广东省人民医院按病种分值付费预测数据集

该数据集合用于解决医保按病种分值付费政策下，医院控费管理的问题。基于广东省人民医院近3年来各个病种的历史数据，实时对病种分值的单价保本点进行测算。在此数据集基础上，医疗机构可以建立了“事前预测、事中监控、事后分析”的按病种分值付费精准控费管理体系，便于医疗机构对医保病种、医疗费用和医疗成本进行分析，有效预防医疗机构对医保费用的超额使用。

This dataset is developed to address the challenges of hospital cost control management under the medical insurance disease score-based payment policy. Leveraging the historical data of all disease categories from Guangdong Provincial People's Hospital over the past three years, it enables real-time calculation of the unit break-even point for disease scores. Based on this dataset, medical institutions can establish a precise cost control management system for disease score-based payment that covers three core links: ex-ante prediction, in-process monitoring and ex-post analysis. This system facilitates medical institutions to conduct analysis on medical insurance-covered disease categories, medical expenses and medical costs, thereby effectively preventing excessive utilization of medical insurance funds by medical institutions.

搜集汇总

背景与挑战

背景概述

该数据集基于广东省人民医院近3年的历史数据，旨在支持医保按病种分值付费政策下的医院控费管理。它通过实时测算病种分值的单价保本点，帮助医疗机构建立事前预测、事中监控和事后分析的精准控费体系，从而有效分析医保病种、医疗费用和成本，预防医保费用超额使用。