a DPC confirmation display screen (step S3a).

  The operator confirms the DPC code on the DPC confirmation display screen displayed in step S3a, and selects DPC codes <0603353x04x00x> and <0603353x04x01x>, which are DPC codes to be analyzed. Hereinafter, a case where the DPC codes <0603353x04x00x> and <0603353x04x01x> are selected will be described.

  When the operator selects the DPC codes <0603353x04x00x> and <0603353x04x01x> on the DPC confirmation display screen, the CPU 32 determines the DPC codes <0603353x04x00x> and <0603353x04x01x> (step S3b).

  Subsequently, the CPU 32 determines the medical treatment fee per hospitalization and DPC evaluation from the cost per medical treatment classification per patient included in the patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x>. To calculate each. Then, using these volume evaluation data and DPC evaluation data, data analysis of hospital management at the time of introducing DPC evaluation is performed (step S3c). The medical practice classification included in the volume portion of the DPC evaluation is, for example, a treatment subtotal, a surgical subtotal, and a meal cost.

  Next, the CPU 32 displays the data analysis result analyzed in step S3c on the display device 36 (step S3d).

  FIG. 11 is a graph showing the data analysis result displayed on the display device 36 in step S3d.

  In step S3b, DPC codes <0603353x04x00x> and <0603353x04x01x>, which are DPC codes to be analyzed, are determined. Hospital management in DPC code <0603353x04x00x> and <0603353x04x01x> at the time of DPC evaluation introduction using a plurality of patient data that matches DPC code <0603353x04x00x> or <0603353x04x01x> and represents DPC code <0603353x04x00x> or <0603353x04x01x> Analyze.

  That is, the medical fee per hospitalization is calculated by the volume evaluation and the DPC evaluation from the cost for each medical treatment classification per patient hospitalization included in the patient data representing the DPC code <0603353x04x00x> or <0603353x04x01x>. FIG. 11 is a graph that averages the medical fees for the volume evaluation for each patient data and averages the medical fees for the DPC evaluation for each patient data and compares them, which is displayed on the display device 36 in step S3d. is there.

  Here, the medical treatment fee for the volume evaluation is the examination fee, medication fee, injection fee, treatment subtotal, surgical subtotal, examination subtotal, diagnostic subtotal, other costs, hospitalization fee, and dietary treatment per patient hospitalization. Composed of expenses. On the other hand, the medical fee for DPC evaluation is composed of a treatment subtotal as a medical practice classification per patient hospitalization, a surgical subtotal, and a DPC comprehensive portion and a volume portion where dietary expenses are arranged.

  12 to 22 are graphs showing a first modified example of the data analysis result displayed on the display device 36 in step S3d.

  In step S3b, DPC codes <0603353x04x00x> and <0603353x04x01x>, which are DPC codes to be analyzed, are determined. Hospital management in DPC code <0603353x04x00x> and <0603353x04x01x> at the time of DPC evaluation introduction using a plurality of patient data that matches DPC code <0603353x04x00x> or <0603353x04x01x> and represents DPC code <0603353x04x00x> or <0603353x04x01x> Analyze.

  That is, the medical fee per hospitalization is calculated by the volume evaluation and the DPC evaluation from the cost for each medical treatment classification per patient hospitalization included in the patient data representing the DPC code <0603353x04x00x> or <0603353x04x01x>. Then, a difference between the volume evaluation and the DPC evaluation (DPC evaluation−volume evaluation, hereinafter referred to as “DPC difference”) is calculated. 12 to 20 are graphs each showing a relationship between the DPC difference and the cost for each main medical practice classification, which is displayed on the display device 36 in step S3d. The main medical practice categories are the examination fees, medications, injection costs, treatment subtotals, surgical subtotals, examination subtotals, diagnostic subtotals, other costs, and other costs shown in the x-axis sections of the graphs of FIGS. Nine types of hospital expenses are listed, but are not limited to these nine types.

  Specifically, FIG. 12 is a scatter diagram of the relationship between the DPC difference (y circle) calculated from the patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the examination fee (x circle) for each patient. It is plotted in the form of Further, a regression line and a correlation coefficient r are displayed on the graph.

  FIG. 13 plots the relationship between the DPC difference (y circle) calculated from the patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the dosage (x circle) in the form of a scatter diagram for each patient. Is. Further, a regression line and a correlation coefficient r are displayed on the graph.

  FIG. 14 plots the relationship between the DPC difference (y circle) calculated from the patient data encoded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the injection cost (x circle) in the form of a scatter diagram for each patient. Is. Further, a regression line and a correlation coefficient r are displayed on the graph.

  FIG. 15 plots the relationship between the DPC difference (y circle) calculated from patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the treatment subtotal (x circle) in the form of a scatter diagram for each patient. Is. Further, a regression line and a correlation coefficient r are displayed on the graph.

  FIG. 16 plots the relationship between the DPC difference (y circle) calculated from the patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the operation subtotal (x circle) in the form of a scatter diagram for each patient. Is. Further, a regression line and a correlation coefficient r are displayed on the graph.

