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Public Health & Philanthropy Lexicon

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emergency medical services — services utilized in responding to the perceived individual need for immediate treatment for medical, physiological or psychological illness or injury.

environment the spaces and relationships that affect an individual’s development.

epidemic — a group of cases of a specific disease or illness clearly in excess of what one would normally expect in a particular geographic area. There is no absolute criterion for using the term epidemic; as standards and expectations change, so might the definition of an epidemic (e.g., an epidemic of violence).

epidemiology — the study of the patterns of determinants and antecedents of disease in human populations. Epidemiology utilizes biology, clinical medicine and statistics in an effort to understand the causes of illness and disease. The ultimate goal of the epidemiologist is not merely to identify underlying causes of a disease but to apply findings to disease prevention and health promotion.

family practice — a form of specialty practice in which physicians provide continuing comprehensive primary care within the context of the family unit.

federally qualified health center — a federal payment option that enables qualified providers in medically underserved areas to receive cost-based Medicare and Medicaid reimbursement and allows for the direct reimbursement of nurse practitioners, physician assistants and certified nurse midwives. Federal legislation creating the FQHC category was enacted in 1989. An FQHC must serve an underserved area or population, offer a sliding fee scale, provide comprehensive services, have an ongoing quality assurance program and have a governing board of directors.

federally qualified health center look-alike — a health center that meets all of the federally qualified health center requirements but does not receive federal grant money.

fee schedule — an exhaustive list of physicians’ services in which each entry is associated with a specific monetary amount that represents the approved payment level for a given insurance plan.

fee-for-service — method of billing for health services under which a physician or other practitioner charges separately for each patient encounter or service rendered. It is the method of billing used by the majority of physicians in the U.S. This system contrasts with salary, per capita and other prepayment systems, where a payment to a physician is not changed with the number of services actually used.

fiduciary — relating to, or founded upon, a trust or confidence. A fiduciary relationship exists where an individual or organization has an explicit or implicit obligation to act on behalf of another person's or organization's interests in matters that affect that person or organization. A physician has such a relation with his or her patient, and a hospital trustee has one with a hospital.

functional independence — the ability to perform the functions and activities of daily living (e.g., grooming, bathing and cooking).

gender lens — a viewpoint used to examine issues and policies from the perspective of women and girls, taking into account how those issues interact with women’s real life situations.

gender monolith — label given to women as a whole when they are misperceived to have the same health concerns and issues, overlooking the impacts of culture, sexual preference, disability, income and access to care on the health of different women.

general practice — a form of practice in which physicians without specialty training provide a wide range of primary health care services to patients.

graduate medical education — medical education after receipt of the doctor of medicine (M.D.) or equivalent degree, including the education received as an intern, resident (which involves training in a specialty) or fellow, as well as continuing medical education.

group practice — a formal association of three or more physicians or other health professionals providing health services. Income from the practice is pooled and redistributed to the members of the group according to some prearranged plan (often, but not necessarily, through a partnership). Groups vary a great deal in size, composition and financial arrangements.

health the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. It is recognized, however, that health has many dimensions (anatomical, physiological and mental) and is largely culturally defined. The relative importance of various disabilities differs depending upon the cultural milieu and the role of the affected individual in that culture.

health care facilities — physical plants used in the provision of health services, usually limited to facilities that were built for the purpose of providing health care, such as hospitals and nursing homes. They do not include office buildings that includes physicians’ offices, but they do include hospitals (both general and specialty), long-term care facilities, kidney dialysis treatment centers and ambulatory surgical facilities.

