CN114974600A - Case grouping method and device, electronic equipment and medium - Google Patents
Case grouping method and device, electronic equipment and medium Download PDFInfo
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Abstract
The application provides a case grouping method, a case grouping device, electronic equipment and a medium, wherein the method comprises the following steps: acquiring a case information field of a case; matching the case information field with a surgical category grouping rule in a preset grouping rule set to determine the grouping category of the case in the grouping rule set; the grouping categories include surgical and medical categories; matching the case information field with the core disease diagnosis related grouping rule under the grouping category in the grouping rule set to determine the core disease diagnosis related grouping result of the case; determining a disease diagnosis related grouping result of the case according to the core disease diagnosis related grouping result and the disease diagnosis related grouping rules in the grouping rule set. The method and the device only match with the DRG grouping rules under the case category during DRG grouping so as to reduce the calculation amount during matching and improve the grouping efficiency.
Description
Technical Field
The present application relates to the field of data processing technologies, and in particular, to a case grouping method, apparatus, electronic device, and medium.
Background
With the great trend of medical insurance payment mode innovation, the DRG payment is taken as a new payment mode, and influences on various aspects of resource allocation, capability construction, operation management, service modes and the like of hospitals. How DRG payments are made is therefore of paramount importance in the development of hospitals.
The payment process of the DRG mainly comprises the steps of grouping cases through a DRG pre-grouping system and then paying according to different weights. For example, the DRG pre-grouping system groups each case according to information such as the main diagnosis, the main operation, other diagnoses, other operations, the way of leaving hospital, the patient age, etc. of the case, and after the case is grouped, each group has its own weight value, and finally, the fee is paid according to the weight value of the group.
Data in the existing case grouping are matched with fields such as diagnosis, operation, patient information, consumed resources and the like in a case and DRG grouping rules one by one according to preset rules, so that the DRG grouping of the case is obtained, and the matching efficiency is low.
Disclosure of Invention
In view of the above, an object of the present application is to provide a case grouping method, apparatus, electronic device and medium, which first determine whether a case information field of a case belongs to a surgical category, then classify the case according to a matching result, and match the case with a DRG grouping rule in the case category only in DRG grouping, so as to reduce the amount of calculation in matching, thereby improving case grouping efficiency.
The case grouping method provided by the embodiment of the application comprises the following steps:
acquiring a case information field of a case, wherein the case information field comprises a field of main diagnosis and a field of option, and the option comprises other diagnosis, a main operation and other operations;
matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result;
determining a grouping category of the case in the grouping rule set according to whether the first matching result satisfies the surgical category grouping rule; wherein the case is classified into a surgical classification and a medical classification in the classification rule set;
matching the case information field of the case with the core disease diagnosis related grouping rules in the grouping rule set under the grouping category according to the grouping category of the case to obtain a second matching result, and determining the core disease diagnosis related grouping result of the case according to the second matching result;
determining a disease diagnosis related grouping result of the case according to the core disease diagnosis related grouping result and the disease diagnosis related grouping rules in the grouping rule set.
In some embodiments, the case grouping method, in which determining the disease diagnosis related grouping result of the case according to the core disease diagnosis related grouping result and the disease diagnosis related grouping rule in the grouping rule set, includes:
judging whether the case information field of the case meets the grouping factor of the disease diagnosis related grouping rule or not according to the core disease diagnosis related grouping result of the case;
if so, determining a disease diagnosis related grouping result of the case according to the disease diagnosis related grouping rule;
and if not, supplementing the grouping factors lacking in the case into the case information field of the case, and determining the disease diagnosis related grouping result of the case according to the supplemented grouping factors and the disease diagnosis related grouping rule.
In some embodiments, the surgical categories in the case grouping method include a factored surgical category, a non-factored surgical category;
determining that the case is behind a grouping category of the grouping rule set according to whether the first matching result satisfies a preset condition of the surgical category grouping rule, the method further comprising:
if the grouping type of the case is a surgical type, judging whether the case information field of the case meets a surgical type grouping rule containing factors;
if yes, determining the grouping category of the case as a factor-containing surgical category;
if not, determining the grouping category of the case as a surgical category without factors.
In some embodiments, the matching the case information field with the surgical classification grouping rule in the preset grouping rule set in the case grouping method to obtain a first matching result includes:
matching the codes of the case information fields of the cases with preset code tables to acquire the codes corresponding to the case information fields of the cases, wherein the preset code tables represent the mapping relation between the case information fields and the codes;
and matching the codes of the cases with the surgical classification grouping rules in the preset grouping rule set to obtain a first matching result.
In some embodiments, the method for grouping cases, which matches the case information field of the case with a preset code table to obtain a code corresponding to the case information field of the case, includes:
and if the case information field of the case is matched with the preset code table in terms of codes, determining a plurality of codes meeting the code matching condition from the plurality of codes meeting the code matching condition according to the selection operation.
In some embodiments, the case grouping method includes grouping surgical categories in the preset grouping rule set into a plurality of levels of screening rules;
the matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result, comprising:
sequentially judging whether the case information fields meet the screening rules of each level or not according to the levels of the screening rules;
if the screening rule of any level is not met, the surgical classification grouping rule which is not met in the grouping rule set is used as a first matching result;
if the screening rules of each level are met, the surgical category grouping rules in the group rule set are met to serve as a first matching result.
