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    衛(wèi)辦農(nóng)衛(wèi)發(fā)„2008‟127號附件 新型農(nóng)村合作醫(yī)療管理信息系統(tǒng) 基本規(guī)范 <2008年修訂版>
    I
    目 錄
    第一章 總 則 .................................................................................................................. 1
    第二章 基本架構(gòu)和原則 ................................................................................................ 2
    第一節(jié) 基本架構(gòu) .................................................................................................................... 2
    第二節(jié) 基本原則 ..................................................................................................................... 4
    第三章 平臺(tái)建設(shè)規(guī)范 .................................................................................................... 6
    第一節(jié) 軟件工程規(guī)范 ............................................................................................................ 6
    第二節(jié) 網(wǎng)絡(luò)系統(tǒng)建設(shè)規(guī)范 .................................................................................................... 7
    第三節(jié) 主機(jī)系統(tǒng)建設(shè)規(guī)范 .................................................................................................... 7
    第四節(jié) 數(shù)據(jù)庫系統(tǒng)建設(shè)規(guī)范................................................................................................. 8
    第五節(jié) 存儲(chǔ)系統(tǒng)建設(shè)規(guī)范 .................................................................................................... 9
    第六節(jié) 系統(tǒng)建設(shè)安全規(guī)范 .................................................................................................... 9
    第四章 功能規(guī)范 .......................................................................................................... 11
    第一節(jié) 用戶分類 ................................................................................................................... 11
    第二節(jié) 縣級業(yè)務(wù)系統(tǒng)功能規(guī)范 ........................................................................................... 12
    一、基本功能 ................................................................................................................................. 12
    二、可選功能 ................................................................................................................................. 16
    第三節(jié) 省級管理信息系統(tǒng)功能規(guī)范 ................................................................................... 19
    一、基本功能 ................................................................................................................................. 19
    二、可選功能 ................................................................................................................................. 22
    第五章 基本數(shù)據(jù)集規(guī)范 .............................................................................................. 23
    第一節(jié) 相關(guān)機(jī)構(gòu)數(shù)據(jù)D101.................................................................................................. 23
    第二節(jié) 縣/鄉(xiāng)鎮(zhèn)/村自然檔案數(shù)據(jù)D201 .............................................................................. 24
    第三節(jié) 農(nóng)民家庭參合數(shù)據(jù)D301-302 .................................................................................. 25
    一、農(nóng)民家庭基本數(shù)據(jù)D301 .......................................................................................................... 25
    二、農(nóng)民家庭參合數(shù)據(jù)D302 .......................................................................................................... 26
    第四節(jié) 農(nóng)民個(gè)人參合數(shù)據(jù)D401-402 .................................................................................. 27
    一、農(nóng)民個(gè)人基本數(shù)據(jù)D401 .......................................................................................................... 27
    二、農(nóng)民個(gè)人參合數(shù)據(jù)D402 .......................................................................................................... 29
    第五節(jié) 醫(yī)療記錄及補(bǔ)償數(shù)據(jù)D501-507 .............................................................................. 30
    一、門診就診基礎(chǔ)數(shù)據(jù)D501 .......................................................................................................... 30
    二、門診診療數(shù)據(jù)D502 .................................................................................................................. 31
    三、門診費(fèi)用及補(bǔ)償數(shù)據(jù)D503 ...................................................................................................... 31
    四、住院就診基礎(chǔ)數(shù)據(jù)D504 .......................................................................................................... 32
    五、住院診療數(shù)據(jù)D505 .................................................................................................................. 33
    六、住院費(fèi)用及補(bǔ)償數(shù)據(jù)D506 ...................................................................................................... 34
    七、轉(zhuǎn)診申請與審核數(shù)據(jù)D507 ...................................................................................................... 35
    八、體檢數(shù)據(jù)D508 ......................................................................................................................... 36
    第六節(jié) 基金管理數(shù)據(jù)D601-603 .......................................................................................... 36
    一、農(nóng)民繳費(fèi)及家庭賬戶管理部分D601 ...................................................................................... 36
    II
    二、基金籌集部分D602 .................................................................................................................. 37
    三、基金分配與支出部分D603 ...................................................................................................... 38
    四、補(bǔ)償資金管理部分D604 .......................................................................................................... 39
