Insurance, Health
Insurance Coverage
Generally refers to the amount of protection available and the kind of loss which would be paid for under an insurance contract with an insurer. (Slee & Slee, Health Care Terms, 2d ed)
Health Benefit Plans, Employee
Health insurance plans for employees, and generally including their dependents, usually on a cost-sharing basis with the employer paying a percentage of the premium.
Insurance
Insurance, Long-Term Care
Health insurance to provide full or partial coverage for long-term home care services or for long-term nursing care provided in a residential facility such as a nursing home.
Insurance, Life
Occupational Health
The promotion and maintenance of physical and mental health in the work environment.
Insurance Carriers
Occupational Health Services
Health services for employees, usually provided by the employer at the place of work.
Workplace
Insurance Pools
Insurance Selection Bias
Medically Uninsured
Individuals or groups with no or inadequate health insurance coverage. Those falling into this category usually comprise three primary groups: the medically indigent (MEDICAL INDIGENCY); those whose clinical condition makes them medically uninsurable; and the working uninsured.
Insurance Benefits
Payments or services provided under stated circumstances under the terms of an insurance policy. In prepayment programs, benefits are the services the programs will provide at defined locations and to the extent needed.
Occupational Diseases
Diseases caused by factors involved in one's employment.
Sick Leave
An absence from work permitted because of illness or the number of days per year for which an employer agrees to pay employees who are sick. (Webster's New Collegiate Dictionary, 1981)
Employer Health Costs
That portion of total HEALTH CARE COSTS borne by an individual's or group's employing organization.
Absenteeism
Chronic absence from work or other duty.
United States
The term "United States" in a medical context often refers to the country where a patient or study participant resides, and is not a medical term per se, but relevant for epidemiological studies, healthcare policies, and understanding differences in disease prevalence, treatment patterns, and health outcomes across various geographic locations.
Employee Incentive Plans
Programs designed by management to motivate employees to work more efficiently with increased productivity, and greater employee satisfaction.
Insurance, Health, Reimbursement
Payment by a third-party payer in a sum equal to the amount expended by a health care provider or facility for health services rendered to an insured or program beneficiary. (From Facts on File Dictionary of Health Care Management, 1988)
National Health Insurance, United States
National Health Insurance in the United States refers to a proposed system of healthcare financing that would provide comprehensive coverage for all residents, funded through a combination of government funding and mandatory contributions, and administered by a public agency.
Insurance, Liability
Industry
Any enterprise centered on the processing, assembly, production, or marketing of a line of products, services, commodities, or merchandise, in a particular field often named after its principal product. Examples include the automobile, fishing, music, publishing, insurance, and textile industries.
Insurance, Major Medical
Insurance, Accident
Private Sector
Universal Coverage
Health insurance coverage for all persons in a state or country, rather than for some subset of the population. It may extend to the unemployed as well as to the employed; to aliens as well as to citizens; for pre-existing conditions as well as for current illnesses; for mental as well as for physical conditions.
Insurance, Hospitalization
Health insurance providing benefits to cover or partly cover hospital expenses.
Occupational Exposure
Health Care Reform
Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.
Health Insurance Portability and Accountability Act
Public Law 104-91 enacted in 1996, was designed to improve the efficiency and effectiveness of the healthcare system, protect health insurance coverage for workers and their families, and to protect individual personal health information.
National Health Programs
Components of a national health care system which administer specific services, e.g., national health insurance.
Employee Grievances
Formal procedures whereby the employee expresses any dissatisfaction or feeling of injustice regarding the work situation.
Cost Sharing
Provisions of an insurance policy that require the insured to pay some portion of covered expenses. Several forms of sharing are in use, e.g., deductibles, coinsurance, and copayments. Cost sharing does not refer to or include amounts paid in premiums for the coverage. (From Dictionary of Health Services Management, 2d ed)
Eligibility Determination
Insurance Claim Review
Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.
Health Expenditures
The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.
Work Capacity Evaluation
Assessment of physiological capacities in relation to job requirements. It is usually done by measuring certain physiological (e.g., circulatory and respiratory) variables during a gradually increasing workload until specific limitations occur with respect to those variables.
Medicaid
Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.
Health Services Accessibility
Chemical Industry
State Health Plans
Personnel Downsizing
Reducing staff to cut costs or to achieve greater efficiency.
Organizational Policy
A course or method of action selected, usually by an organization, institution, university, society, etc., from among alternatives to guide and determine present and future decisions and positions on matters of public interest or social concern. It does not include internal policy relating to organization and administration within the corporate body, for which ORGANIZATION AND ADMINISTRATION is available.
