本文選題：醫(yī)療保險(xiǎn)　切入點(diǎn)：實(shí)時(shí)監(jiān)控　出處：《山東大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：近年來我國經(jīng)濟(jì)的發(fā)展,帶動(dòng)了醫(yī)療保險(xiǎn)事業(yè)的發(fā)展,我國已經(jīng)進(jìn)入醫(yī)療保險(xiǎn)業(yè)務(wù)發(fā)展的新階段[1]。隨著全民、惠民、便民醫(yī)保政策的不斷推進(jìn),人民的就醫(yī)需求集中釋放,醫(yī)療服務(wù)供給失序,違規(guī)騙保等各種異常醫(yī)療現(xiàn)象越來越突出,造成醫(yī)療保險(xiǎn)基金大幅度流失,嚴(yán)重威脅到醫(yī)療保險(xiǎn)安全[2]。隨著醫(yī)療保險(xiǎn)事業(yè)的發(fā)展,所有醫(yī)療機(jī)構(gòu)每天產(chǎn)生大量醫(yī)療數(shù)據(jù),這些數(shù)據(jù)與我們的工作、學(xué)習(xí)和生活密切相關(guān)。這些醫(yī)療數(shù)據(jù)的類型和規(guī)模正以前所未有的速度增長,越來越多的數(shù)據(jù),無法進(jìn)行合理的存儲(chǔ),不能進(jìn)行及時(shí)有效的分析和解釋,從而造成數(shù)據(jù)價(jià)值的浪費(fèi)。另外,人工模式去分析解釋這些數(shù)據(jù)存在很多困難,就醫(yī)量大,人員有限,數(shù)據(jù)分布范圍廣泛,實(shí)時(shí)性差,專業(yè)標(biāo)準(zhǔn)難以把握等各種問題出現(xiàn)。基于以上背景,本文考慮到以上所有問題,基于可視化原理,將大數(shù)據(jù)整理轉(zhuǎn)化成圖形或者圖像,通過LED大屏顯示出來,幫助用戶及時(shí)地從信息中提取有效的知識(shí),解決人工模式存在的問題,從而設(shè)計(jì)研發(fā)了基于大屏的醫(yī)保實(shí)時(shí)監(jiān)控與展示系統(tǒng)。本系統(tǒng)提供了對醫(yī)療保險(xiǎn)信息進(jìn)行實(shí)時(shí)監(jiān)控,主要監(jiān)控的信息包括各個(gè)地區(qū)參保情況、報(bào)銷情況、醫(yī)�？òl(fā)放情況、以及醫(yī)院、門診和藥店的住院信息、門診信息、大病保險(xiǎn)信息、慢性病信息等。系統(tǒng)主要面向各個(gè)地市醫(yī)保處,基于醫(yī)保處的匯總信息進(jìn)行分析,幫助各個(gè)部門及時(shí)了解相關(guān)醫(yī)療信息,發(fā)現(xiàn)違規(guī)數(shù)據(jù),及時(shí)制定調(diào)度策略,從而阻止違規(guī)行為的發(fā)生,減少醫(yī)療保險(xiǎn)基金的損失。本文主要從研究背景、需求分析、相關(guān)技術(shù)、概要設(shè)計(jì)、系統(tǒng)詳細(xì)設(shè)計(jì)、系統(tǒng)實(shí)現(xiàn)和系統(tǒng)測試等方面構(gòu)建了基于大屏的醫(yī)保實(shí)時(shí)監(jiān)控與展示系統(tǒng),提供了多種圖表展示、動(dòng)態(tài)表格展示、離線地圖展示以及其他自定義圖形展示,來對各種醫(yī)療保險(xiǎn)數(shù)據(jù)指標(biāo)進(jìn)行實(shí)時(shí)監(jiān)控。本文基于Vaadin框架,開發(fā)多種圖形展示組件,運(yùn)用Leaflet技術(shù)開發(fā)地圖監(jiān)控,運(yùn)用實(shí)時(shí)推送技術(shù)實(shí)現(xiàn)數(shù)據(jù)的實(shí)時(shí)更新,采用EclipseLink JPA實(shí)現(xiàn)方式和JPQL查詢語言來操作數(shù)據(jù)庫,提供一種數(shù)據(jù)統(tǒng)一訪問接口,支持異構(gòu)數(shù)據(jù)庫的統(tǒng)一透明訪問,使用Java技術(shù)進(jìn)行開發(fā)業(yè)務(wù)邏輯,在開發(fā)過程中,使用Maven工具對項(xiàng)目進(jìn)行管理。本系統(tǒng)主要采用Oracle數(shù)據(jù)庫和MongoDB數(shù)據(jù)庫進(jìn)行數(shù)據(jù)存儲(chǔ)。本系統(tǒng)提供豐富的圖形展示形式,采用清晰度高的LED大屏展示,充分表達(dá)出醫(yī)療保險(xiǎn)數(shù)據(jù)蘊(yùn)含的意義,并對醫(yī)療保險(xiǎn)信息進(jìn)行實(shí)時(shí)有效的監(jiān)控�；诖笃恋尼t(yī)保實(shí)時(shí)監(jiān)控與展示系統(tǒng)在部分地市投入使用,得到了用戶良好的反饋,取得了良好的社會(huì)效益。
[Abstract]:In recent years, the economic development of our country has led to the development of medical insurance, and our country has entered a new stage of the development of medical insurance business [1]. With the continuous promotion of the policy of medical insurance for the whole people, the benefit of the people, and the convenience of the people, the people's demand for medical treatment has been concentrated and released. Various abnormal medical phenomena, such as the disorder of medical service supply and illegal insurance, are becoming more and more prominent, resulting in a large loss of medical insurance funds and a serious threat to the safety of medical insurance [2]. With the development of medical insurance, All medical institutions produce a lot of medical data every day that are closely related to our work, learning, and our lives. The type and scale of these medical data is growing at an unprecedented rate, more and more. There is no reasonable storage, no timely and effective analysis and interpretation, which results in a waste of data value. In addition, there are many difficulties in the analysis and