    第七節(jié) 財(cái)務(wù)管理、監(jiān)督審計(jì)管理數(shù)據(jù) ............................................................................... 41
    一、財(cái)務(wù)管理數(shù)據(jù)D701 .................................................................................................................. 41
    二、資產(chǎn)負(fù)債表數(shù)據(jù)D702 .............................................................................................................. 42
    三、收支表數(shù)據(jù)D703...................................................................................................................... 42
    四、凈資產(chǎn)變動(dòng)表數(shù)據(jù)D704 .......................................................................................................... 42
    五、監(jiān)督審計(jì)管理數(shù)據(jù)D705 .......................................................................................................... 43
    第六章 數(shù)據(jù)代碼規(guī)范 .................................................................................................. 44
    第一節(jié) 標(biāo)準(zhǔn)引用、編寫規(guī)則............................................................................................... 44
    第二節(jié) 數(shù)據(jù)代碼規(guī)范目錄 .................................................................................................. 44
    第三節(jié) 數(shù)據(jù)代碼規(guī)范 .......................................................................................................... 46
    S101-01性別代碼(國家標(biāo)準(zhǔn)GB/T2261-1980) ......................................................................... 46
    S101-02婚姻狀況代碼(國家標(biāo)準(zhǔn)GB/T4766-1984) ................................................................. 46
    S101-03中國各民族代碼(國家標(biāo)準(zhǔn)GB/T3304-1991) ............................................................. 46
    S101-04地區(qū)代碼(國家標(biāo)準(zhǔn)GB/T10114-2003) ....................................................................... 48
    S101-05健康狀況代碼(國家標(biāo)準(zhǔn)GB/T4767-1984) ................................................................. 48
    S101-06家庭關(guān)系代碼(國家標(biāo)準(zhǔn)GB/T4761-1984) ..................................................................... 49
    S101-07 職業(yè)分類代碼(參照國家標(biāo)準(zhǔn)GB/T6565-1999) ............................................................. 50
    S101-08 專業(yè)技術(shù)職務(wù)代碼(參照國家標(biāo)準(zhǔn)GB/T8561-1988) ..................................................... 50
    S101-09 戶屬性代碼 ....................................................................................................................... 51
    S101-10戶口類別代碼 .................................................................................................................... 51
    S101-11遷移標(biāo)志代碼 .................................................................................................................... 51
    S101-12個(gè)人當(dāng)前狀態(tài)代碼 ............................................................................................................ 51
    S201-01衛(wèi)生機(jī)構(gòu)(組織)分類與代碼(衛(wèi)生行業(yè)標(biāo)準(zhǔn)WS218-2002) ...................................... 52
    S201-02機(jī)構(gòu)隸屬關(guān)系代碼(國家標(biāo)準(zhǔn)GB/T12404-1997) ....................................................... 52
    S201-03診療科室代碼 .................................................................................................................... 52
    S201-04 定點(diǎn)醫(yī)療機(jī)構(gòu)類型代碼 ................................................................................................... 58
    S201-05資助部門類型代碼 ............................................................................................................ 58
    S201-06醫(yī)療機(jī)構(gòu)級別代碼 ............................................................................................................ 58
    S301-01 疾病分類代碼(國家標(biāo)準(zhǔn)GB/T14396-2001) .............................................................. 58
    S301-02 入院狀態(tài)代碼 ................................................................................................................... 58
    S301-03 出院狀態(tài)代碼 ................................................................................................................... 59
    S301-04 醫(yī)療服務(wù)項(xiàng)目代碼 ........................................................................................................... 59
    S301-05 就診類型代碼 ................................................................................................................... 59
    S301-06 補(bǔ)償類別代碼 ................................................................................................................... 59
    S301-07 參合屬性代碼 ................................................................................................................... 60
    S301-08 手術(shù)名稱代碼 ................................................................................................................... 60
    S301-09 補(bǔ)償賬戶類別代碼 ........................................................................................................... 60
    S301-10 審核狀態(tài)代碼 ................................................................................................................... 60
    S401-01 體檢指標(biāo)代碼 ................................................................................................................... 60
    S501-01 基本藥品代碼 ................................................................................................................... 63
    S601-01 會(huì)計(jì)科目代碼 ................................................................................................................... 63
    S701-01 是否標(biāo)識(shí)代碼 ................................................................................................................... 64
    S701-02 報(bào)告期別代碼 ................................................................................................................... 64
