Health Terms Glossary
A
In the healthcare setting, “acute” refers to a sudden or severe illness or injury that requires urgent medical attention and typically involves a short-term, intense course of treatment to stabilize the patient’s condition. Examples of acute conditions include heart attack, stroke, severe infections, and traumatic injuries. On the other hand, “nonacute” refers to a chronic or long-term medical condition that may require ongoing medical management, but does not typically require urgent or immediate medical attention. Examples of nonacute conditions include diabetes, hypertension, asthma, and arthritis. The distinction between acute and nonacute conditions is important for healthcare providers and administrators to appropriately allocate resources, prioritize care, and manage patient flow in hospitals and other healthcare facilities.
The process of being admitted into a hospital or medical facility for the purpose of receiving medical care, treatment, or observation for a health condition or illness. This typically involves undergoing an assessment by a healthcare professional and being assigned a hospital room or bed for the duration of the stay.
An antibiotic is a type of medication that is used to treat bacterial infections. Antibiotics work by either killing the bacteria or inhibiting their growth, which helps the body’s immune system to fight off the infection. Antibiotics are only effective against bacterial infections and are not effective against viral infections, such as the common cold or flu.
Antimicrobial refers to a substance or medication that is capable of destroying or inhibiting the growth of microorganisms, such as bacteria, viruses, fungi, and parasites. Antimicrobial medications are commonly used to treat infections caused by these microorganisms. There are several different classes of antimicrobial medications, including antibiotics, antivirals, antifungals, and antiparasitics, and each type of medication is designed to target specific types of microorganisms.
B
The bed size of a hospital refers to the number of beds available for patients in the hospital. This can include both inpatient and outpatient beds, and may vary depending on the hospital’s size, specialty, and patient population. Bed size is an important factor in determining a hospital’s capacity to provide medical services and accommodate patient needs, and can have implications for staffing, resource allocation, and patient flow within the hospital. Hospitals may be classified as small, medium, or large based on their bed size, with specific criteria varying by country and healthcare system.
Brand name and generic name are two different names given to prescription drugs. The brand name is the name given to a drug by its manufacturer, while the generic name is the name of the active ingredient in the drug. The generic name is the name that is used to identify the drug in the official pharmacopoeias, such as the United States Pharmacopeia (USP) or the International Nonproprietary Name (INN). Brand name drugs tend to be more expensive than generic drugs, as the manufacturer invests a lot of money in research and development, as well as marketing. The generic version of drugs are often cheaper as the manufacturers do not incur the initial costs of trials, research, and development that the brand name drug manufacturers underwent to bring the drug to market. Generic drugs may be produced by different manufacturers, while brand name drugs are produced only by the original manufacturer. This can result in slight differences in the formulation and appearance of the drug, although the active ingredient remains the same.
C
A catheterization laboratory, commonly called a cath lab, is a specialized medical facility or room where minimally invasive diagnostic and therapeutic procedures are performed using catheters, which are thin, flexible tubes that are inserted into the body through blood vessels or other openings. The cath lab is typically equipped with advanced imaging technology, such as X-ray, ultrasound, or magnetic resonance imaging (MRI), which is used to guide the catheter and monitor the procedure. Procedures commonly performed in the cath lab include cardiac catheterization, angiography, angioplasty, stenting, and electrophysiology studies, among others.
Compliance status in the healthcare setting refers to an individual or organization’s adherence to applicable laws, regulations, policies, and standards related to healthcare operations and patient care. Compliance can cover a wide range of areas, including patient privacy and confidentiality, billing and coding practices, quality of care, and safety standards. Maintaining compliance status is essential for ensuring patient safety and quality of care, as well as avoiding legal and financial penalties for noncompliance. Healthcare organizations typically have compliance programs in place to monitor and ensure compliance, and healthcare professionals are responsible for understanding and following relevant compliance requirements in their practice.
D
DRG code stands for Diagnosis Related Group code. It is a system of classification that groups patients with similar diagnoses and treatments into categories for billing and reimbursement purposes. Each DRG code is assigned a specific payment amount based on the resources needed to treat patients in that group. The DRG coding system is used in the United States to determine reimbursement rates for Medicare and Medicaid patients, and it is also used by many private insurance companies. The coding is typically done by healthcare professionals, such as medical coders, and it is important to ensure accuracy in order to receive appropriate reimbursement.
Discharge disposition in the healthcare setting refers to the destination or location where a patient is discharged after receiving care in a hospital or other healthcare facility. This information is typically documented in the patient’s medical record and is used for administrative and clinical purposes, such as tracking patient outcomes, planning for post-discharge care, and monitoring healthcare resource utilization. Discharge dispositions may include home, skilled nursing facility, rehabilitation facility, hospice, or transfer to another healthcare facility for ongoing care.
Drug classification refers to the process of categorizing medications into groups based on their chemical structure, mode of action, therapeutic uses, and potential for abuse or dependence. Drugs can be classified into various categories, including prescription and over-the-counter, controlled substances, antihypertensives, antidiabetics, anticoagulants, and many others. The classification of drugs can also help to inform regulations and policies related to drug use and distribution, such as scheduling and monitoring requirements for controlled substances.
