Healthcare

Healthcare encompasses a broad range of medical, social, and ancillary services aimed at maintaining or improving the health of individuals and communities. It involves the prevention, diagnosis, treatment, and management of illnesses, diseases, injuries, and other physical and mental impairments in people. Delivered by trained and licensed professionals, healthcare can be provided in various settings, from homes to specialized medical facilities.

Overview

At its core, healthcare seeks to achieve optimal health outcomes by leveraging scientific advancements, specialized skills, and a humane approach. It not only addresses immediate health concerns but also focuses on prevention, ensuring the well-being of individuals throughout their life.

Key Components

• Primary care: This is the first point of contact for most individuals with the healthcare system, typically involving general practitioners or family doctors who provide comprehensive care to their patients.
• Specialty care: Delivered by specialized medical practitioners who focus on specific areas, such as cardiologists, dermatologists, or orthopedic surgeons.
• Tertiary care: Advanced medical care provided in specialized facilities, often involving complex procedures or treatments like major surgeries or cancer treatments.
• Quaternary care: An extension of tertiary care, it involves more complex and specialized treatments, often in research facilities or highly specialized hospitals.
• Mental health care: Focuses on diagnosing, treating, and preventing mental health disorders.
• Rehabilitative Services: Helps patients regain or improve their physical, mental, and cognitive abilities after an illness or injury.

Allied Health Professionals

While physicians and nurses play pivotal roles in healthcare delivery, many allied health professionals also contribute significantly:

• Pharmacists: Experts in medication therapy and its management.
• Physical therapists: Specialists in promoting mobility and functional ability.
• Occupational therapists: Focus on enhancing everyday skills and activities.
• Radiographers: Professionals specialized in imaging technologies.
• Dietitians: Experts in food and nutrition.
• Paramedics: Provide emergency pre-hospital care.

Challenges in Healthcare

The global healthcare landscape faces numerous challenges:

• Accessibility: Ensuring all individuals have access to quality healthcare services.
• Cost: Rising healthcare costs are a concern in many regions.
• Quality and Safety: Ensuring that healthcare services are efficient, effective, and safe.
• Workforce Issues: Addressing the shortage or uneven distribution of healthcare professionals.

