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)Independent Practice Associations: A partnership, corporation, association, or other legal entity that enters into an arrangement for the provision of services with persons who are licensed to practice medicine, osteopathy, and dentistry, and with other care personnel. Under an IPA arrangement, licensed professional persons provide services through the entity in accordance with a mutually accepted compensation arrangement, while retaining their private practices. Services under the IPA are marketed through a prepaid health plan. (From Facts on File Dictionary of Health Care Management, 1988)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)Capitation Fee: A method of payment for health services in which an individual or institutional provider is paid a fixed, per capita amount without regard to the actual number or nature of services provided to each patient.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.Economic Competition: 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.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.CaliforniaHealth Care Sector: Economic sector concerned with the provision, distribution, and consumption of health care services and related products.United StatesWashingtonHealth 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)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)Insurance Selection Bias: Adverse or favorable selection bias exhibited by insurers or enrollees resulting in disproportionate enrollment of certain groups of people.Fees, Medical: Amounts charged to the patient as payer for medical services.OregonHealth Facility Merger: The combining of administrative and organizational resources of two or more health care facilities.Northwestern United States: The geographic area of the northwestern region of the United States. The states usually included in this region are Idaho, Montana, Oregon, Washington, and Wyoming.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.Employer Health Costs: That portion of total HEALTH CARE COSTS borne by an individual's or group's employing organization.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.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)Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Primary Health Care: 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)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)Group Practice, Prepaid: An organized group of three or more full-time physicians rendering services for a fixed prepayment.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Marketing of Health Services: Application of marketing principles and techniques to maximize the use of health care resources.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)Medicare Part C: The Balanced Budget Act (BBA) of 1997 establishes a Medicare+Choice program under part C of Title XVIII, Section 4001, of the Social Security Act. Under this program, an eligible individual may elect to receive Medicare benefits through enrollment in a Medicare+Choice plan. Beneficiaries may choose to use private pay options, establish medical savings accounts, use managed care plans, or join provider-sponsored plans.Insurance, Physician Services: Insurance providing benefits for the costs of care by a physician which can be comprehensive or limited to surgical expenses or for care provided only in the hospital. It is frequently called "regular medical expense" or "surgical expense".Utilization Review: An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use.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 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.Risk Sharing, Financial: Any system which allows payors to share some of the financial risk associated with a particular patient population with providers. Providers agree to adhere to fixed fee schedules in exchange for an increase in their payor base and a chance to benefit from cost containment measures. Common risk-sharing methods are prospective payment schedules (PROSPECTIVE PAYMENT SYSTEM), capitation (CAPITATION FEES), diagnosis-related fees (DIAGNOSIS-RELATED GROUPS), and pre-negotiated fees.Health Services Accessibility: 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.IsraelGatekeeping: The controlling of access to health services, usually by primary care providers; often used in managed care settings to reduce utilization of expensive services and reduce referrals. (From BIOETHICS Thesaurus, 1999)Physician Incentive Plans: Compensatory plans designed to motivate physicians in relation to patient referral, physician recruitment, and efficient use of the health facility.Group Practice: Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income.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.Economics, Medical: Economic aspects of the field of medicine, the medical profession, and health care. It includes the economic and financial impact of disease in general on the patient, the physician, society, or government.Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.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.Organizations, Nonprofit: Organizations which are not operated for a profit and may be supported by endowments or private contributions.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.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.MassachusettsPublic Health: 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.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)Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.State Health Plans: 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.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.Drug Costs: The amount that a health care institution or organization pays for its drugs. It is one component of the final price that is charged to the consumer (FEES, PHARMACEUTICAL or PRESCRIPTION FEES).Hospitals, Proprietary: Hospitals owned and operated by a corporation or an individual that operate on a for-profit basis, also referred to as investor-owned hospitals.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)Salaries and Fringe Benefits: The remuneration paid or benefits granted to an employee.Outcome Assessment (Health Care): 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).Fees and Charges: Amounts charged to the patient as payer for health care services.MichiganColoradoHealth Services: Services for the diagnosis and treatment of disease and the maintenance of health.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Hospital Administration: Management of the internal organization of the hospital.Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.Drug Utilization Review: Formal programs for assessing drug prescription against some standard. Drug utilization review may consider clinical appropriateness, cost effectiveness, and, in some cases, outcomes. Review is usually retrospective, but some analysis may be done before drugs are dispensed (as in computer systems which advise physicians when prescriptions are entered). Drug utilization review is mandated for Medicaid programs beginning in 1993.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.Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer.Case Management: A traditional term for all the activities which a physician or other health care professional normally performs to insure the coordination of the medical services required by a patient. It also, when used in connection with managed care, covers all the activities of evaluating the patient, planning treatment, referral, and follow-up so that care is continuous and comprehensive and payment for the care is obtained. (From Slee & Slee, Health Care Terms, 2nd ed)Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.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.Health Services Misuse: Excessive, under or unnecessary utilization of health services by patients or physicians.Child Health Services: Organized services to provide health care for children.Specialization: An occupation limited in scope to a subsection of a broader field.Medicine: The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.WisconsinPhysicians: Individuals licensed to practice medicine.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.Reimbursement Mechanisms: Processes or methods of reimbursement for services rendered or equipment.Formularies as Topic: Works about lists of drugs or collections of recipes, formulas, and prescriptions for the compounding of medicinal preparations. Formularies differ from PHARMACOPOEIAS in that they are less complete, lacking full descriptions of the drugs, their formulations, analytic composition, chemical properties, etc. In hospitals, formularies list all drugs commonly stocked in the hospital pharmacy.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.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Drug Prescriptions: Directions written for the obtaining and use of DRUGS.MinnesotaQuestionnaires: 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.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.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.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.Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Consumer Participation: Community or individual involvement in the decision-making process.Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.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.Mental Health: The state wherein the person is well adjusted.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Quality Assurance, Health Care: 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.Medical Records: Recording of pertinent information concerning patient's illness or illnesses.New YorkHealth: The state of the organism when it functions optimally without evidence of disease.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.Diabetes Mellitus: A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.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.Hospitalization: The confinement of a patient in a hospital.World Health Organization: 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.Demography: Statistical interpretation and description of a population with reference to distribution, composition, or structure.Cost-Benefit Analysis: 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.Job Satisfaction: Personal satisfaction relative to the work situation.Insurance, Pharmaceutical Services: Insurance providing for payment of services rendered by the pharmacist. Services include the preparation and distribution of medical products.Health Planning: Planning for needed health and/or welfare services and facilities.Physicians, Family: Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.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.Risk Adjustment: The use of severity-of-illness measures, such as age, to estimate the risk (measurable or predictable chance of loss, injury or death) to which a patient is subject before receiving some health care intervention. This adjustment allows comparison of performance and quality across organizations, practitioners, and communities. (from JCAHO, Lexikon, 1994)Sampling Studies: Studies in which a number of subjects are selected from all subjects in a defined population. Conclusions based on sample results may be attributed only to the population sampled.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Prevalence: 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.World Health: The concept pertaining to the health status of inhabitants of the world.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.Program Evaluation: 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.Patient Education as Topic: The teaching or training of patients concerning their own health needs.Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen.Health Knowledge, Attitudes, Practice: 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).Interviews as Topic: 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.Mammography: Radiographic examination of the breast.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)Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Drug Utilization: The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.Infant, Newborn: An infant during the first month after birth.Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Confidence Intervals: A range of values for a variable of interest, e.g., a rate, constructed so that this range has a specified probability of including the true value of the variable.Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Evaluation Studies as Topic: Studies determining the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. For drugs and devices, CLINICAL TRIALS AS TOPIC; DRUG EVALUATION; and DRUG EVALUATION, PRECLINICAL are available.Group Purchasing: A shared service which combines the purchasing power of individual organizations or facilities in order to obtain lower prices for equipment and supplies. (From Health Care Terms, 2nd ed)Public Health Administration: Management of public health organizations or agencies.Medical Records Systems, Computerized: Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record.Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.Income: Revenues or receipts accruing from business enterprise, labor, or invested capital.Databases, Factual: Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references.Chronic Disease: 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)Risk: The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome.Occupational Health: The promotion and maintenance of physical and mental health in the work environment.Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.Health Status Disparities: 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.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Smoking: Inhaling and exhaling the smoke of burning TOBACCO.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.Delivery of Health Care, Integrated: 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)Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.Health Care Rationing: Planning for the equitable allocation, apportionment, or distribution of available health resources.Health Priorities: Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.Public Health Practice: The activities and endeavors of the public health services in a community on any level.Mental Health Services: Organized services to provide mental health care.Chi-Square Distribution: A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Breast Neoplasms: Tumors or cancer of the human BREAST.Asthma: A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL).