  FIG. 17 plots the relationship between the DPC difference (y circle) calculated from the patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the examination subtotal (x circle) in the form of a scatter diagram for each patient. Is. Further, a regression line and a correlation coefficient r are displayed on the graph.

  Figure 18 plots the relationship between the DPC difference (y circle) calculated from the patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the diagnostic imaging subtotal (x circle) in the form of a scatter diagram for each patient. It is a thing. Further, a regression line and a correlation coefficient r are displayed on the graph.

  FIG. 19 plots the relationship between the DPC difference (y circle) calculated from patient data encoded with the DPC code <0603353x04x00x> or <0603353x04x01x> and other costs (x circle) in the form of a scatter diagram for each patient. Is. Further, a regression line and a correlation coefficient r are displayed on the graph.

  FIG. 20 plots the relationship between the DPC difference (y yen) calculated from the patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the hospitalization cost (x yen) in the form of a scatter diagram for each patient. Is. Further, a regression line and a correlation coefficient r are displayed on the graph.

  In addition, the medical fee per hospitalization is calculated by the volume evaluation and the DPC evaluation from the cost for each medical treatment classification per hospitalization included in the patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x>. Calculate the DPC difference per hospitalized patient. FIG. 21 is a graph showing the relationship between the DPC difference and the number of hospitalization days displayed on the display device 36 in step S3d.

  Specifically, the relationship between the DPC difference (y circle) calculated from patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the number of hospitalization days (x days) is plotted in the form of a scatter diagram for each patient. It is a thing. Further, a regression line and a correlation coefficient r are displayed on the graph.

  Further, the medical treatment fee per patient is calculated by the volume evaluation from the cost for each medical treatment classification per hospitalization included in the DPC code <0603353x04x00x> or <0603353x04x01x> coded patient data. FIG. 22 is a graph showing the relationship between the volume evaluation and the number of hospitalization days displayed on the display device 36 in step S3d.

  Specifically, the relationship between the volume evaluation (y circle) calculated from the patient data coded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the number of hospitalization days (x days) is plotted in the form of a scatter diagram for each patient. It is a thing. Further, a regression line and a correlation coefficient r are displayed on the graph.

  In the case of the DPC code <0603353x04x00x> or <0603353x04x01x> determined by “laparoscopic cholecystectomy” and “gallbladder edema, cholecystitis, etc.” in the hospital, from the graphs shown in FIGS. It can be seen that there is a strong negative correlation between the DPC difference and the cost of the main medical practice classification.

  Specifically, in the graph shown in FIG. 14, there is a strong negative correlation (r = -0.844) in the relationship between the DPC difference and the injection cost. Therefore, in the case of the DPC codes <0603353x04x00x> and <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." This shows that the DPC evaluation for medical costs decreases and profits decrease after the introduction of DPC evaluation.

  In the graph shown in FIG. 17, there is a strong negative correlation (r = -0.737) in the relationship between the DPC difference and the inspection subtotal. Therefore, in the case of DPC codes <0603353x04x00x> and <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." It shows that DPC evaluation will decrease and profit will decrease after DPC evaluation introduction.

  In the graph shown in FIG. 18, there is a strong negative correlation (r = -0.799) in the relationship between the DPC difference and the image diagnosis subtotal. Therefore, in the case of DPC codes <0603353x04x00x> and <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." This shows that the DPC evaluation for the decrease and the profit will decrease after the introduction of DPC evaluation.

  In the graph shown in FIG. 20, there is a strong negative correlation (r = -0.708) in the relationship between the DPC difference and the hospitalization cost. Therefore, in the case of DPC codes <0603353x04x00x> and <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." It shows that DPC evaluation will decrease and profit will decrease after DPC evaluation introduction.

  In the graph shown in FIG. 21, there is a strong negative correlation (r = -0.665) in the relationship between the DPC difference and the number of days of hospitalization. Therefore, in the case of DPC codes <0603353x04x00x> and <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." It shows that DPC evaluation will decrease and profit will decrease after DPC evaluation introduction.

  Further, comparing the graphs shown in FIGS. 14, 17, 18, 20 and 21, in the hospital, the DPC code <0603353x04x00x> determined by “laparoscopic cholecystectomy” and “gallbladder edema, cholecystitis, etc.” In the case of <0603353x04x01x>, it can be inferred that reducing the medical cost of the test subtotal with the maximum absolute value of the slope of the regression line is effective for improving the balance after the introduction of DPC evaluation.

  Furthermore, in the graph shown in FIG. 22, there is a strong positive correlation (r = 0.877) in the relationship between the medical fee and the number of days of hospitalization. Therefore, in the case of the DPC code <0603353x04x00x> and <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." It shows increasing.

  When two or more types of graphs shown in FIGS. 12 to 22 are displayed on the display device 36, they are displayed by parallel display, scroll display, stack display or page switching display on the same screen. Also good.

  Further, among the graphs shown in FIGS. 12 to 22, for graphs in which the correlation coefficient r or the slope of the regression line exceeds a predetermined value, the graph display form, for example, the graph background color, marker color or regression line color, The correlation coefficient r and the slope of the regression line may be visually distinguished from a graph having a predetermined value or less.