Glossary of healthcare

• Access - An individual's ability to obtain appropriate health care services. Barriers to access can be financial, geographic, organizational and sociological. Efforts to improve access often focus on providing/improving health coverage.
• Accessibility - As required by the Americans with Disabilities Act, removal of barriers that would hinder a person with a disability from entering, functioning, and working within a facility. Required restructuring of the facility cannot cause undue hardship for the employer.
• Active Error - An error that occurs at the level of the front line operator and whose effects are felt almost immediately.
• Activities of Daily Living (ADLs) - Basic personal activities which include bathing, eating, dressing, mobility, transferring from bed to chair, and using the toilet. ADLs are used to measure how dependent a person may be on requiring assistance in performing any or all of these activities.
• Acute Care - Care that is generally provided for a short period of time to treat a certain illness or condition. This type of care can include short-term hospital stays, doctor's visits, surgery, and X-rays.Medical treatment rendered to individuals whose illnesses or health problems are of a short-term or episodic nature. Acute care facilities are those hospitals that mainly serve persons with short-term health problems.
• Acute Disease - A disease that is characterized by a single episode of a relatively short duration from which the patient returns to his/her normal or previous level of activity. While acute diseases are frequently distinguished form chronic diseases, there is no standard definition or distinction.
• Acute Illness - Illness that is usually short-term and that often comes on quickly.
• Adjusted Average Per Capita Cost (AAPCC) - The basis for HMO or CMP reimbursement under Medicare-risk contracts. The average monthly amount received per enrollee is currently calculated as 95% of the average costs to deliver medical care in the fee-for-service sector.
• Administrative Services Organization (ASO) - An entity that contracts with a state or other purchaser to provider designated administrative services, such as billing or utilization tracking.
• Admission - Date at which an individual was reported to have been admitted to a nursing home for which a Medicaid claim has been paid. Admission may occur before the beginning of a Medicaid-financed nursing home spell if a person entered the nursing home with other insurance coverage before Medicaid began covering the nursing facility care.
• Adult Care Home - (Also called board and care home or group home.) Residence which offers housing and personal care services for 3 to 16 residents. Services (such as meals, supervision, and transportation) are usually provided by the owner or manager. May be single family home. (Licensed as adult family home or adult group home.)
• Adult Day Care - A daytime community-based program for functionally impaired adults that provides a variety of health, social, and related support services in a protective setting.
• Advance Care Planning - The process of discussing, determining and/or executing treatment directives and appointing a proxy decision maker.
• Advance Health Care Directive - (Also called advance directive.) A written instructional health care directive and/or appointment of an agency, or a written refusal to appoint an agent or execute a directive.
• Adverse Drug Reaction (ADR) - An undesirable response associated with use of a drug that compromises therapeutic efficacy., enhances toxicity, or both.
• Adverse Event - In a medical context, an injury resulting from a medical intervention.
• Adverse Selection - A tendency for utilization of health services in a population group to be higher than average. From an insurance perspective, adverse selection occurs when persons with poorer-than-average health status apply for, or continue, insurance coverage to a greater extent than do persons with average or better health expectations.
• Agency - An individual designated in a legal document known as a power of attorney for health care to make a health care decision for the individual granting the power; also referred to in statute as durable power of attorney for health care, attorney in fact, or health care representative.
• All-Payer System - A system in which prices for health services and payment methods are the same, regardless of who is paying. For instance, in an all-payer system, federal or state government, a private insurer, a self-insured employer plan, an individual, or any other payer could pay the same rates. The uniform fee bars health care providers from shifting costs from one payer to another. See cost shifting.
• Allowable Costs - Items or elements of an institution's costs that are reimbursable under a payment formula. Both Medicare and Medicaid reimburse hospitals on the basis of only certain costs. Allowable costs may exclude, for example, luxury accommodations, costs that are not reasonable expenditures, or that are unnecessary for the efficient delivery of health services to persons covered under the program in question.
• Alternative Market - The Alternative Market to nursing home liability insurance is composed of various forms of self-insurance, meaning the risk os borne by the participants and not an insurance company. The different forms of self-insurance include risk retention and risk purchasing groups, captives, rent-a-captives, and sponsored captives.
• Alzheimer's Disease - A progressive, irreversible disease characterized by degeneration of the brain cells and serve loss of memory, causing the individual to become dysfunctional and dependent upon others for basic living needs.
• Ambulatory Care - All types of health services which are provided on an outpatient basis, in contrast to services provided in the home or to persons who are inpatients. While many inpatients may be ambulatory, the term ambulatory care usually implies that the patient must travel to a location to receive services which do not require an overnight stay. Also see ambulatory setting and outpatient.
• Ancillary Services - Supplemental services, including laboratory, radiology, physical therapy, and inhalation therapy, that are provided in conjunction with medical or hospital care.
• Anonymous Reporting - An error reporting method used to protect the identity of those individuals who report medical errors so that their reports cannot be easily used in civil lawsuits against them. Under anonymous reporting, data that could identify the reporter are omitted from the report. See de-identification.
• Antitrust - A legal term encompassing a variety of efforts on the part of government to ensure that sellers do not conspire to restrain trade or fix prices for their goods or services in the market.
• Any Willing Provider Laws - Laws that require managed care plans to contract with all health care providers that meet their terms and conditions.
• Appropriateness - Appropriate health care is care for which the expected health benefit exceeds the expected negative consequences by a wide enough margin to justify treatment.
• Area Agency on Aging (AAA) - A local (city or county) agency, funded under the federal Older Americans Act, that plans and coordinates various social and health service programs for persons 60 years of age or more. The network of AAA offices consists of more than 600 approved agencies.
• Artificial Nutrition and Hydration - (Also known as tube feeding.) Artificial nutrition and hydration supplements or replaces ordinary eating and drinking by giving nutrients and fluids through a tube placed directly into the stomach (gastrostomy tube or G-tube), the upper intestine, or a vein.
• Assignment - A process in which a Medicare beneficiary agrees to have Medicare's share of the cost of a service paid directly ("assigned") to a doctor or other provider, and the provider agrees to accept the Medicare approved charge as payment in full. Medicare pays 80% of the cost and the beneficiary 20%, for most services. See participating physician.
• Assisted Living/Other Facility Benefits Paid During Reporting Period - The total dollar amount of benefits paid during the reporting period for care provided in an ALF or similar alternate care facility other than a nursing home.
• Assistive Devices - Tools that enable individuals with disabilities to perform essential job functions, e.g., telephone headsets, adapted computer keyboards, enhanced computer monitors.
• Average Wholesale Price (AWP) of Prescription Drugs - The average wholesale price of a drug relates to the price that wholesalers charge pharmacies, and is often used by pharmacists to price prescriptions. Drug manufacturers and labelers commonly publish suggested wholesale prices for their products. Price surveys of wholesalers are also available.
• Avoidable Hospital Conditions - Medical diagnosis for which hospitalization could have been avoided if ambulatory care had been provided in a timely and efficient manner.
• Bad Debts - Income lost to a provider because of failure of patients to pay amounts owed. Bad debts may sometimes be recovered by increasing charges to paying patients. Some cost-based reimbursement programs reimburse certain bad debts. The impact of the loss of revenue from bad debts may be partially offset for proprietary institutions by the fact that income tax is not payable on income not received.
• Balance Billing - In Medicare and private fee-for-service health insurance, the practice of billing patients for charges that exceed the amount that the health plan will pay. Under Medicare, the excess amount cannot be more than 15% above the approved charge. See approved charge and participating physician.
• Basis of Eligibility (BOE) - Eligibility group that traditionally has been used by CMS to classify enrollees as children, adults, aged, or disabled.
• Behavioral Health - An umbrella term that includes mental health and substance abuse, and frequently is used to distinguish from "physical" health. Health care services provided for depression or alcoholism would be considered behavioral health care, while setting a broken leg would be physical health. See parity.
• Benchmark - A level of care set as a goal to be attained. Internal benchmarks are derived from similar processes or services within an organization. Competitive benchmarks are comparisons with the best external competitors in the field. Generic benchmarks are drawn drom the best performance of similar processes in other industries.
• Beneficiary - An individual who receives benefits from or is covered by an insurance policy or other health care financing program.
• Benefit Start Date of Current Claim Period - The date on which benefit payments began during the reporting period.
• Biased Selection - The market imperfection that results from the uneven grouping of risks among competing subscribers. Biased selection includes favorable selection (attracting good risks and repelling bad ones) as well as adverse selection (the reverse). Biased selection can occur naturally, according to historical or accidental patterns, or it can occur strategically, according to conscious choices by either subscribers or insurers.
• Bioterrorism - The unlawful use, or threatened use, of micro-organisms or toxins derived from living organisms to produce death or disease in humans, animals, or plants. The act is intended to create fear and/or intimidate governments or societies in the pursuit of political, religious, or ideological goals.
• Blended Funding - The process of integrating funds from different sources (e.g., Medicaid and block grant monies) to enhance flexibility in supporting an individualized set of services for designated patients.
• Board Certified - Status granted a medical specialist who completes a required course of training and experience (residency) and passes an examination in his/her specialty. Individuals who have met all requirements except examination are referred to as "board eligible".
• Board and Care Home - (Also called adult care home or group home.) Residence which offers housing and personal care services for 3 to 16 residents. Services (such as meals, supervision, and transportation) are usually provided by the owner or manager. May be single family home. (Licensed as adult family home or adult group home.)
• Boren Amendmend - Part of the Medicaid law, known by the name of its principal Congressional sponsor. It provides that state payment for hospitals and nursing facilities must be reasonable and adquate to meet the costs incurred by efficiently and economically operated facilities to provide care and services meeting state and federal standards.
• Braided Funding - The process of combining funds from different sources to support an individualized set of services so that expenditures from each source can be tracked and applied to specific individuals eligible for that funding.
• Buy-up Option Available - Indicates that, in addition to an employer paid core plan, insureds can elect to purchase on their own additional coverage amounts and types, typically subject to some form of underwriting.
• Cafeteria Benefits Plan - An arrangement under which employees may choose their own benefit struction, allowing employees to tailor their benefits package to best meet their specific needs. For example, an employee with no dependents may forgo life insurance but may prefer more comprehensive health insurance package.
• Capacity - An individual's ability to understand the significant benefits, risks, and alternatives to proposed health care and to make and communicate a health care decision. The term is frequently used interchangeably with compentency but is not the same. Competency is a legal status imposed by the court.
