医院医保分科定额管理中的数据挖掘研究

Research on Data Mining of Polyclinic Quota Management in the Medical Insurance

目的:随着医疗保障制度的不断完善,医保工作在医院管理工作中占据了越来越重要的地位,如何制定科学、合理的定额指标也成了医院医保工作的一个重点和难点。方法:利用数据挖掘技术制定医保定额指标并进行相关数据的分析。结果:数据挖掘技术能够制定动态的定额指标,加快分析反馈的速度,并做出及时的分析返溯。结论:数据挖掘与传统技术对比具有灵活、快速的优点,把数据挖掘技术引入定额管理将适应医保管理工作新的变化与挑战。

Objective With the consummation of the medical insurance system, the working of medical insurance gets more and more important in the management of hospital. How to establish scientific and reasonable index of ration becomes one of the emphases and difficulty. Methods By using the data mining technology, the index of ration in medical treatment insurance system is constituted and the related dates are analyzed too. Results The technology of data mining can be made the dynamic index of ration, picked up the analysis feedback speed, as well as made promptly the analysis and recalls. Conclusion The technology of dates mining technology is introduced in quota management that will adapt the changes and challenges in the management of medical insurance.[Chinese Medical Equipment Journal,2009,30（3） ： 53-541