In some embodiments, the multiple levels of screening rules in the case grouping method include:
the screening rule of the first level is to judge whether the main diagnosis and other diagnoses accord with a first screening condition;
the second level of screening rules are used for judging whether the main operations all accord with second screening conditions;
the third level of screening rules is to determine whether the primary operation matches the primary diagnosis, other diagnoses.
In some embodiments, the number of the preset grouping rule sets in the case grouping method is multiple, and each grouping rule set corresponds to at least one city;
before matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result, the method further comprises:
and acquiring the city to which the case belongs, and determining a grouping rule set corresponding to the city from a plurality of grouping rules according to the city to which the case belongs, wherein the grouping rule set is used as the grouping rule set matched with the case information.
In some embodiments, there is also provided a case grouping apparatus comprising:
the system comprises an acquisition module, a diagnosis module and a diagnosis module, wherein the acquisition module is used for acquiring case information fields of cases, the case information fields comprise fields of main diagnosis and fields of option items, and the option items comprise other diagnoses, main operations and other operations;
the matching module is used for matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result;
a first determination module for determining a grouping category of the case in the grouping rule set according to whether the first matching result satisfies the surgical category grouping rule; wherein the case is classified into a surgical classification and a medical classification in the classification rule set;
a second determining module, configured to match, according to the grouping category of the case, the case information field of the case with the core disease diagnosis related grouping rule in the grouping rule set under the grouping category to obtain a second matching result, and determine, according to the second matching result, the core disease diagnosis related grouping result of the case;
a third determining module for determining the grouping result related to disease diagnosis of the case according to the grouping result related to core disease diagnosis and the grouping rules related to disease diagnosis in the grouping rule set.
In some embodiments, there is also provided an electronic device comprising: a processor, a memory and a bus, the memory storing machine readable instructions executable by the processor, the processor and the memory communicating over the bus when the electronic device is operating, the machine readable instructions when executed by the processor performing the steps of the case grouping method.
The case information fields of the cases are matched with the surgical category grouping rules in the grouping rule set so that the cases can be classified into surgical categories or medical categories according to the matching results, and when DRG grouping is performed, only the DRG grouping rules in the categories corresponding to the cases are matched with the case information fields, so that the matching calculation can be reduced, and the grouping efficiency is improved.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings that are required to be used in the embodiments will be briefly described below, it should be understood that the following drawings only illustrate some embodiments of the present application and therefore should not be considered as limiting the scope, and for those skilled in the art, other related drawings can be obtained from the drawings without inventive effort.
Fig. 1 shows a method flow diagram of a case grouping method according to an embodiment of the present application;
fig. 2 is a flowchart illustrating a method for matching the case information field with a surgical classification grouping rule in a preset grouping rule set to obtain a first matching result according to an embodiment of the present application;
fig. 3 is a flowchart illustrating a method for determining the category of the case according to the first-level filtering rule of the embodiment of the present application;
fig. 4 is a flowchart of a method for determining the category of the case through the second, third, and fourth levels of screening rules according to an embodiment of the present application;
fig. 5 shows a flowchart of a method of determining a DRG grouping result for the case according to an embodiment of the application;
FIG. 6 is a schematic diagram of a DRG query module shown in a graphical user interface according to an embodiment of the present application;
FIG. 7 is a diagram illustrating a DRG grouping query condition interface according to an embodiment of the present application;
FIG. 8 is a schematic diagram illustrating a diagnostic search interface according to an embodiment of the present application;
FIG. 9 is a search result diagram illustrating an interface according to an embodiment of the present application;
FIG. 10 is a diagram illustrating an overall query condition presentation interface according to an embodiment of the present application;
FIG. 11 is a diagram illustrating a prompt popup control according to an embodiment of the present application;
FIG. 12 is a schematic diagram of an input interface according to an embodiment of the application;
FIG. 13 is a schematic diagram of a result presentation interface according to an embodiment of the present application;
fig. 14 is a schematic structural diagram of a case grouping apparatus according to an embodiment of the present application;
fig. 15 shows a schematic structural diagram of an electronic device according to an embodiment of the present application.
Detailed Description
In order to make the purpose, technical solutions and advantages of the embodiments of the present application clearer, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it should be understood that the drawings in the present application are for illustrative and descriptive purposes only and are not used to limit the scope of protection of the present application. Additionally, it should be understood that the schematic drawings are not necessarily drawn to scale. The flowcharts used in this application illustrate operations implemented according to some embodiments of the present application. It should be understood that the operations of the flow diagrams may be performed out of order, and steps without logical context may be performed in reverse order or simultaneously. One skilled in the art, under the guidance of this application, may add one or more other operations to, or remove one or more operations from, the flowchart.
In addition, the described embodiments are only a part of the embodiments of the present application, and not all of the embodiments. The components of the embodiments of the present application, generally described and illustrated in the figures herein, can be arranged and designed in a wide variety of different configurations. Thus, the following detailed description of the embodiments of the present application, presented in the accompanying drawings, is not intended to limit the scope of the claimed application, but is merely representative of selected embodiments of the application. All other embodiments, which can be derived by a person skilled in the art from the embodiments of the present application without making any creative effort, shall fall within the protection scope of the present application.
It should be noted that in the embodiments of the present application, the term "comprising" is used to indicate the presence of the features stated hereinafter, but does not exclude the addition of further features.
The DRG is translated into a Diagnosis Related Group (DRG) mainly used for short-term hospitalization medical service performance evaluation and medical insurance payment management. With the great trend of medical insurance payment mode innovation, the DRG payment is taken as a new payment mode, and influences on various aspects of resource allocation, capability construction, operation management, service modes and the like of hospitals. How DRG payments are made is therefore of paramount importance in the development of hospitals.
