商业保险理赔数据服务应用场景数据服务主题库数据

将已汇聚的山东省和济南市卫生健康信息平台的医疗数据，根据商保理赔应用场景数据服务方案的数据需求和数据开放目录，并按照数据工程标准、数据质量控制规则经过值码转换、术语归一、数据关联、脱敏等做好数据治理、数据质控后，形成商业保险理赔应用场景主题数据库。商保理赔场景主题库数据主要包括患者个人信息、就诊信息、医疗机构信息、诊断信息、结算信息、费用明细信息、手术记录、检查检验等。目前数据已覆盖济南市32家医疗机构患者就诊相关医疗数据。

Medical data aggregated from the health information platforms of Shandong Province and Jinan City has been processed to establish a thematic database for commercial insurance claims application scenarios. The processing follows the data requirements and data open catalog specified in the data service plan for commercial insurance claims application scenarios, complies with data engineering standards and data quality control rules, and includes core procedures such as value-code conversion, terminology normalization, data association, and de-identification, followed by comprehensive data governance and quality control. The data in this thematic database mainly covers patient personal information, visit information, medical institution information, diagnostic information, settlement information, itemized expense information, surgical records, laboratory and imaging examinations, and other relevant medical data. Currently, the dataset covers medical data related to patient visits from 32 medical institutions in Jinan City.

搜集汇总

数据集介绍

特点

该数据集为商业保险理赔应用场景主题数据库，包含患者个人信息、就诊信息等医疗数据，覆盖济南市32家医疗机构。数据用于优化保险理赔流程，解决理赔难、赔付慢等问题，提升客户体验和保险公司服务评级。