  FIG. 23 is a graph showing a second modification of the data analysis result displayed on the display device 36 in step S3d.

  In step S3b, DPC codes <0603353x04x00x> and <0603353x04x01x>, which are DPC codes to be analyzed, are determined. Hospital management in DPC code <0603353x04x00x> and <0603353x04x01x> at the time of DPC evaluation introduction using a plurality of patient data that matches DPC code <0603353x04x00x> or <0603353x04x01x> and represents DPC code <0603353x04x00x> or <0603353x04x01x> Analyze.

  That is, the medical fee per patient hospitalization included in the patient data representing the DPC code <0603353x04x00x> or <0603353x04x01x> is calculated by the volume evaluation and the DPC evaluation, respectively, and the DPC difference is calculated for each patient. FIG. 23 is a graph showing, as a list, the relationship between the DPC difference and the cost for each main medical practice category displayed on the display device 36 in step S3d. The main medical practice classifications are the examination fee, medication fee, injection cost, treatment subtotal, surgical subtotal, examination subtotal, diagnostic subtotal, other costs, hospitalization costs and meals shown in the x-axis section of the graph of FIG. Although 10 types of medical expenses are mentioned, it is not limited to these 10 types.

Specifically, the relationship between the DPC difference calculated from the patient data encoded with the DPC code <0603353x04x00x> or <0603353x04x01x> and the cost of the main medical practice classification (FIGS. 12 to 20) is calculated. and slope of the regression line obtained from the relationship (y ₁₎ and the correlation coefficient r (y _2), is a graph showing the relationship between major interventions classification (x).

  From the graph shown in FIG. 23, in the case of the DPC code <0603353x04x00x> or <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." There is a strong negative correlation (r = -0.844). Therefore, in the case of DPC codes <0603353x04x00x> and <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." It shows that DPC evaluation will decrease and profit will decrease after DPC evaluation introduction.

  Further, from the graph shown in FIG. 23, there is a strong negative correlation (r = -0.737) in the relationship between the DPC difference and the inspection subtotal. Therefore, in the case of DPC codes <0603353x04x00x> and <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." It shows that DPC evaluation will decrease and profit will decrease after DPC evaluation introduction.

  Furthermore, from the graph shown in FIG. 23, there is a strong negative correlation (r = -0.799) in the relationship between the DPC difference and the image diagnosis subtotal. Therefore, in the case of DPC codes <0603353x04x00x> and <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." This shows that the DPC evaluation for the decrease and the profit will decrease after the introduction of DPC evaluation.

  In addition, from the graph shown in FIG. 23, there is a strong negative correlation (r = -0.708) in the relationship between DPC difference and hospitalization cost. Therefore, in the case of DPC codes <0603353x04x00x> and <0603353x04x01x> determined by "laparoscopic cholecystectomy" and "gallbladder edema, cholecystitis, etc." It shows that DPC evaluation will decrease and profit will decrease after DPC evaluation introduction.

  In addition, when comparing the clinical practice classification from the graph shown in FIG. 23, the DPC codes <0603353x04x00x> and <0603353x04x01x> determined by “laparoscopic cholecystectomy” and “gallbladder edema, cholecystitis, etc.” In this case, it can be inferred that reducing the medical cost of the examination subtotal with the maximum absolute value of the slope of the regression line is effective for improving the balance after the introduction of DPC evaluation.

  Note that in the graph shown in FIG. 23, regarding the area of the medical practice classification in which the correlation coefficient r or the slope of the regression line exceeds a predetermined value, the display form is changed to display the correlation coefficient r and the regression You may make it visually distinguishable from the medical treatment classification | category whose inclination of a straight line is a predetermined value or less.

  FIG. 24 is a graph showing a third modification of the data analysis result displayed on the display device 36 in step S3d.

  In step S3b, DPC codes <0603353x04x00x> and <0603353x04x01x>, which are DPC codes to be analyzed, are determined. Hospital management in DPC code <0603353x04x00x> and <0603353x04x01x> at the time of DPC evaluation introduction using a plurality of patient data that matches DPC code <0603353x04x00x> or <0603353x04x01x> and represents DPC code <0603353x04x00x> or <0603353x04x01x> Analyze.

  In other words, the medical fee per hospitalization included in the representative patient data of the DPC code <0603353x04x00x> or <0603353x04x01x> is calculated by the volume evaluation. FIG. 24 is a plot of the relationship between the volume evaluation (y circle) and the number of hospitalization days (x days) displayed on the display device 36 in step S3d in the form of a scatter diagram for each patient. Further, a regression line and a correlation coefficient r are displayed on the graph.

  Furthermore, the relationship L1 between the DPC evaluation (y circle) calculated from the patient data coded with the DPC code <0603353x04x00x> whose minor injury category is “None” and the number of hospitalization days (x days) is shown on the graph. Further, the graph shows a relationship L2 between the DPC evaluation (y circle) calculated from the patient data coded with the DPC code <0603353x04x01x> whose minor injury category is “Yes” and the number of hospitalization days (x days).

