Appendix 144-502-B - GLOSSARY OF HEALTH CARE TERMS1 ACCESSIBILITY: In connection with the provisions of PL 93-641, the degree to which an individual's entry to the health care system and receipt of services is inhibited or facilitated. Factors include such things as insurance coverage and transportation.2 ACUTE CARE: Treatment of an injury or disease of a short term nature within a medical/surgical hospital.3 ADMISSION RATE: The number of persons admitted annually to health care facilities within a community, usually expressed as a number per 1,000 persons in the community. It also may be based on the population served by a particular institution.4 AMBULATORY CARE: Health care delivered to patients who transport themselves and do not occupy a hospital bed.5 ALLOPATHIC/OSTEOPATHIC/HOMEOPATHIC PHYSICIAN: An Allopathic physician is one who is practicing a philosophy of medicine which views the role of the physician as an active interventionist who attempts to counteract the effect of a disease by using surgical or medical treatments which produce effects opposite to those of the disease. The practice of an Osteopathic physician, on the other hand, is based on the theory that diseases are due chiefly to the loss of structural integrity which can be restored by manipulation of the body parts in combination with therapeutic measures. A Homeopathic Physician generally uses a drug therapy which reinforces the body's natural self-healing process.6 AMBULATORY SURGICAL FACILITY: A facility, not part of a hospital, which provides surgical treatment to Patients not requiring hospitalization. This term does not include the offices of private physicians or dentists, whether in individual or group practice.7 AT RISK: An insurance concept that refers to a group or community's Potential to experience health problems. For example, a group of elderly persons would be expected to experience more health problems than a younger population.8 AVAILABILITY: The degree to which the supply of health resources and services exists to meet the needs or demands of a community.9 BASIC LIFE SUPPORT SERVICES: Basic medical services delivered by emergency medical personnel.10 BIRTHING CENTER: A free standing facility for the delivery of children, normally emphasizing deliver by midwife.11 BOARDING CARE FACILITY: A home that is primarily engaged in providing to three (3) or more persons: a. Personal care, supervision and social services for persons 18 years of age or over who are ambulatory and who do not have such an illness, disease, injury or other conditions as to require the degree of care and treatment which a hospital or skilled nursing care facility or intermediate care facility is designed to provide.b. Such care and services under-the supervision of sufficient personnel to provide adequate care for its residents during all hours of each day and all days of each week.12 CAPITAL EXPENDITURE: An expenditure, including a force account expenditure, which under generally accepted accounting principles is not properly chargeable as an expense of operation and maintenance and, for the purposes of certificate of need, shell include capitalized interest on borrowed funds and the fair market value of any property or equipment which is acquired under lease or comparable arrangement or through donation. Generally, an expenditure which benefits more than one accounting period, which is generally one year in length.13 CAPITATION: A method of payment for health services in which an individual or institutional provider is paid a fixed per capita amount for each person served without regard to the actual number or nature of services provided to each person. Capitation is characteristic of health maintenance organizations.14 CATEGORICALLY NEEDY: Under Medicaid (Title XIX), persons aged, blind, disabled, or a member of a family with children under la with one parent absent, incapacitated or unemployed.15 CHRONIC CARE: Health care for diseases or problems that are characterized by permanence, residual disability, non-reversible pathological alteration. special rehabilitation or prolonged duration.16 COMPUTERIZED AXIAL TOMOGRAPHY (CAT): A diagnostic imaging device which uses a computer to analyze the differential strength of X-ray beams Scanner Passed through body tissues in order to locate and identify abnormalities.17 CONGREGATE HOUSING: A residential environment which provides support services, such as meals, housekeeping, health care, etc. It is designed to assist impaired, but not ill, elderly to maintain (or return to) a semi-independent life style.18 CONTINUITY: The concept that people who experience disease or injury should have some agent (either a person or an organization) which assumes responsibility for assuring the provision of needed care. As needs of the patient are addressed, the person is not passed from one provider to another with no overall care management. 19 ELIGIBILITY: Condition that must exist or be met if a person is to Qualify for a government program.20 FISCAL YEAR: Any yearly period at the end of which a firm, government, etc., determines its financial condition without regard to the calendar year.21 GENERIC DRUG: A pharmaceutical compound not marketed under a brand name.22 HEALTH MAINTENANCE ORGANIZATION: a public or private organization which: a. Provides or otherwise makes available to enrolled participants health care services, including at least the following basic health services: usual physician services, hospitalization, laboratory X-ray, emergency and preventive health services and out-of-areas covered.b. Is compensated, except for copayments, for the provision of the basic health services to enrolled participants on a predetermined periodic rate basis; andc. Provides Physicians' services primarily through physicians who are either employees or partners of the organization or through arrangements with individual physicians or one or more groups of