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.

The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.

Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.

The concept concerned with all aspects of providing and distributing health services to a patient population.

Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.

Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.

A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.

The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.

Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.

The state wherein the person is well adjusted.

The state of the organism when it functions optimally without evidence of disease.

The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.

Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.

Activities concerned with governmental policies, functions, etc.

Planning for needed health and/or welfare services and facilities.

Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)

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.

Public attitudes toward health, disease, and the medical care system.

Components of a national health care system which administer specific services, e.g., national health insurance.

Economic sector concerned with the provision, distribution, and consumption of health care services and related products.

Services for the diagnosis and treatment of disease and the maintenance of health.

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.

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.

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)

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.

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)

The concept pertaining to the health status of inhabitants of the world.

Management of public health organizations or agencies.

Planning for the equitable allocation, apportionment, or distribution of available health resources.

Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.

The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.

Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).

Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.

The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.

A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7)

Variation in rates of disease occurrence and disabilities between population groups defined by socioeconomic characteristics such as age, ethnicity, economic resources, or gender and populations identified geographically or similar measures.

Organized services to provide mental health care.

The promotion and maintenance of physical and mental health in the work environment.

State plans prepared by the State Health Planning and Development Agencies which are made up from plans submitted by the Health Systems Agencies and subject to review and revision by the Statewide Health Coordinating Council.

The activities and endeavors of the public health services in a community on any level.

The seeking and acceptance by patients of health service.

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.

Diagnostic, therapeutic and preventive health services provided for individuals in the community.

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.

Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.

The status of health in rural populations.

The concept covering the physical and mental conditions of women.

Organized services to provide health care for children.

A specialized agency of the United Nations designed as a coordinating authority on international health work; its aim is to promote the attainment of the highest possible level of health by all peoples.

The level of governmental organization and function at the national or country-wide level.

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)

The availability of HEALTH PERSONNEL. It includes the demand and recruitment of both professional and allied health personnel, their present and future supply and distribution, and their assignment and utilization.

Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).

Degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

Federal, state, or local government organized methods of financial assistance.

The status of health in urban populations.

The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures.

Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.

Planning that has the goals of improving health, improving accessibility to health services, and promoting efficiency in the provision of services and resources on a comprehensive basis for a whole community. (From Facts on File Dictionary of Health Care Management, 1988, p299)

Planning for health resources at a regional or multi-state level.

Institutions which provide medical or health-related services.

Social and economic factors that characterize the individual or group within the social structure.

Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.

Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.

Process of shifting publicly controlled services and/or facilities to the private sector.

The effort of two or more parties to secure the business of a third party by offering, usually under fair or equitable rules of business practice, the most favorable terms.

Facilities which administer the delivery of health care services to people living in a community or neighborhood.

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)

The organization and administration of health services dedicated to the delivery of health care.

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.

That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests.

Detailed financial plans for carrying out specific activities for a certain period of time. They include proposed income and expenditures.

An interactive process whereby members of a community are concerned for the equality and rights of all.

Services designed for HEALTH PROMOTION and prevention of disease.

Methods of generating, allocating, and using financial resources in healthcare systems.

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.

Professions or other business activities directed to the cure and prevention of disease. For occupations of medical personnel who are not physicians but who are working in the fields of medical technology, physical therapy, etc., ALLIED HEALTH OCCUPATIONS is available.

Those actions designed to carry out recommendations pertaining to health plans or programs.

Organized services to provide health care to expectant and nursing mothers.

A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions.

Organized institutions which provide services to ameliorate conditions of need or social pathology in the community.

A nursing specialty concerned with promoting and protecting the health of populations, using knowledge from nursing, social, and public health sciences to develop local, regional, state, and national health policy and research. It is population-focused and community-oriented, aimed at health promotion and disease prevention through educational, diagnostic, and preventive programs.

The area of a nation's economy that is tax-supported and under government control.

Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online consumer health information that is relevant to the health conditions and treatments related to a specific patient.

The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, materiel, etc.