In addition, as a hospital stay I and II as well as certain hospital stay T determined for each DPC code, on the graph, DPC code hospitalization _I 1 determined by <0603353x04x00x> (7 days) and _II 1 (13 days) as well as certain hospital stay T ₁ (23 days) and hospitalization periods I ₂ (9 days) and II ₂ (17 days) and a specific hospitalization period T ₂ (32 days) determined by the DPC code <0603353x04x01x> are shown, respectively.

  From the graph shown in FIG. 24, in the case of the DPC codes <0603353x04x00x> and <0603353x04x01x> determined by “laparoscopic cholecystectomy” and “gallbladder edema, cholecystitis, etc.” This medical cost can be compared with the DPC evaluation determined from the relationship L1 and the relationship L2 with the same number of days of hospitalization as the patient.

  Further, from the graph shown in FIG. 24, in the hospital, in the case of the DPC codes <0603353x04x00x> and <0603353x04x01x> determined by “laparoscopic cholecystectomy” and “gallbladder edema, cholecystitis, etc.” Compare hospital stays with other patients.

  In the graph shown in FIG. 24, for a singular point that exceeds a predetermined value in multivariate analysis or the like, the marker display form, for example, the marker shape or color, is changed to visually identify a marker that is not a singular point. You may make it distinguishable.

  Further, in FIG. 24, a plot of patient data in which the DPC code <0603353x04x00x> having the minor injury category “none” is coded and a plot of patient data in which the DPC code <0603353x04x01x> being the minor injury category “present” is coded. Are shown on the same graph. However, the plot of the patient in which the DPC code <0603353x04x00x> is coded may be shown on one graph, and the plot of the patient in which the DPC code <0603353x04x01x> is coded on the other graph.

  FIG. 25 is a graph showing a fourth modification of the data analysis result displayed on the display device 36.

In step S3b, <0603353x04x01x>, which is the DPC code to be analyzed, is determined. Using the specific patient data of a specific patient that is matched with the DPC code <0603353x04x01x> and coded with the DPC code <0603353x04x01x>, the medical fee per hospitalization for the specific patient included in the specific patient data is calculated by the volume evaluation and the DPC evaluation, respectively. To do. FIG. 25 is an example of a graph that is displayed on the display device 36 and shows the relationship between the volume evaluation (y ₁ yen) for each medical treatment classification of a specific patient and the number of days of hospitalization (x day).

In addition, on the graph, the cumulative total (y ₂ yen) of the volume evaluation calculated from the specific patient data included in the specific patient data coded with the DPC code <0603353x04x01x>, the cumulative DPC evaluation (y ₂ yen), and hospitalization The relationship with the number of days elapsed (day x) is shown.

  The specific patient shown in FIG. 25 has been transferred to surgery (2 hospitalizations) due to hypertension from the 22nd day of hospitalization, for example, after having undergone internal medicine due to gallbladder edema. The specific patient is examined by MR (Magnetic Resonance) as an outpatient outpatient on the fourth day of hospitalization, and is examined by SPECT (Single Photon Emission Computed Tomography) as an outpatient outpatient on the 12th day of hospitalization.

Furthermore, in the specific patient data during the hospitalization period, “None”, which is the required “surgery name”, is selected in step S2f, the surgery category is determined as surgery category <99>, and in step S2h, the DPC code is <0603353x99x00x> is determined, and the DPC code <0603353x99x00x> determined in step S2m is coded. On the other hand, the DPC code <0603353x04x00x> is coded in the specific patient data during the hospitalization period. That is, the specific patient data transferred during hospitalization is divided into two hospitalizations on the boundary of the transfer date, and the DPC code is coded for the hospitalization period, and the DPC code <0603353x04x01x for the hospitalization period, > To compute the DPC rating. On the graph, the relationship between the cumulative DPC evaluation (y ₂ yen) and the number of days of hospitalization (day x) is shown.

  From the graph shown in FIG. 25, in the case of the DPC code <0603353x04x01x> determined by the operation name “laparoscopic cholecystectomy”, the injury disease name “gallbladder edema, cholecystitis, etc.” As the number of days of hospitalization increases, the difference between the cumulative volume evaluation and the cumulative DPC evaluation equivalent to one hospitalization increases. Therefore, as the number of days of hospitalization increases, the DPC evaluation for the volume evaluation decreases, and the profit decreases after the introduction of the DPC evaluation. In particular, the difference between the volume evaluation and the DPC evaluation for one hospitalization becomes large on the 4th and 12th days of the hospitalization that was examined as an outpatient during hospitalization.

  In addition, from the graph shown in FIG. 25, the DPC code <0603353x04x01x> determined by the operation name “laparoscopic cholecystectomy”, the wound name “gallbladder edema, cholecystitis, etc.” and the minor wound disease “Yes” in the hospital. If the patient is transferred from internal medicine to surgery, the longer the length of hospitalization, the greater the DPC evaluation equivalent to 2 hospitalizations than the DPC evaluation equivalent to 1 hospitalization. It can be seen that the decrease in profits is reduced.

  26 and 27 are graphs showing a fifth modified example of the data analysis result displayed on the display device 36. FIG.

  In step S3b, the DPC code to be analyzed is determined. Using a plurality of patient data representing the DPC code, the hospital management for each DPC code when the DPC evaluation is introduced is analyzed.