The payment process of the DRG mainly comprises the steps of grouping cases through a DRG pre-grouping system and then paying according to different weights. For example, the DRG pre-grouping system groups each case according to information such as main diagnosis, main operation, other diagnoses, other operations, leaving manner, patient age, sex, number of days of hospitalization, etc. of the case, and after the case is grouped, each group has its own weight value, and finally, the payment of the fee is performed according to the weight value of the group.
Data in the existing case grouping are matched with fields such as diagnosis, operation, patient information, consumed resources and the like in a case and DRG grouping rules one by one according to preset rules to obtain DRG grouping of the case, and the matching efficiency is low, so that the existing DRG pre-grouping system has long grouping time for a single case. Based on the above, the present application provides a case grouping method, in which case information fields of cases are first matched with a surgical category grouping rule in a grouping rule set, so as to classify the cases into a surgical category or an internal category according to a matching result, and when DRG grouping is performed, only the DRG grouping rule in the category corresponding to the case is matched with the case information fields, so that matching calculation can be reduced, and the grouping efficiency can be improved.
As shown in fig. 1, the present application provides a case grouping method, comprising the steps of:
s101, acquiring a case information field of a case, wherein the case information field comprises a field of main diagnosis and a field of option, and the option comprises other diagnoses, a main operation and other operations;
s102, matching the case information field with a surgical classification grouping rule in a preset grouping rule set to obtain a first matching result;
s103, determining the grouping category of the case in the grouping rule set according to whether the first matching result meets the surgical category grouping rule; wherein the case is classified into a surgical category and a medical category in the classification rule set;
s104, according to the grouping type of the case, matching the case information field of the case with the core disease diagnosis related grouping rule in the grouping rule set under the grouping type to obtain a second matching result, and determining the core disease diagnosis related grouping result of the case according to the second matching result.
S105, determining the disease diagnosis related grouping result of the case according to the core disease diagnosis related grouping result and the disease diagnosis related grouping rules in the grouping rule set.
In step S101, the main diagnosis is generally the reason for hospitalization of the patient, and in principle, a disease diagnosis with the greatest health hazard, the greatest medical resource consumption, and the longest hospitalization time should be selected for the current hospitalization. Typically, the choice of primary diagnosis affects disease species statistics, and more directly affects DRG grouping results, RW, and CMI values.
The other diagnosis, usually the surgery corresponding to the primary diagnosis, is generally the most technically difficult, the most complicated procedure and the highest risk surgery.
The main diagnosis is a mandatory item, and the other diagnoses, main operations, and other operations are optional items, that is, if there are no other diagnoses, main operations, or other operations in a case, the corresponding case information field is not obtained, specifically, the case information field may be obtained by obtaining a preset negative field, for example, the case information fields of the other diagnoses, main operations, or other operations are all absent.
The case information field of the acquired case comprises:
receiving a case information field input by a user;
or capturing case data in a hospital information management system, and extracting case information fields corresponding to the cases according to the case data, wherein the hospital information management system is also called a his system.
As shown in fig. 2, in step S102, the matching the case information field with the surgical category grouping rule in the preset grouping rule set to obtain a first matching result includes:
s201, carrying out code matching on the case information field of the case and a preset code table to obtain a code corresponding to the case information field of the case, wherein the preset code table represents a mapping relation between the case information field and the code;
s202, matching the codes of the cases with the surgical category grouping rules in the preset grouping rule set to obtain a first matching result.
In step S201, the preset coding table may be an ICD table, a SNOMED CT table, a medical service item classification and code; when the case information field of the case is code-matched with a preset code table, the specific code matching mode can be precise matching, fuzzy matching, pinyin initial matching and the like.
The codes are codes corresponding to main diagnosis, other diagnoses, main operation and other operations existing in the case information field of the case, for example: the main diagnosis is as follows: aspiration pneumonia-J69.001; other diagnoses were: II respiratory failure-J69.900 × 003; the main operation is as follows: endotracheal tube-96.0400; other operations are as follows: temporary tracheotomy-31.1 × 00 × 005。
Further, the matching of the codes of the case information field of the case and a preset code table to obtain the codes corresponding to the case information field of the case includes:
and if the case information field of the case is matched with the preset code table in terms of codes, determining a plurality of codes meeting the code matching condition from the plurality of codes meeting the code matching condition according to the selection operation.
For example: when the case information field of the main diagnosis is aspiration pneumonia, the code matching conditions are satisfied as follows: j69.001 inhalation pneumonia, P24.901 neonatal inhalation pneumonia, J68.000x001 inhalation toxic gas pneumonia, P24.002, neonatal meconium inhalation pneumonia, P24.101 neonatal amniotic fluid inhalation pneumonia and J95.401 inhalation anesthesia induced chemical pneumonia, and one of the pneumonia is selected as a code of main diagnosis according to the selection operation of a user.
In step S103, determining a grouping category of the case in the grouping rule set according to whether the first matching result satisfies the surgical category grouping rule; wherein the case is classified into a surgical classification and a medical classification in the classification rule set.
Namely, if the first matching result meets the surgical classification grouping rule, the case is determined to belong to a surgical class, and if the preset condition of the surgical classification grouping rule is not met, the case is determined to belong to a medical class.