• Capital Expenditure Review - A review of proposed capital expenditures of hospitals and/or other health facilities to determine the need for, and appropriateness of, the proposed expenditures. The review is done by a designated regulatory agency and has a sanction attached that prevents or discourages unneeded expenditures.
• Capital - Fixed or durable non-labor inputs or factors used in the production of goods and services, the value of such factors, or the money specifically allocated for their acquisition or development. Capital costs include, for example, the buildings, beds, and equipment used in the provision of hospital services. Capital assets are usually thought of as permanent and durable as distinguished from consumables such as supplies.
• Capitalization - Funding that reserves of an insurance or self-insurance program to pay claims.
• Capitation Rate - A fixed amount of money paid per person for covered services for a specific time; usually expressed in "per member per month" units.
• Capitation - A method of payment for health services in which the provider is paid a fixed amount for each patient without regard to the actual number or nature of services provided. Capitation payments are charactistic of health maintenance organizations (HMOs). Also, a method of public support of health professional schools in which eligible schools receive a fixed grant for each student enrolled.
• Captive - A self-formed pool of providers who share risk among themselves, thus acting as their own insurance company. Members do their own underwriting, meaning they decide among themselves which providers to admit to the captive. Members will share liability risk with the providers they admit.
• Cardiopulmonary Resuscitation (CPR) - A group of treatments used when someone's heart and/or breathing stops. CPR is used in an attempt to restart the heart and breathing. It usualy consists of mouth-to-mouth breathing and pressing on the chest to cause blood to circulate. Electric shock and drugs also are used to restart or control the rhythm of the heart.
• Care Plan - (Also called service plan or treatment plan.) Written document which outlines the types and frequency of the long-term care services that a consumer receives. It may include treatment goals for him or her for a specified time period.
• Caregiver - Person who provides support and assistance with various activities to a family member, friend, or neighbor. May provide emotional or financial support, as well as hands-on help with different tasks. Caregiving may also be done from long distance.
• Carrier - A private organization, usually an insurance company, that finances health care.
• Carve Out - Regarding health insurance, an arrangement whereby an employer eliminates coverage for a specific category of services (e.g., vision care, mental health/psychological services, and prescription drugs) and contracts with a separate set of providers for those services according to a predetermined fee schedule or capitation arrangement. Carve out may also refer to a method of coordinating dual coverage for an individual.
• Case Severity - A measure of intensity or gravity of a given condition or diagnosis for a patient.
• Case-Based - Refers to a single patient or case.
• Case-Rate - A fixed amount of money paid per person to allow a provider or designated entity to pay for covered services needed by that person; rates are typically based on diagnoses of persons who present for services and expressed as monthly amounts.
• Catastrophic Health Insurance - Health insurance that provides protection against the high cost of treating severe or lengthy illnesses or disability. Generally such policies cover all, or a specified percentage of, medical expenses above an amount that is the responsibility of another insurance policy up to a maximum limit of liability.
• Catchment Area - A geographic area defined and served by a health program or institution such as a hospital or community mental health center that is delineated on the basis of such factors as population distribution, natural geographic boundaries, and transportation accessibility. By definition, all residents of the area needing the services of the program are usually eligible for them, although eligibility may also depend on additional criteria.
• Cell Captive - A captive in which member providers share administrative expenses but not risk.
• Certificate Issue State - The state in which a certificate under a group policy is delivered. This would be either the situs state for the group policy or, in the case of a state that claims extraterritorial jurisdiction over the group policy situs state, it would be the state of residence for the individual certificate-holder.
• Certificate of Need (CON) - A certificate issued by a government body to a health care provider who is proposing to construct, modify, or expand facilities, or to offer new or different types of health services. CON is intended to prevent duplication of services and overbedding. The certificate signifies that the change has been approved.
• Certified Nurse Aide (CNA) - A nurse aide that has completed required state training and competency testing in the skills required to work as a nurse aide.
• Charity Care - Generally refers to physician and hospital services provided to persons who are unable to pay for the cost of services, especially those who are low-income, uninsured, and underinsured. A high proportion of the costs of charity care is derived from services for children and pregnant women (e.g., neonatal intensive care).
• Chore Services - Help with chores such as home repairs, yard work, and heavy housecleaning.
• Chronic Care - Care and treatment given to individuals whose health problems are of a long-term and continuing nature. Rehabilitation facilities, nursing homes, and mental hospitals may be considered chronic care facilities.
• Chronic Disease - A disease that has one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alternation; requires special training of the patient for rehabilitation; or may be expected to require a long period of supervision, observation, or care.
• Chronic Illness - Long-term or permanent illness (e.g., diabetes, arthritis) which often results in some type of disability and which may require a person to seek help with various activities.
• Chronically Ill - A patient has been certified by a licensed health care pratitioner as: being unable to perform, without substantial assistance from another person, at least two ADLs for a period that is expected to last at least 90 consecutive days due to a loss of functional capacity; or requiring substantial supervision to protect themself form threats to health and safety due to a severe cognitive impairment.
• Claim Status - Indicates whether or not an insured with a Partnership policy is in claim status during the reporting period.
• Claims Made Policy - Provides coverage for insured events that both occur and for which a claim is made during the term of the policy. If an incident occurs, but the policy is terminated before a claim is made, liability for the incident is not insured.
• Claims Occurrence Policy - Provides coverage for all incidents and events that occur during the term of the policy, regardless of when a liability claim is made, or when a lawsuit is settled.
• Clinic - A facility, or part of one, devoted to diagnosis and treatment of outpatients. "Clinic" is irregularly defined. It may either include or exclude physicians' offices; may be limited to describing facilities that serve poor or public patients; and may be limited to facilities in which graduate or undergraduate medical education is done.
• Clinical Condition - A diagnosis (e.g., cerebrovascular hemorrhage) or a patient state that may be associated with more than one diagnosis (such as paraplegia) or that may be as yet undiagnosed (such as low back pain).
• Clinical Event - Services provided to patients (items of history taking, physical examination, preventative care, tests, procedures, drugs, advice) or information on clinical condition or on patient state used as a patient outcome.
• Clinical Performance Measures - Instruments that estimate that extent to which a health care provider: delivers clinical services that are appropriate for each patient's condition; provides them safely, competently, and in an appropriate time frame; and achieves desired outcomes in terms of those aspects of patient health and patient satisfaction that can be affected by clinical services.
• Clinical Practice Guidelines - Systematically developed statements to assist practitioners and patients' decisions about health care to be provided for specific clinical circumstances.
• Cluster - A naturally occurring unit like a school (which has many classrooms, students, and teachers). Other clusters include universities, hospitals, cities, states, Census blocks, and living quarters. The clusters are randomly selected, and all members, or a random sample, of the selected cluser are included in the sample.
• Co-Morbidity - Condition that exists at the same time as the primary condition in the same patient (e.g., hypertension is a co-morbidity of many conditions such as diabetes, ischemic heart disease, end-stage renal disease, etc.).
• Coefficient of Variation - The standard error of an estimate divided by the mean.
• Collateral Damages - Damages incurred by the plaintiff that are already covered by other sources of payment. "Collateral source offset" rules reduce awards by denying plaintiffs compensation for losses that are recouped from other sources such as health insurance. These rules aim to prevent plaintiffs from "double dipping" by recovering for losses for which the plaintiff has already been remunerated through other sources of payment.
• Community Mental Health Center (CMHC) - An entity that provides comprehensive mental health services (principally ambulatory), primarily to individuals residing or employed in a defined catchment area.
• Community Rating by Class (CRC or Class Rating) - For federally qualified HMOs, the CRC is the adjustment of community-rated premiums on the basis of such factors as age, sex, family size, marital status, and industry classification. These health plan premiums reflect the experience of all enrollees of a given class within a specific geographic area, rather than the experience of any one employer gorup.
• Company Code - The 5-digit code assigned by the National Association of Insurance Commissioners to each insurance company. For self-funded plans or the Federal Employees' Long Term Care Insurance Program (FLTCIP), a unique 5-digit code will be assigned for use in these reporting requirements.
• Competitive Medical Plan (CMP) - A state-licensed entity, other than a federally qualified HMO, that signs a Medicare Risk Contract and agrees to assume financial risk for providing care to Medicare eligibles on a prospective, prepaid basis.
• Composite Estimation - Use of an estimator that is a weighted average of two other estimators. Frequently a composite is constructed from a direct sample-based estimator and a model-based estimator.
• Confidence Interval - A range of values used to predict the location of the true population parameter. The probability of the true parameter values falling within the intervals is specified.м
• Congregate Housing - Individual apartments in which residents may receive some services, such as a daily meal with other tenants. (Other services may be included as well.) Buildings usually have some common areas such as a dining room and lounge as well as additional safety measures such as emergency call buttons. May be rent-subsidized (known as Section 8 housing).
• Consumer - A person who purchases or receives goods or services for personal needs or use and not for resale.
• Continuing Medical Education (CME) - Formal education obtained by a health professional after completing his/her degree and full-time post-graduate training. For physicians, some states require CME (usually 50 hours per year) for continued licensure, as do some specialty boards for certification.
• Conversion - A transaction where all or part of the assets of a health care organization undergo a shift in profit state (non-profit, public, or for-profit) through sale, lease, joint venture, or operating/management agreements.
• Core Plan - An employer-paid long-term care insurance benefit provided typically on a guaranteed issue basis to all eligible actively at work employees as defined by the insurer and/or the employer in the group policy.
• Cost Center - An accounting device whereby all related costs attributable to some "financial center" within an institution, such as a department or program, are segregated for accounting or reimbursement purposes.
• Cost Consequence Analysis (CCA) - A form of cost-effectiveness analysis comparing alternative interventions or programs in which the components of incremental costs (e.g., additional therapies, hospitalization) and consequences (e.g., health outcomes, adverse effects) are computed and listed, without aggregating these results (e.g., into a cost-effectiveness ratio).
• Cost Minimization Analysis (CMA) - An assessment of the least costly intervention/technology among alternatives that produce equivalent outcomes.
• Cost Sharing - Any provision of a health insurance policy that requires the insured individual to pay some portion of medical expenses. The general term includes deductibles, copayments, and coinsurance.
• Cost Shifting - The practice of obtaining care for a child at the expense of another party or agency.
• Cost Utility Analysis - A form of cost-effectiveness analysis were outcomes are rated in terms of utility, or quality of life, e.g., quality-adjusted life-years (QALYs).
• Cost of Illness Analysis (COI) - An assessment of the economic impact of an illness or condition, including treatment costs.
