JP3263414B2 - Receipt check method - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a data management method of a check master for performing a relation check between a medical practice and a disease name in a system dedicated to medical office work.

[0002] In the conventional system dedicated to medical affairs, the main task is to issue a claim. However, with the increase and diversification of the medical care action code and disease name code data, today, as a pre-process for issuing a claim, Before issuing a receipt for the input data, a function of checking its consistency has been required.

[0003] This function is usually called a receipt check system, and the content of the check is a standard check for checking the format of the receipt (name, date of birth, insurer number, symbol number omission). (The format check as to whether the format satisfies the minimum claim, etc.) and the data entered into the machine (the medical treatment of each patient and the name of the disease) (the consistency here is the medical treatment of each patient) There is a so-called related check for checking the validity of the medical treatment and the name of the disease given to the patient, omission of calculation based on the medical fee score table for various medical treatments, and calculation error).

[0004] The related check method of the receipt check system in the conventional system dedicated to medical affairs uses a code for each of the inputted medical care action and the disease name (a number or a character for the system to uniquely identify the medical care action and the disease name). The column code) and the relevant check master for each hospital and clinic registered in advance by the operator were checked by a check method, which required a huge amount of processing time, and greatly reduced the processing speed. There is a need for a data management method for check masters.

[0005]

2. Description of the Related Art FIGS. 5 and 6 are views for explaining a conventional check master data management method. FIG. 5A shows an example of a file structure of a related check master.
6B schematically shows a conventional check method, and FIG. 6C shows a problem of the conventional check method.

Conventional related check master file structure: Conventional related check masters for each hospital and clinic have a file structure as shown in FIG. That is, the key part has a check number as a check identification key, the medical care action code for performing the related check, and the disease name code in the data part, and a representative name (representative name) used for printing the title of the check when displaying an error message. (Medical practice name, representative disease name).

Specific check contents and an example of registration in a related check master: Check contents: For example, the name of "heart disease" (ie, angina pectoris, heart failure, arrhythmia) while the drug "persatin" is used. When checking that there is no.

[0008] As a medical care action code, a persatin code for each hospital is registered. -As a disease name code, the codes of angina pectoris, heart failure, and arrhythmia are registered as heart disease names.

[0009] Persatin is registered as a representative medical practice name.・ Register heart disease as the representative disease name. Check method: The input medical practice data and disease name data file are read, and the registration codes 1 to N of the relevant check master are compared, and as shown in FIG.
Develop and create check number-specific medical practice deployment tables and check number-specific disease name deployment tables.

[0010] With regard to the table developed in this way, the medical practice deployment table is referred to for each check No., and the code is included in the medical practice deployment table for each check No., and the code is 1 in the disease name development table for each check No. If not, it is determined that an error has occurred, and the following error message “There is no“ heart disease ”corresponding to“ persatin ”” is edited and output.

[0011]

The problem of the above-mentioned check method is that, as shown in FIG.
The disease name data is read in order, matching is performed between each code of the check number-specific medical care action development table and each code of the check number-specific disease name expansion table, and the existence check is performed.

In this matching, N times must be compared for the medical care action and N times for the disease name for each related check number in the check number-specific medical action development table / check number-specific disease name expansion table. Become,
As the number of items in the expansion table increases, even if a part of the content of each item corresponding to the check number of the table is different, the problem is that brute force matching is performed and the processing time becomes enormous. there were.

In view of the above-mentioned conventional disadvantages, the present invention can significantly reduce the check processing time when managing check master data for performing a check on the association between a medical practice and a disease name in a medical office dedicated system. It is an object of the present invention to provide a check master data management method.

[0014]

FIG. 1 is a diagram for explaining the principle of the present invention. FIG. 1 (a) shows an example of a medical practice-check No. file sorted in the order of medical practice codes, and FIG. 1 (b) shows a disease name code. An example of a disease name-check No. file sorted in order is shown.