Further, the surgical categories include a factored surgical category, a non-factored surgical category;
determining that the case is behind a grouping category of the grouping rule set according to whether the first matching result satisfies a preset condition of the surgical category grouping rule, the method further comprising:
if the grouping type of the case is a surgical type, judging whether the case information field of the case meets a surgical type grouping rule containing factors;
if so, determining the grouping category of the case as a factor-containing surgical category;
if not, determining the grouping category of the case as a surgical category without factors.
That is, after it is determined that the case belongs to the surgical category, the surgical category is further divided into a factored surgical category and a non-factored surgical category, so that the number of rules that need to be matched when the case is matched with the disease diagnosis-related grouping rule is further reduced, further reducing the amount of calculation in matching.
Further, in the case grouping method, the surgical category grouping rule in the preset grouping rule set includes a plurality of levels of screening rules;
the matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result, comprising:
sequentially judging whether the case information field meets the screening rule of each level according to the level of the screening rule;
if the screening rule of any level is not met, the surgical classification grouping rule which is not met in the grouping rule set is used as a first matching result;
if the screening rules of each level are satisfied, the surgical category grouping rules that are in compliance with the grouping rule set are taken as a first matching result.
Since the grouping of the cases into the operation types needs to satisfy a plurality of conditions, the conditions are divided into a plurality of levels of screening rules, and if the cases do not satisfy the screening rule of the first level, the surgical classification grouping rule which does not conform to the grouping rule set is used as a first matching result, so that the classification of the case is determined to be the medical classification according to the first matching result; and otherwise, if the case does not meet the screening rule of the first level, entering the screening rule of the second level, and so on until a first matching result of the case is obtained.
Through the multi-stage screening rule, the case is determined to belong to the internal medicine category or the surgical category by using the least matching calculation as far as possible, so that the grouping efficiency is improved.
Specifically, the screening rules of the multiple levels include:
the screening rule of the first level is to judge whether the main diagnosis and other diagnoses accord with a first screening condition;
the second level of screening rules are used for judging whether the main operations all accord with second screening conditions;
the third level of screening rules is to determine whether the primary operation matches the primary diagnosis, other diagnoses.
Specifically, when other operations exist in the case information field of the case, the multiple levels of screening rules further include a fourth level of screening rules, and the fourth level of screening rules further divide the surgical category into a factored operation and a non-factored operation, so that the number of rules that need to be matched when matching with the disease diagnosis related grouping rule is further reduced, and the calculation amount during matching is further reduced.
In step S104, the core disease diagnosis related group is also called ADRG group.
In step S105, the disease diagnosis related group is also referred to as a DRG group.
Different ADRG grouping results correspond to different DRG grouping rules.
In an embodiment of the present application, determining the disease diagnosis related grouping result of the case according to the core disease diagnosis related grouping result and the disease diagnosis related grouping rule in the grouping rule set includes:
judging whether the case information field of the case meets the grouping factor of the disease diagnosis related grouping rule or not according to the core disease diagnosis related grouping result of the case;
if so, determining a disease diagnosis related grouping result of the case according to the disease diagnosis related grouping rule;
and if not, supplementing the grouping factors lacking in the case into the case information field of the case, and determining the disease diagnosis related grouping result of the case according to the supplemented grouping factors and the disease diagnosis related grouping rule.
In the embodiment of the application, after the ADRG grouping result to which the case belongs is determined, whether new grouping factors such as the age of a patient, the using time of a breathing machine and the like need to be submitted in the case information field is judged according to the ADRG grouping result, and if the new grouping factors do not need to be submitted, the DRG grouping of the case is directly obtained according to the DRG grouping rule in the grouping rule set; and if the new grouping factor needs to be submitted, acquiring the DRG grouping of the case according to the DRG grouping rule in the grouping rule set after acquiring the new grouping factor.
That is to say, only the case needing to add the grouping factor is supplemented with the required grouping factor, and the supplemented grouping factor is matched with the grouping rule set, and for the case not needing the grouping factor, the grouping factor does not need to be acquired, and the step of matching the grouping factor with the preset grouping rule set is not needed, so that the matching calculation in the case grouping method is further simplified.
A grouping procedure of the case grouping method is described in detail below.
The grouping rule set is shown as the following table I and comprises a plurality of grouping rule tables;
watch 1
Acquiring case information fields of cases, and respectively acquiring a main diagnosis code, other diagnosis codes, a main operation code and other operation codes based on a preset code table.
As shown in fig. 3, the flow of the method for determining the category of the case by the first-level screening rule is as follows:
s301, judging whether the main diagnosis code exists in a table 00-multiple trauma position table or not;
if not, go to step S306;
if yes, go to step S302;
s302, judging whether other diagnoses exist or not;
if not, go to step S306;
if yes, go to step S303;
s303, judging that the codes of the other diagnoses exist in a table 00-multiple trauma position table;
if not, go to step S306;
if yes, go to step S304;
s304, judging whether the types of the wound parts corresponding to the main diagnosis and other diagnoses are more than or equal to 2;
if not, go to step S306;
if yes, go to step S305;
s305, determining the MDC grouping of the case.
S306, the case is judged not to belong to the surgical category, a first matching result is obtained, and the MDC grouping of the case is determined.
In the embodiment of the present application, in step S306, it is determined that the MDC groups of the case are MDCA-Y groups; in step S305, it is determined that the MDC groups of the case are MDCZ groups.
When the screening rule of the first level in the embodiment of the application judges the type of the case, after the judgment result is obtained and the range of the rule which needs to be matched with the case information field is narrowed down, the MDC grouping result of the case is determined to prepare for the follow-up ADRG grouping.
