CN113780457A

CN113780457A - Method, device, equipment and medium for detecting abnormity of traditional Chinese medicine resource consumption

Info

Publication number: CN113780457A
Application number: CN202111095851.5A
Authority: CN
Inventors: 吴骁; 王玉婷; 周全; 罗忆春
Original assignee: Ping An Medical and Healthcare Management Co Ltd
Current assignee: Ping An Medical and Healthcare Management Co Ltd
Priority date: 2021-09-18
Filing date: 2021-09-18
Publication date: 2021-12-10
Anticipated expiration: 2041-09-18
Also published as: CN113780457B

Abstract

The application relates to the field of artificial intelligence and digital medical treatment, in particular to a method and a device for detecting abnormity of traditional Chinese medicine resource consumption, computer equipment and a storage medium, wherein the method comprises the following steps: acquiring case data of a patient; inputting case data into a case classification model to obtain a case classification result; when the patient is determined to belong to the traditional Chinese medicine case according to the case classification result, calculating case data based on a preset protocol algorithm to obtain traditional Chinese medicine resource consumption information of the patient; when the patient is determined to belong to the traditional Chinese medicine treatment case, calculating case data based on a protocol algorithm and a preset clustering algorithm to obtain traditional Chinese medicine resource consumption information of the patient; acquiring standard resource consumption information corresponding to the case classification result; and comparing the obtained traditional Chinese medicine resource consumption information with the standard resource consumption information to generate an abnormal detection result. In addition, the application also relates to a block chain technology, and case data can be stored in the block chain. The application realizes the abnormity detection of the traditional Chinese medicine resource consumption.

Description

Method, device, equipment and medium for detecting abnormity of traditional Chinese medicine resource consumption

Technical Field

The present application relates to the field of digital medical technology, and in particular, to a method and an apparatus for detecting an abnormality in consumption of resources in traditional Chinese medicine, a computer device, and a storage medium.

Background

In recent years, the development of traditional Chinese medicine is receiving wide attention, and the traditional Chinese medicine plays more and more important roles in disease treatment and health care. The development of traditional Chinese medicine requires various resource investments, such as human resources of doctors and the like, drug consumables and the like. In the medical insurance scene, the medical insurance subsidy is also an important traditional Chinese medicine resource consumption, which is related to the problems of the civilian life and the society, and the expenditure of the medical insurance subsidy is unreasonable when the expenditure is too high or too low. Therefore, medical insurance patches are required to be used as a resource consumption of traditional Chinese medicine to detect whether the medical insurance patches are abnormal or not.

However, for the case data of the patient relating to the treatment of the chinese medical science, there is currently no suitable scheme for detecting the consumption of the chinese medical resources, and it is impossible to reasonably detect the abnormality of the consumption of the chinese medical resources.

Disclosure of Invention

An object of the embodiments of the present application is to provide a method, an apparatus, a computer device, and a storage medium for detecting an abnormality of consumption of resources in traditional Chinese medicine, so as to achieve abnormality detection of consumption of resources in traditional Chinese medicine.

In order to solve the above technical problem, an embodiment of the present application provides a method for detecting an abnormality in consumption of resources in traditional Chinese medicine, which adopts the following technical scheme:

acquiring case data of a patient;

inputting the case data into a case classification model to obtain a case classification result;

when the patient is determined to belong to the traditional Chinese medicine case according to the case classification result, calculating the case data based on a preset protocol algorithm to obtain traditional Chinese medicine resource consumption information of the patient;

when the patient is determined to belong to the traditional Chinese medicine treatment case according to the case classification result, calculating the case data based on the protocol algorithm and a preset clustering algorithm to obtain traditional Chinese medicine resource consumption information of the patient;

acquiring standard resource consumption information corresponding to the case classification result;

and comparing the obtained traditional Chinese medicine resource consumption information with the standard resource consumption information to generate an abnormal detection result.

In order to solve the above technical problem, an embodiment of the present application further provides an abnormality detection apparatus for resource consumption in traditional Chinese medicine, which adopts the following technical scheme:

the data acquisition module is used for acquiring case data of a patient;

the case classification module is used for inputting the case data into a case classification model to obtain a case classification result;

the disease category calculation module is used for calculating the case data based on a preset protocol algorithm to obtain the traditional Chinese medicine resource consumption information of the patient when the patient is determined to belong to the traditional Chinese medicine disease category case according to the case classification result;

the treatment calculation module is used for calculating the case data based on the protocol algorithm and a preset clustering algorithm to obtain the traditional Chinese medicine resource consumption information of the patient when the patient is determined to belong to the traditional Chinese medicine treatment case according to the case classification result;

the standard acquisition module is used for acquiring standard resource consumption information corresponding to the case classification result;

and the information comparison module is used for comparing the obtained traditional Chinese medicine resource consumption information with the standard resource consumption information to generate an abnormal detection result.

In order to solve the above technical problem, an embodiment of the present application further provides a computer device, which adopts the following technical solutions:

acquiring case data of a patient;

In order to solve the above technical problem, an embodiment of the present application further provides a computer-readable storage medium, which adopts the following technical solutions:

acquiring case data of a patient;

Compared with the prior art, the embodiment of the application mainly has the following beneficial effects: after acquiring case data of a patient, adopting a case classification model to classify the cases according to the traditional Chinese medicine treatment condition of the patient, and calculating traditional Chinese medicine resource consumption information of the patient through a preset protocol algorithm when the patient belongs to a traditional Chinese medicine case; when the patient belongs to the case of the traditional Chinese medicine therapy, the traditional Chinese medicine resource consumption information of the patient is calculated through a preset protocol algorithm and a clustering algorithm, the calculation of the traditional Chinese medicine resource consumption information is realized by pertinently selecting a calculation strategy according to the actual condition of case data, and the reasonability and accuracy of a calculation result are ensured; and then acquiring standard resource consumption information corresponding to the case classification result, wherein the standard resource consumption information is used for evaluating the traditional Chinese medicine resource consumption information, so that an abnormality detection result is generated, and the abnormality detection of the traditional Chinese medicine resource consumption is realized.