  That is, the medical treatment fee per patient hospitalization included in the patient data representing the DPC code to be analyzed is calculated based on the volume evaluation. FIG. 26 shows, for each patient, the relationship between the volume evaluation (y yen) and the number of hospitalization days (x days) when the minor injury category is “None” and “Yes” displayed on the display device 36 in step S3d. Plotted in the form of a scatter plot. Further, a regression line and a correlation coefficient r are displayed on the graph.

  Furthermore, on the graph of FIG. 26, the relationship L3 between the DPC evaluation (y circle) calculated from the patient data coded with the DPC code whose minor injury category is “none” and the number of hospitalization days (x days) is shown. Furthermore, the relationship L4 between the DPC evaluation (y circle) calculated from the patient data in which the DPC code with the minor injury category “Yes” is coded and the number of hospitalization days (x days) is shown on the graph.

In addition, as the hospitalization periods I and II determined for each DPC code and the specific hospitalization period T, the hospitalization periods I ₃ and II ₃ and the specific hospitalization determined by the DPC code whose side injury category is “None” on the graph of FIG. The period T ₃ and the hospitalization periods I ₄ and II ₄ and the specific hospitalization period T ₄ defined by the DPC code whose sub-injury classification is “present” are shown.

  On the other hand, the DPC code to be analyzed is determined in step S3b. Using a plurality of patient data representing the DPC code, the hospital management for each DPC code when the DPC evaluation is introduced is analyzed.

  That is, the medical treatment fee per patient hospitalization included in the patient data representing the DPC code to be analyzed is calculated by the volume evaluation excluding the cost of the required medical practice classification, for example, treatment subtotal, surgical subtotal and dietary medical expenses. To do. FIG. 27 shows the volume evaluation (y yen) and the number of days of hospitalization (x) when the secondary injury / illness classification excluding the cost of the required medical practice classification displayed in step S3d is “None” and “Yes”. Day) is plotted in the form of a scatter diagram for each patient. Further, a regression line and a correlation coefficient r are displayed on the graph.

  Further, on the graph of FIG. 27, the DPC evaluation (y yen) excluding the cost of the required medical practice classification calculated from the patient data coded with the DPC code whose minor injury category is “none” and the number of hospitalization days (x L5) is shown. Furthermore, on the graph, the calculated DPC evaluation (y yen) and the number of hospitalization days (x days) excluding the cost of the required medical practice classification from the patient data coded with the DPC code whose minor injury category is “Yes” The relationship L6 is shown.

In addition, as the hospitalization periods I and II determined for each DPC code and the specific hospitalization period T, the hospitalization periods I ₅ and II ₅ and the specific hospitalization determined by the DPC code whose side injury category is “none” on the graph of FIG. the period _{T 5,} also showing secondary injuries indicator "Yes" hospital stays _{I 6} determined by the DPC code is and II ₆ as well as certain hospital stay _{T 6,} respectively.

  From the graphs shown in FIGS. 26 and 27, in the hospital, it is possible to compare the medical cost for hospitalization of one patient with the DPC evaluation determined from the relationship L1 and the relationship L2 with the same number of hospitalization days as the patient.

  In addition, from the graphs shown in FIGS. 26 and 27, the number of hospitalization days required for hospitalization of one patient and the number of hospitalization days of other patients can be compared in the hospital.

  When the data analysis result obtained by the data analysis is displayed on the display device 36 in step S3d, the data is arbitrarily removed from the plurality of patient data representing the DPC code to be analyzed by the operator on the DPC confirmation screen. Thus, the CPU 32 determines whether or not it is necessary to recalculate the medical fee (step S3e).

  If the determination in step 3e is Yes, that is, if the operator arbitrarily deletes data from a plurality of patient data representing the DPC code to be analyzed, and the CPU 32 determines that the medical fee needs to be recalculated Return to step S3c. On the other hand, No in step 3e, that is, the operator does not arbitrarily remove data from a plurality of patient data representing the DPC code to be analyzed, and the CPU 32 does not need to recalculate the medical fee. If determined, the operation is terminated.

  On the other hand, when the CPU 32 determines in the determination in step S2b that the disease name mode has been selected, the CPU 32 displays each element of the MDC on the display device 36 (step S2c). When the required “MDC [disease name]” is selected on the DPC classification definition selection (injury name mode) screen, the CPU 32 determines the MDC (step S2d).

  The CPU 32 displays each element of the injury / illness classification on the display device 36 (step S2p). In the display screen 36, the “injury name” corresponding to the required “MDC [disease name]” selected in step S2d is displayed. When the required “wound and disease name” is selected on the DPC classification definition selection (wound and disease name mode) screen, the CPU 32 determines the wound and disease classification (step S2q).

  The CPU 32 displays each element of the surgical section on the display device 36 (step S2r). The display screen 36 displays the required “MDC [disease name]” selected in step S2d and the “surgery name” corresponding to the required “injury name” selected in step S2q. .

  A required “DPC code” is selected from a plurality of “DPC codes” displayed in a list on the DPC classification definition selection (injury name mode) screen. When the required “DPC code” is selected, the CPU 32 determines the required DPC code (step S1h). Here, when selecting the required DPC code, the operator selects the required “surgery name” while viewing a plurality of “surgery names” displayed on the DPC classification definition selection (sickness name mode) screen. Done.