    第七章 分析指標(biāo)規(guī)范 .................................................................................................. 66
    第一節(jié) 基本統(tǒng)計(jì)指標(biāo)項(xiàng) ...................................................................................................... 66
    一、分類 ......................................................................................................................................... 66
    III
    二、指標(biāo)項(xiàng) ..................................................................................................................................... 66
    第二節(jié) 會(huì)計(jì)報(bào)表指標(biāo)項(xiàng) ...................................................................................................... 76
    一、分類 ......................................................................................................................................... 76
    二、指標(biāo)項(xiàng) ..................................................................................................................................... 76
    第三節(jié) 綜合分析指標(biāo)項(xiàng) ...................................................................................................... 86
    一、分類 ......................................................................................................................................... 86
    二、指標(biāo)項(xiàng) ..................................................................................................................................... 86
    第八章 數(shù)據(jù)傳輸規(guī)范 .................................................................................................. 90
    第一節(jié) 數(shù)據(jù)傳輸技術(shù)規(guī)范 .................................................................................................. 90
    第二節(jié) 業(yè)務(wù)數(shù)據(jù)傳輸內(nèi)容規(guī)范........................................................................................... 96
    一、門診醫(yī)療補(bǔ)償數(shù)據(jù)T101 ......................................................................................................... 96
    二、門診醫(yī)療數(shù)據(jù)T102 ................................................................................................................. 97
    三、門診補(bǔ)償數(shù)據(jù)T103 ................................................................................................................. 97
    四、住院醫(yī)療就診數(shù)據(jù)T104 ......................................................................................................... 98
    五、住院醫(yī)療數(shù)據(jù)T105 ................................................................................................................. 99
    六、住院補(bǔ)償數(shù)據(jù)T106 ............................................................................................................... 100
    七、轉(zhuǎn)診申請與審核數(shù)據(jù)T107 ................................................................................................... 101
    第三節(jié) 統(tǒng)計(jì)指標(biāo)傳輸內(nèi)容規(guī)范......................................................................................... 102
    一、社會(huì)經(jīng)濟(jì)與參合情況數(shù)據(jù)傳輸規(guī)范T201 ........................................................................... 102
    二、基金籌資情況數(shù)據(jù)傳輸規(guī)范T202 ....................................................................................... 103
    三、基金分配與支出情況數(shù)據(jù)傳輸規(guī)范T203 ........................................................................... 104
    四、住院補(bǔ)償情況數(shù)據(jù)傳輸規(guī)范T204 ....................................................................................... 105
    五、門診補(bǔ)償情況數(shù)據(jù)傳輸規(guī)范T205 ....................................................................................... 106
    六、其他補(bǔ)償情況數(shù)據(jù)傳輸規(guī)范T206 ....................................................................................... 107
    七、經(jīng)辦機(jī)構(gòu)人員及收支情況數(shù)據(jù)傳輸規(guī)范T207 ................................................................... 108
    第四節(jié) 會(huì)計(jì)報(bào)表傳輸內(nèi)容規(guī)范......................................................................................... 109
    一、資產(chǎn)負(fù)債表數(shù)據(jù)傳輸規(guī)范T301 ........................................................................................... 109
    二、收支表數(shù)據(jù)傳輸規(guī)范T302 ................................................................................................... 110
    三、基金變動(dòng)表數(shù)據(jù)傳輸規(guī)范T303 ........................................................................................... 112
    第五節(jié) 參合農(nóng)民規(guī)范化傳輸內(nèi)容規(guī)范 ............................................................................. 113
    參考文獻(xiàn) .............................................................................................................................. 116
    IV
    使用說明 一、本規(guī)范是為適應(yīng)全國新型農(nóng)村合作醫(yī)療信息系統(tǒng)建設(shè)而編寫,主要用于規(guī)范全國各地新型農(nóng)村合作醫(yī)療信息系統(tǒng)的設(shè)計(jì)和開發(fā)。 二、本規(guī)范包括新型農(nóng)村合作醫(yī)療信息系統(tǒng)建設(shè)的總則、基本架構(gòu)和原則、平臺(tái)建設(shè)規(guī)范、功能規(guī)范、基本數(shù)據(jù)集規(guī)范、數(shù)據(jù)代碼規(guī)范、分析指標(biāo)規(guī)范和數(shù)據(jù)傳輸規(guī)范八個(gè)部分。 三、基本架構(gòu)和原則部分給出了新型農(nóng)村合作醫(yī)療信息系統(tǒng)平臺(tái)建設(shè)的基本架構(gòu),規(guī)定了系統(tǒng)建設(shè)的基本原則。 四、平臺(tái)建設(shè)規(guī)范規(guī)定了新型農(nóng)村合作醫(yī)療信息系統(tǒng)軟件工程規(guī)范、網(wǎng)絡(luò)系統(tǒng)建設(shè)規(guī)范、主機(jī)系統(tǒng)建設(shè)規(guī)范、數(shù)據(jù)庫系統(tǒng)建設(shè)規(guī)范、存儲(chǔ)及系統(tǒng)建設(shè)安全規(guī)范。 五、應(yīng)用系統(tǒng)功能規(guī)范分為縣級業(yè)務(wù)系統(tǒng)功能和省級管理信息系統(tǒng)功能兩部分。每部分的功能均分為基本功能和可選功能兩類;竟δ苁歉鞯匦滦娃r(nóng)村合作醫(yī)療信息系統(tǒng)中必須實(shí)現(xiàn)的功能?蛇x功能在新型農(nóng)村合作醫(yī)療信息系統(tǒng)建設(shè)中可以有選擇的逐步使用。用戶分類規(guī)范中用戶分類可根據(jù)各地實(shí)際情況進(jìn)行補(bǔ)充和細(xì)化。 六、基本數(shù)據(jù)集是新型農(nóng)村合作醫(yī)療信息系統(tǒng)中用于信息表達(dá)的基本數(shù)據(jù);緮(shù)據(jù)集有以下含義: 1、作為新型農(nóng)村合作醫(yī)療信息系統(tǒng)設(shè)計(jì)的基礎(chǔ)數(shù)據(jù)必須在軟件和數(shù)據(jù)庫設(shè)計(jì)中給予體現(xiàn); 2、作為新型農(nóng)村合作醫(yī)療信息系統(tǒng)的規(guī)范化數(shù)據(jù)標(biāo)準(zhǔn)
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