Application of marketing principles and techniques to maximize the use of health care resources.

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.

The level of governmental organization and function below that of the national or country-wide government.

Voluntary groups of people representing diverse interests in the community such as hospitals, businesses, physicians, and insurers, with the principal objective to improve health care cost effectiveness.

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 care services related to human REPRODUCTION and diseases of the reproductive system. Services are provided to both sexes and usually by physicians in the medical or the surgical specialties such as REPRODUCTIVE MEDICINE; ANDROLOGY; GYNECOLOGY; OBSTETRICS; and PERINATOLOGY.

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.

Community or individual involvement in the decision-making process.

Exercise of governmental authority to control conduct.

The physical condition of human reproductive systems.

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)

All organized methods of funding.

The obligations and accountability assumed in carrying out actions or ideas on behalf of others.

Processes or methods of reimbursement for services rendered or equipment.

Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.

Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.

Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.

Providing for the full range of personal health services for diagnosis, treatment, follow-up and rehabilitation of patients.

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)

Differences in access to or availability of medical facilities and services.

Demographic and epidemiologic changes that have occurred in the last five decades in many developing countries and that are characterized by major growth in the number and proportion of middle-aged and elderly persons and in the frequency of the diseases that occur in these age groups. The health transition is the result of efforts to improve maternal and child health via primary care and outreach services and such efforts have been responsible for a decrease in the birth rate; reduced maternal mortality; improved preventive services; reduced infant mortality, and the increased life expectancy that defines the transition. (From Ann Intern Med 1992 Mar 15;116(6):499-504)

The purposes, missions, and goals of an individual organization or its units, established through administrative processes. It includes an organization's long-range plans and administrative philosophy.

Financial resources provided for activities related to health planning and development.

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.

Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.

A system of medical care regulated, controlled and financed by the government, in which the government assumes responsibility for the health needs of the population.

The attitude of a significant portion of a population toward any given proposition, based upon a measurable amount of factual evidence, and involving some degree of reflection, analysis, and reasoning.

Health care provided to specific cultural or tribal peoples which incorporates local customs, beliefs, and taboos.

Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.

Health services for employees, usually provided by the employer at the place of work.

Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.

Organizations which assume the financial responsibility for the risks of policyholders.

Organizations of health care providers that agree to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it. Assigned means those beneficiaries for whom the professionals in the organization provide the bulk of primary care services. (www.cms.gov/OfficeofLegislation/Downloads/Accountable CareOrganization.pdf accessed 03/16/2011)

Time period from 1901 through 2000 of the common era.

A cabinet department in the Executive Branch of the United States Government concerned with administering those agencies and offices having programs pertaining to health and human services.

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)

A geographic area defined and served by a health program or institution.

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 process whereby the values, attitudes, or institutions of society, such as education, family, religion, and industry become modified. It includes both the natural process and action programs initiated by members of the community.

Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.

The systematic application of information and computer sciences to public health practice, research, and learning.

An operating division of the US Department of Health and Human Services. It is concerned with the overall planning, promoting, and administering of programs pertaining to health and medical research. Until 1995, it was an agency of the United States PUBLIC HEALTH SERVICE.

Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.

Accountability and responsibility to another, enforceable by civil or criminal sanctions.

Descriptions and evaluations of specific health care organizations.

An approach to health care financing with only one source of money for paying health care providers. The scope may be national (the Canadian System), state-wide, or community-based. The payer may be a governmental unit or other entity such as an insurance company. The proposed advantages include administrative simplicity for patients and providers, and resulting significant savings in overhead costs. (From Slee and Slee, Health Care Reform Terms, 1993, p106)

Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.

Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.

The function of directing or controlling the actions or attitudes of an individual or group with more or less willing acquiescence of the followers.

The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.

Administrative units of government responsible for policy making and management of governmental activities.

Financial assistance to impoverished persons for the essentials of living through federal, state or local government programs.

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)

An organization of insurers or reinsurers through which particular types of risk are shared or pooled. The risk of high loss by a particular insurance company is transferred to the group as a whole (the insurance pool) with premiums, losses, and expenses shared in agreed amounts.