Drawings

In order to more clearly illustrate the solution of the present application, the drawings needed for describing the embodiments of the present application will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present application, and that other drawings can be obtained by those skilled in the art without inventive effort.

FIG. 1 is an exemplary system architecture diagram in which the present application may be applied;

FIG. 2 is a flow chart of one embodiment of a method of anomaly detection of TCM resource consumption according to the application;

fig. 3 is a schematic structural diagram of an embodiment of an abnormality detection apparatus of chinese medical resource consumption according to the present application;

FIG. 4 is a schematic block diagram of one embodiment of a computer device according to the present application.

Detailed Description

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs; the terminology used in the description of the application herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application; the terms "including" and "having," and any variations thereof, in the description and claims of this application and the description of the above figures are intended to cover non-exclusive inclusions. The terms "first," "second," and the like in the description and claims of this application or in the above-described drawings are used for distinguishing between different objects and not for describing a particular order.

Reference herein to "an embodiment" means that a particular feature, structure, or characteristic described in connection with the embodiment can be included in at least one embodiment of the application. The appearances of the phrase in various places in the specification are not necessarily all referring to the same embodiment, nor are separate or alternative embodiments mutually exclusive of other embodiments. It is explicitly and implicitly understood by one skilled in the art that the embodiments described herein can be combined with other embodiments.

In order to make the technical solutions better understood by those skilled in the art, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings.

As shown in fig. 1, the system architecture 100 may include

terminal devices

101, 102, 103, a network 104, and a server 105. The network 104 serves as a medium for providing communication links between the

terminal devices

101, 102, 103 and the server 105. Network 104 may include various connection types, such as wired, wireless communication links, or fiber optic cables, to name a few.

The user may use the

terminal devices

101, 102, 103 to interact with the server 105 via the network 104 to receive or send messages or the like. The

terminal devices

101, 102, 103 may have various communication client applications installed thereon, such as a web browser application, a shopping application, a search application, an instant messaging tool, a mailbox client, social platform software, and the like.

The

terminal devices

101, 102, 103 may be various electronic devices having a display screen and supporting web browsing, including but not limited to smart phones, tablet computers, e-book readers, MP3 players (Moving Picture experts Group Audio Layer III, mpeg compression standard Audio Layer 3), MP4 players (Moving Picture experts Group Audio Layer IV, mpeg compression standard Audio Layer 4), laptop portable computers, desktop computers, and the like.

The server 105 may be a server providing various services, such as a background server providing support for pages displayed on the

terminal devices

101, 102, 103.

It should be noted that, the abnormality detection method for chinese medical resource consumption provided in the embodiments of the present application is generally executed by a server, and accordingly, the abnormality detection apparatus for chinese medical resource consumption is generally disposed in the server.

It should be understood that the number of terminal devices, networks, and servers in fig. 1 is merely illustrative. There may be any number of terminal devices, networks, and servers, as desired for implementation.

With continuing reference to fig. 2, a flowchart of one embodiment of a method of anomaly detection of chinese medical resource consumption in accordance with the present application is shown. The method for detecting the abnormity of the traditional Chinese medicine resource consumption comprises the following steps:

in step S201, case data of a patient is acquired.

In this embodiment, an electronic device (for example, a server shown in fig. 1) on which the abnormality detection method of chinese medical resource consumption operates may communicate with a terminal by a wired connection manner or a wireless connection manner. It should be noted that the wireless connection means may include, but is not limited to, a 3G/4G connection, a WiFi connection, a bluetooth connection, a WiMAX connection, a Zigbee connection, a uwb (ultra wideband) connection, and other wireless connection means now known or developed in the future.

Specifically, case data of a patient is first acquired. The case data may include basic information of the patient (e.g., name, sex, age, etc.), diagnosis information (record information of the patient's condition, diagnosis result of the disease category by the doctor, etc.), and medical item information (which treatment the patient has received and related expense details, and which examination items the patient has received).

In one embodiment, the case data may be a medical insurance statement for the patient at the time of medical insurance reimbursement. The server may acquire case data for a plurality of patients at once.

It is emphasized that the case data may also be stored in a node of a block chain in order to further ensure privacy and security of the case data.

The block chain referred by the application is a novel application mode of computer technologies such as distributed data storage, point-to-point transmission, a consensus mechanism, an encryption algorithm and the like. A block chain (Blockchain), which is essentially a decentralized database, is a series of data blocks associated by using a cryptographic method, and each data block contains information of a batch of network transactions, so as to verify the validity (anti-counterfeiting) of the information and generate a next block. The blockchain may include a blockchain underlying platform, a platform product service layer, an application service layer, and the like.

Step 202, inputting the case data into a case classification model to obtain a case classification result.

Specifically, case data is input into the case classification model, and the case classification model performs case classification according to the case data to obtain a case classification result. Case classification is mainly classified according to the degree of traditional Chinese medicine treatment received by a patient, and if the patient is judged to have higher coupling degree with the traditional Chinese medicine treatment in the diagnosis and treatment process through case data, the patient is judged to belong to a traditional Chinese medicine case; if the coupling degree of the patient and the traditional Chinese medicine treatment is low in the diagnosis and treatment process according to the case data, the patient is judged to belong to the traditional Chinese medicine treatment data. The patient belongs to the Chinese medical science case or the Chinese medical therapy data and is recorded in the case classification result.