physicians.23 HEALTH SERVICE AREA: A geographic area appropriate for the effective planning and development of health services.24 HEALTH SHORTAGE AREA: A geographical area or group of communities that looks an adequate number of one or more of the various health Professions.25 HOME HEALTH CARE: Component of a continuum of comprehensive health care where health services are provided to individuals in their place of residence for the purpose of promoting, maintaining or restoring health or of maximizing the level of independence while minimizing the effects of disability and illness, including terminal illness.26 HOMEMAKER SERVICES: Services provided by a person employed by a health or welfare agency to furnish home help to families with children; to convalescent, aged, acutely or chronically ill and disabled persons; or to all of these. The primary functions are the maintenance of household routine and the maintenance or creation of wholesome family living in times of stress.27 HOSPITAL: An institution which is primarily engaged in providing to inpatients by or under supervision of physicians, diagnostic services and therapeutic services for medical diagnosis, treatment, and care of injured, disabled or sick persons, or rehabilitation services for the rehabilitation of injured, disabled or sick persons.28 HYPERTENSION: Abnormally high blood pressure.29 INCIDENCE: The frequency of occurrence of events.30 INCIDENCE RATE: The incidence of conditions per 1,000 persons in a Population during a period of time (usually one year).31 INPATIENT: The condition of remaining in health care facility overnight.32 INTENSIVE CARE UNIT (ICU): A specialized nursing unit that concentrates seriously ill patients needing constant observation.33 INTERMEDIATE CARE FACILITY (ICF): An institution which provides, on a regular basis, health-related care and services to individuals who do not require the degree of care and treatment which a hospital or skilled nursing facility is designed to provide, but who because of their mental or Physical conditions require health-related care and services above the level of room and board.34 LENGTH OF STAY: The number of days a patient is in a health care facility.35 LICENSE: A Permission granted by a government to an individual or organization authorizing the provision of health care services or the establishment and operation of a health care facility.36 LONG TERM CARE FACILITY: An institution that provides care for the chronically ill, the aged, the disabled and the retarded.37 MEDICAID (Title XIX, SOCIAL SECURITY ACT): A federally-aided, State operated and administered program which provides medical benefits for certain low-income persons in need of health and medical care.38 MEDICALLY NEEDY: In the Medicaid program, persons who have enough income and resources to pay for their basic living expenses (and so not need welfare), but not enough to pay for their medical expenses.39 MEDICARE (Title XVIII, SOCIAL SECURITY ACT): A nationwide health insurance program for people age 65 and over, for persons eligible for Social Security disability payments for over two years, and for certain workers and their dependents who need kidney transplantation or dialysis.40 NATIONAL HEALTH SERVICE CORPS (NHSC): A federal program that provides health manpower to areas that do not have an adequate supply of appropriate health care professionals.41 PEER REVIEW: The evaluation of health Professionals by their peers.42 PEDIATRICS: A branch of medicine dealing with the development, care and diseases of children.43 PERINATAL: The period around the birth of a child. There are several technical definitions. A commonly used one is from the 20th week of gestation to the 28th day of life.44 PRENATAL CARE: Preventive and diagnostic care and treatment rendered to a mother during pregnancy. Pregnancy is divided into three three-month periods known as trimesters.45 PREVALENCE: The number of cases of a disease present at a particular time in a particular population.46 PREVALENCE RATE: The number of cases of a disease present at a particular time in a given population per 1,000 persons in the population.47 PRIMARY CARE: Basic or general health care which emphasizes the point when the patient first seeks assistance from the medical care system and the care of the simpler and more common illnesses. The primary care provider usually also assumes ongoing responsibility for the patient in both health maintenance and therapy of illness. It is comprehensive in the sense that it takes responsibility for the overall coordination of the care of the patient's health problems, be they biological, behavioral or social.. The appropriate use of consultants and community resources is an important part of effective primary care. Such care is generally provided by physicians, but is increasingly provided by other personnel such as family nurse practitioners.48 QUALITY: connection with the provisions of PL 93-641. the extent to which health care services are delivered in accordance with established professional standards in terms of structure, process and outcome. Elements of quality health care include technical competence, respect for the patient, treatment method, length and environment, and effectiveness.49 REIMBURSEMENT: To pay back to someone. Payment for health care services can be made by the patient (self-pay), his insurer (e.g., Blue Cross/Blue Shield or Union Mutual) or a third party purchaser of care (e.g., Medicaid).50 SKILLED NURSING FACILITY: An institution or distinct part of an institution which is primarily engaged in providing to inpatients skilled nursing care and related services for patients who require medical or nursing care, or rehabilitation services for the rehabilitation of injured, disabled or sick persons.51 SUPPLEMENTAL SECURITY INCOME (SSI): A program of income support for low-income, aged, blind or disabled persons. C.M.R. 10, 144, ch. 502, app 144-502-B