• Cost-Based Reimbursement - Payment made by a health plan or payor to health care providers based on the actual costs incurred in the delivery of care and services to plan beneficiaries. This method of paying providers is still used by some plans; however, cost-based reimbursement is being replaced by prospective payment and other payment mechanisms.
• Cost-Effectiveness Analysis (CEA) - A form of analysis that seeks to determine the costs and effectiveness of a medical intervention compared to similar alternative interventions to determine the relative degree to which they will obtain the desired health outcome(s). Cost-effectiveness analysis can be applied to any of a number of standards such as median life expectancy or quality of life following an intervention.
• Cost-Shifting - Recouping the cost of providing uncompensated care by increasing revenues from some payers to offset losses and lower net payments from other payers.
• Coverage Basis - Indicates whether the coverage is issued as a group or an individual policy. The coverage basis is determined by how the State Department of Insurance classifies the policy or certificate, not based on the basis by which the policy is marketed. For example, a worksite-based product which uses an individual policy form but is marketed to an employer group is an individual coverage basis.
• Coverage Decision - A policy decision about categories of health interventions or benefits that will be provided to a population of patients as part of the contract between a health plan and a beneficiary.
• Coverage - The guarantee against specific losses provided under the terms of an insurance policy. Coverage is sometimes used interchangeably with benefits or protection, and is also used to mean insurance or insurance contract.
• Covered Entity - Refers to three types of entities that must comply with federal health information privacy regulations (e.g., HIPAA Privacy Rule): health care providers, health plans, and health care clearinghouses. For these purposes, health care providers include hospitals, physicians, and other caregivers, as well as researchers, who provide health and care receive, access, or generate individually identifiable health care information.
• Covered Services - Health care services covered by an insurance plan.
• Crowd-Out - A phenomenon whereby new public programs or expansions of existing public programs designed to extend coverage to the uninsured prompt some privately insured persons to drop their private coverage and take advantage of the expanded public subsidy.
• Current Annual Premium - The amount of annual premium being paid for the coverage, including both the insured's portion and any portion paid by the employer, if applicable. This would reflect the current premium amount such that any voluntary changes in coverage that might have increased or decreased the premium from its original issue amount would be reflected in this figure.
• Current Claimant - Refers to an insured who is in active claim status which means that they meet the definition of chronically ill and are receiving benefit payments in accordance with the coverage provisions and requirements of the policy or certificate.
• Current Population Survey (CPS) - A national survey conducted annually by the U.S. Department of Commerce, Bureau of the Census, the CPS gathers information on the noninstituionalized population of the United States. The CPS is the most commonly reported source for the number of persons without health insurance and other information about this population.
• Current Procedural Terminology, Fourth Edition (CPT-4) - A manual that assigns five digit codes to medical services and procedures to standardize claims processing and data analysis.
• Custodial Care - Care that does not require specialized training or services. (See also personal care.)
• Customary Charge - One of the factors determining a physician's payment for a service under Medicare. Calculated as the physician's median charge for that service over a prior 12-month period.
• Customary, Prevailing, and Reasonable (CPR) - Current method of paying physicians under Medicare. Payment for a service is limited to the lowest of : (1) the physician's billed charge for the service; (2) the physician's customary charge for the service; or (3) the prevailing charge for that service in the community. Similar to the Usual, Customary, and Reasonable system used by private insurers.
• De-Identification - A process whereby information that could identify the clinician, the reporter, the health care institution, or another organization involved in a medical error are removed from an error report after it is received. This process is used to maintain records of factors that could cause errors, but assure those who report errors that their reports will not be used in civil lawsuits against them.
• Defined Contribution - Funding mechanism for pension plans that can also be applied to health benefits based on a specific dollar contribution, without defining the services to be provided.
• Deinstitutionalization - Policy which calls for the provision of supportive care and treatment for medically and socially dependent individuals in the community rather than in an institutional setting.
• Dementia - Term which describes a group of diseases (including Alzheimer's Disease) which are characterized by memory loss and other declines in mental functioning.
• Design Effect - The sampling variance of the actual complex design used to select a sample divided by the sampling variance of a simple random sample of the same size. This measure reflects the effect on the precision of a survey estimate due to the difference between the sample design actually used to collect data and a simple random sample.
• Detailing - Provision of information about drug products by sales representatives of the pharmaceutical industry to physicians to influence the physicians' prescribing behavior. Counter detailing is the educational efforts by health care purchasers or insurers to influence physicians' prescribing behaviors, often to counter the detailing efforts of pharmaceutical manufacturers.
• Diagnostic and Statistical Manual of Mental Disorders (DSM) - A tool used by the medical and psychological communities to identify and classify behavioral, cognitive, and emotional problems according to a standard numerical coding system of mental disorders.
• Direct Cost - A cost which is identifiable directly with a particular activity, service, or product of the program experiencing the costs. These costs do not include the allocation of costs to a cost center which are not specifically attributable to that cost center.
• Direct Patient Care - Any activities by a health professional involving direct interaction, treatment, administration of medications, or other therapy or involvement with a patient.
• Direct to Consumer (DTC) Advertising - The advertising of prescription drugs (or other products) directly to consumers via various conventional means such as television, radio, or periodicals. DTC advertising can be in lieu of, or in addition to, marketing efforts targeting physicians or other health care professionals.
• Disability - The limitation of normal physical, mental, social activity of an individual. There are varying types (functional, occupational, learning), degrees (partial, total), and durations (temporary, permanent) of disability. Benefits are often available only for specific disabilities, such as total and permanent (the requirement for Social Security and Medicare).
• Disaster Drill - An exercise, or demonstration, that tests the readiness and capacity of a hospital, a community, or other system to respond to a public health emergency or other disaster.
• Discharge - The release of a patient from a provider's care, usually referring to the date at which a patient checks out of a hospital.
• Disproportionate Share Adjustment - A payment adjustment under Medicare's prospective payment system or under Medicaid for hospitals that serve a relatively large volume of low-income patients.
• Do Not Resuscitate Order - (Also called a DNR order, a No CPR order, a DNAR order (do not attempt resuscitation), and an AND order (allow natural death).) A physician's order written in a patient's medical record indicating that health care providers should not attempt CPR in the event of cardiace or respiratory arrest. In some regions, this order may be transferable between medical venues.
• Drug Claims Processing - An automated assessment of drug claims at the point of service, meant to detect potential problems that should be addressed before drugs are dispensed to patients (for example, checking patients' eligibility for drug coverage or checking whether the prescription has been filled at another pharmacy in the last prescription cycle).
• Drug Utilization Review (DUR) - A formal program for assessing drug prescription and use patterns. DURs typically examine patterns of drug misuse, monitor current therapies, and intervene when prescribing or utilization patterns fall outside pre-established standards. DUR is usually retrospective, but can also be performed before drugs are dispensed. DURs were established by the OBRA in 1990 and are required for Medicaid programs.
• Dual Eligible - A person who is eligible for two health insurance plans, often referring to a Medicare beneficiary who also qualifies for Medicaid benefits.
• Durable Medical Equipment (DME) - (Also called home medical equipment.) Equipment such as hospital beds, wheelchairs, ventilator, oxygen system, home dialysis system, and prosthetics used at home. May be covered by Medicaid and in part by Medicare or private insurance. Prescribed by a physician for a patient's use for an extended period of time.
• Economic Damages - Civil litigation is compensation due the plainiff for financial losses caused by the wrongful actions of another party (e.g., awards for the medical bills of a nursing home resident caused by an abusive employee).
• Effective Sample Size - The actual sample size divided by the design effect that reflects the effect of the deviations form simple random sampling.
• Electronic Claim - A digital representation of a medical bill generated by a provider or by the provider's billing agent for submission using telecommunications to a health insurance payer.
• Electronic Data Interchange (EDI) - The mutual exchange of routine information between business using standardized, machine-readable formats.
• Emergency Medical Services (EMS) - Services utilized in responding to the perceived individual need for immediate treatment for medical, physiological, or psychological illness or injury.
• Emergency Shelter - Facilities used solely for out-of-home placement on a short-term basis during periods or sudden emergency, pending formulation or long-term solutions.
• Employee Retirement Income Security Act (ERISA) - A federal act, passed in 1974, that established new standards and reporting/disclosure requirements for employer-funded pension and health benefit programs.
• Employer Name - The name of the employer identified as the group policyholder.
• Employer Type - The category of the employer as expressed using standard industry codes.
• Encounter - A contact between an individual and the health care system for a health care service or set of services related to one or more medical conditions.
• Enterprise Liability - A plan relating to tort reform in which medical liability is shifted from physicians to health plans (e.g., HMOs). Under such a system, patients would sue the health plan rather than the physician, thereby providing physicians immunity from medical liability.
• Epidemic - A group of cases of a specific disease or illness clearly in excess of what one would normally expect in a particular geographic area. There is no absolute criterion for using the term epidemic; as standards and expectations change, so might the definition of an epidemic (e.g., an epidemic of violence).
• Epidemiology - The study of the patterns of determinants and antecedents of disease in human populations. It utilizes biology, clinical medicine, and statistics in an effort to understand the etiology (causes) of illness and/or disease. The ultimate goal of the epidemiologist is not merely to identify underlying causes of a disease but to apply findings to disease prevention and health promotion.
• Escort Services - (Also called transportation services.) Provides transportation for older adults to services and appointments. May use bus, taxi, volunteer drivers, or van services that can accommodate wheelchairs and persons with other special needs.
• Estate Recovery - By law states are required to recover funds from certain deceased Medicaid recipients' estates up to the amount spent by the state for all Medicaid services (e.g., nursing facility, home and community-based services, hospital, and prescription costs).
• Evidence-Based Decision Making - In a health policy context, evidence-based decision making is the application of the best available scientific evidence to policy decisions about specific medical treatments or changes in the delivery system. The goals of evidence-based decision making are to improve the quality of care, increase the efficiency of care delivery, and improve the allocation of health care resources.
• Evidence-Based Medicine - Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. This approach must balance the best external evidence with the desires of the patient and the clinical expertise of health care providers.
• Exclusive Provider Arrangement (EPA) - An indemnity or service plan that provides benefits only if care is rendered by the institutional and professional providers with which it contracts (with exceptions for emergency and out-of-area services).
• Expenditure Target (ET) - A mechanism to adjust fee updates (or the fees themselves) based on how actual expenditures in an area compare to a target for those expenditures.