In one embodiment, medical treatment item information is extracted from case data, data related to examination and examination items are deleted from the medical treatment item information, and then the cost of the medical treatment items related to the traditional Chinese medicine is calculated; if the proportion of the cost in the total cost of the diagnosis and treatment items is larger than a preset threshold value, the patient is judged to belong to the case of the Chinese medical treatment, otherwise, the patient is judged to belong to the case of the Chinese medical treatment.

And 203, when the patient is determined to belong to the traditional Chinese medicine case according to the case classification result, calculating case data based on a preset protocol algorithm to obtain traditional Chinese medicine resource consumption information of the patient.

Specifically, for patients with different case classification results, there is a difference in the calculation strategy adopted when calculating the corresponding consumption information of the traditional Chinese medicine resources. And when the patient is determined to belong to the traditional Chinese medical disease case according to the case classification result, calculating by adopting a preset protocol algorithm.

The protocol algorithm is an algorithm determined by a preset protocol and can be used for calculating the traditional Chinese medicine resource consumption information. In the application scenario of the medical insurance patch, medical insurance patch information can be calculated according to a protocol algorithm, the medical insurance patch information comprises medical insurance patch cost for a patient, and the medical insurance patch information is used as traditional Chinese medicine resource consumption information of the patient.

In practical application, the Chinese medicine seed cases also comprise a plurality of seed cases including Chinese medicine bone fracture, Chinese medicine anorectal and Chinese medicine special therapy, wherein each seed case is subjected to Chinese medicine precipitation for many years, the industry consensus is achieved, the disease symptoms of each seed case are fixed, and the diagnosis and treatment items are definite (for example, the diagnosis and treatment items of the bone fracture in traditional Chinese medicine comprise fracture reduction, fracture reduction internal fixation, joint dislocation reduction, external fixation integer adjustment, fracture splint external fixation and the like, the diagnosis and treatment items related to anorectal in traditional Chinese medicine comprise rectal operation, hemorrhoid operation, anal operation and the like, the diagnosis and treatment items related to special treatment in traditional Chinese medicine comprise cataract operation and body surface fistula incision and the like), the judgment can be realized based on the diagnosis and treatment information and the diagnosis and treatment item information, the medical effect is also definite, and the western medicine diagnosis and treatment items can be replaced for treatment. For the case of traditional Chinese medicine therapy, the treatment usually adopts a treatment mode of combining traditional Chinese medicine and western medicine, and adopts a part of traditional Chinese medicine diagnosis and treatment projects.

And 204, when the patient is determined to belong to the traditional Chinese medicine treatment case according to the case classification result, calculating case data based on a protocol algorithm and a preset clustering algorithm to obtain traditional Chinese medicine resource consumption information of the patient.

Specifically, when it is determined that the patient belongs to the case of the traditional Chinese medical treatment according to the case classification result, since the case of the traditional Chinese medical treatment receives both the traditional Chinese medical treatment and treatment items and the western medical treatment and treatment items, for the case of the composite type, a special clustering algorithm is required to calculate the consumption information of the traditional Chinese medical resources in addition to the protocol algorithm.

During calculation, for the western medicine diagnosis and treatment project, a protocol algorithm can be adopted to calculate the resource consumption information, wherein the protocol algorithm is the same as the protocol algorithm adopted in the traditional Chinese medicine disease case; for the traditional Chinese medicine diagnosis and treatment project, the resource consumption information is calculated by adopting a preset clustering algorithm, and finally, the total traditional Chinese medicine resource consumption information is generated.

For the case of the traditional Chinese medicine therapy, the calculated traditional Chinese medicine resource consumption information is also medical insurance subsidy information, and the medical insurance subsidy information comprises medical insurance subsidy cost for the patient.

Step 205, standard resource consumption information corresponding to the case classification result is acquired.

Specifically, after calculating the consumption information of the traditional Chinese medicine resources of the patient, it is necessary to detect whether the consumption information of the traditional Chinese medicine resources is abnormal, and during the detection, it is necessary to obtain standard resource consumption information as a detection benchmark.

And extracting case types from the case classification results, and acquiring standard resource consumption information of the sub-case types according to the sub-case types in the case classification results for the cases of the traditional Chinese medicine. For the traditional Chinese medicine treatment data, according to the disease Classification codes (which may be ICD-10 codes, ICD is international Classification of diseases, international disease Classification, a system which classifies diseases according to certain characteristics of diseases and is represented by a coding method according to rules, ICD-10 is the 10 th version of ICD) in the case Classification results, standard resource consumption information corresponding to the disease Classification codes is obtained. The acquired standard resource consumption information can be pre-calculated and stored in a designated data table, and the standard resource consumption information can be inquired from the data table according to the category of the sub-case or the disease classification code.

And step 206, comparing the obtained traditional Chinese medicine resource consumption information with the standard resource consumption information to generate an abnormal detection result.

Specifically, the traditional Chinese medicine resource consumption information and the standard resource consumption information are compared, and in the application scenario of medical insurance subsidy, the standard resource consumption information can be standard medical insurance subsidy cost. Then, the medical insurance subsidy cost in the traditional Chinese medicine resource consumption information is compared with the standard medical insurance subsidy cost, and an abnormality detection result is generated according to the comparison result.