*  Health Maintenance Organizations - Irvington, NJ - SILive.com

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*  The Determinants of Care Quality in a Health Maintenance Organization

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*  HMO - Health Maintenance Organization

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*  Health Maintenance Organization (HMO) - HealthCare.gov Glossary | HealthCare.gov

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*  Diabetes management in a health maintenance organization. Efficacy of care management using cluster visits. | Diabetes Care

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*  Health maintenance organizations--Employees--Salaries, etc.

... Information about the Resource. Schema.org Name(s): Controlled ... Health maintenance organizations--Employees--Salaries, etc.. Is In SKOS Scheme: * http://id.worldcat.org/fast/ontology/1.0/# ...
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*  Health Maintenance Organizations - Lebanon, PA - PennLive.com

Get Health Maintenance Organizations business addresses, phone numbers, driving directions, maps, reviews and more. ... Find Health Maintenance Organizations local business listings in and near Lebanon, PA. ...
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*  HMO (Health Maintenance Organization) health insurance plans

... Health Maintenance Organizations (also widely referred to as HMOs ... Why would you want to choose an HMO health insurance plan?. HMOs represent the most affordable and cheap health insurance ... In case the health problem of a person exceeds the professional field of knowledge of the PCP, the doctor refers this patient ... Health insurance is something that everybody must have and select in a very specific way. We can´t just forget about the ...
roomen-online.blogspot.com/2010/03/hmo-health-maintenance-organization.html

*  Health Maintenance Organization (HMO) | D. Beacom & Sons Insurance

Prepaid group health insurance which entitles it's members to services to a network of participating physicians, hospitals and ... Health Maintenance Organization (HMO). Prepaid group health insurance which entitles it's members to services to a network of ... Members must use contracted health-care providers, who focus on preventative care. ...
https://beacominsurance.com/glossary/hmo/

*  Health Maintenance Organization Amendments of 1981: Hearing Before the Committee on Labor and Human Reaources, United States...

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https://search.lib.virginia.edu/catalog/u1471640

*  Health Maintenance Organization Amendments: Hearings Before the Subcommittee on Health of the Committee on Labor and Public...

Subcommittee on Health. t, Health maintenance organization amendments. d, [Bethesda, Md.] : ProQuest,[2004] o, CIS 76 S541-34 w ... a, Health maintenance organization amendments h, [electronic resource] : b, hearings before the Subcommittee on Health of the ... Health Maintenance Organization Amendments [electronic resource]: Hearings Before the Subcommittee on Health of the Committee ... United States Congress Senate Committee on Labor and Public Welfare Subcommittee on Health ...
https://search.lib.virginia.edu/catalog/cis2007441737

*  alabama community health care network inc in montgomery, al | health maintenance organization | Yellowise.com

Find an address, phone number, business reviews and related information for alabama community health care network inc ... alabama community health care network inc is a business in montgomery, al. ... Legal Name:Alabama Community Health Care Network INC. Other Names:Alabama Community Health Care Network INC, Alabama Cmnty Hlth ... Alabama Community Health Care Network INC. 1712 Platt Pl. Montgomery, AL 36117-7761 (334) 270-8377. Business Description:. ...
yellowise.com/business/montgomery-al/health-maintenance-organization/alabama-community-health-care-network-inc/101431007-st1

*  PPO Woodhaven NY - Woodhaven NY, Preferred provider organization, Woodhaven NY Healthcare in the United States, Woodhaven NY ...

Healthcare in the United States is becoming more and more costly and health insurance is very necessary for every United States ... is a specific type of health insurance dictated by a flexible network of medical providers for a participant. Employees and ... All Topics > Health > PPO > New York > PPO Woodhaven NY. A preferred provider organization (PPO) is a specific type of health ... Massive health care organizations work with insurers to develop extensive fee schedules to ensure that individuals within a ...
guides.wkbw.com/PPO_Woodhaven_NY-r854714-Woodhaven_NY.html

*  Star Trek (2009) / Headscratchers - TV Tropes

Star Trek is and always has been a light touch on military ranks and protocol to give some organization to exploration fantasy ... A translator technician must have gotten killed in the attack on Kirk's father's ship, and the translator who did maintenance ... Nero's torture has probably had very serious side-effects to his health. ... in any bureaucratic organisation like Starfleet, it's going to take some time to put the dots together. Over here you've got a ...
tvtropes.org/pmwiki/pmwiki.php/Headscratchers/StarTrek2009