interpretation of these data in the manual mode, the amount of medical treatment is large, and the number of personnel is limited. A wide range of data distribution, poor real-time, professional standards difficult to grasp and other problems. Based on the above background, this paper takes all the above problems into account, based on the principle of visualization, big data will be organized into graphics or images, Through the LED large screen display, help the user to extract effective knowledge from the information in time, solve the problems existing in the manual mode, This system provides real-time monitoring and display of medical insurance information. The main monitoring information includes insurance coverage, reimbursement, medical insurance card issuance in various regions, the system provides real-time monitoring of medical insurance information, the system provides real-time monitoring of medical insurance information, the main monitoring information includes the status of insurance coverage in various regions, the status of reimbursement, and the distribution of medical insurance cards. As well as hospital, outpatient and pharmacy inpatient information, outpatient information, serious illness insurance information, chronic disease information, etc. The system is mainly aimed at all prefectural and municipal medical insurance offices, and is analyzed based on the summary information of the medical insurance department. Help each department to understand relevant medical information timely, discover illegal data, formulate scheduling strategy in time, so as to prevent the occurrence of violations and reduce the loss of medical insurance fund. This paper mainly from the research background, demand analysis, related technology, In the aspects of outline design, system detailed design, system implementation and system test, the real time monitoring and displaying system of medical insurance based on large screen is constructed, which provides many kinds of chart display, dynamic table display, etc. Off-line map display and other custom graphics display to monitor various medical insurance data indicators in real time. Based on the Vaadin framework, this paper develops a variety of graphics display components, and uses Leaflet technology to develop map monitoring. The real-time push technology is used to realize the real-time update of the data, the EclipseLink JPA implementation mode and the JPQL query language are used to operate the database, and a unified data access interface is provided to support the uniform and transparent access of the heterogeneous database. Using Java technology to develop business logic, in the process of development, using Maven tools to manage the project. This system mainly uses Oracle database and MongoDB database for data storage. The LED large screen display with high definition can fully express the significance of medical insurance data, and monitor the medical insurance information in real time and effectively. The medical insurance real-time monitoring and displaying system based on large screen is put into use in some cities. Got good feedback from users, and achieved good social benefits.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：TP311.52;TP277

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