When the medical insurance subsidy cost in the traditional Chinese medicine resource consumption information is more than the standard medical insurance subsidy cost, the abnormity detection result displays that the traditional Chinese medicine resource consumption information is abnormal; when the medical insurance subsidy cost in the traditional Chinese medicine resource consumption information is less than the standard medical insurance subsidy cost, the abnormal detection result shows that the traditional Chinese medicine resource consumption information is normal.

In the embodiment, after the case data of the patient is acquired, case classification is carried out according to the traditional Chinese medicine treatment condition of the patient by adopting a case classification model, and when the patient belongs to a traditional Chinese medicine case, the traditional Chinese medicine resource consumption information of the patient is calculated through a preset protocol algorithm; when the patient belongs to the case of the traditional Chinese medicine therapy, the traditional Chinese medicine resource consumption information of the patient is calculated through a preset protocol algorithm and a clustering algorithm, the calculation of the traditional Chinese medicine resource consumption information is realized by pertinently selecting a calculation strategy according to the actual condition of case data, and the reasonability and accuracy of a calculation result are ensured; and then acquiring standard resource consumption information corresponding to the case classification result, wherein the standard resource consumption information is used for evaluating the traditional Chinese medicine resource consumption information, so that an abnormality detection result is generated, and the abnormality detection of the traditional Chinese medicine resource consumption is realized.

Further, the step S202 may include: extracting information of the case data according to the field identification to obtain extracted information, wherein the extracted information comprises diagnosis information and diagnosis and treatment item information; and inputting the extracted information into a case classification model to obtain a case classification result.

Specifically, case data is composed of a field identification and the format of associated field information. And acquiring a preset field identifier, and extracting field information corresponding to the field identifier from the case data to obtain the extracted information. The extracted information may be mainly composed of diagnosis information and medical item information. In one embodiment, the medical item information does not include patient exam information.

The extracted information classifies the input case classification model, which in this application may be a tree model including, but not limited to, random forest, Xgboost, GBDT, and lightgbm. The tree model needs to be trained in advance, and then the patient is mapped to a classification according to the extracted information to obtain a case classification result.

In one embodiment, the case data may be subjected to feature screening by a random forest to remove part of the field identifiers and the corresponding field information. When generating a random forest for feature screening, a certain amount of case data with labels is needed, and the labels can be case classification results of patients corresponding to the case data. And then, when case classification is carried out, only the field identifications screened out by the random forest and the corresponding field information are input into a case classification model to obtain a case classification result.

In the embodiment, the required data is extracted from the case data and input into the case classification model, and the trained case classification model is used for classification and prediction, so that the accuracy of case classification is ensured.

Further, the step S203 may include: when the patient is determined to belong to the traditional Chinese medical science case according to the case classification result, extracting diagnosis and treatment item information from the case data; and carrying out expense measurement and calculation on the diagnosis and treatment item information based on a preset resource consumption calculation protocol to obtain the traditional Chinese medicine resource consumption information of the patient, wherein the resource consumption calculation protocol comprises DRG and DIP.

Specifically, when the patient is determined to belong to the traditional Chinese medical science case according to the case classification result, diagnosis and treatment item information is extracted from the case data, and the diagnosis and treatment item information records diagnosis and treatment items performed by the patient and related expense details.

And then, carrying out expense measurement and calculation on the diagnosis and treatment item information according to a preset resource consumption protocol, in a medical insurance subsidy scene, calculating the medical insurance subsidy expense aiming at the patient, and taking the medical insurance subsidy expense as the traditional Chinese medicine resource consumption information of the patient.

The DRG is essentially a case combination classification scheme, namely, a system for dividing patients into a plurality of Diagnosis Groups to manage according to factors such as age, disease Diagnosis, complications, treatment modes, disease severity, transfer, resource consumption and the like, and can also be a double Data Diagnosis-interaction package (DIP), which refers to the total budget of a regional point method and the payment according to the disease score, and solves the problem of payment of medical insurance by using a fuzzy mathematical method and comprises the steps of payment according to the disease type and total management).

In the calculation of the expense of the medical insurance subsidy, the calculation can be carried out according to the public DRG or DIP standard to obtain the consumption information of the traditional Chinese medicine resources.

In this embodiment, when the medical item information is extracted from the case data of the medical case of the traditional Chinese medicine and the cost is measured, the traditional Chinese medicine resource consumption information of the patient can be accurately obtained according to resource consumption protocols such as DRG or DIP.

Further, the step S204 may include: when the patient is determined to belong to a traditional Chinese medicine treatment case according to the case classification result, dividing diagnosis and treatment item information in case data into western medicine diagnosis and treatment item information and traditional Chinese medicine diagnosis and treatment item information; based on a resource consumption calculation protocol, carrying out cost measurement and calculation on the western medicine diagnosis and treatment project information to obtain first resource consumption information; performing unit clustering on the medical treatment item information based on a preset clustering algorithm to obtain a clustering unit; carrying out expense measurement and calculation on the clustering unit to obtain second resource consumption information; and generating traditional Chinese medicine resource consumption information of the patient according to the first resource consumption information and the second resource consumption information.

Specifically, diagnosis and treatment item codes are recorded in the diagnosis and treatment item information, the diagnosis and treatment item codes are diagnosis and treatment item identifiers, and whether the diagnosis and treatment items are traditional Chinese medicine diagnosis and treatment items or western medicine diagnosis and treatment items can be determined according to the diagnosis and treatment item codes, so that the diagnosis and treatment item information is divided into the western medicine diagnosis and treatment item information and the traditional Chinese medicine diagnosis and treatment item information.

For the western medicine diagnosis and treatment project information, the medical insurance subsidy cost corresponding to the western medicine diagnosis and treatment project information, namely the first resource consumption information, can be obtained by performing cost measurement and calculation according to a resource consumption protocol, namely a DRG (dry running rule) or a DIP (dual in-line package) standard.