  On the other hand, if the CPU 32 determines in the determination of step 2b that the disease name mode has been selected, the display device 36 displays all “injury and disease names” included in the hospital data managed by the hospital DB 27 of the hospital management information storage system 11. (Step S2t). When a required “wound and disease name” is selected from a plurality of “wound and disease names” on the accumulated data for hospitalization analysis (wound and disease name mode) screen, the CPU 32 determines the wound and disease names (step S2u). From the hospital DB 27 of the hospital management information storage system 11, the patient data corresponding to the required “wound and disease name” selected on the hospitalization analysis cumulative data (wound and disease name mode) screen is searched. The CPU 32 displays the “surgery name” included in the patient data having the searched “sickness name” for each patient on the display device 36 (step S2v).

  A list of “surgery names” for each patient is displayed on the DPC classification definition selection (injury name mode) screen. The operation device 35 is used by the operator, and a required “surgical name” is selected from a plurality of “surgical names” displayed in a list, so that the CPU 32 uses the hospital data for data analysis. The patient data having the “injury name” and the required “surgery name” are determined (step S21).

  Subsequently, the CPU 32 codes the DPC code determined in step S2h in the patient data determined in step S2l (step S2m).

  According to the hospital management information analysis system 10, the hospital management information analysis method, the computer-readable storage medium and the computer program according to the present invention, the medical accounting data and medical history data of a predetermined hospital are managed per hospitalization in step S1. The patient data is coded in step S2, and the graphs shown in FIGS. 11 to 23 are displayed as analysis results in step S3 from the patient data representing the coded DPC. Therefore, it is possible to statistically narrow down the unprofitable medical treatment that affects the hospital balance at the time of introducing the DPC evaluation for each DPC in the hospital.

  In addition, according to the hospital management information analysis system 10, the hospital management information analysis method, the computer-readable storage medium and the computer program according to the present invention, the medical accounting data and medical history data of a predetermined hospital are obtained per hospitalization in step S1. In step S2, the patient data is coded, and the graphs shown in FIGS. 24, 26 and 27 are displayed as analysis results in step S3 from the patient data representing the coded DPC. Therefore, for each DPC in the hospital, it is possible to statistically narrow down patients who have received unprofitable medical treatment that affects the hospital balance at the time of introduction of DPC evaluation.

  Further, according to the hospital management information analysis system 10, the hospital management information analysis method, the computer-readable storage medium and the computer program according to the present invention, the medical accounting data and medical history data of a predetermined hospital are obtained per hospitalization in step S1. In the case of a specific patient who has been managed and coded patient data in step S2 and transferred to the hospital, the specific patient data is calculated by DPC evaluation using each DPC code determined for each department in charge in step S3. The relationship between the cumulative DPC evaluation and the number of days of hospitalization is displayed as a graph shown in FIG. Therefore, it is possible to compare the medical fee between the case where DPC evaluation is performed for a patient who has been transferred at the hospital as one hospitalization and the case where the DPC evaluation is performed using each DPC code determined for each hospitalization.

  FIG. 28 is a block diagram showing a second embodiment of the hospital management information analysis system, computer-readable storage medium, and computer program according to the present invention.

  FIG. 28 shows a hospital management information analysis system 10A. In this hospital management information analysis system 10A, a hospital management information storage system 11 and a patient whose DPC is determined as a DPC code, and which is one patient data from the hospital data. The data is confirmed, the procedure for coding the DPC code in this patient data, and the medical fee is calculated by the volume evaluation and the DPC evaluation using the patient data in which the DPC code is coded. A computer 12 having a program for executing a procedure for analyzing and displaying the hospital management, a display device (not shown) for displaying various screens used in the analysis of the hospital management, and a display device And a terminal 50 having an operation device (not shown) that can be selected and operated according to the screen.

  The medical accounting data management system 8, the medical history data management system 9, the hospital management information storage system 11, the computer 12 and the terminal 50 are connected to each other by a network capable of data communication, for example, a LAN 18 in the hospital.

  In the hospital management information analysis system 10A, the hospital management information analysis method using a computer-readable storage medium, and a computer program, an operation similar to the flowchart shown in FIG. It is.

  According to the hospital management information analysis system 10A, the hospital management information analysis method, the computer-readable storage medium and the computer program according to the present invention, the medical accounting data and the medical history data of a predetermined hospital are managed per patient hospitalization in step S1. The patient data is coded in step S2, and the graphs shown in FIGS. 11 to 23 are displayed as analysis results in step S3 from the patient data representing the coded DPC. Therefore, it is possible to statistically narrow down the unprofitable medical treatment that affects the hospital balance at the time of introducing the DPC evaluation for each DPC in the hospital.

  Further, according to the hospital management information analysis system 10A, the hospital management information analysis method, the computer readable storage medium and the computer program according to the present invention, the medical accounting data and medical history data of a predetermined hospital are obtained per hospitalization in step S1. In step S2, the patient data is coded, and the graphs shown in FIGS. 24, 26 and 27 are displayed as analysis results in step S3 from the patient data representing the coded DPC. Therefore, for each DPC in the hospital, it is possible to statistically narrow down patients who have received unprofitable medical treatment that affects the hospital balance at the time of introduction of DPC evaluation.