*  Discussion | Vascular Birthmarks Foundation

Should you have any health care related questions regarding this matter, please see your physician or other health care ... Mission Statement:An international charitable organization that networks families affected by a vascular birthmark, tumor, or ... Site Design and Maintenance performed by M. Scott.. ... with your physician or other health care provider. Information ...
https://birthmark.org/node/379?do=newreply&noquote=1&p=12164

*  Research Overview - Honors College, Integrated Life Sciences

Research, clinical, and service opportunities related to the health professions from the Health Professions Advising Office ... The team won gold for a second year for their work developing a new method for plasmid maintenance without the use of ... and non-profit research organizations in the DC metro area ...
ils.umd.edu/research

*  Online Debate: Novice Tournament R1: The United States should implement a system of Single Payer health care. | Debate.org

The United States should implement a system of Single Payer health care. ... Ironically, with the rise of Health Maintenance Organizations (HMOs), private health insurance plans actually regulate health ... In the World Health Organization's rankings of overall health in 191 nations, the US ranked 72nd, which was worse than almost ... The current health care system in America is very costly, with 17% of the GDP going to health care6; while this is cited as one ...
debate.org/debates/Novice-Tournament-R1-The-United-States-should-implement-a-system-of-Single-Payer-health-care./1/

*  American Urological Association - Coding Resources and Information

Gallagher Health Policy Scholar Program * 2018 Gallagher Health Policy Scholar Application * Holtgrewe Legislative Fellowship ... Maintenance of Certification (MOC) * Ultrasound Accreditation * About the AIUM * Practice Guideline for Urologic Ultrasound ... Related Organizations * Sub-Specialty Societies * Affiliated Organizations * Industry Relations * Industry Relations Overview ...
auanet.org/practice-resources/coding-and-reimbursement/coding-resources-and-information?q=&ContentType=&filters=321|306|323|

ULTRA (UK agency): ULTRA, the Unrelated Live Transplant Regulatory Authority, was a British agency that regulated organ transplants. According to the official website:San Diego County, California Probation: The San Diego County Probation Department is the body in San Diego County, California responsible for supervising convicted offenders in the community, either who are on probation, such as at the conclusion of their sentences, or while on community supervision orders.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,Environmental issues in Puget Sound: Puget Sound is a deep inlet of the Pacific Ocean in Washington, extending south from the Strait of Juan de Fuca through Admiralty Inlet. 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The Foundation was founded in 1979 by Dr.Healthcare in Tanzania: Health care in Tanzania is available depending on one's income and accessibility. People in urban areas have better access to private and public medical facilities.Massachusetts Tobacco Cessation and Prevention Program: The Massachusetts Tobacco Cessation and Prevention Program (MTCP) is an anti-tobacco program run by the Massachusetts Department of Public Health with the goal of decreasing tobacco prevalence in the state of Massachusetts. MTCP has four main components: preventing youth smoking, assisting current smokers with quitting, protecting against second hand smoke, and eliminating tobacco related disparities.Public Health Act: Public Health Act is a stock short title used in the United Kingdom for legislation relating to public health.For-profit hospital: For-profit hospitals, or alternatively investor-owned hospitals, are investor-owned chains of hospitals which have been established particularly in the United States during the late twentieth century. In contrast to the traditional and more common non-profit hospitals, they attempt to garner a profit for their shareholders.Michigan State University College of Nursing: The Michigan State University College of Nursing is the nursing college at Michigan State University. It is located on the southeastern side of campus in East Lansing, Michigan, USA.Uranium mining in Colorado: Uranium mining in Colorado, United States, goes back to 1872, when pitchblende ore was taken from gold mines near Central City, Colorado. The Colorado uranium industry has seen booms and busts, but continues to this day.Pavement life-cycle cost analysis: In September 1998, the United States Department of Transportation (DoT) introduced risk analysis, a probabilistic approach to account for the uncertainty of the inputs of the cost/benefit evaluation of pavement projects, into its decision-making policies. The traditional (deterministic) approach did not consider the variability of inputs.Lifestyle management programme: A lifestyle management programme (also referred to as a health promotion programme, health behaviour change programme, lifestyle improvement programme or wellness programme) is an intervention designed to promote positive lifestyle and behaviour change and is widely used in the field of health promotion.Precautionary savings: Precautionary saving is saving (non-expenditure of a portion of income) that occurs in response to uncertainty regarding future income. The precautionary motive to delay consumption and save in the current period rises due to the lack of completeness of insurance markets.Assistance in Recovery: Assistance in Recovery (AiR) is an international provider of addiction recovery assistance that focuses on treating addiction as a chronic disease, and provides services to reflect this. AiR has behavioral health case management services for chronic disease care and specializes in the treatment of chemical dependency, mental health and eating disorders.Health policy: Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific health care goals within a society."World Health Organization.Wisconsin Senate, District 4: The 4th District of the Wisconsin Senate is located in Southern Wisconsin, and is composed of parts of Milwaukee County.District MapSamuel Bard (physician): Samuel Bard (April 1, 1742 – May 24, 1821) was an American physician. He founded the first medical school in New York.Iranian National Formulary: The Iranian National Formulary (INF) has more than 2,300 molecules registered at the Iran's Ministry of Health, including various strengths and dosage forms. The standards regarding pharmaceutical products in Iran are determined and modified by the Pharmacopeia Council.Rochester Epidemiology ProjectClosed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.Regression dilution: Regression dilution, also known as regression attenuation, is the biasing of the regression slope towards zero (or the underestimation of its absolute value), caused by errors in the independent variable.Rock 'n' Roll (Status Quo song)Beef aging: Beef aging is a process of preparing beef for consumption, mainly by breaking down the connective tissue.Cancer screening