The above problem is solved by a check master data management system configured as follows. This is a receipt check method that uses a medical practice code that has a check number in the key part and performs a related check, and a relevant check master that has a disease name code in the data part. A code, the check No. and the medical practice code are paired, and a medical care activity-check No. file sorted in the order of the medical practice code is created, and from the related check master,
All the disease name codes are paired with the check No. and the disease name code, and a disease name-check No. file is created which is sorted in the order of the disease name code, and the created medical practice-check No. file and disease name-check No. The file is stored in the related check code sort area, and from the related check master, the above-mentioned medical practice-check No. file and disease name-
After the check No. file is created, the medical practice of each patient, the medical practice of the patient input from the disease name data file, and the medical practice in the related check code sort area using the code of the disease name data as a key -Check No. file and disease name-Check No. file are searched by a binary search method, and a check No. corresponding to the medical treatment performed for the patient and a check N corresponding to the assigned disease name
o. and get

For each check No., representative medical practice name, number of medical practice codes, code table address for each check No.
(Action) and related check consisting of representative disease name, number of disease name codes, check table number code table address (disease name)
Generates a No. management table, and specifies the code table address for each check number (act) and the code table address for each check number (disease name) specified by the related check number management table.
From the relevant check No. management table, the area for the number of medical care action codes and the number of disease name codes indicated by the above related check No. management table is stored in the check no.
A separate disease name code table is secured, and based on the acquired check number, the corresponding check number management table indicates the corresponding check number specific medical practice code table and check number specific disease name code table. The medical practice code and the disease name code are sorted, and the above-mentioned check No. separate medical practice code table and check N
o. Referring to the different disease name code table, determine the error for each check No.

[0017]

[Operation] As described above, in the conventional check method, the respective codes of the check number-specific medical care action development table and the check number-specific disease name expansion table are developed and created from the related check master, and the input medical care is performed. The medical treatment code and disease name code are read from the file of the act data and disease name data,
In order to perform matching with each code in the check number-specific disease name development table, in this matching, it is necessary to always perform comparison N times for the medical practice and N times for the disease name for one related check table.

In the present invention, from the relevant check master, all the medical treatment codes to be checked are paired with the check numbers, and the medical treatment-check number files sorted in the order of the medical treatment codes, and A disease name-check No. file sorted in the order of the disease name code is created by pairing the disease name code of the patient with the check No., and stored in the related check code sort area. Using the code of the patient's medical care and disease name data input from the file as a key, the above-mentioned medical care-check No. file and disease name-check in the related check code sort area
No. file and the corresponding medical practice code and disease name code by the binary search method in order,
This is to search for a check number.

Thereafter, for each check No. having the medical practice code and the disease name code, an area is reserved in advance, and the check-specific medical practice code table a and the check number-specific disease name code are stored. By distributing the inputted medical care action code and disease name code of a certain patient to the table b, for example, there is the medical care action data in the corresponding area of the check no. If the disease name data does not exist in the No. different disease name code table b, it is determined that an error has occurred.

The main point of the present invention is to generate medical treatment code data and paired data of disease name code data and check number from the related check master, and sort them in the order of the medical treatment code data and disease name code data. The medical practice-check No. file and the disease name-check No. file are stored in the related check code sort area, and when a medical practice code requiring a search and a disease name code are input, the medical practice code is entered. , And disease name code, search the above-mentioned medical practice-check No. file and disease name-check No. file in the related check code sort area. No. can be recognized.

Therefore, since the check No. having the inputted medical treatment code and disease name code of the patient can be searched at a high speed, there is an effect that the relation check between the medical treatment and the disease name can be performed at a high speed.

[0022]

BRIEF DESCRIPTION OF THE DRAWINGS FIG. FIG. 1 is an explanatory view of the principle of the present invention.
FIG. 3 is an example of a file structure of a related check master according to the present invention. FIG. 3 is a diagram showing a check method according to the present invention. FIG. 4 is a diagram for explaining the effect of the present invention.
1) and (a2) show the case of the conventional method, and FIGS. 4 (b1) and (b2) show the case of the present invention.

According to the present invention, in a data management method of a check master for a check related to a medical practice and a disease name in a system dedicated to medical affairs, a medical practice code having a check number as a key part and performing a related check and a disease name code are provided. From the related check master in the data section, all the medical treatment codes to be checked are paired with the check numbers, and the medical treatments are sorted in the order of the medical treatment codes.
Check No. file and all disease name codes are paired with the check No. to create a disease name-check No. file sorted in the order of disease name code, stored in the related check code sort area, and entered. By using the code of the patient's medical practice and disease name data as a key, the above-mentioned medical practice-check No. file and disease name-check N
o. The file is searched, for example, by the binary search method, and the check No. corresponding to the medical treatment performed on the obtained patient is obtained.
And means for checking the validity of the disease name for the medical practice based on the check No. corresponding to the assigned disease name is a means necessary for carrying out the present invention. Note that the same reference numerals indicate the same object throughout the drawings.