  Furthermore, according to the hospital management information analysis system 10A, the hospital management information analysis method, the computer-readable storage medium and the computer program according to the present invention, the medical accounting data and medical history data of a predetermined hospital are obtained per hospitalization in step S1. In the case of a specific patient who has been managed and coded patient data at step S2 and transferred to the hospital, the specific patient data is calculated by DPC evaluation using each DPC code determined for each department in charge at step S3. The relationship between the cumulative DPC evaluation and the number of days of hospitalization is displayed as a graph shown in FIG. Therefore, it is possible to compare the medical fee between the case where DPC evaluation is performed for a patient who has been transferred at the hospital as one hospitalization and the case where the DPC evaluation is performed using each DPC code determined for each hospitalization.

1 is a block diagram showing a first embodiment of a hospital management information analysis system, a computer-readable storage medium, and a computer program according to the present invention. The table | surface which shows the hospital data managed by hospital DB. The flowchart which shows the hospital management information analysis method which concerns on this invention. The figure which shows a mode selection screen. The figure which shows an example of a DPC classification definition selection (operation name mode) screen. The figure which shows an example of a DPC classification definition selection (operation name mode) screen. The figure which shows an example of a DPC classification definition selection (operation name mode) screen. The figure which shows an example of the accumulation data (operation name mode) screen for hospitalization analysis. The figure which shows an example of the accumulation data (operation name mode) screen for hospitalization analysis. The figure which shows an example of the accumulation data (operation name mode) screen for hospitalization analysis. The graph which shows a data analysis result. It is a 1st modification of a data analysis result, and is a graph which shows the relationship between a DPC difference and a medical examination fee. It is a 1st modification of a data analysis result, and is a graph which shows the relationship between a DPC difference and a dosage. It is a 1st modification of a data analysis result, and is a graph which shows the relationship between DPC difference and injection cost. It is a 1st modification of a data analysis result, and is a graph which shows the relationship between a DPC difference and a treatment subtotal. The graph which is a 1st modification of a data analysis result, and shows the relationship between a DPC difference and an operation subtotal. The graph which is a 1st modification of a data analysis result, and shows the relationship between a DPC difference and a test subtotal. The graph which is a 1st modification of a data analysis result, and shows the relationship between a DPC difference and a diagnostic imaging subtotal. The graph which is a 1st modification of a data analysis result, and shows the relationship between DPC difference and other subtotals. The graph which is a 1st modification of a data analysis result, and shows the relationship between DPC difference and hospitalization expenses. The graph which is the 1st modification of a data analysis result, and shows the relationship between DPC difference and hospitalization days. The graph which is the 1st modification of a data analysis result, and shows the relationship between volume evaluation and hospitalization days. The graph which shows the 2nd modification of a data analysis result. The graph which shows the 3rd modification of a data analysis result. The graph which shows the 4th modification of a data analysis result. It is a 5th modification of a data analysis result, and is a graph which shows the relationship between the volume evaluation and hospitalization days when a secondary injury disease classification is "None" and "Yes". The graph which is the 5th modification of a data analysis result, and shows the relationship between the volume evaluation and hospitalization days except the expense of the required medical practice classification | category when the minor injury classification is "None" and "Yes". The block diagram which shows 2nd Embodiment of the hospital management information analysis system, computer-readable storage medium, and computer program which concern on this invention. The figure explaining the DPC inclusion part and volume part which comprise the medical treatment fee of DPC evaluation.

Explanation of symbols

10, 10A Hospital management information analysis system 11 Hospital management information management system 12 Computer 12a, 50 Terminal 18 LAN
35 Operating device 36 Display device 40 Recording medium

Claims (20)

