基于互联网医院的“先诊疗后付费”信用就医新模式
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(扬州大学附属医院 扬州 225012)

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成欣悦,助理工程师,发表论文1篇;

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R-058

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江苏省医院协会医院管理创新研究课题(项目编号:JSYGY-3-2024-435)。


A New Credit-based Medical Service Model of “Pay after Treatment” Based on Internet Hospitals
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(Affiliated Hospital of Yangzhou University,Yangzhou 225012,China)

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    摘要:

    目的/意义 探索复合参保人群“先诊疗后付费”服务模式,提升服务效率。方法/过程 以互联网医院为对外服务载体,搭建信用就医平台,采集多源异构数据,利用部署于本地的大语言模型,构建患者信用评分模型,实现对复合参保患者信用等级的精准评估。根据评估结果分配信用额度,用于诊疗支付,患者可在诊疗结束后一次性结算。结果/结论 该模式有效缩短了患者就诊时间,使医院信用就医结算服务覆盖所有患者群体,特别是为拥有复合医疗保险的个体提供了更为便捷和高效的医疗体验。

    Abstract:

    Purpose/Significance To explore a “pay after treatment” service model for patients with multiple insurances, and to enhance service efficiency. Method/Process Taking internet hospitals as the carrier for external services, a credit-based medical service platform is established. The platform integrates multi-source heterogeneous data and employs a locally deployed large language model to construct a patient credit scoring model. This model accurately assesses the credit levels of patients with multiple insurances, and credit limits will be allocated based on the assessment results for medical treatment payments. Patients can settle the bill in one lump sum after the treatment is completed.Result/Conclusion The model significantly shortens patient waiting time and expands credit-based settlement services to all patient groups, particularly benefiting those with multiple insurances by providing a more streamlined and efficient medical experience.

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成欣悦,曹子佳,肖万里.基于互联网医院的“先诊疗后付费”信用就医新模式[J].医学信息学杂志,2025,46(11):80-84, 98

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  • 最后修改日期:2025-11-05
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  • 在线发布日期: 2025-12-15
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