Hereinafter, referring to FIG. 1 and FIGS. 2 to 4, a data management method of a check master of a check related to a medical practice and a disease name in a system dedicated to medical affairs according to the present invention and the related check master to FIG. A description will be given of the medical treatment by a and b and a method of checking a disease name.

In the present invention, the file structure of the related check master is modified as follows. File structure of related check master in the present invention: 1) Generation of related check number management table (one check table is required).

As shown in FIG. 2A, for each check No., the representative medical practice name, the number of medical practice codes, and the check No.
Different code table address (act), representative disease name, number of disease name codes, check No. different code table address (disease name)
Is a table composed of

2) Related check code sorting area: For the medical treatment, the medical treatment code of all the related checks is sorted in the order of the medical treatment code in a pair with the check number, and a medical treatment-check number file is created, and Store in the check code sort area.
<< Refer to Fig. 1 (a) >> For disease names, create a disease name-check No. file sorted by disease name code and its check number in pairs in the same order as in the medical treatment, and store it in the related check code sort area. . ｛Figure 1 (b)
Reference 3) Check number-specific medical care action code table a: As shown in FIG. 5 (a) as a related check master, a specific number of medical care action codes are defined for each check number. Therefore, based on the check number-specific code table address (act) indicated by the related check number management table, the area for the number of medical treatment codes specified by the related check number management table is determined by the check number-specific medical treatment code. Reserve as table a.

4) Check No. Specific Disease Name Code Table b: In the same manner as described above, a specific number of disease name codes are determined corresponding to the check numbers.
o. Based on the check number-specific code table address (disease name) specified by the management table, an area corresponding to the number of disease name codes specified by the related check number-management table is secured as the check number-specific disease name code table b.

Checking method according to the present invention: The input medical care action code data and disease name code data file are read, and the read medical care action code and disease name code are respectively stored in the check no. A check No. is assigned to the disease name code table b. Specifically, as shown in FIG. 3, (1) Search the medical care-check No. file and the disease name-check No. file in the related check code sort area by the code of the patient's medical care data. I do.

(2) If the code (medical practice code) exists in the above-mentioned medical practice-check No. file in the related check code sort area, the relevant check No. in the related check No. management table group The check number-specific medical action code table a indicated by the check number-specific code table address (in this example, addresses “100” to “107”) corresponding to the check number specified by the management table includes Distribute action codes.

(3) If there are two or more identical medical practice codes in the above-mentioned medical practice-check No. file in the relevant check code sort area, distribution is performed on those check Nos.

The same is done for disease name data.
(In this example, the disease name code is assigned to the address "230".
~ "235"), after all the sorting processes are completed, referring to the check number-specific medical practice code table a, the check number-specific disease name code table b {see FIGS. 2 (b1) and (b2)}, Error judgment for each check No. {Specifically, check
No. There is a medical action code assigned to the No. specific medical action code table a, but there is no disease name code assigned to the check No. specific medical action code table b. For example, if the disease name code for the medical treatment code “PL granule” is erroneously set to “asthma”, the medical care activity code “PL granule” , The correct disease name code “acute upper respiratory inflammation” or the like cannot be sorted out, and the above error is understood. } To edit and output the error message.

As is clear from the check method shown in FIG. 3, in the present invention, the medical care action code,
Then, when the disease name code is given, the above-mentioned medical treatment-check No. file and the disease name-check No. file in the related check code sort area of the present invention are searched (ascending order, descending order, or binary search). Just by performing a search by law, etc., alternatively, the medical care action code and the check number with the disease name code can be known.
Thereafter, on the related check number management table, in the column corresponding to the recognized check number, the check number code table address indicates the check number-specific medical practice code table a and the check number-specific disease name. Only by allocating the medical care action code and the disease name code to the code table b, the relevance of the medical care action code and the disease name code of the patient can be checked.

[0034]

The effects of the present invention are examined by comparing the number of determinations when the following association check is performed by the conventional association check method.