In an information analysis system that enables statistical analysis of medical accounting data and medical history data existing in hospitals,
A hospital data management system that takes in the medical accounting data and the medical history data, and manages hospital data integrated as data per hospitalization for each patient;
While DPC is determined as a DPC code, patient data which is data of one patient is determined from the hospital data, and the DPC code is coded in the patient data, and the patient data in which the DPC code is encoded is used. The medical fee is calculated by volume evaluation and DPC evaluation, and a terminal having a program for executing the procedure for analyzing and displaying the hospital management at the time of introducing DPC evaluation is connected via the network. Hospital management information analysis system characterized by In an information analysis system that enables statistical analysis of medical accounting data and medical history data existing in hospitals,
A hospital data management system that takes in the medical accounting data and the medical history data, and manages hospital data integrated as data per hospitalization for each patient;
While DPC is determined as a DPC code, patient data which is data of one patient is determined from the hospital data, and the DPC code is coded in the patient data, and the patient data in which the DPC code is encoded is used. A computer having a program for calculating a medical fee by volume evaluation and DPC evaluation, and analyzing and displaying the hospital management at the time of DPC evaluation introduction from the calculation results;
A display device that displays various screens used in the analysis of the hospital management, and a terminal having an operation device that can be selected and operated according to the screens displayed on the display device are connected via a network. Hospital management information analysis system. In an information analysis method that enables statistical analysis of medical accounting data and medical history data existing in a hospital,
A hospital data management process in which the medical accounting data and the medical history data are respectively captured and hospital data integrated as data per hospitalization for each patient is managed,
A DPC coding step in which the DPC is determined as a DPC code, patient data as one patient data is determined from the hospital data, and the DPC code is coded in the patient data;
Data for calculating and reimbursing the medical fee based on the cost for each diagnostic action classification included in the patient data coded with the DPC code in the volume evaluation and the DPC evaluation, and analyzing and displaying the hospital management when the DPC evaluation is introduced A hospital management information analysis method characterized by comprising an analysis / display process. In the DPC coding step, each element of the MDC, each element of the operation name, and each element of the injury name constituting the DPC code are displayed so as to be selectable. 4. The hospital management information analysis method according to claim 3, wherein the DPC code is determined by selecting an MDC, an operation name, and a wound name from each element. In the DPC coding process, a plurality of “surgery names” and “sickness and sickness names” included in the hospital data are displayed on the screen, and a required “surgery name” is selected from the plurality of “surgery names” and “sickness and sickness names”. The hospital management information analysis method according to claim 3, wherein the patient data is confirmed by selecting “Wound and disease name”. The volume evaluation is based on the examination fee, medication fee, injection fee, treatment subtotal, surgical subtotal, examination subtotal, diagnostic imaging subtotal, other costs, hospitalization costs and dietary expenses as the cost of medical practice classification included in the patient data. 4. The hospital management information analysis method according to claim 3, wherein the DPC evaluation is calculated from a treatment subtotal, an operation subtotal, and a meal cost as a cost of medical practice classification included in the patient data. . 4. In the data analysis / display step, the output evaluation for each patient data is averaged, while the DPC evaluation for each patient data is averaged to display a graph for comparing both. The hospital management information analysis method described. In the data analysis / display step, a DPC difference, which is a difference between the volume evaluation and the DPC evaluation, is calculated, and a relationship between the DPC difference and the cost for each medical practice classification is shown in a scatter diagram for each patient data. The hospital management information analysis method according to claim 3, wherein a graph plotted in a form is displayed. When two or more types are selected as the medical practice classification, and the relationship between the DPC difference and the cost for each medical practice classification is displayed as two or more types of graphs, the two or more types of graphs are displayed on the same screen. The hospital management information analysis method according to claim 8, wherein parallel display, scroll display, stack display, or page switching display is performed. 9. The hospital management information analysis method according to claim 8, wherein a regression line and a correlation coefficient of the scatter diagram are respectively displayed on the graph. The hospital management information analysis method according to claim 10, wherein the graph in which the correlation coefficient or the slope of the regression curve exceeds a predetermined value is displayed with a changed display form. The correlation coefficient of the scatter diagram and the slope of the regression line are calculated from the graph, and a graph showing the relationship between the correlation coefficient and the slope of the regression line and the medical practice classification is displayed. 8. The hospital management information analysis method according to 8. The hospital management information analysis method according to claim 12, wherein a display form is changed and displayed for a medical practice classification region in which the slope of the regression curve or the correlation coefficient exceeds a predetermined value. In the data analysis / display step, a graph in which the relationship between the volume evaluation and the number of days of hospitalization is plotted in the form of a scatter diagram for each patient data is displayed, and on this graph, the relationship between the DPC evaluation and the number of days of hospitalization is displayed. The hospital management information analysis method according to claim 3, wherein the hospital management information analysis method is displayed. In the data analysis / display step, a graph in which the relationship between the volume evaluation and the number of days of hospitalization is plotted in the form of a scatter diagram for each patient is displayed, and on this graph, the inclusion part and the number of days of hospitalization of the DPC evaluation are displayed. The hospital management information analysis method according to claim 3, wherein the relationship is displayed. The hospital management information analysis method according to claim 14 or 15, wherein a regression line and a correlation coefficient of the scatter diagram are respectively displayed on the graph. On the graph, the regression line and the correlation coefficient of the scatter diagram are respectively displayed, and for the slope of the regression curve or the area of the medical practice classification where the correlation coefficient exceeds a predetermined value, the display form is changed. The hospital management information analysis method according to claim 14 or 15, wherein the information is displayed.   Based on the cost for each medical practice classification included in the specific patient data of the specific patient who was transferred during hospitalization, the medical fee is calculated by the volume evaluation and DPC evaluation, and the relationship between the volume evaluation and the number of days of hospitalization is displayed as a graph On the graph, the cumulative total of the volume evaluation and the relationship between the cumulative DPC evaluation and the number of days of hospitalization are displayed, and the specific patient data is treated using a DPC code determined for each department in charge. 4. The hospital management information analysis method according to claim 3, wherein the reward is calculated by DPC evaluation, and the relationship between the cumulative number of DPC evaluation and the number of days of hospitalization is displayed. A computer-readable recording medium having recorded thereon a program for causing a computer to execute the method according to any one of claims 3 to 18. A computer program for causing a computer to execute the method according to any one of claims 3 to 18.

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