• Experience Rating - A method of adjusting health plan premiums based on the historical utilization data and distinguishing characteristics of a specific subscriber group.
• Family Foster Home - Non-secure, 24-hour, residential care in a permanent or temporary family setting (include adoptive placements that have not yet been finalized, and relatives only if they are licensed or reimbursed).
• Family Practice - A form of specialty practice in which physicians provide continuing comprehensive primary care within the context of the family unit.
• Family and Medical Leave Act (FMLA) - A 1993 federal law requiring employers with more than 50 employees to provide eligible workers up to 12 weeks of unpaid leave for birth, adoptions, foster care placement, and illnesses of employees and their families.
• Favorable Selection - A tendency for utilization of health services in a population group to be lower than expected or estimated.
• Federal Employees Health Benefits Program (FEHBP) - A voluntary health insurance subsidy program administered by the Office of Personnel Management for civilian employees (including retirees and dependents) of the Federal Government. Enrollees select from a number of approved plans, the costs of which are primarily borne by the government.
• Federal Poverty Level (FPL) - The amount of income determined by the federal Department of Health and Human Services to provide a bare minimum for food, clothing, transportation, shelter, and other necessities. FPL is reported annually and varies according to family size (e.g., for a family of three in 1999, the FPL was $13,880, or $1,157 per month). Public assistance programs usually define income limits in relation to FPL.
• Federally Qualified Health Center (FQHC) - A health center in a medically under-served area that is eligible to receive cost-based Medicare and Medicaid reimbursement and provide direct reimbursement to nurse practitioners, physician assistants, and certified nurse midwives.
• Fee Schedule - A list of physician services in which each entry is associated with a specific monetary amount that represents the approved payment level for a given insurance plan.
• Fiduciary - Relating to, or founded upon, a trust or confidence. A fiduciary relationship exists where an individual or organization has an explicit or implicit obligation to act in behalf of another person's or organization's interests in matters that affect the other person or organization. A physician has such a relation with his/her patient, and a hospital trustee has one with a hospital.
• For-Profit - Organization or company in which profits are distributed to shareholders or private owners.
• Foster Child - Any child in public foster care, or in private foster care but under the case management and planning responsibility of the primary state child welfare agency, who is 0-17 years old, or 18,19, or 20 years old and entered foster care before age 18.
• Frequency of Future Purchase Option - Indicates whether the FPO is made on an annual basis, or on a frequency less often than that (e.g., every two or three years).
• Functionally Disabled - A person with a physical or mental impairment that limits the individual's capacity for independent living.
• Future Purchase Option (FPO) - The type of periodic benefit increase which allows the individual to purchase additional increments of coverage for additional premium amounts based on their attained age at the time they elect the increase. These coverage increases are available at set time periods (annually or otherwise) and are available to the insured who wishes to elect them without requiring evidence of insurability.
• Gatekeeper - The primary care practitioner in managed care organizations who determines whether the presenting patient needs to see a specialist or requires other nonroutine services. The goal is to guide the patient to appropriate services while avoiding unnecessary and costly referrals to specialists.
• General Liability Claims/Losses - Amounts a nursing home liability insurer is legally obligated to pay as damages to a plaintiff due to bodily injury or property damage.
• General Practice - A form of practice in which physicians without specialty training provide a wide range of primary health care services to patients.
• Genomics - The study of genomes, which includes gene mapping, gene sequencing, and gene function.
• Geriatrician - Physician who is certified in the care of older people.
• Geriatrics - Medical specialty focusing on treatment of health problems of the elderly.
• Gerontology - Study of the biological, psychological and social processes of aging.
• Global Budgeting - A method of hospital cost containment in which participating hospitals must share a prospectively set budget. Method for allocating funds among hospitals may vary but the key is that the participating hospitals agree to an aggregate cap on revenues that they will receive each year. Global budgeting may also be mandated under a universal health insurance system.
• Global Fee - A total charge for a specific set of services, such as obstetrical services that encompass prenatal, delivery, and post-natal care.
• Graduate Medical Education (GME) - Medical education after receipt of the Doctor of Medicine (MD) or equivalent degree, including the education received as an intern, resident (which involves training in a specialty), or fellow, as well as continuing medical education. CMS partly finances GME through Medicare direct and indirect payments.
• Group Home 21+ - (Also called residential treatment facility or child care institution.) Nonsecure, 24-hour, residential care facility serving 21 or more persons which provides nonspecialized physical care and may or may not offer a therapeutic service or an educational program for emotionally disturbed or otherwise handicapped youth.
• Group Practice - A formal association of three or more physicians or other health professionals providing health services. Income from the practice is pooled and redistributed to the members of the group according to some prearranged plan (often, but not necessarily, through partnership). Groups vary a great deal in size, composition, and financial arrangements.
• Guaranteed Issue - Requirement that insurance carriers offer coverage to groups and/or individuals during some period each year. HIPAA requires that insurance carriers guarantee issue of all products to small groups (2-50). Some state laws exceed HIPAA's minimum standards and require carriers to guarantee issue to additional groups and individuals.
• Guaranteed Renewal - Requirement that insurance carriers renew existing coverage to groups and/or individuals. HIPAA requires that insurance issuers guarantee renewal of all products to all groups and individuals.
• Guardian - A judicially appointed guardian or conservator having authority to make a health care decision for an individual.
• Health Care Paraprofessional - Home health aides, certified nurses aids, and personal care attendants who provide direct care and personal support services in hospitals, nursing homes, other institutions, as well as home-based care to the disabled, aged, and infirm.
• Health Education - Any combination of learning opportunities designed to facilitate voluntary adaptations of behavior (in individuals, groups, or communities) conducive to health.
• Health Insurance Portability and Accountability Act (HIPAA) - Federal health insurance legislation passed in 1996, which sets standards for access, portability, and renewability that apply to group coverage--both fully insured and self-funded--as well as to individual coverage. HIPAA allows under specified conditions, for long-term care insurance policies to be qualified for certain tax benefits under Section 7702(b) of the Internal Revenue Code.
• Health Insurance - Financial protection against the medical care costs arising from disease or accidental bodily injury. Such insurance usually covers all or part of the medical costs of treating the disease or injury. Insurance may be obtained on either an individual or a group basis.
• Health Maintenance Organization (HMO) - Managed care organization that offers a range of health services to its members for a set rate, but which requires its members to use health care professionals who are part of its network of providers. (See also Medicare HMOs.)
• Health Manpower Shortage Area (HMSA) - An area or group which HHS designates as having an inadequate supply of health care providers. HMSAs can include: (1) an urban or rural geographic area, (2) a population gorup for which access barriers can be demonstrated to prevent members of the group from using local providers, or (3) medium and maximum-security correctional institutions and public or nonprofit private residential facilities.
• Health Personnel - Collectively, all persons working in the provision of health services, whether as individual practitioners or employees of health institutions and program, whether or not professionally trained, and whether or not subject to public regulation. Facilities and health personnel are the principal health resources used in producing health services.
• Health Plan Employer Data and Information Set (HEDIS) - A set of performance measures for health plans developed for the National Committee for Quality Assurance (NCQA) that provides purchasers with information on effectiveness of care, plan finances and costs, and other measures of plan performance and quality.
• Health Plan - An organization that provides a defined set of benefits. This term usually refers to an HMO-like entity, as opposed to an indemnity insurer.
• Health Planning - Planning concerned with improving health, whether undertaken comprehensively for a whole community or for a particular poulation, type of health service, institution, or health program. The components of health planning include: data assembly and analysis, goal determination, action recommendation, and implementation strategy.
• Health Policy - An insurance contract consisting of a defined set of benefits. See health insurance.
• Health Promotion - Any combination of health education and related organizational, political, and economic interventions designed to facilitate behavioral and environmental adaptations that will improve or protect health.
• Health Risk Factors - Chemical, psychological, physiological, or genetic factors and conditions that predispose an individual to the development of a disease.
• Health Service Area - Geographic area designated on the basis of such factors as geography, political boundaries, population, and health resources, for the effective planning and development of health services.
• Health Systems Agency (HSA) - A health planning agency created under the National Health Planning and Resources Development Act of 1974. HSAs were usually nonprofit private organizations and served defined health service areas as designated by the states.
• Health Technology Assessment (HTA) - The systematic evaluation of properties, effects, or other impacts of health care technology. HTA is indended to inform decision-makers about health technologies and may measure the direct or indirect consequences of a given technology or treatment.
• Hill-Burton Act - Coined from the names of the principal sponsors of the Public Law 79-725 (the Hospital Survey and Construction Act of 1946). This program provided federal support for the construction and modernization of hospitals and other health facilities. Hospitals that have received Hill-Burton funds incur an obligation to provide a certain amount of charity care.
• Hindsight Bias - A bias in investigating the cause of a medical error or accident where in retrospect the reviewer simplifies the cause of the error to a single element, overlooking multiple contributing factors. The hindsight bias makes it easy to arrive at a simple solution or to blame an individual, but often makes it difficult to determine the true cause(s) of the error or propose systematic solutions.
• Hold-Harmless - A contractual requirement prohibiting a provider from seeking payment from an enrollee for services renedered prior to a health plan insolvency.
• Home Health Agency (HHA) - A public or private organization that provides home health services supervised by a licensed health professional in the patient's home either directly or through arrangements with other organizations.
• Home Health Aide - A person who, under the supervision of a home health or social service agency, assists elderly, ill or disabled person with household chores, bathing, personal care, and other daily living needs. Social service agency personnel are sometimes called personal care aides.
• Home Health Care Benefits Paid During Report Period - The total amount of benefits paid during the reporting period for care at home or in a noninstitutional covered care setting (e.g., adult day care) as defined as "home or community-based care" within the policy or certificate.
• Home Medical Equipment - (Also called durable medical equipment.) Equipment such as hospital beds, wheelchairs, and prosthetics used at home. May be covered by Medicaid and in part by Medicare or private insurance.
• Home and Community-Based Services (HCBS) - Any care or services provided in a patient's place of residence or in a noninstitutional setting located in the immediate community. HCBS may include home health care, adult day care or day treatment, medical services, or other interventions provided for the purpose of allowing a patient to receive care at home or in their community.
• Homebound - One of the requirements to qualify for Medicare home health care. Means that someone is generally unable to leave the house, and if they do leave home, it is only for a short time (e.g., for a medical appointment) and requires much effort.