(1/1026) Use of out-of-plan services by Medicare members of HIP.

Use of out-of-plan services in 1972 by Medicare members of the Health Insurance Plan of Greater New York (HIP) is examined in terms of the demographic and enrollment characteristics of out-of-plan users, types of services received outside the plan, and the relationship of out-of-plan to in-plan use. Users of services outside the plan tended to be more seriously ill and more frequently hospitalized than those receiving all of their services within the plan. The costs to the SSA of providing medical care to HIP enrollees are compared with analogous costs for non-HIP beneficiaries, and the implications for the organization and financing of health services for the aged are discussed.  (+info)

(2/1026) Hypertension, antihypertensive medication use, and risk of renal cell carcinoma.

To investigate whether diuretic medication use increases risk of renal cell carcinoma (RCC), the authors conducted a case-control study of health maintenance organization members in western Washington State. Cases (n = 238) diagnosed between January 1980 and June 1995 were compared with controls (n = 616) selected from health maintenance organization membership files. The computerized health maintenance organization pharmacy database provided information on medications prescribed after March 1977. Additional exposure information was collected from medical records. For women, use of diuretics was associated with increased risk of RCC (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.0-3.1), but the association was not independent of a diagnosis of hypertension (adjusted for hypertension, OR = 1.1, 95% CI 0.5-2.1). Similarly, nondiuretic antihypertensive use was associated with increased risk, but only when unadjusted for hypertension. For men, neither diuretic nor nondiuretic antihypertensive use was associated with risk of RCC. A diagnosis of hypertension was clearly associated with RCC risk for women (OR = 2.5, 95% CI 1.2-5.1), but not men (OR = 1.3, 95% CI 0.7-2.5). High systolic and diastolic blood pressures were associated with increased risk in both sexes. These results do not support the hypothesis that use of diuretic medication increases RCC risk; they are more consistent with an association between RCC and high blood pressure.  (+info)

(3/1026) The changing elderly population and future health care needs.

The impending growth of the elderly population requires both fiscal and substantive changes in Medicare and Medicaid that are responsive to cost issues and to changing patterns of need. More emphasis is required on chronic disease management, on meaningful integration between acute and long-term care services, and on improved coordination between Medicare and Medicaid initiatives. This paper reviews various trends, including the growth in managed-care approaches, experience with social health maintenance organizations and Program of All-Inclusive Care for the Elderly demonstrations, and the need for a coherent long-term care policy. Such policies, however, transcend health care and require a broad range of community initiatives.  (+info)

(4/1026) Raising the bar: the use of performance guarantees by the Pacific Business Group on Health.

