依托商业智能系统的医院医保费用分析

Analysis of Health Insurance Cost Based on Business Intelligent System

目的:利用商业智能技术实现医保患者费用的科学、实时分析,为医院医保业务的科学管理和决策提供智能支持。方法:利用商业智能工具实时提取数据,并建立分析模型及各种分析统计结果的图形和报表。结果:实现对医保中心数据和医院数据库数据的自动化的抽取、匹配,并对医保收入和工作量、医保患者费用等进行了多维度、多角度的灵活统计和分析。结论:要做好医保业务科学管理和决策,就必须做好医保业务分析,控制过度治疗、控制医保支出,从而给予患者充足的优质医疗服务。

Objective To analyze health insurance cost based business intelligence technology in which science and realtime environment, the intelligent support of scientific management and decision-making was provided for hospital health insurance operation, Methods The analysis model and various graphics and report analysis of statistical results were established by use of modem business intelligence tools to extract data. Results It is feasible and scientific to make further analysis of health insurance administration and decision-making. The insurance income, workloads and the medicare costs for patients are analyzed on multi-dimension and multi-angle conditions. Conclusion It is necessary to do a good job in the analysis of health insurance for scientific management and decision-making, which can control over-treatment and insurance spending, thus adequate quality of health care services are given by patients.