Longitudinal patient-maintained records of individual health history and tools that allow individual control of access.

The concept covering the physical and mental conditions of men.

Recommendations for directing health planning functions and policies. These may be mandated by PL93-641 and issued by the Department of Health and Human Services for use by state and local planning agencies.

The obtaining and management of funds for institutional needs and responsibility for fiscal affairs.

Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)

The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).

The process by which decisions are made in an institution or other organization.

The health status of the family as a unit including the impact of the health of one member of the family on the family as a unit and on individual family members; also, the impact of family organization or disorganization on the health status of its members.

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.

Programs in which participation is required.

The inhabitants of rural areas or of small towns classified as rural.

Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy.

Criteria to determine eligibility of patients for medical care programs and services.

The complex of political institutions, laws, and customs through which the function of governing is carried out in a specific political unit.

The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed)

Organized services to provide health care to adolescents, ages ranging from 13 through 18 years.

Educational institutions for individuals specializing in the field of public health.

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)

Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.

Failure of a professional person, a physician or lawyer, to render proper services through reprehensible ignorance or negligence or through criminal intent, especially when injury or loss follows. (Random House Unabridged Dictionary, 2d ed)

Health care workers specially trained and licensed to assist and support the work of health professionals. Often used synonymously with paramedical personnel, the term generally refers to all health care workers who perform tasks which must otherwise be performed by a physician or other health professional.

A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.

An international organization whose members include most of the sovereign nations of the world with headquarters in New York City. The primary objectives of the organization are to maintain peace and security and to achieve international cooperation in solving international economic, social, cultural, or humanitarian problems.

Services designed to promote, maintain, or restore dental health.

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.

Amounts charged to the patient as payer for health care services.

Preventive health services provided for students. It excludes college or university students.

The interactions between representatives of institutions, agencies, or organizations.

Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)

The condition in which individuals are financially unable to access adequate medical care without depriving themselves and their dependents of food, clothing, shelter, and other essentials of living.

The state of being engaged in an activity or service for wages or salary.

An infant during the first month after birth.

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.

Interactional process combining investigation, discussion, and agreement by a number of people in the preparation and carrying out of a program to ameliorate conditions of need or social pathology in the community. It usually involves the action of a formal political, legal, or recognized voluntary body.

The interaction of persons or groups of persons representing various nations in the pursuit of a common goal or interest.

The quality or state of relating to or affecting two or more nations. (After Merriam-Webster Collegiate Dictionary, 10th ed)

Customer satisfaction or dissatisfaction with a benefit or service received.

Educational attainment or level of education of individuals.

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.

A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income.

Outside services provided to an institution under a formal financial agreement.

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.

Community health education events focused on prevention of disease and promotion of health through audiovisual exhibits.

A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.

A non-medical term defined by the lay public as a food that has little or no preservatives, which has not undergone major processing, enrichment or refinement and which may be grown without pesticides. (from Segen, The Dictionary of Modern Medicine, 1992)

Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer.

The rights of the individual to cultural, social, economic, and educational opportunities as provided by society, e.g., right to work, right to education, and right to social security.

Studies in which variables relating to an individual or group of individuals are assessed over a period of time.

Administration and functional structures for the purpose of collectively systematizing activities for a particular goal.

Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.

The field of information science concerned with the analysis and dissemination of medical data through the application of computers to various aspects of health care and medicine.

The transfer of information from experts in the medical and public health fields to patients and the public. The study and use of communication strategies to inform and influence individual and community decisions that enhance health.

Promotion and protection of the rights of patients, frequently through a legal process.

The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.

Individuals licensed to practice medicine.

Design of patient care wherein institutional resources and personnel are organized around patients rather than around specialized departments. (From Hospitals 1993 Feb 5;67(3):14)

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.

Management of the organization of HEALTH FACILITIES.

The inhabitants of a city or town, including metropolitan areas and suburban areas.