For the traditional Chinese medicine diagnosis and treatment project information, unit clustering is carried out according to a preset clustering algorithm to obtain a plurality of clustering units. The clustering algorithm clusters the traditional Chinese medicine diagnosis and treatment items according to clustering dimensions such as occurrence days, occurrence times or quantity and the like to obtain a plurality of clustering units. For example, the diagnosis and treatment items of traditional Chinese medicine can include traditional Chinese medicine external treatment (application therapy, traditional Chinese medicine package therapy, traditional Chinese medicine fumigation therapy and the like), acupuncture (common acupuncture, micro-needle acupuncture, ear needle, electric needle and the like), moxibustion (cupping, thunder fire moxibustion and the like), massage (bone massage, muscle and tendon massage, internal medicine massage and the like) and other diagnosis and treatment items (such as traditional Chinese medicine decoction pieces, decoction and the like). For the electro-acupuncture diagnosis and treatment, unit clustering is carried out according to the occurrence frequency and the number of acupuncture points, and the obtained clustering unit is used for carrying out the following clustering on the patient: firstly, electrically needling 10 acupuncture points once; electric acupuncture, 20 acupuncture points, once; and 60 acupuncture points are performed once.

Each clustering unit has corresponding medical insurance subsidy cost, and when the cost is calculated, the medical insurance subsidy cost of each clustering unit can be obtained and then accumulated, and the accumulated cost is used as second resource consumption information.

According to the first resource consumption information and the second resource consumption information, the traditional Chinese medicine resource consumption information of the patient can be calculated, and particularly, the medical insurance subsidy cost calculated by the western medicine diagnosis and treatment item information can be added with the medical insurance subsidy cost calculated by the traditional Chinese medicine diagnosis and treatment item information.

In this embodiment, when the patient belongs to a case of the traditional Chinese medicine therapy, the diagnosis and treatment item information in the case data is split, and then different algorithms are correspondingly selected to calculate the resource consumption information, so that the total traditional Chinese medicine resource consumption information of the patient can be orderly obtained.

Further, the step of calculating the cost of the clustering unit to obtain the second resource consumption information may include: acquiring historical diagnosis and treatment information corresponding to the traditional Chinese medicine diagnosis and treatment item identification according to the traditional Chinese medicine diagnosis and treatment item identification of the traditional Chinese medicine diagnosis and treatment item information; performing unit clustering on the historical diagnosis and treatment information to obtain a historical clustering result; determining the cost information of each clustering unit based on the historical clustering result; and carrying out expense measurement and calculation on the clustering unit based on the determined expense information to obtain second resource consumption information.

In particular, the medical insurance subsidy costs of the clustering units may be determined from historical data. Extracting the traditional Chinese medicine diagnosis and treatment item information, and acquiring historical diagnosis and treatment information corresponding to the traditional Chinese medicine diagnosis and treatment item identification. And performing unit clustering on the historical diagnosis and treatment information based on a clustering algorithm to obtain a historical clustering result.

For the same clustering dimension (occurrence number of days, occurrence frequency, number), a plurality of clustering units can be obtained, the clustering units with the same clustering dimension and the same clustering dimension value can be divided into the same historical clustering unit group, for example, for a traditional Chinese medicine diagnosis and treatment project, the clustering units which are the same as 10 acupuncture points and one time are divided into one group. Determining corresponding expense information according to the diagnosis and treatment item expense details of each cluster unit of the group, wherein the expense information is expense information in medical insurance subsidy; the calculation of the cost information can be performed according to a preset calculation strategy, for example, the average value of the diagnosis and treatment item cost details is used as the cost information in medical insurance subsidy, or the calculation is determined manually. When the expense is measured and calculated, if the clustering unit belongs to the historical clustering unit group, the expense information of the historical clustering unit group is used as the medical insurance subsidy expense information of the clustering unit.

Or, the clustering units with the same clustering dimension and the clustering dimension value within the preset range are divided into the same group, for example, for a traditional Chinese medicine diagnosis and treatment project, clustering units meeting 0-10 acupoints and one time are divided into a historical clustering unit group, clustering units meeting 11-50 acupoints and one time are divided into a historical clustering unit group, and clustering units meeting more than 50 acupoints and one time are divided into a historical clustering unit group. Then, for each historical clustering unit group, determining diagnosis and treatment item cost details of each clustering unit of the group, and determining corresponding cost information, wherein the cost information is cost information in medical insurance subsidy; the calculation of the cost information can be performed according to a preset calculation strategy, for example, the average value of the diagnosis and treatment item cost details is used as the cost information in medical insurance subsidy, or the calculation is determined manually. When the expense is measured and calculated, if the clustering unit belongs to the historical clustering unit group, the expense information of the historical clustering unit group is used as the medical insurance subsidy expense information of the clustering unit.

In one embodiment, clustering can be performed on the clustering dimension and the clustering dimension value through a clustering algorithm such as K-means, so as to obtain a historical clustering unit group.

And accumulating the expense information of each clustering unit to obtain second resource consumption information.

In this embodiment, unit clustering is performed on historical diagnosis and treatment information corresponding to the medical treatment items, and cost information of each clustering unit is determined according to the distribution of historical data, so that the value taking accuracy of the second resource consumption information is ensured.

Further, the step S205 may include: inquiring standard case data corresponding to the case classification result in a database; based on the resource consumption information of the standard case data, standard resource consumption information of the case classification result is determined.