After step S305, as shown in fig. 4, for the case whose MDC group is an MDCZ group, the flow of the method for determining the category of the case by the screening rules of the second level, the third level, and the fourth level is as follows:
s401, judging whether a main operation exists or not;
if not, go to step S406;
if yes, go to step S402;
s402, judging whether the code of the main operation exists in the operation pack (judging according to a table 03);
if not, go to step S406;
if yes, go to step S403;
s403, judging whether other operations exist;
if not, go to step S408;
if yes, go to step S404;
s404, judging whether the main operation and other operations meet an ADRG factor table;
that is, it is determined whether the coding of the primary and other procedures is present in the case combination grouping rule set or the ADRG other factors table (in table 01 or table 05);
if not, go to step S408;
if yes, go to step S405;
s405, determining the ADRG grouping of the case as surgical ADRG containing factors;
s406, judging whether the main diagnosis is in an internal medicine ADRG or a diagnosis package (according to a table 03 Pa Nu), and entering a step S407;
s407, determining internal ADRG grouping results of the cases;
s408, judging whether the operation packet corresponding to the main operation and the diagnosis packet corresponding to the main diagnosis are the same ADRG group (judged according to a table 02);
if not, go to step S406;
if yes, go to step S409;
s409, determining the ADRG grouping of the case as surgical ADRG containing factors.
When the screening rules of the second level, the third level and the fourth level in the embodiment of the application judge the category of the case, after obtaining the judgment result and narrowing the range of the rule of the grouping rule set which needs to be matched with the case information field, the ADRG grouping result of the case is determined to prepare for the subsequent DRG grouping.
The flowchart of the method for determining the DRG grouping result of the case based on the ADRG grouping result of the case described in step S105 is shown in fig. 5:
s501, according to a case combination grouping rule table in a table 01, the ADRG grouping results are divided into three types: ADRG grouping results that do not distinguish between complications or complications, ADRG grouping results that distinguish between complications or complications without determining DRG grouping factors, ADRG grouping results that distinguish between complications or complications and determine DRG grouping factors.
S502, directly determining the DRG grouping result of the ADRG grouping result without distinguishing the complication or the complication according to the DRG grouping rule;
specifically, the complication syndrome label of the case combination grouping rule table 01 corresponding to the ADRG grouping result without distinguishing complications or complications is "9", the ADRG group is equal to the DRG group, and no further matching with the DRG grouping rule is needed, only the number 9 needs to be added to the ADRG group code as the ADRG grouping result, i.e. the DRG group code as the DRG grouping result is obtained.
For the ADRG grouping result which distinguishes complications or complications but does not need to judge DRG grouping factors, the grades of the complications and the complications are further judged, and the DRG grouping result is determined according to the grades of the complications, and the specific method flow is as follows:
s503, judging whether the complication grade is 5 according to the complication grade table 04 and the complication excluding table 06 for the ADRG grouping result which distinguishes the complication or complication but does not need to judge the DRG grouping factor;
the method comprises the following specific steps: if the other diagnosis in the case information field satisfies the "other diagnosis" included in the table 06 complication exclusion table corresponding to the "main diagnosis" of the complication level table 04, the other diagnosis level of the case is 5; if the other diagnosis of the case is not in the complication rating table of table 04, the other diagnosis rating of the case is 5.
And S504, if the grade of the complications and the complications of the case is not 5, determining the grade of the complications and the complications according to the table 04.
Specifically, if the other diagnoses conform to a plurality of grades, the highest grade of the other diagnoses is taken as the grade of the complications and complications of the case.
Wherein the complication or complication rating: "1" represents: severe complications or complications, "3" represents: general complications or complications, "5" represents: without complications or complications.
And S505, determining the DRG grouping result according to the case combination grouping rule table 01.
Specifically, the method comprises the following steps. The DRG is grouped into ADRG group + complication rating, if ADRG is grouped into AC1 and complication rating is 3, DRG is grouped into AC 13.
According to the ADRG grouping results of the cases, the complication or complication grade of the table 01 case combination grouping rule table corresponding to the ADRG grouping results of a plurality of cases is not '1, 3, 5, 9', the ADRG grouping results are classified into the ADRG grouping results which distinguish the complications or complications and need to judge DRG grouping factors, and the DRG grouping factors corresponding to the table 01 need to be further judged.
S506, judging whether the case information field meets DRG grouping factors or not according to the main diagnosis and the main operation in the case information field and other factor tables of DRG in a table 07;
specifically, according to the main diagnosis and the main operation in the case information field, the lookup table 07 is made whether the codes corresponding to the other factor tables of the DRG satisfy the corresponding DRG factors in table 01.
S507, if yes, determining a DRG grouping result;
specifically, the DRG group is an ADRG group + complication level code;
and S508, if the grouping result does not meet the requirements, determining the grouping result related to the disease diagnosis of the case according to grouping factors which are deficient in the case and supplemented into the case information field of the case and a case combination grouping rule shown in a table 01.
Specifically, if the primary diagnosis and the primary operation cannot satisfy the DRG factor, the system user is prompted to input a new grouping factor, which is as follows: if ADRG is grouped into RB1, RB2 and the like, the number of hospitalization days needs to be input, if the ADRG is grouped into BV1, ES2 and the like, the age of a patient needs to be input, and if the ADRG is grouped into BR2, the leaving mode needs to be input; if the ADRG group is AH1, inputting the usage time of the respirator; if the ADRG group is PB1, PC1, etc., the birth age of the newborn needs to be input; if the ADRG group is PS1, PT1, etc., the newborn birth weight needs to be inputted.
