Patient education for Dummies
Wiki Article
医療機関による医薬品の処方に際しては、被保険者（患者）が保健医療機関で医師の診察を受け、その診断結果をもとに医師が処方箋を発行、同処方箋に基づき保険薬局にて医薬品が調剤、提供される、という流れになっている。保険が適用される医薬品の費用請求については、被保険者による一部費用負担を除くと、医療機関・保険薬局などが、レセプトと呼ばれる診療報酬明細書に、診療、検査、投薬、手術など医療行為の内容を記入し、月ごとに審査支払機関に提出、医療費を請求する。審査は、社会保険診療報酬支払基金と都道府県支部、国民健康保険中央会と各都道府県の国民健康保険団体連合会にて実施され、かかった医療費をそのまま医療保険から支払う「出来高払い制」を採用されている。
In basic phrases, the prescription is a little bit of paper that is penned from the registered health care practitioner (RMP) based on the customer's ailment difficulty.
Once the inquiry from the medical institution, the final prescription written content is transmitted through the healthcare establishment to the information system once the prescription drug is decided. When an insurance policies pharmacy inquires about the availability of coverage for prescription drugs described in prescriptions, the existence / absence of the inquiry history with the clinical establishment and the effects are distributed. Ultimately, a series of inquiry histories is dispersed to the examination and payment establishment and the insurance provider, and the information inquiry / judgment process is finished.
指定条件を満たしていると判定した場合には、次に、医療機関・保険者の住所から近くに存在する複数の保険薬局に対して、処方対象医薬品の取扱状況・在庫状況を確認、結果をあわせて医療機関へ配信する。一方、指定条件を満たしていないと判定した場合には、審査支払機関及び保険者の指定条件に合致する範囲内で医療機関が提示した被保険者情報をもとに導出される処方推奨対象となる医薬品のリストを医療機関に配信、医療機関にて再選択を促す。医療機関にて処方推奨医薬品が選択されると、近隣の保険薬局での取扱状況・在庫状況を確認、結果を通知する。
従って、本発明の課題は、わが国の医療保険制度の中で、医療サービス受給の公平性を維持しつつ、被保険者・保険者もしくは審査支払機関が、代替品の中から最も強く処方を希望する医薬品を、医療機関・保険薬局が、他の代替品の中から優先的に採用する機会を提供することを可能にさせる、医療用医薬品処方情報照会・配信システムを提供することにある。
Next, the flow wherein the usually means in the existing creation is executed is going to be described in time collection with reference to FIG.
It's an item with the existing invention to supply a prescription information inquiry / distribution procedure for prescription information that enables medical institutions / insurance pharmacies to preferentially adopt the alternative medicines from other possibilities. 前記課題を解決するための本発明は、以下の各部から構成されることを特徴とする
In the preparation stage from the procedure, the evaluation payer and also the insurance provider enter essential information and specify circumstances. Examples of information entered via the examination payer as well as insurer and the desired ailments are based on information within the insurance company subject to assessment, conditions such as the insured's age, gender, constitution and earlier record You will find assumed healthcare price factors calculated for each personal sickness and symptom divided, drug value specifications of utilised drugs, insurance plan factors, and also other details demanded for evaluation of clinical price specifics.
次に、図２を用いて本発明の手段が実行されるフローを時系列で説明する。本発明の手段の実行は情報システムを通じて行われるが、この実行は大別して、システムの準備段階及び運用段階の二段階に分けられる。
From the prescription information inquiry / distribution program In keeping with claim one, in the event the prescription drugs inquired from the health care establishment for every medical follow satisfies the specified ailments of your insurance provider / evaluation / payment establishment, the handle of your health-related institution or insured person Drug prescription information inquiry / distribution system that accesses and confirms the managing information / stock information with the drug at numerous insurance plan pharmacies near the pharmacy.
Prescriptions is often a sort accustomed to retailer prescribed medication. The form is helpful for it helps you track side effects and temper swings connected with the interaction of some medications you are already prescribed.
Furthermore, the evaluation and payment institution as well as the insurance company will specify the medicines that they would like to preferentially prescribe. The designation approach is as follows: (one) Specify the title of a particular group of drugs for each injury and symptom classified Based on numerous situations such as the insured's age, gender, Structure and clinical heritage. Or use (2) the higher Restrict in the healthcare remuneration score / made use of drug coverage score and allow the prescription in the drug so long as the higher limit is not exceeded. These enter information and specified situations are saved as info inside the information system.
An illustration of the configuration of these types of an information procedure is shown in FIG. In this example of information program, no less than Display screen and output device / input unit / data storage like common pc with conversation indicates mounted in Every single of assessment paying out institution, insurance company, insurance coverage health-related establishment, insurance coverage pharmacy In addition to a central system that performs information inquiry / resolve are connected by way of a conversation line which include the world wide web.
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