Workload
The total amount of work to be performed by an individual, a department, or other group of workers in a period of time.
Financing, Personal
Payment by individuals or their family for health care services which are not covered by a third-party payer, either insurance or medical assistance.
Social Security
Government sponsored social insurance programs.
Questionnaires
Job Satisfaction
Personal satisfaction relative to the work situation.
Blue Cross Blue Shield Insurance Plans
Prepaid health and hospital insurance plan.
Socioeconomic Factors
Public Sector
The area of a nation's economy that is tax-supported and under government control.
Medical Savings Accounts
Finland
I'm sorry for any confusion, but "Finland" is not a medical term and does not have a medical definition. It is a country located in Northern Europe, known officially as the Republic of Finland. If you have any questions related to medical topics or definitions, I would be happy to help with those!
Patient Protection and Affordable Care Act
An Act prohibiting a health plan from establishing lifetime limits or annual limits on the dollar value of benefits for any participant or beneficiary after January 1, 2014. It permits a restricted annual limit for plan years beginning prior to January 1, 2014. It provides that a health plan shall not be prevented from placing annual or lifetime per-beneficiary limits on covered benefits. The Act sets up a competitive health insurance market.
Occupational Medicine
Labor Unions
Organizations comprising wage and salary workers in health-related fields for the purpose of improving their status and conditions. The concept includes labor union activities toward providing health services to members.
Insurance, Disability
Insurance designed to compensate persons who lose wages because of illness or injury; insurance providing periodic payments that partially replace lost wages, salary, or other income when the insured is unable to work because of illness, injury, or disease. Individual and group disability insurance are two types of such coverage. (From Facts on File Dictionary of Health Care Management, 1988, p207)
Metallurgy
The science, art, or technology dealing with processes involved in the separation of metals from their ores, the technique of making or compounding the alloys, the techniques of working or heat-treating metals, and the mining of metals. It includes industrial metallurgy as well as metallurgical techniques employed in the preparation and working of metals used in dentistry, with special reference to orthodontic and prosthodontic appliances. (From Jablonski, Dictionary of Dentistry, 1992, p494)
Health Insurance Exchanges
State-provided health insurance marketplaces established under the PATIENT PROTECTION AND AFFORDABLE CARE ACT.
Cross-Sectional Studies
Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.
Insurance, Physician Services
Workers' Compensation
Accidents, Occupational
State Government
The level of governmental organization and function below that of the national or country-wide government.
Occupational Health Physicians
Physicians employed in a company or corporate setting that is generally not in the health care industry.
Data Collection
Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.
Rehabilitation, Vocational
Training of the mentally or physically disabled in work skills so they may be returned to regular employment utilizing these skills.
Insurance, Pharmaceutical Services
Managed Care Programs
Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.
Employee Retirement Income Security Act
A 1974 Federal act which preempts states' rights with regard to workers' pension benefits and employee benefits. It does not affect the benefits and rights of employees whose employer is self-insured. (From Slee & Slee, Health Care Reform Terms, 1993)
Health Care Surveys
Work Schedule Tolerance
Employee Discipline
Models, Econometric
Preferred Provider Organizations
Arrangements negotiated between a third-party payer (often a self-insured company or union trust fund) and a group of health-care providers (hospitals and physicians) who furnish services at lower than usual fees, and, in return, receive prompt payment and an expectation of an increased volume of patients.
Group Purchasing
Taiwan
Health Status
Japan
## I'm sorry for any confusion, but "Japan" is not a medical term or concept. It is a country located in Asia, known as Nihon-koku or Nippon-koku in Japanese, and is renowned for its unique culture, advanced technology, and rich history. If you have any questions related to medical topics, I would be happy to help answer them!
Health Policy
Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.
Risk Factors
Health Maintenance Organizations
Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)
Restaurants
Logistic Models
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
Government Agencies
Administrative units of government responsible for policy making and management of governmental activities.
Cost Control
The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed)
Income Tax
Tax on the net income of an individual, organization, or business.
Privatization
Process of shifting publicly controlled services and/or facilities to the private sector.
Netherlands
Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.
Managed Competition
A strategy for purchasing health care in a manner which will obtain maximum value for the price for the purchasers of the health care and the recipients. The concept was developed primarily by Alain Enthoven of Stanford University and promulgated by the Jackson Hole Group. The strategy depends on sponsors for groups of the population to be insured. The sponsor, in some cases a health alliance, acts as an intermediary between the group and competing provider groups (accountable health plans). The competition is price-based among annual premiums for a defined, standardized benefit package. (From Slee and Slee, Health Care Reform Terms, 1993)
Return to Work
Resumption of normal work routine following a hiatus or period of absence due to injury, disability, or other reasons.