In general, DRG grouping rules of different cities are different, and in order to further facilitate user use and determine grouping of cases more accurately, in the case grouping method according to the embodiment of the present application, the number of the preset grouping rule sets is multiple, and each grouping rule set corresponds to at least one city;
before matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result, the method further comprises:
and acquiring the city to which the case belongs, and determining a grouping rule set corresponding to the city from a plurality of types of grouping rules according to the city to which the case belongs, wherein the grouping rule set is used as the grouping rule set matched with the case information.
Specifically, the acquisition of the city to which the case belongs may be user input or determined according to the location of a user terminal; and after determining the city of the case according to the positioning of the terminal, modifying the city of the case according to the received correction operation.
The embodiment of the application also provides a case grouping system, which comprises a terminal and a server, wherein the server executes the case grouping method.
The terminal can be a computer, a mobile phone, a tablet and the like, and the DRG front end of the terminal can be a web end, an iOS end and an android end.
The terminal can perform DRG search or DRG query, the terminal calls a case grouping method in the server through a network request (HTTPS POST mode), the server performs calculation and generates a calculation result according to case information fields and grouping factors input by the terminal based on the case grouping method, and the calculation result is returned to the terminal through the network request.
In the embodiment of the application, the mobile phone is used as an operation terminal to introduce the grouping flow of the case grouping method in detail.
As shown in fig. 6, at least a DRG query module is shown in the graphical user interface of the mobile phone; the graphical user interface can also display various functional application modules, such as a quick-reading inquiry, a family doctor, a convenient outpatient service, a consultation and the like, and the interface content can contain more functional applications.
When the mobile phone detects the touch operation aiming at the DRG module, responding to the touch operation aiming at the DRG module, and displaying a DRG grouping query condition interface of fig. 7, wherein the interface comprises input controls and submission controls of main diagnosis, other diagnoses, main operations, other operations and the like; the main diagnosis is a necessary option, and the submission operation of the submission control can be responded and the next step is continued only after the main diagnosis is successfully added.
The main diagnostic operations are added through the input controls as follows:
s601: responding to a touch operation aiming at an 'add diagnosis' control below the main diagnosis input control, and entering a diagnosis search interface shown in the figure 8, wherein the interface displays a search input box and an input method;
s602: responding to the search operation of the keyword input in the search input box, such as 'inhalation pneumonia', displaying a search result, wherein the search result is displayed on an interface, the search result is shown in fig. 9, and the search result comprises a plurality of disease codes capable of fuzzy matching and diagnosis name controls in Chinese name click results;
s603: responding to the touch operation of the controls according with the expected disease names, and returning to the DRG query condition interface;
s604: sequentially responding to touch operations aiming at other diagnosis input controls, main operation input controls and other operation input controls, and then executing S602 and S603, wherein finally, all query condition display interfaces are shown in FIG. 10 and mainly comprise: the names and terms of the main diagnosis, other diagnoses, main operation and other operations which are input by the user still remain to add diagnosis controls and operation controls under the other diagnoses and other operations.
If the patient does not have other diagnosis, major surgery, other surgery, step S604 may be omitted; wherein, the main diagnosis and the main operation can only add 1 record respectively; other diagnoses and other operations, multiple records may be added, and the specific method is implemented through step S604;
under the condition that the user selects the name entry incorrectly, responding to the touch operation of a deleting control aiming at the right side of the diagnosis name control, and deleting the name entry of the current main diagnosis; similarly, the name terms of other diagnoses, major surgery, other surgeries may be present;
s605: based on step S605, responding to the touch operation for the "submission control", performing calculation based on the grouping method, if the currently input query condition can meet the condition required for calculation, determining the DRG grouping result of the case, and displaying a result display interface as shown in fig. 13, where the interface shown in fig. 13 includes the DRG grouping result and the query condition input in the previous step, and the interface does not perform complete display of the query condition;
the DRG grouping result includes a DRG grouping name, for example, the grouping name of the query is "tracheotomy ventilator support <300 hours", and the group corresponds to a three-level hospital payment weight, employee overall payment (yuan), and resident overall payment (yuan); the method comprises the following steps of paying by a primary hospital, performing overall payment (yuan) by employees and performing overall payment (yuan) by residents, wherein the grade of the hospital is not limited by the method;
s606: responding to the information required by the calculation of the grouping method when the current query condition does not meet the requirement, and displaying a prompt popup window control shown in fig. 11, wherein the prompt popup window control prompts to supplement case information fields of the missing grouping factors in an interface;
responding to the determination operation aiming at the prompt popup window control, displaying an input interface shown in fig. 12, and displaying case information fields of grouping factors needing to be filled under the query condition, wherein the case information fields are necessary to be filled; for example, embodiments of the present application prompt for an input of ventilator usage duration;
s607: responding to the input operation of the input interface shown in fig. 12, and judging whether the current query condition satisfies the information required for the grouping method calculation after the grouping factor is added;
s608: if not, repeating the steps S606 and S607; if yes, the user directly enters a result display interface shown in fig. 13 after calculation of the grouping method.