• Homemaker Services - In-home help with meal preparation, shopping, light housekeeping, money management, personal hygiene and grooming, and laundry.
• Horizontal Integration - Merging of two or more firms at the same level of production in some formal, legal relationship.
• Hospice Care - Services for the terminally ill provided in the home, a hospital, or a long-term care facility. Includes home health services, volunteer support, grief counseling, and pain management.
• Hospice - A program which provides palliative and supportive care for terminally ill patients and their families, either directly or on a consulting basis with the patient's physician or another community agency. The whole family is considered the unit of care, and care extends through their period of mourning.
• Hospital - An institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and nonsurgical.
• Impairment - Any loss or abnormality of psychological, physiological, or anatomical function.
• Independent Living Facility - Rental units in which services are not included as part of the rent, although services may be available on site and may be purchased by residents for an additional fee.A facility (house, apartment, etc.) in which a child/youth is permitted to live or reside "independently" without a paid caretaker.
• Indigent Care - Health services provided to the poor or those unable to pay. Since many indigent patients are not eligible for federal or state programs, the costs which are covered by Medicaid are generally recorded separately from indigent care costs.
• Indirect Cost - Cost which cannot be identified directly with a particular activity, service or product of the program experiencing the cost. Indirect costs are usually apportioned among the program's services in proportion to each service's share of direct costs.
• Individual Instruction - An individual's direction concerning a health care decision. This may be written or verbal describing goals for health care, treatment preferences, or willingness to tolerate future health states.
• Inflation Protection Duration Type: Attained Age of Policy/Certificate - The type of inflation that ends when the insured has received annual benefit increases for a predefined number of years (e.g., 10 or 20 years).
• Inflation Protection Duration: Attended Age of Insured - The type of inflation protection that ends when the insured reaches a specified age (e.g., age 80, or others).
• Inflation Protection Duration: Life of Policy/Certificate - The type of inflation protection that continues through the life of the coverage, and continues even while the insured is in claim status (receiving benefits).
• Inflation Protection Duration: When Benefit Has Doubted - The type of inflation protection that continues until the daily benefit amount for nursing home care has doubled from its original value at time of purchase.
• Inflation Protection Increase Amount or Index Value - The specific percentage increase applied to benefits each year designed to keep pace with inflation, if it is a set amount as previously defined. If the increase is based on an index, the specific increase amount expressed in terms of a percent of the prior year's increase, that is applicable to the current reporting period.
• Inpatient - A person who has been admitted at least overnight to a hospital or other health facility (which is therefore responsible for his or her room and board) for the purpose of receiving diagnostic treatment or other health services.
• Institutional Health Services - Health services delivered on an inpatient basis in hospitals, nursing homes, or other inpatient institutions. The term may also refer to services delivered on an outpatient basis by departments or other organizational units of, or sponsored by, such institutions.
• Institutional Long-Term Care (ILTC) - Nursing facility services, services provided in ICFs/MR, mental hospital services for people over age 65, and inpatient psychiatric facility services for individuals under age 21.
• Instructional Health Care Directive - (Also called a living will.) A written directive describing preferences or goals for health care, or treatment preferences or willingness to tolerate health states, aimed at guiding future health care.
• Instrumental Activities of Daily Living (IADLs) - Household/independent living tasks which include using the telephone, taking medications, money management, housework, meal preparation, laundry, and grocery shopping.
• Intermediate Care Facility for the Mentally Retarded (ICF/MR) - An ICF which cares specifically for the mentally retarded.
• Intermediate Care - Occasional nursing and rehabilitative care ordered by a doctor and performed or supervised by skilled medical personnel.
• International Classification of Diseases, ninth edition (Clinical Modification) (ICD-9-CM) - A list of diagnoses and identifying codes used by physicians and other health care providers. The coding and terminology provide a uniform language that permits consistent communication on claim forms.
• International Classification of Functioning, Disability and Health (ICF) - An internationally standardized list of identifying codes and definitions of human functioning and disabilities organized by body functions and structures, domains of activities and participation, and environmental factors. The coding and terminology provide a uniform language that permits consistent communication on claim forms.
• Intubation - Refers to "endotracheal intubation" the insertion of a tube through the mouth or nose into the trachea (windpipe) to create and maintain an open airway to assist treathing.
• Inventory - A detailed description of quantities and locations of different kinds of facilities, major equipment, and personnel which are available in a geographic area and the amount, type, and distribution of services these resources can support.
• Learning Disability - A disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculation. The term includes such conditions as perceptual handicaps, brain injury, and minimal brain dysfunction.
• Level of Care (LOC) - Amount of assistance required by consumers which may determine their eligibility for programs and services. Levels include: protective, intermediate, and skilled.
• Level of Care Criteria - Guidelines employed to assist in determining the appropriate setting and intensity of behavioral health treatment.
• License/Licensure - A permission granted to an individual or organization by a competent authority, usually public, to a engage lawfully in a practice, occupation, or activity.
• Life-Sustaining Treatment - Medical procedures that replace or support an essential bodily funciton. Life-sustaining treatments include CPR, mechanical ventilation, artificial nutrition and hydration, dialysis, and certain other treatments.
• Lifetime Policy Maximum for ALD/Other Facility Care (Dollars) - If the coverage uses a pool of dollars design and has separate pools for the major covered services, this is where the dollar amount which represents the lifetim maximum paid for ALF care would be specified. If the policy combines nursing home and ALF care into a single "facility care lifetime maximum" this entry would be indicated as "not applicable."
• Lifetime Policy Maximum for ALF/Other Facility Care Benefits (Days) - If the coverage uses days of benefit received to calculate the policy maximum and has separate pools for the major covered services, this is where the number of days which represents the lifetime maximum paid for ALF care would be specified.
• Lifetime Policy Maximum for Home Health Care (Dollars) - If the coverage uses a pool of dollars design and has separate pools for the major covered services, this is where the dollar amount which represents the lifetime maximum paid for home health care would be specified.
• Lifetime Policy Maximum for Home Health Care Benefits (Days) - If the coverage uses days of benefit received to calculate the policy maximum and has separate pools for the major covered services, this is where the number of days which represents the lifetime maximum paid for home health care would be specified.
• Lifetime Policy Maximum for Nursing Home Benefits (Days) - If the coverage uses days of benefit received to calculate the policy maximum and has separate pools for the major covered services, this is where the number of days which represents the lifetime maximum paid for nursing home care (or facility care all levels combined) would be specified.
• Lifetime Policy Maximum for Nursing Home Coverage (Dollars) - If the coverage uses a pool of dollars design and has separate pools for the major covered services, this is where the dollar amount which represents the lifetime maximum paid for nursing home care (or facility care all levels combined) would be specified.
• Long-Term Care (LTC) - Range of medical and/or social services designed to help people who have disabilities or chronic care needs. Services may be short- or long-term and may be provided in a person's home, in the community, or in residential facilities (e.g., nursing homes or assisted living facilities).
• Long-Term Care Insurance (LTCI) - Insurance policies which pay for long-term care services (such as nursing home and home care) that Medicare and Medigap policies do not cover. Policies vary in terms of what they will cover, and may be expensive. Coverage may be denied based on health status or age.
• Maintenance Assistance Status (MAS) - Eligibility grouping traditionally used by CMS to classify enrollees by the financial-related criteria by which they are eligible for Medicaid. MAS groups include cash assistance-related, medically needy, poverty-related, 1115 demonstration waiver, and other.
• Maternal and Child Health Block Grant (Programs for Children with Special Needs) - There are no Federal criteria for defining children with special health care needs. These programs primarily served children with crippling conditions such as polio and cerebral palsy. However, these programs have expended to serve children with a wide range of chronic health conditions.
• Mean Square Error - Measure of accuracy computed by squaring the individual errors (error is the difference between an actual value in a dataset and its expected value) and taking the mean of these squared values.
• Medical Necessity - Services or supplies which are appropriate and consistent with the diagnosis in accord with accepted standards of community practice and are not considered experimental. They also can not be omitted without adversely affecting the individual's condition or the quality of medical care.
• Medically Indigent - People who cannot afford needed health care because of insufficient income and/or lack of adequate health insurance.
• Medicare Supplement Insurance (MedSupp) - (Also called Medigap.) Insurance supplement to Medicare that is designed to fill in the "gaps" left by Medicare (such as co-payments). May pay for some limited long-term care expenses, depending on the benefits package purchased.
• Medigap - (Also called Medicare supplement insurance. Insurance supplement to Medicare that is designed to fill in the "gaps" left by Medicare (such as co-payments). May pay for some limited long-term care expenses, depending on the benefits package purchased.
• Mental Health Services - Variety of services provided to people of all ages, including counseling, psychotherapy, psychiatric services, crisis intervention, and support groups. Issues addressed include depression, grief, anxiety, stress, as well as severe mental illnesses.
• Mental Health - The capacity in an individual to function effectively in society. Mental health is a concept influenced by biological, environmental, emotional, and cultural factors and is highly variable in definition, depending on time and place. It is often defined in practice as the absence of any identifiable or significant mental disorder and sometimes improperly used as a synonym for mental illness.
• Mental Illness/Impairment - A deficiency in the ability to think, perceive, reason, or remember, resulting in loss of the ability to take care of one's daily living needs.
• Mentally Retarded - Significantly subaverage general intellectual functioning (specifically an I.Q. below 70) existing concurrently with deficits in adaptive behavior manifested during the developmental period (age 0-21).
• Morbidity - The extent of illness, injury, or disability in a defined population. It is usually expressed in general or specific rates of incidence or prevalence.
• Mortality - Death. Used to describe the relation of deaths to the population in which they occur.
• Multi-Stage Probability Sample - A sample drawn in successive stages. The population is first divided into primary groups (called primary sampling units or PSUs), some of which are selected (for example, with a probability proportional to their population size). Selected PSUs are then divided into clusters (e.g., of blocks), from which a sample (e.g., of households) is drawn.
• Noneconomic Damages - Civil litigation is compensation due the plaintiff for intangible harms (e.g., pain and suffering).
• Nonprofit/Not-For-Profit - An organization that reinvests all profits back into that organization.
• Nonsampling Error - The discrepancy between a sample statistic and the true population parameter that results from factors other than the sampling process. Common sources of nonsampling errors include noncoverage of certain subpopulations, questionnaire wording, and recall errors.
• Number of Insureds with Buy-Up Partnership Qualified (PQ) Coverage - The number of covered lives who have elected to purchase the voluntary buy-up coverage offered by the group plan, in addition to the Core Plan coverage already provided to them.
• Number of Persons Insured with Core Coverage - Indicates the number of covered lives enrolled in the core plan coverage offered by the employer.