Specifically, according to the sub-case categories of the cases of the Chinese medical science type displayed in the case classification results or the Chinese medical therapy case disease classification codes, the corresponding standard case data is inquired in the database. The standard case data may be pre-screened and then stored in a database. In one embodiment, the standard case data may be case data that fully employs a western medical procedure.

For each standard case data, its resource consumption information can be calculated. The data of a plurality of standard cases can be inquired, the average value of the resource consumption information of the data of the plurality of standard cases is calculated (in the medical insurance subsidy scene, the average value of the medical insurance subsidy expenses of the data of the plurality of standard cases is calculated), and the average value is used as the standard resource consumption information.

In this embodiment, the resource consumption information of the standard case data corresponding to the case classification result is averaged to obtain the standard resource consumption information, and benchmarking data is provided for anomaly detection of the resource consumption information of the traditional Chinese medicine.

Further, after step S206, the method may further include: when the traditional Chinese medicine resource consumption information is determined to be in an abnormal state according to the abnormal detection result, generating early warning information according to the case data, the case classification result, the traditional Chinese medicine resource consumption information and the standard resource consumption information; and sending the early warning information to a terminal logged in by the target account.

Specifically, when it is determined that the traditional Chinese medicine resource consumption information is in an abnormal state according to the abnormality detection result, the early warning information is generated according to the case data, the case classification result, the traditional Chinese medicine resource consumption information, and the standard resource consumption information. The early warning information is sent to a terminal logged in by the target account, the terminal triggers an alarm state and displays the received early warning information, so that relevant workers can conveniently perform abnormal investigation and the consumption of traditional Chinese medicine resources is kept in a reasonable state in real time.

In this embodiment, the generated warning information is sent to the terminal logged in by the target account, so as to perform exception troubleshooting in time and repair the abnormal consumption of the traditional Chinese medicine resources.

The embodiment of the application can acquire and process related data based on an artificial intelligence technology. For example, the required data can be identified and extracted from the medical record data for calculation by natural language processing technology in artificial intelligence technology. Among them, Artificial Intelligence (AI) is a theory, method, technique and application system that simulates, extends and expands human Intelligence using a digital computer or a machine controlled by a digital computer, senses the environment, acquires knowledge and uses the knowledge to obtain the best result.

The artificial intelligence infrastructure generally includes technologies such as sensors, dedicated artificial intelligence chips, cloud computing, distributed storage, big data processing technologies, operation/interaction systems, mechatronics, and the like. The artificial intelligence software technology mainly comprises a computer vision technology, a robot technology, a biological recognition technology, a voice processing technology, a natural language processing technology, machine learning/deep learning and the like.

It will be understood by those skilled in the art that all or part of the processes of the methods of the embodiments described above can be implemented by a computer program, which can be stored in a computer-readable storage medium, and can include the processes of the embodiments of the methods described above when the computer program is executed. The storage medium may be a non-volatile storage medium such as a magnetic disk, an optical disk, a Read-Only Memory (ROM), or a Random Access Memory (RAM).

It should be understood that, although the steps in the flowcharts of the figures are shown in order as indicated by the arrows, the steps are not necessarily performed in order as indicated by the arrows. The steps are not performed in the exact order shown and may be performed in other orders unless explicitly stated herein. Moreover, at least a portion of the steps in the flow chart of the figure may include multiple sub-steps or multiple stages, which are not necessarily performed at the same time, but may be performed at different times, which are not necessarily performed in sequence, but may be performed alternately or alternately with other steps or at least a portion of the sub-steps or stages of other steps.

With further reference to fig. 3, as an implementation of the method shown in fig. 2, the present application provides an embodiment of an anomaly detection apparatus for chinese medical resource consumption, which corresponds to the method shown in fig. 2, and which can be applied in various electronic devices.

As shown in fig. 3, the apparatus 300 for detecting abnormality of chinese medical resource consumption according to this embodiment includes: a data acquisition module 301, a case classification module 302, a disease category calculation module 303, a therapy calculation module 304, a standard acquisition module 305, and an information comparison module 306, wherein:

a data acquiring module 301, configured to acquire case data of a patient.

The case classification module 302 is configured to input case data into the case classification model to obtain a case classification result.

And the disease category calculating module 303 is configured to calculate case data based on a preset protocol algorithm to obtain traditional Chinese medicine resource consumption information of the patient when it is determined that the patient belongs to a traditional Chinese medicine disease category case according to the case classification result.

And the treatment calculation module 304 is used for calculating case data based on a protocol algorithm and a preset clustering algorithm to obtain traditional Chinese medicine resource consumption information of the patient when the patient is determined to belong to a traditional Chinese medicine treatment case according to the case classification result.

A standard obtaining module 305 for obtaining standard resource consumption information corresponding to the case classification result.

And an information comparison module 306, configured to compare the obtained traditional Chinese medicine resource consumption information with the standard resource consumption information, and generate an anomaly detection result.

In some optional implementations of the present embodiment, the case classification module 302 may include: an information extraction submodule and a case classification submodule, wherein:

and the information extraction submodule is used for extracting information of the case data according to the field identification to obtain extracted information, and the extracted information comprises diagnosis information and diagnosis and treatment item information.

And the case classification submodule is used for inputting the extracted information into the case classification model to obtain a case classification result.

In some optional implementations of this embodiment, the disease species calculating module 303 may include: diagnose and extract submodule piece and agreement calculation submodule piece, wherein:

and the diagnosis and treatment extraction submodule is used for extracting diagnosis and treatment item information from the case data when the patient is determined to belong to the traditional Chinese medicine case according to the case classification result.

