The Design And Implementation Of A Medical Insurance Charging And Management System

With the medical insurance reform, and gradually expand the coverage, ginsengprotect personnel to increase rapidly, how health care system in response to largequantities of the customer settlement has become a hot issue. At the same time, theexpenditure of medical insurance fund has a rapid growth, so the insurance consumptionmanagement receives more and more attention around the medical agency. But atpresent domestic to medical insurance fund management, rely mainly on the function ofconventional statistics, the lack of a systematic medical insurance fund controlmanagement system.Based on research of the1stedition of the medical insurance system with3-layerarchitecture, the2ndedition of medical insurance and management system is designedand implemented in this thesis. For the1stversion, when there are large quantities ofconcurrent users, the system can not respond to the quests. Tuxedo middleware platformis introduced in version2. Message queue asynchronous communication and two-phasecommit mechanism are used to ensure the response of a large number of concurrentrequests. Hospital front-end data synchronization mechanism is designed. Networkinterruption between the hospital and health center does not affect the insurance cardsettlement. At the same time, in order to reasonably control the pooling fundexpenditure, based on the theory of data mining, the analysis of historical data, andexisting medical illness claims records, the Pro-Apriori analysis algorithm is used tofind the association between disease and the use of drugs and treatment project,established disease, drugs, and relational database. Using correlation database andK-means algorithm, analysis to the hospital medical records each year is carried on.Scores of hospital credit rating using analysis results is divided into good, poor, threelevels, and the hospital credit grade library is established.The2ndversion of the medical insurance fees and management system designedand implemented in this thesis is currently on-line and achieves good results. A largenumber of concurrent users of the card system, settlement, and the new management method can reasonably control the pooling fund expenditure. It is a new attempt to themanagement of medical insurance system, and provides realization method fortheoretical reference for the design and development of similar system.