• Nurse Practitioner (NP) - A registered nurse working in an expanded nursing role, usually with a focus on meeting primary health care needs. NPs conduct physical examinations, interpret laboratory results, select plans of treatment, identify medication requirements, and perform certain medical management activities for selected health conditions. Some NPs specialize in geriatric care.
• Nurse - An individual trained to care for the sick, aged, or injured. Can be defined as a professional qualified by education and authorized by law to practice nursing.
• Nursing Home Benefits Paid During Reporting Period - The total amount of benefits paid during the reporting period for care in a nursing home or in a similar covered care institutional setting as defined as "nursing home" or "facility-based" care within the policy or certificate.
• Nursing Home Care - Full-time care delivered in a facility designed for recovery from a hospital, treatment, or assistance with common daily activities.
• Nursing Home Liability Insurance - Indemnification of nursing home providers against damages for negligent care and abuse.
• Nursing Home Residents' Rights Statutes - State and federal laws to protect each nursing home resident's civil, religious and human rights.
• Nursing Home - Facility licensed by the state to offer residents personal care as well as skilled nursing care on a 24 hour a day basis. Provides nursing care, personal care, room and board, supervision, medication, therapies and rehabilitation. Rooms are often shared, and communal dining is common. (Licensed as nursing homes, county homes, or nursing homes/residential care facilities.)
• Occupancy Rate - A measure of inpatient health facility use, determined by dividing available bed days by patient days. It measures the average percentage of a hospital's beds occupied and may be institution-wide or specific for one department or service.
• Occupational Health Services - Health services concerned with the physical, mental, and social well-being of an individual in relation to his or her working environment and with the adjustment of individuals to their work. The term applies to more than the safety of the workplace and includes health and job satisfaction.
• Occupational Therapy (OT) - Designed to help patients improve their independence with activities of daily living through rehabilitation, exercises, and the use of assistive devices. May be covered in part by Medicare.
• Offshore Captives - Captives located outside the United States. The most popular host states for offshore captives include Bermuda, Guernsey and the Cayman Islands.
• Older Americans Act (OAA) - Federal legislation that specifically addresses the needs of older adults in the United States. Provides some funding for aging services (such as home-delivered meals, congregate meals, senior center, employment programs). Creates the structure of federal, state, and local agencies that oversee aging services programs. (See also Title III services.)
• Ombudsman - A representative of a public agency or a private nonprofit organization who investigates and resolves complaints made by or on behalf of older individuals who are residents of long-term care facilities.
• Omnibus Budget Reconciliation Act (OBRA) of 1993 - Federal legislation that limits the amount of compensation that can be paid to employees covered by long-term disability plans funded through voluntary employees' beneficiary association trusts. Any such plan with participants earning more than $150,000 could lose its tax-exempt status.
• Original Coverage Effective Date as Partnership Qualified (PQ) Policy - The date that coverage first became effective under the policy or certificate help by the insured.
• Other Benefit Amounts Paid During Reporting Period - The total amount of any other benefits paid during this period (e.g., caregiver training, medical devices, other ancillary benefits and services, etc.).
• Outpatient - A patient who is receiving ambulatory care at a hospital or other facility without being admitted to the facility. Usually, it does not mean people receiving services from a physician's office or other program which also does not provide inpatient care.
• Palliative Care - (Also called comfort care.) A comprehensive approach to treating serious illness that focuses on the physical, psychological, and spiritual needs of the patient. Its goal is to achieve the best quality of life available to the patient by relieving suffering, controlling pain and symptoms, and enabling the patient to achieve maximum functional capacity. Respect for the patient's culture, beliefs, and values is an essential component.
• Panel Survey - A survey that follows a given sample of individuals over time, thus providing multiple observations on each individual in the sample.
• Parents or Relatives - (Also referred to as own home). Return of the child to parental or nonlicensed/reimbursed relative's home, with ongoing assistance and/or supervision provided.
• Peer Review - Generally, the evaluation by practicing physicians or other professionals of the effectiveness and efficiency of services ordered or performed by other members of the profession (peers).
• Physical Therapy (PT) - Designed to restore/improve movement and strength in people whose mobility has been impaired by injury and disease. May include exercise, massage, water therapy, and assistive devices. May be covered in part by Medicare.
• Physician Assistant (PA) - (Also known as a physician extender.) A specially trained and licensed or otherwise credentialed individual who performs tasks, which might otherwise be performed by a physician, under the direction of a supervising physician.
• Point of Service - A health insurance benefits program in which subscribers can select between different delivery systems (i.e., HMO, PPO and fee-for-service) when in need of medical services, rather than making the selection between delivery systems at time of open enrollment at place of employment.
• Policy Benefit Type - Some policies are comprehensive in that they pay for care in all long-term care settings (nursing home, ALF, home care and others). Other policies pay just for facility-based care, and others pay for only care outside a facility. This variable indicates the type of policy with respect to the range of services it covers.
• Policy Issue State - The state in which the individual policy is issued. This would also be the state of residents of the insured to whom the individual policy is delivered.
• Policy Number - The unique policy or certificate identification number assigned to each insured's coverage.
• Policy/Certificate Age at which Inflation Protection Ends - The type of inflation protection that ends when the insured has received annual benefit increases for a predefined number of years. Value refers to the actual number of years which are specified in the coverage.
• Pre-Admission Certification - A process under which admission to a health institution is reviewed in advance to determine need and appropriateness and to authorize a length of stay consistent with norms for the evaluation.
• Pre-Existing Conditionм - Illnesses or disability for which the insured was treated or advised within a stipulated time period before making application for a life or health insurance policy. A pre-existing condition can result in cancellation of the policy.
• Precision - The precision is the inverse of the amount of random error in an estimate. It indicates how close an estimate is likely to be to the true population value (see standard error).
• Preferred Provider Arrangement (PPA) - Selective contracting with a limited number of health care providers, often at reduced or pre-negotiated rates of payment
• Preferred Provider Organization (PPO) - Managed care organization that operates in a similar manner to an HMO or Medicare HMO except that this type of plan has a larger provider network and does not require members to receive approval from their primary care physician before seeing a specialist. It is also possible to use doctors outside the network, although there may be a higher co-payment.
• Premium - The periodic payment (e.g., monthly, quarterly) required to keep an insurance policy in force.The charge paid by a policyholder for insurance coverage.
• Prepayment - Usually refers to any payment to a provider for anticipated services (such as an expectant mother paying in advance for maternity care).
• Preventive Medicine - Care which has the aim of preventing disease or its consequences. It includes health care programs aimed at warding off illnesses (e.g., immunizations), early detection of disease (e.g., Pap smears), and inhibiting further deterioration of the body (e.g., exercise or prophylactic surgery). Preventive medicine is also concerned with general prevention measures aimed at improving the healthfulness of the environment.
• Primary Care - Basic or general health care focused on the point at which a patient ideally first seeks assistance from the medical care system.
• Primary Sampling Unit (PSU) - Groups selected as the first stage of a multi-stage sample. For example, for the CPS sample, the United States is divided into approximately 1,900 geographic areas, or PSUs, of which 729 are selected for the sample.
• Private Duty Nursing - Services, except those for mental health or substance abuse treatment, provided by registered nurses or licensed practical nurses under direction of a physician to recipients in their own homes, hospitals, or nursing facilities as specified by the state.
• Probability (P value) - The likelihood that an event will occur.
• Professional Liability Claims/Losses - Amounts a nursing home liability insurer is legally obligated to pay as damages and associated claims and defense expenses to a plaintiff due to a negligent act, error or omission in a nursing home provider's rendering or failure to render professional services.
• Program of All-Inclusive Care for the Elderly (PACE) - A managed care plan that coordinates Medicare and Medicaid acute care and long-term care for dual eligible enrollees (those age 55 and older, living in a PACE area, and otherwise eligible for nursing home care). A capitated payment mechanism is used for PACE plan enrollees.
• Prospective Payment - Any method of paying hospitals or other health programs in which amounts or rates of payment are established in advance for a defined period (usually a year).
• Provider Sponsored Organization (PSO) - Managed care organization that is similar to an HMO or Medicare HMO except that the organization is owned by the providers in that plan and these providers share the financial risk assumed by the organization.
• Provider - Individual or organization that provides health care or long-term care services (e.g., doctors, hospital, physical therapists, home health aides, and more).
• Proxy - Substitute decision maker.
• Psychiatric Rehabilitation Option - An optional Medicaid service that can include (depending on state definitions) community support programs, school-based services, crisis intervention services, and outpatient psychotherapy services.
• Public Health - The science dealing with the protection and improvement of community health by organized community effort.
• Punitive Damages - Civil litigation means monetary compensation awarded by a judge or jury which exceeds the losses suffered by the injured party in order to punish the defendant.
• Purchasing Collaborative - A collaborative behavioral health services model that brings all agencies tasked with the delivery, funding or oversight of behavioral health care services together to create a single behavioral health service delivery system.
• Qualifying Condition - The specific conditions for which the individual qualifies as chronically ill. This could include dependency in the required number of ADLs, cognitive impairment or both.
• Quality of Care - can be defined as a measure of the degree to which delivered health services meet established professional standards and judgments of value to the consumer.
• Ratio Adjustment - Potentially biased indirect state-level estimates can be ratio adjusted to regional totals so that the sum across states matches regional estimates. This eliminates bias at the regional level and attempts to remove bias from the state-level indirect estimator.
• Re-insurance - The practice of insurance carriers ceding risk to other firms, called re-insurance companies, in order to limit their liability exposure. Re-insurance companies essentially provide insurance to insurance companies. Instead of assessing the risk of individual policyholders, re-insurance companies assess risk on a broader scale, such as on the basis of a particular product-line (nursing home liability insurance) or a geographic region.
• Registered Nurse (RN) - A nurse who has graduated from a formal program of nursing education and has been licensed by an appropriate state authority. RNs are the most highly educated of nurses with the widest scope of responsibility, including all aspects of nursing care. RNs can be graduated from one of three educational programs: two-year associate degree program, three-year hopsital diploma program, or four-year baccalaureate program.
• Rehabilitation Services - Services designed to improve/restore a person's functioning; includes physical therapy, occupational therapy, and/or speech therapy. May be provided at home or in long-term care facilities. May be covered in part by Medicare.
• Rehabilitation - The combined and coordinated use of medical, social, educational, and vocational measures for training or retaining individuals disabled by disease or injury to the highest possible level of functional ability. Several different types of rehabilitation are distinguished: vocational, social, psychological, medical, and educational.