And the protocol calculation submodule is used for carrying out expense measurement and calculation on the diagnosis and treatment project information based on a preset resource consumption calculation protocol to obtain the traditional Chinese medicine resource consumption information of the patient, and the resource consumption calculation protocol comprises a DRG and a DIP.

In some optional implementations of the present embodiment, the therapy calculation module 304 may include: diagnosis and treatment division submodule, first calculation submodule, traditional Chinese medicine clustering submodule, second calculation submodule and consumption calculation submodule, wherein:

and the diagnosis and treatment division submodule is used for dividing diagnosis and treatment item information in the case data into western medicine diagnosis and treatment item information and traditional Chinese medicine diagnosis and treatment item information when the fact that the patient belongs to the traditional Chinese medicine treatment case is determined according to the case classification result.

And the first calculation submodule is used for carrying out expense measurement and calculation on the western medicine diagnosis and treatment project information based on the resource consumption calculation protocol to obtain first resource consumption information.

And the traditional Chinese medicine clustering submodule is used for carrying out unit clustering on the information of the medical treatment items based on a preset clustering algorithm to obtain a clustering unit.

And the second calculation submodule is used for carrying out expense measurement and calculation on the clustering unit to obtain second resource consumption information.

And the consumption calculation submodule is used for generating the traditional Chinese medicine resource consumption information of the patient according to the first resource consumption information and the second resource consumption information.

In some optional implementations of this embodiment, the second computation submodule may include: history acquisition unit, history clustering unit, expense determine unit and consumption calculating unit, wherein:

and the history acquisition unit is used for acquiring the history diagnosis and treatment information corresponding to the traditional Chinese medicine diagnosis and treatment item identification according to the traditional Chinese medicine diagnosis and treatment item identification of the traditional Chinese medicine diagnosis and treatment item information.

And the historical clustering unit is used for carrying out unit clustering on the historical diagnosis and treatment information to obtain a historical clustering result.

And the expense determining unit is used for determining the expense information of each clustering unit based on the historical clustering result.

And the consumption calculating unit is used for carrying out expense measurement and calculation on the clustering unit based on the determined expense information to obtain second resource consumption information.

In some optional implementations of this embodiment, the standard obtaining module 305 may include: a standard query submodule and a standard determination submodule, wherein:

and the standard query submodule is used for querying standard case data corresponding to the case classification result in the database.

And the standard determining submodule is used for determining standard resource consumption information of the case classification result based on the resource consumption information of the standard case data.

In some optional implementations of the present embodiment, the apparatus 300 for detecting an abnormality of consumption of resources in traditional chinese medicine may further include: early warning generation module and early warning sending module, wherein:

and the early warning generation module is used for generating early warning information according to the case data, the case classification result, the traditional Chinese medicine resource consumption information and the standard resource consumption information when the traditional Chinese medicine resource consumption information is determined to be in an abnormal state according to the abnormal detection result.

And the early warning sending module is used for sending the early warning information to the terminal logged in by the target account.

In order to solve the technical problem, an embodiment of the present application further provides a computer device. Referring to fig. 4, fig. 4 is a block diagram of a basic structure of a computer device according to the present embodiment.

The computer device 4 comprises a memory 41, a processor 42, a network interface 43 communicatively connected to each other via a system bus. It is noted that only computer device 4 having components 41-43 is shown, but it is understood that not all of the shown components are required to be implemented, and that more or fewer components may be implemented instead. As will be understood by those skilled in the art, the computer device is a device capable of automatically performing numerical calculation and/or information processing according to a preset or stored instruction, and the hardware includes, but is not limited to, a microprocessor, an Application Specific Integrated Circuit (ASIC), a Programmable Gate Array (FPGA), a Digital Signal Processor (DSP), an embedded device, and the like.

The computer device can be a desktop computer, a notebook, a palm computer, a cloud server and other computing devices. The computer equipment can carry out man-machine interaction with a user through a keyboard, a mouse, a remote controller, a touch panel or voice control equipment and the like.

The memory 41 includes at least one type of readable storage medium including a flash memory, a hard disk, a multimedia card, a card type memory (e.g., SD or DX memory, etc.), a Random Access Memory (RAM), a Static Random Access Memory (SRAM), a Read Only Memory (ROM), an Electrically Erasable Programmable Read Only Memory (EEPROM), a Programmable Read Only Memory (PROM), a magnetic memory, a magnetic disk, an optical disk, etc. In some embodiments, the memory 41 may be an internal storage unit of the computer device 4, such as a hard disk or a memory of the computer device 4. In other embodiments, the memory 41 may also be an external storage device of the computer device 4, such as a plug-in hard disk, a Smart Media Card (SMC), a Secure Digital (SD) Card, a Flash memory Card (Flash Card), and the like, which are provided on the computer device 4. Of course, the memory 41 may also include both internal and external storage devices of the computer device 4. In this embodiment, the memory 41 is generally used for storing an operating system installed in the computer device 4 and various types of application software, such as computer readable instructions of the anomaly detection method for traditional Chinese medicine resource consumption. Further, the memory 41 may also be used to temporarily store various types of data that have been output or are to be output.

The processor 42 may be a Central Processing Unit (CPU), controller, microcontroller, microprocessor, or other data Processing chip in some embodiments. The processor 42 is typically used to control the overall operation of the computer device 4. In this embodiment, the processor 42 is configured to execute computer readable instructions stored in the memory 41 or process data, such as computer readable instructions for executing the anomaly detection method for TCM resource consumption.

The network interface 43 may comprise a wireless network interface or a wired network interface, and the network interface 43 is generally used for establishing communication connection between the computer device 4 and other electronic devices.