As an example of a conventional related check master,
The following is an example of Check No. 1 and 2. (1) Whether there is upper respiratory inflammation for cold (Check No.
1)

[Clinical practice] [Necessary disease name] 20314 Dan Rich 03008 Pharyngitis 24394 PL granules 03006 Acute upper respiratory tract inflammation 27913 Myokamycin tablet 200 03002 Bronchitis 27178 Phosmicin capsule 500 40624 SP Lozenge Meiji 40346 Isodinger gaggle 14153 Oracef tablet 13750 Epiners P (2) Whether there is a common cold name for antihistamines (Check No. 2)

[Medical practice] [Necessary disease name] 20314 Dan Rich 03000 Cold 24394 PL granule 03006 Acute upper respiratory tract inflammation 27913 Myokamycin tablet 200 03002 Bronchitis 27178 Phosmicin capsule 500 03032 Asthma 40624 SP Loach Meiji 02014 Allergic rhinitis 40346 Fig. 4 (a1) and (a2) are from the above related check masters.
FIG. 5 (b) shows an example of the conventional check number-specific medical care action development table and the check number-specific disease name expansion table described above for the check Nos. 1 and 2, respectively.

Now, the code "2439"
4) When PL granules are present and the disease name is code "03006" acute upper respiratory inflammation, first, the medical treatment code "2439
4) At least six comparisons are required when searching the medical practice deployment table for PL granules.

Next, at least six comparisons are required when searching the disease name development table for the disease name code "03006" acute upper respiratory inflammation. Therefore, in the above related example, the conventional association check method requires a total of at least 12 comparisons.

When the same check as described above is performed by searching the medical care action-check No. file in the related check code sort area of the present invention, the following is performed. There is a code "24394" PL granules as a patient's medical treatment,
When the code "03006" acute upper respiratory inflammation is present as a disease name, first, for the medical treatment code "24394" PL granules, the above-mentioned medical treatment-check No. file in the related check code sort area is searched four times. The comparison ends. Next, regarding the disease name code "03006" acute upper respiratory inflammation, when searching for the disease name-check No. file in the above related check code sort area relating to the disease name, the comparison is completed four times, for a total of eight comparisons. Becomes In this example, the data amount is small, and the code search method is described by comparing each one from the beginning, but in this data management method, the code search method includes:
For example, the efficiency can be further increased by using a binary search method.

Therefore, since the check No. having the inputted medical treatment code and disease name code of the patient can be searched at high speed, there is an effect that the check between the medical treatment and the disease name can be performed at high speed.

[Brief description of the drawings]

FIG. 1 is a diagram illustrating the principle of the present invention.

FIG. 2 shows an example of a file structure of a related check master according to the present invention.

FIG. 3 is a diagram showing a check method according to the present invention.

FIG. 4 is a diagram illustrating an effect of the present invention.

FIG. 5 is a diagram for explaining a conventional check master data management method (part 1);

FIG. 6 is a diagram for explaining a conventional check master data management method (part 2);

[Description of Signs] Conventional Related Check Master Medical Practice-Check No. File Disease Name-Check No. File Related Check Code Sort Area Related Check No. Management Table a. table

Claims (1)

(57) [Claims] [Claim 1] A check number is held in a key part, and a related check
In the data section, the medical treatment code to perform the check and the disease name code
Reception check using related check master ()
From the related check master (), all the check target
The check code and the check code
And the medical treatment sorted in the order of the medical treatment code
Action-Create a check No. file () and, from the relevant check master (),
The check No. and the disease name code are paired to form a disease name code.
Disease name-check No. file (
Created, the created medical practice-check No. file () and
Disease name-Check No. file () related check code
Stored in sort area () and related check master ()
The above-mentioned medical practice-Check No. file () and disease name-
Check No. file () was created, and each patient's medical practice and disease name data file
The patient's medical treatment and the code of the disease name data are used as keys.
And the above related check code in the sort area ()
Medical practice-Check No. file () and disease name-Check
No. file () is searched by the binary search method, and check No. corresponding to the medical treatment performed on the patient is performed.
And the check No. corresponding to the assigned disease name, and for each check No., the name of the representative medical practice and the code of the medical practice
Code table address (act) by number, check number, and
And representative disease name, number of disease name codes, code number by check No.
Management of related check No. consisting of table address (disease name)
Table (), and check the relevant check number management table ().
Code table address (act), check No.
From the separate code table address (disease name),
The number of medical treatment codes indicated by the
Check No. for each disease code number
Code table (a) and check No.
Table (b), and based on the obtained check number,
Check No. indicated by the check No. management table ()
o. Different medical practice code table (a) and check No.
The medical care action code and the disease are stored in another disease name code table (b).
Name codes are sorted, and the above check No. separate medical treatment action code table (a) and
And refer to the check number-specific disease name code table (b).
Error determination for each check No.
Reception check method.