F
A formulary is a list of prescription drugs, medical devices, and supplies that are approved for use within a healthcare system, such as a hospital, clinic, or health plan. A formulary is developed and maintained by a committee of healthcare professionals, including but not limited to primary care and specialty physicians, pharmacists, legal experts, and administrators. It is typically based on the safety, efficacy, and cost-effectiveness of the products. The formulary is used to guide prescribing practices and to ensure that patients have access to the most appropriate and cost-effective medications for their conditions. The drugs included in the formulary may be categorized into different tiers or levels, based on their cost and availability. The formulary may also include guidelines for the use of certain drugs, such as dosage recommendations or restrictions on off-label use.
H
HbA1c, or glycated hemoglobin, is a blood test that measures the average level of blood sugar (glucose) over the past two to three months. It is used as a diagnostic tool and to monitor the management of diabetes. The test measures the percentage of hemoglobin that has been bound to glucose, with higher levels indicating poor blood sugar control.
I
ICD-9 codes are a system of medical codes used to classify and categorize diagnoses and procedures in healthcare. ICD-9 stands for International Classification of Diseases, 9th Revision. The system uses alphanumeric codes to represent specific diagnoses and medical procedures. It was developed by the World Health Organization (WHO) and is used worldwide for statistical and reimbursement purposes. The ICD-9 code set has been replaced by the newer ICD-10 code set in most countries, including the United States. However, some healthcare organizations may still use ICD-9 codes for historical data or other purposes.
L
Hospital length of stay refers to the number of days a patient spends in a hospital or medical facility receiving medical care, treatment, or observation for a health condition or illness. This can vary depending on the severity of the condition, the type of treatment needed, and the individual patient’s response to treatment. The length of stay is often used as a measure of hospital efficiency and cost-effectiveness.
LOINC code stands for Logical Observation Identifiers Names and Codes. It is a standardized coding system used to identify laboratory and clinical observations and measurements, such as blood tests, vital signs, and medical imaging. The LOINC system is designed to facilitate the exchange and sharing of clinical data between healthcare providers and organizations, as well as to support clinical research and quality improvement initiatives. Each LOINC code is a unique identifier for a specific clinical observation or test, and it includes information about the test method, specimen type, and other relevant details. The LOINC system is maintained by the Regenstrief Institute in the United States and is used globally in healthcare settings.
M
MDC code stands for Major Diagnostic Category code. It is a system used to categorize and group similar medical diagnoses into 25 major categories based on organ systems and diseases. The MDC system is used for administrative and financial purposes, such as Medicare reimbursement and healthcare data analysis. Each MDC is further divided into diagnostic related groups (DRGs), which are used to calculate reimbursement rates for specific treatments and procedures. The MDC system is used primarily in the United States, and it is maintained by the Centers for Medicare and Medicaid Services (CMS).
Medical specialty refers to a particular field of medicine that focuses on the diagnosis, treatment, and management of a specific group of diseases, conditions, or patient populations. Examples of medical specialties include cardiology, dermatology, and pediatrics, among others. Medical specialists work collaboratively with other healthcare professionals to provide comprehensive care to patients within their area of expertise.
N
The National Drug Code (NDC) is a unique identifier assigned to every medication, including prescription drugs, over-the-counter drugs, and medical supplies, that is available for sale in the United States. The code consists of three segments: the first segment identifies the manufacturer, the second segment identifies the drug product and its strength, and the third segment identifies the package size and type. The NDC is used for tracking and billing purposes, as well as for ensuring accurate dispensing and administration of medications.
P
A payer (or payor) in the healthcare arena refers to an entity that pays for or reimburses the cost of medical services or treatments provided to patients. This can include insurance companies, government programs such as Medicare and Medicaid, and self-insured employers. The payer is responsible for negotiating rates with healthcare providers, processing claims, and making payments to providers on behalf of the patients they cover. Payers may also establish guidelines and criteria for determining the medical necessity and appropriateness of treatments and services, and may require prior authorization or referrals for certain services.
Q
A portion of a year when divided into four sections. January through March is quarter 1; April through June is quarter 2; July through September is quarter 3; and October through December is quarter 4.
R
When a patient returns to a hospital and becomes hospitalized for a second or subsequent time due to a condition that they were previously hospitalized for. Each readmission will have a new admission date. Readmissions can be observed over different time periods, including 7 days, 14 days, 30 days, 60 days, and 90 days. A high rate of readmissions can indicate that the quality of care provided in the hospital is poor, a patient does not have adequate discharge planning or does not follow discharge instructions, or necessary follow-up care is not obtained. The Centers for Medicare and Medicaid Services (CMS) can financially penalize hospitals with high readmission rates.
S
SNOMED code stands for Systematized Nomenclature of Medicine Clinical Terms code. It is a standardized coding system used to identify and describe clinical concepts and terms related to human health and disease. SNOMED codes are used in electronic health records, clinical decision support systems, and other healthcare applications to support data exchange, interoperability, and analysis. The SNOMED system is maintained by the International Health Terminology Standards Development Organization (IHTSDO).
U
In the context of hospitals, “urban rural status” refers to the classification of a hospital’s location based on its proximity to urban or rural areas. The classification of a hospital’s urban rural status can have important implications for healthcare policy and resource allocation. Rural hospitals, for example, may face unique challenges in terms of staffing, funding, and access to specialized services, which can impact the quality and availability of healthcare in these areas. Additionally, rural hospitals may serve a different patient population than urban hospitals, with different healthcare needs and priorities.