Decision support system for medical care quality assessment based on health records analysis in Russia

Abstract

The paper presents developed decision system, oriented for healthcare providers. The system allows to healthcare providers to detect and decrease medical nonconformities in health records and forecast the sum of insurance payments taking into account-detected nonconformities. The main components are ISO13606, fuzzy logic and case-based reasoning concept. The result of system implementation allowed to 10% increase insurance payments for healthcare provider.