In an embodiment of the present application, there is further provided a case grouping apparatus, as shown in fig. 14, including:
an obtaining module 1401, configured to obtain a case information field of a case, where the case information field includes a field of a main diagnosis and a field of an option, and the option includes other diagnoses, a main operation, and other operations;
the matching module 1402 matches the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result;
a first determination module 1403 for determining a grouping category of the case in the grouping rule set according to whether the first matching result satisfies the surgical category grouping rule; wherein the case is classified into a surgical category and a medical category in the classification rule set;
a second determining module 1404, configured to match, according to the grouping category of the case, the case information field of the case with the core disease diagnosis related grouping rule in the grouping rule set under the grouping category to obtain a second matching result, and determine, according to the second matching result, the core disease diagnosis related grouping result of the case;
a third determining module 1405, determining a disease diagnosis related grouping result of the case according to the core disease diagnosis related grouping result and the disease diagnosis related grouping rule in the grouping rule set.
In this embodiment of the application, the third determining module 1405 is specifically configured to determine, according to the core disease diagnosis related grouping result of the case, whether the case information field of the case satisfies the grouping factor of the disease diagnosis related grouping rule;
if so, determining a disease diagnosis related grouping result of the case according to the disease diagnosis related grouping rule;
and if not, supplementing the grouping factors lacking in the case into the case information field of the case, and determining the disease diagnosis related grouping result of the case according to the supplemented grouping factors and the disease diagnosis related grouping rule.
Further, the medical treatment system further comprises a judging module, wherein the judging module is used for determining whether the case is behind the grouping category of the grouping rule set according to whether the first matching result meets the preset condition of the surgical category grouping rule when the surgical category comprises a surgical category with factors and a surgical category without factors, and judging whether the case information field of the case meets the surgical category grouping rule with factors if the grouping category of the case is the surgical category; if so, determining the grouping category of the case as a factor-containing surgical category; if not, determining the grouping category of the case as a surgical category without factors.
Further, the matching module 1402 is specifically configured to perform code matching on the case information field of the case and a preset code table to obtain a code corresponding to the case information field of the case, where the preset code table represents a mapping relationship between the case information field and the code;
and matching the codes of the cases with the surgical category grouping rules in the preset grouping rule table to obtain a first matching result.
Further, the matching module is further configured to perform code matching between the case information field of the case and a preset code table, and determine, according to a selection operation, a code corresponding to the case information field of the case from the plurality of codes satisfying the code matching condition when there are a plurality of codes satisfying the code matching condition.
Further, the surgical classification grouping rule in the preset grouping rule table includes a plurality of levels of screening rules, and the matching module is further specifically configured to sequentially determine whether the case information field satisfies the screening rule of each level according to the level of the screening rule;
if the screening rule of any level is not met, the surgical category grouping rule which is not met in the grouping rule table is used as a first matching result;
if the screening rule of each level is satisfied, the surgical category grouping rule in the conforming grouping rule table is taken as a first matching result.
Further, the multiple levels of filtering rules include:
the screening rule of the first level is to judge whether the main diagnosis and other diagnoses accord with a first screening condition;
the second level of screening rules are used for judging whether the main operations all accord with second screening conditions;
the third level of screening rules is to determine whether the primary operation matches the primary diagnosis, other diagnoses.
Further, the apparatus further comprises:
a fourth determining module, configured to, when the preset grouping rule table has multiple types and each type of grouping rule table corresponds to a city, match the case information field with a surgical classification grouping rule in the preset grouping rule table, obtain a city to which the case belongs before obtaining a first matching result, and determine, according to the city to which the case belongs, a grouping rule set corresponding to the city from the multiple grouping rules, as the grouping rule set that is matched with the case information.
As shown in fig. 15, an embodiment of the present application further provides an electronic device, including: a processor 1501, a memory 1502 and a bus 1503, the memory 1502 storing machine readable instructions executable by the processor 1501, the processor 1501 communicating with the memory 1502 via the bus 1503 when the electronic device is operating, the machine readable instructions when executed by the processor 1501 performing the steps of the case grouping method.
Embodiments of the present application further provide a computer-readable storage medium, on which a computer program is stored, and the computer program is executed by a processor to perform the steps of the case grouping method.
It can be clearly understood by those skilled in the art that, for convenience and brevity of description, the specific working processes of the system and the apparatus described above may refer to corresponding processes in the method embodiments, and are not described in detail in this application. In the several embodiments provided in the present application, it should be understood that the disclosed system, apparatus and method may be implemented in other ways. The above-described apparatus embodiments are merely illustrative, and for example, the division of the modules is merely a logical division, and there may be other divisions in actual implementation, and for example, a plurality of modules or components may be combined or integrated into another system, or some features may be omitted, or not executed. In addition, the shown or discussed mutual coupling or direct coupling or communication connection may be an indirect coupling or communication connection of devices or modules through some communication interfaces, and may be in an electrical, mechanical or other form.
The modules described as separate parts may or may not be physically separate, and parts displayed as modules may or may not be physical units, may be located in one place, or may be distributed on a plurality of network units. Some or all of the units can be selected according to actual needs to achieve the purpose of the solution of the embodiment.
In addition, functional units in the embodiments of the present application may be integrated into one processing unit, or each unit may exist alone physically, or two or more units are integrated into one unit.
The functions, if implemented in the form of software functional units and sold or used as a stand-alone product, may be stored in a non-volatile computer-readable storage medium executable by a processor. Based on such understanding, the technical solutions of the present application or portions thereof that substantially contribute to the prior art may be embodied in the form of a software product, which is stored in a storage medium and includes several instructions for enabling a computer device (which may be a personal computer, a platform server, or a network device) to execute all or part of the steps of the methods described in the embodiments of the present application. And the aforementioned storage medium includes: various media capable of storing program codes, such as a U disk, a removable hard disk, a ROM, a RAM, a magnetic disk, or an optical disk.