In 1996 the Pacific Business Group on Health (PBGH) negotiated more than two dozen performance guarantees with thirteen of California's largest health maintenance organizations (HMOs) on behalf the seventeen large employers in its Negotiating Alliance. The negotiations put more than $8 million at risk for meeting performance targets with the goal of improving the performance of all health plans. Nearly $2 million, or 23 percent of the premium at risk, was refunded to the PBGH by the HMOs for missed targets. The majority of plans met their targets for satisfaction with the health plan and physicians, as well as cesarean section, mammography, Pap smear, and prenatal care rates. However, eight of the thirteen plans missed their targets for childhood immunizations, refunding 86 percent of the premium at risk.  (+info)

(5/1026) Financial incentives and drug spending in managed care.

This study estimates the impact of patient financial incentives on the use and cost of prescription drugs in the context of differing physician payment mechanisms. A large data set was developed that covers persons in managed care who pay varying levels of cost sharing and whose physicians are compensated under two different models: independent practice association (IPA)-model and network-model health maintenance organizations (HMOs). Our results indicate that higher patient copayments for prescription drugs are associated with lower drug spending in IPA models (in which physicians are not at risk for drug costs) but have little effect in network models (in which physicians bear financial risk for all prescribing behavior).  (+info)

(6/1026) Waking the health plan giant: Group Health Cooperative stops counting sheep and starts counting key tobacco indicators.

Implementing a comprehensive approach to decreasing tobacco use in a large health plan requires hard work and commitment on the part of many individuals. We found that major organisational change can be accomplished and sustained. Keys to our success included our decision to remove access barriers to our cessation programmes (including cost); obtaining top leadership buy-in; identifying accountable individuals who owned responsibility for change; measuring key processes and outcomes; and finally keeping at it tenaciously through multiple cycles of improvement.  (+info)

(7/1026) Health maintenance organizations in developing countries: what can we expect?

Health maintenance organizations (HMOs) are a relatively new and alternative means of providing health care, combining a risk-sharing (insurance) function with health service provision. Their potential for lowering costs has attracted great interest in the USA and elsewhere, and has raised questions regarding their applicability to other settings. Little attention, however, has been given to critically reviewing the experience with HMOs in other countries, particularly concerning their introduction to settings other than the USA. This paper first reviews the current experience of HMOs in low- and middle-income countries, including Argentina, Bolivia, Brazil, Colombia, Ecuador, Uruguay, Chile and Indonesia. Secondly, the paper reviews the USA experience with HMOs: prerequisites for the establishment of HMOs in the USA are identified and discussed, followed by a review of the performance of HMOs in terms of cost containment, integration of care and quality of care for the elderly and poor. The analysis concludes that difficulties may arise when implementing HMOs in developing countries, and that potential adverse effects on the overall health care delivery system may occur. These should be avoided by careful analyses of a nation's health care system.  (+info)

(8/1026) The corporate practice of health care ... a panel discussion.

The pros and cons of treating health care as a profit-making business got a lively airing in Boston May 16, when the Harvard School of Public Health's "Second Conference on Strategic Alliances in the Evolving Health Care Market" presented what was billed as a "Socratic panel." The moderator was Charles R. Nesson, J.D., a Harvard Law School professor of 30 years' standing whose knack for guiding lively discussions is well known to viewers of such Public Broadcasting Service series as "The Constitution: That Delicate Balance. "As one panelist mentioned, Boston was an interesting place for this conversation. With a large and eminent medical establishment consisting mostly of traditionally not-for-profit institutions, the metropolis of the only state carried in 1972 by liberal Presidential candidate George McGovern is in one sense a skeptical holdout against the wave of aggressive investment capitalism that has been sweeping the health care industry since the 1994 failure of the Clinton health plan. In another sense, though, managed care-heavy Boston is an innovative crucible of change, just like its dominant HMO, the not-for-profit but merger-minded Harvard Pilgrim Health Care. Both of these facets of Beantown's health care psychology could be discerned in the comments heard during the panel discussion. With the permission of the Harvard School of Public Health--and asking due indulgence for the limitations of tape-recording technology in a room often buzzing with amateur comment--MANAGED CARE is pleased to present selections from the discussion in the hope that they will shed light on the business of health care.  (+info)



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  • Public Use Tape 16 is the second public use data release from the NMES Health Insurance Plans Survey (HIPS). (umich.edu)
  • The scientific data leaves no doubt that the proper application of fluoridation is essential to public health and the control of oral diseases, and that the benefits outweigh the risks. (copswiki.org)