Extraction and Processing Industry
The industry concerned with the removal of raw materials from the Earth's crust and with their conversion into refined products.
Health Services Needs and Demand
Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.
Poverty
A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level.
Health Care Costs
The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.
California
I'm sorry for any confusion, but "California" is a place, specifically a state on the western coast of the United States, and not a medical term or concept. Therefore, it doesn't have a medical definition.
Employee Performance Appraisal
The assessment of the functioning of an employee in relation to work.
Health Care Sector
Commerce
The interchange of goods or commodities, especially on a large scale, between different countries or between populations within the same country. It includes trade (the buying, selling, or exchanging of commodities, whether wholesale or retail) and business (the purchase and sale of goods to make a profit). (From Random House Unabridged Dictionary, 2d ed, p411, p2005 & p283)
Organizational Culture
Health Services Research
The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)
Local Government
Health Promotion
Cohort Studies
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
Arkansas
I'm sorry for any confusion, but the term "Arkansas" is a place name and does not have a medical definition. It is a state located in the southern region of the United States.
Burnout, Professional
Decision Making, Organizational
Air Pollutants, Occupational
Air pollutants found in the work area. They are usually produced by the specific nature of the occupation.
Competitive Medical Plans
Alternative health care delivery mechanisms, such as PREFERRED PROVIDER ORGANIZATIONS or other health insurance services or prepaid plans (other than HEALTH MAINTENANCE ORGANIZATIONS), that meet Medicare qualifications for a risk-sharing contract. (From Facts on File Dictionary of Health Care Management, 1988)
Health Personnel
Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)
Costs and Cost Analysis
Tax Exemption
Status not subject to taxation; as the income of a philanthropic organization. Tax-exempt organizations may also qualify to receive tax-deductible donations if they are considered to be nonprofit corporations under Section 501(c)3 of the United States Internal Revenue Code.
Job Description
Aid to Families with Dependent Children
Financial assistance provided by the government to indigent families with dependent children who meet certain requirements as defined by the Social Security Act, Title IV, in the U.S.
Organizational Innovation
Manufactured Materials
Fee-for-Service Plans
Method of charging whereby a physician or other practitioner bills for each encounter or service rendered. In addition to physicians, other health care professionals are reimbursed via this mechanism. Fee-for-service plans contrast with salary, per capita, and prepayment systems, where the payment does not change with the number of services actually used or if none are used. (From Discursive Dictionary of Health Care, 1976)
Liability, Legal
Occupational Health Nursing
The practice of nursing in the work environment.
Petroleum
Musculoskeletal Diseases
Medicare
Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)
Sex Factors
Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.
Financing, Government
Federal, state, or local government organized methods of financial assistance.
Government Programs
Age Factors
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
Program Evaluation
Delivery of Health Care
The concept concerned with all aspects of providing and distributing health services to a patient population.
Health Surveys
Administrative Personnel
Social Justice
Federal Government
Interviews as Topic
Oregon
I'm sorry for any confusion, but the term "Oregon" is a geographical location and not a medical concept or condition. It is a state in the Pacific Northwest region of the United States. If you have any questions related to medical topics, I would be happy to help answer those!
Germany
National Institute for Occupational Safety and Health (U.S.)
Regression Analysis
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
Deductibles and Coinsurance
Cost-sharing mechanisms that provide for payment by the insured of some portion of covered expenses. Deductibles are the amounts paid by the insured under a health insurance contract before benefits become payable; coinsurance is the provision under which the insured pays part of the medical bill, usually according to a fixed percentage, when benefits become payable.
Health Behavior
Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural.
Policy Making
Disabled Persons
Economic Competition
Social Class
A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income.
Prevalence
Family Leave
The authorized absence from work of a family member to attend the illness or participate in the care of a parent, a sibling, or other family member. For the care of a parent for a child or for pre- or postnatal leave of a parent, PARENTAL LEAVE is available.
Ships
District of Columbia
A federal area located between Maryland and Virginia on the Potomac river; it is coextensive with Washington, D.C., which is the capital of the United States.
United States Occupational Safety and Health Administration
Sweden
Retrospective Studies
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Massachusetts
I'm sorry for any confusion, but "Massachusetts" is a geographical location and not a medical term or concept. It is a state located in the northeastern region of the United States. If you have any medical questions or terms you would like me to define, please let me know!
Efficiency, Organizational
Quality of Health Care
Insurance, Surgical
A specific type of health insurance which provides surgeons' fees for specified amounts according to the type of surgery listed in the policy.
Medical Indigency
Longitudinal Studies
Follow-Up Studies
Multivariate Analysis
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
Odds Ratio
The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.