The above description is only for the specific embodiments of the present application, but the scope of the present application is not limited thereto, and any person skilled in the art can easily conceive of the changes or substitutions within the technical scope of the present application, and shall be covered by the scope of the present application. Therefore, the protection scope of the present application shall be subject to the protection scope of the claims.
Claims (10)
1. A case grouping method, comprising the steps of:
acquiring a case information field of a case, wherein the case information field comprises a field of main diagnosis and a field of option, and the option comprises other diagnosis, a main operation and other operations;
matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result;
determining a grouping category of the case in the grouping rule set according to whether the first matching result satisfies the surgical category grouping rule; wherein the case is classified into a surgical classification and a medical classification in the classification rule set;
matching the case information field of the case with the core disease diagnosis related grouping rules in the grouping rule set under the grouping category according to the grouping category of the case to obtain a second matching result, and determining the core disease diagnosis related grouping result of the case according to the second matching result;
determining a disease diagnosis related grouping result of the case according to the core disease diagnosis related grouping result and the disease diagnosis related grouping rules in the grouping rule set.
2. The case grouping method according to claim 1, wherein determining the disease diagnosis related grouping result of the case based on the core disease diagnosis related grouping result and the disease diagnosis related grouping rules in the grouping rule set comprises:
judging whether the case information field of the case meets the grouping factor of the disease diagnosis related grouping rule or not according to the core disease diagnosis related grouping result of the case;
if so, determining a disease diagnosis related grouping result of the case according to the disease diagnosis related grouping rule;
and if not, supplementing the grouping factors lacking in the case into the case information field of the case, and determining the disease diagnosis related grouping result of the case according to the supplemented grouping factors and the disease diagnosis related grouping rule.
3. The case grouping method according to claim 1, wherein the surgical categories include a factored surgical category, a non-factored surgical category;
determining that the case is behind a grouping category of the grouping rule set according to whether the first matching result satisfies a preset condition of the surgical category grouping rule, the method further comprising:
if the grouping type of the case is a surgical type, judging whether the case information field of the case meets a surgical type grouping rule containing factors;
if so, determining the grouping category of the case as a factor-containing surgical category;
if not, determining the grouping category of the case as a surgical category without factors.
4. The case grouping method according to claim 1, wherein matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result comprises:
matching the codes of the case information fields of the cases with preset code tables to acquire the codes corresponding to the case information fields of the cases, wherein the preset code tables represent the mapping relation between the case information fields and the codes;
and matching the codes of the cases with the surgical classification grouping rules in the preset grouping rule set to obtain a first matching result.
5. The case grouping method according to claim 4, wherein matching the case information field of the case with a preset code table to obtain a code corresponding to the case information field of the case comprises:
and if the case information field of the case is matched with the preset code table in terms of codes, determining a plurality of codes meeting the code matching condition from the plurality of codes meeting the code matching condition according to the selection operation.
6. The case grouping method according to claim 1, wherein the surgical category grouping rule in the preset grouping rule set includes a plurality of levels of screening rules;
the matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result, comprising:
sequentially judging whether the case information field meets the screening rule of each level according to the level of the screening rule;
if the screening rule of any level is not met, the surgical classification grouping rule which is not met in the grouping rule set is used as a first matching result;
if the screening rules of each level are satisfied, the surgical category grouping rules that are in compliance with the grouping rule set are taken as a first matching result.
7. The case grouping method according to claim 6, characterized in that; the multiple levels of screening rules include:
the screening rule of the first level is to judge whether the main diagnosis and other diagnoses accord with a first screening condition;
the second level of screening rules are used for judging whether the main operations all accord with second screening conditions;
the third level of screening rules is to determine whether the primary operation matches the primary diagnosis or not.
8. The case grouping method according to claim 1, wherein the number of the preset grouping rule sets is plural, each grouping rule set corresponding to at least one city;
before matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result, the method further comprises:
and acquiring the city to which the case belongs, and determining a grouping rule set corresponding to the city from a plurality of grouping rules according to the city to which the case belongs, wherein the grouping rule set is used as the grouping rule set matched with the case information.
9. A case grouping apparatus, comprising:
the system comprises an acquisition module, a diagnosis module and a diagnosis module, wherein the acquisition module is used for acquiring case information fields of cases, the case information fields comprise fields of main diagnosis and fields of option items, and the option items comprise other diagnoses, main operations and other operations;
the matching module is used for matching the case information field with a surgical category grouping rule in a preset grouping rule set to obtain a first matching result;
a first determination module for determining a grouping category of the case in the grouping rule set according to whether the first matching result satisfies the surgical category grouping rule; wherein the case is classified into a surgical classification and a medical classification in the classification rule set;
a second determining module, configured to match, according to the grouping category of the case, the case information field of the case with the core disease diagnosis related grouping rule in the grouping rule set under the grouping category to obtain a second matching result, and determine, according to the second matching result, the core disease diagnosis related grouping result of the case;
and the third determining module is used for determining the disease diagnosis related grouping result of the case according to the core disease diagnosis related grouping result and the disease diagnosis related grouping rule in the grouping rule set.
10. An electronic device, comprising: a processor, a memory and a bus, the memory storing machine-readable instructions executable by the processor, the processor and the memory communicating over the bus when the electronic device is running, the machine-readable instructions when executed by the processor performing the steps of the case grouping method of any of claims 1 to 8.
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