• Reimbursement - The process by which health care providers receive payment for their services. Because of the nature of the health care environment, providers are often reimbursed by third parties who insure and represent patients.
• Reinsurance - The practice of insurance carriers ceding risk to other firms, called reinsurance companies, in order to limit their liability exposure. Reinsurance companies essentially provide insurance to insurance companies. Instead of assessing the risk of individual policyholders, reinsurance companies assess risk on a broader scale, such as on the basis of a particular product line (nursing home liability insurance) or a geographic region.
• Remaining Lifetime ALF/Other Facility Benefits (Days) - Under a policy design with separate pools of benefits, paying on the basis of days of covered services, the total number of days of care remaining available to the insured in the ALF Benefit Pool.
• Remaining Lifetime ALF/Other Facility Benefits (Dollars) - Under a policy design with separate pools of benefits, paying on the basis of dollars for covered services, the total dollar amount of care remaining available to the insured in the ALF Benefit Pool.
• Remaining Lifetime Benefits - Under a policy design with a single pool of dollars as the Lifetime Maximum, the total dollar amount of benefits remaining available to the insured in the Lifetime Maximum at the end of the reporting period.
• Remaining Lifetime Home Health Care Benefits (Days) - Under a policy design with separate pools of benefits, paying on the basis of days of covered services, the total number of days of care remaining available to the insured in the Home Health Care Benefit Pool.
• Remaining Lifetime Home Health Care Benefits (Dollars) - Under a policy design with separate pools of benefits, paying on the basis of dollars for covered services, the total dollar amount of care remaining available to the insured in the Home Health Care Benefit Pool.
• Remaining Lifetime Nursing Home Benefits (Days) - Under a policy design with separate pools of benefits, paying on the basis of days of covered services, the total number of days of care remaining available to the insured in the Nursing Home Benefit Pool.
• Remaining Lifetime Nursing Home Benefits (Dollars) - Under a policy design with separate pools of benefits, paying on the basis of dollars for covered services, the total dollar amount of care remaining available to the insured in the Nursing Home Benefit Pool.
• Rent-A-Captive - A captive, usually formed by an insurance company, broker or captive manager, and rented out to users (in this case nursing home providers) who avoid the cost of funding their own captive. The user provides some form of collateral so that the rent-a-captive is not at risk from any underwriting loss suffered by the user.
• Report Date - The date on which the Registry File is submitted.
• Respiratory Therapy - The diagnostic evaluation, management, and treatment of the care of patients with deficiences and abnormalities in the cardiopulmonary (heart-lung) system.
• Respite Care - Service in which trained professionals or volunteers come into the home to provide short-term care (from a few hours to a few days) for an older person to allow caregivers some time away from their caregiving role.
• Restricted-Benefit Enrollee - Enrollee who receives limited Medicaid coverage, inlcuding unqualified aliens only eligible for emergency hospital benefits, duals receiving only Medicare cost-sharing benefits, and people eligible for only family-planning services.
• Risk Management -
• Risk Retention Group (RRG) - An insurance company that is owned by its members. The members of an RRG come from the same industry. For instance, nursing home providers can form an RRG in order to obtain nursing home liability coverage.
• Sampling Error - The discrepancy between a sample statistic and the true population parameter that results from the sampling process. Sampling error can have a random component (sampling variance) and fixed component (bias).
• Sampling Variance - Random error (discrepancy between a sample statistic and the true population parameter) that arises because a random process is used to select the survey sample. If the sampling process is repeated several times, a different group of respondents would be selected each time and the sample distributions of answers to the survey questions would be somewhat different in each sample.
• Screening - The use of quick procedures to differentiate apparently well persons who have a disease or a high risk of disease from those who probably do not have the disease.
• Secondary Care - Services provided by medical specialists who generally do not have first contact with patients (e.g., cardiologist, urologists, dermatologists).
• Secure Facility - (Also called training school, reformatory, detention center, jail, or secure hospital.) Twenty-four hour residential care facility of any size, designed and operated to ensure that all entrances and exits are under the exclusive control of the staff, whether or not the person being detained has freedom of movement within the facility perimeters.
• Senility - The generalized characterization of progressive decline in mental functioning as a condition of the aging process. Within geriatric medicine, this term has limited meaning and is often substituted for the diagnosis of senile dementia and/or senile psychosis.
• Senior Center - Provides a variety of on-site programs for older adults including recreation, socialization, congregate meals, and some health services. Usually a good source of information about area programs and services.
• Service Plan - (Also called care plan or treatment plan.) Written document which outlines the types and frequency of the long-term care services that a consumer receives. It may include treatment goals for him or her for a specified time period.
• Settlement - An agreement reached between the legal counsel of the plaintiff and the defendant that terminates a civil litigation before a verdict is reached by the court.
• Severity of Illness - A risk prediction system to correlate the "seriousness" of a disease in a particular patient with the statistically "expected" outcome (e.g., mortality, morbidity, efficiency of care).
• Situs State - The state in which the group policy is sitused, as specified on the group policy form.
• Skilled Care - "Higher level" of care (such as injections, catheterizations, and dressing changes) provided by trained medical professionals, including nurses, doctors, and physical therapist.
• Skilled Nursing Care - Daily nursing and rehabilitative care that can be performed only by or under the supervision of, skilled medical personnel.
• Skilled Nursing Facility (SNF) - Facility that is certified by Medicare to provide 24-hour nursing care and rehabilitation services in addition to other medical services. (See also nursing home.)
• Social Services Block Grant (SSBG) Services - (Formerly known as Title XX services.) Grants given to states under the Social Security Act which fund limited amounts of social services for people of all ages (including some in-home services, abuse prevention services, and more).There is no Federal statutory definition. States set their own criteria for determining disability.
• Special Care Units - Long-term care facility units with services specifically for persons with Alzheimer's Disease, dementia, head injuries, or other disorders.
• Speech Therapy - Designed to help restore speech through exercises. May be covered by Medicare.
• Spell - A series of months during which a person received Medicaid-covered nursing home services for at least one day of each month and received no such services during the month preceding and following the series.
• Spend-Down - Medicaid financial eligibility requirments are strict, and may require beneficiaries to spend down/use up assets or income until they reach the eligibility level.
• Spousal Impoverishment - Federal regulations preserve some income and assets for the spouse of a nursing home resident whose stay is covered by Medicaid.
• Standard Deviation - Common measure of dispersion or spread of data about the mean.
• Standard Error - The most commonly used measure of the precision of an estimate. A gauge of how close an estimate is likely to be to the population value in the absence of any bias.
• State Unit on Aging - Authorized by the Older Americans Act. Each state has an office at the state level which administers the plan for service to the aged and coordinates programs for the aged with other state offices.
• Support Groups - Groups of people who share a common bond (e.g., caregivers) who come together on a regular basis to share problems and experiences. May be sponsored by social service agencies, senior centers, religious organizations, as well as organizations such as the Alzheimer's Association.
• Surrogate - (Also called proxy by default.) A person who, by default, become the proxy decision maker for an individual who has no appointed agent.
• Survey - An investigation in which information is systematically collected.
• Synthetic Estimates - A class of model-dependent estimates generally formed by dividing the population into subgroups (e.g., by age/race/sex) and assuming that national estimates for each subgroup can be applied to the local populations.
• Technology Assessment - A comprehensive form of policy research that examines the technical, economic, and social consequences of technology applications.
• Termination of FPO Option - Indicates when the FPO offers end. For some policies they may continue for the life of the policy even while the insured is on claim; for others they may end when the individual is on claim or within a specified time period of having received benefits. The FPO offers may end at a defined age or when the insured has declined a certain number of increase offers.
• Title XIX (Medicaid) - federal and state-funded program of medical assistance to low-income individuals of all ages. There are income eligibility requirements for Medicaid.
• Title XVIII (Medicare) - Federal health insurance program for persons age 65 and over (and certain disabled persons under age 65). Consists of 2 parts: Part A (hospital insurance) and Part B (optional medical insurance which covers physicians' services and outpatient care in part and which requires beneficiaries to pay a monthly premium).
• Title XX Services - (Now known as Social Services Block Grant services.) Grants given to states under the Social Security Act which fund limited amounts of social services for people of all ages (including some in-home services, abuse prevention services, and more).
• Total Cash Benefits Paid During Reporting Period - The total dollar amount of benefits paid on a cash basis during the reporting period.
• Total Lifetime Benefits Paid to Date - Indicates the total amount of benefits paid under the certificate to date as of the end of the reporting period.
• Transportation Services - (Also called escort services.) Provides transportation for older adults to services and appointments. May use bus, taxi, volunteer drivers, or van services that can accommodate wheelchairs and persons with other special needs.
• Treatment Plan - (Also called care plan or service plan.) Written document which outlines the types and frequency of the long-term care services that a consumer receives. It may include treatment goals for him or her for a specified time period.
• Uncompensated Care - Service provided by physicians and hospitals for which no payment is received from the patient or from third party payers.
• Underinsured - People with public or private insurance policies that do not cover all necessary medical services, resulting in out-of-pocket expenses that exceed their ability to pay.
• Underwriting - The process by which an insurer assesses the risk of insuring a particular applicant for coverage. Risk retention groups also underwrite by assessing the risk of accepting a prospective member.
• Undue Hardship - With respect to the provision of accommodation for an individual with a disability under the Americans with Disabilities Act--significant difficulty or expense, considered in light of the employer's financial resources, facilities, workforce, and business operations.
• Veterans' Disability Compensation Program - An individual must have a partial or total impairment by injury or disease incurred or aggravated during military service. A Veterans' Affairs (VA) rating board employs criteria developed by the VA to rate the extent of a disability.
• Veterans' Disability Pension Program - An individual must have an injury or disease sustained outside of military service regarding a veteran permanently and totally impaired. Impairment is determined based on the veteran's ability to function at work and at home.
• Vital Statistics - Statistics relating to births (natality), deaths (mortality), marriages, health, and disease (morbidity).
• Wellness - A dynamic state of physical, mental, and social well-being; a way of life which equips the individual to realize the full potential of his or her capabilities and to overcome and compensate for weaknesses; a lifestyle which recognizes the importance of nutrition, physical fitness, stress reduction, and self-responsibility.
• Withholding/Withdrawing Treatment - Forgoing or discontinuing life-sustaining measures.

Conclusion

Healthcare is a dynamic and multifaceted domain, crucial for the well-being of populations. Its complexity necessitates collaboration among various professionals to ensure holistic care. With emerging challenges and rapid scientific advancements, healthcare continues to evolve, seeking to offer better solutions for global health needs.

See Also

• Public health
• Healthcare systems
• Medical research
• Healthcare policy
• Healthcare terminology glossary

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