CASPIAN JOURNAL
MANAGEMENT AND HIGH TECHNOLOGIES
Model and algorithm of the data selection for support the information process of assessment reliability of data in the expertise quality of medical care
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Read | Shchipakina A.A., Kvyatkovskaya A.Ye. Model and algorithm of the data selection for support the information process of assessment reliability of data in the expertise quality of medical care // Caspian journal : management and high technologies. — 2015. — №4. — pp. 86-95. |
Shchipakina A.A. - post-graduate student, Astrakhan State Technical University, 16 Tatishchev St., Astrakhan, 414056, Russian Federation, kamakina@inbox.ru
Kvyatkovskaya A.Ye. - Astrakhan State Technical University, 16 Tatishchev St., Astrakhan, 414056, Russian Federation, i.kvyatkovskaya@astu.org
Currently, assessment of the validity of the actually rendered medical care (MC) information is performed in a medical organization and the insurance company. This assessment is conducted in according to standards of medical care by indicator groups (efficacy, safety, timeliness, accessibility, etc.) and quality indicators of MC, however, these indicators cannot be used during operation with the limited data format of the register rendered medical services. To automate the examination of quality MC based on information provided by medical organizations to the insurance companies, it is proposed to develop a model and algorithm selection data for the support of information reliability of the information. The article describes the methodological basis of the expertise quality control of MC. Algorithms form a preliminary list of services that do not satisfy the requirements and standards of medical data in preparation for expertise are developed. Analyzed characteristics of various sources of information gathering and the methods of its assessment of at the expertise the quality of the MC conducted. Proposed the use of qualimetric approach at creation indicators systems of reliability of the information to be subjected to expertise. Developed a system of indicators the support of information reliability of the data registers of medical services rendered, which is recommended to be used for the preliminary analysis of information about the rendered medical care.
Key words: медицинская помощь, экспертиза качества, медицинское страхование, модель, алгоритм, отбор данных, достоверность сведений, информационные технологии, medical care, system of criteria of assessment the validity, expertise quality of medical care, medical in