The computer device provided in this embodiment may execute the above abnormality detection method for consumption of resources in chinese medicine. Here, the abnormality detection method of the consumption of the resources of chinese medicine may be the abnormality detection method of the consumption of the resources of chinese medicine of the above-described respective embodiments.

The present application further provides another embodiment, which is to provide a computer-readable storage medium storing computer-readable instructions executable by at least one processor to cause the at least one processor to perform the steps of the above-mentioned method for anomaly detection of TCM resource consumption.

Through the above description of the embodiments, those skilled in the art will clearly understand that the method of the above embodiments can be implemented by software plus a necessary general hardware platform, and certainly can also be implemented by hardware, but in many cases, the former is a better implementation manner. Based on such understanding, the technical solutions of the present application may be embodied in the form of a software product, which is stored in a storage medium (such as ROM/RAM, magnetic disk, optical disk) and includes instructions for enabling a terminal device (such as a mobile phone, a computer, a server, an air conditioner, or a network device) to execute the method according to the embodiments of the present application.

It is to be understood that the above-described embodiments are merely illustrative of some, but not restrictive, of the broad invention, and that the appended drawings illustrate preferred embodiments of the invention and do not limit the scope of the invention. This application is capable of embodiments in many different forms and is provided for the purpose of enabling a thorough understanding of the disclosure of the application. Although the present application has been described in detail with reference to the foregoing embodiments, it will be apparent to one skilled in the art that the present application may be practiced without modification or with equivalents of some of the features described in the foregoing embodiments. All equivalent structures made by using the contents of the specification and the drawings of the present application are directly or indirectly applied to other related technical fields and are within the protection scope of the present application.

Claims

1. A method for detecting abnormity of traditional Chinese medicine resource consumption is characterized by comprising the following steps:

acquiring case data of a patient;

2. The method for detecting abnormality in resource consumption of chinese medical science according to claim 1, wherein the step of inputting the case data into a case classification model to obtain a case classification result comprises:

extracting information of the case data according to the field identification to obtain extracted information, wherein the extracted information comprises diagnosis information and diagnosis and treatment item information;

and inputting the extracted information into a case classification model to obtain a case classification result.

3. The method of claim 1, wherein the step of calculating the case data based on a predetermined protocol algorithm to obtain the consumption information of the chinese medical resources of the patient when the patient is determined to belong to the medical case of the chinese medical science according to the case classification result comprises:

extracting diagnosis and treatment item information from the case data when the patient is determined to belong to the traditional Chinese medicine case according to the case classification result;

and carrying out expense measurement and calculation on the diagnosis and treatment item information based on a preset resource consumption calculation protocol to obtain the traditional Chinese medicine resource consumption information of the patient, wherein the resource consumption calculation protocol comprises a DRG and a DIP.

4. The method of claim 3, wherein the step of calculating the case data based on the protocol algorithm and a preset clustering algorithm to obtain the TCM resource consumption information of the patient when the patient is determined to belong to the TCM therapy case according to the case classification result comprises:

when the patient is determined to belong to a traditional Chinese medicine treatment case according to the case classification result, dividing diagnosis and treatment item information in the case data into western medicine diagnosis and treatment item information and traditional Chinese medicine diagnosis and treatment item information;

based on the resource consumption calculation protocol, carrying out expense measurement and calculation on the western medicine diagnosis and treatment project information to obtain first resource consumption information;

performing unit clustering on the traditional Chinese medicine diagnosis and treatment item information based on a preset clustering algorithm to obtain a clustering unit;

carrying out expense measurement and calculation on the clustering unit to obtain second resource consumption information;

and generating traditional Chinese medicine resource consumption information of the patient according to the first resource consumption information and the second resource consumption information.

5. The method for detecting abnormality in resource consumption of chinese medical science according to claim 4, wherein the step of performing a cost calculation on the clustering unit to obtain second resource consumption information comprises:

acquiring historical diagnosis and treatment information corresponding to the traditional Chinese medicine diagnosis and treatment item identification according to the traditional Chinese medicine diagnosis and treatment item identification of the traditional Chinese medicine diagnosis and treatment item information;

performing unit clustering on the historical diagnosis and treatment information to obtain a historical clustering result;

determining the cost information of each clustering unit based on the historical clustering result;

and carrying out expense measurement and calculation on the clustering unit based on the determined expense information to obtain second resource consumption information.

6. The method of detecting abnormality in resource consumption of chinese medical science according to claim 1, wherein the step of acquiring the standard resource consumption information corresponding to the case classification result includes:

querying standard case data corresponding to the case classification result in a database;

determining standard resource consumption information of the case classification result based on the resource consumption information of the standard case data.

7. The method for detecting abnormality in consumption of chinese medical resources according to claim 1, wherein after the step of comparing the obtained consumption information of chinese medical resources with the standard consumption information to generate the abnormality detection result, the method further comprises:

when the traditional Chinese medicine resource consumption information is determined to be in an abnormal state according to the abnormal detection result, generating early warning information according to the case data, the case classification result, the traditional Chinese medicine resource consumption information and the standard resource consumption information;

and sending the early warning information to a terminal logged in by the target account.

8. An abnormality detection device of resource consumption in traditional Chinese medicine, characterized by comprising:

the data acquisition module is used for acquiring case data of a patient;

9. A computer device comprising a memory having computer readable instructions stored therein and a processor which when executed implements the steps of the method of anomaly detection of chinese medical resource consumption according to any one of claims 1 to 7.

10. A computer readable storage medium, having stored thereon computer readable instructions, which when executed by a processor, implement the steps of the method for anomaly detection of chinese medical resource consumption according to any one of claims 1 to 7.