Health Care Financing Administration — the government agency within the Department of Health and Human Services that directs the Medicare and Medicaid programs (Titles XVIII and XIX of the Social Security Act) and conducts research to support those programs.

health care personnel — persons working in the provision of health care 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.

health care safety net — providers of health care services for underserved populations, including community clinics, dental clinics, mobile health clinics, mental health programs, and health education and referral programs.

health education — any combination of learning opportunities designed to facilitate voluntary adaptations of behaviors (in individuals, groups or communities) conducive to health.

health equity — the opportunity for all people to attain their full health potential. Factors such as social position, race, ethnicity, gender, religion, sexual identity and disability can limit a person’s access to the resources needed to be healthy, resulting in health inequities. (See social determinants of health.)

health indicators — characteristics of an individual, population or environment that are subject to measurement and can be used to describe one or more aspects of the health of an individual or population. Health indicators may include measurements of illness and disease; positive aspects of health, such as quality of life and life skills; and behaviors and actions by individuals that are related to health. They may also include indicators that measure social and economic conditions and physical environments as they relate to health.

health inequities — the unfair and avoidable differences in health status seen within and between countries, states, counties and neighborhoods.

health insurance — financial protection against the medical costs arising from disease or accidental bodily injury. Such insurance usually covers all or part of the medical costs of treating the disease or injury. Insurance may be obtained on either an individual or a group basis.

health insurance exchange — a resource where individuals, families and small businesses can learn about their health coverage options, compare health insurance plans, choose plans and enroll in coverage. Covered California is the name of the health insurance exchange in California and can be accessed online.

health insurance company — an organization that provides a defined set of benefits to financially cover medical expenses; this term does not usually include indemnity insurers.

health insurance policy — an insurance contract consisting of a defined set of benefits to financially cover medical expenses.

health maintenance organization — an organized system providing health care in a geographic area that accepts the responsibility to provide or otherwise assure the delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services to a voluntarily enrolled group of persons for which services the entity is reimbursed through a predetermined fixed, periodic prepayment made by, or on behalf of, each person or family unit enrolled. The payment is fixed without regard to the amounts of actual services provided to an individual enrollee. Individual practice associations involving groups or independent physicians can be included under the definition.

health outcomes — changes in the health status of an individual, group or population that are attributable to a planned intervention or series of interventions. Interventions may include government policies and consequent programs, laws and regulations, or health services and programs, including health promotion programs. Health promotion outcomes are changes to personal characteristics and skills, social norms and actions, or organizational practices and public policies that are attributable to health promotion activity.

health planning — planning concerned with improving health, whether undertaken comprehensively for a whole community or for a particular population, type of health service, institution or health program. The components of health planning include: data assembly and analysis, goal determination, action recommendation and implementation strategy.

health professional shortage area — an area or group that the U.S. Department of Health and Human Services designates as having an inadequate supply of health care providers. A health professional shortage area can be: (1) an urban or rural geographic area, (2) a population group for which access barriers can be demonstrated to prevent members of the group from using local providers or (3) a medium- or maximum-security correctional institution or a public or nonprofit private residential facility.

health promotion — any combination of health education and related organizational, political and economic interventions designed to facilitate behavioral and environmental adaptations that will improve or protect health.

health status — the level of health of an individual, group or population as measured by health indicators. (See health indicators.)

Health Resources and Services Administration — a federal agency that has responsibility for addressing resource issues relating to access, equity and quality of health care, particularly to the disadvantaged and underserved. It is one of eight agencies within the U.S. Public Health Service. The HRSA provides leadership to assure the support and delivery of primary health care services, particularly in underserved areas, and the development of qualified primary care health professionals and facilities to meet the health needs of the nation. HRSA focuses on support of states and communities in their efforts to plan, organize and deliver primary health care, as well as strengthen the overall public health system.

health service area — geographic area designated on the basis of such factors as geography, political boundaries, population and health resources for the effective planning and development of health services.

health status — the state of health of a specified individual, group or population. It may be measured by: obtaining proxies, such as people's subjective assessments of their health; using one or more indicators of mortality and morbidity in the population, such as longevity or maternal and infant mortality; or using the incidence or prevalence of major diseases (communicable, chronic or nutritional). Conceptually, health status is the proper outcome measure for the effectiveness of a specific population's medical care system, although attempts to relate effects of available medical care to variations in health status have proved difficult.

home health care — health services rendered in the home to aged, disabled, sick or convalescent individuals who do not need institutional care. The services may be provided by a visiting nurse association, home health agency, county public health department, hospital or other organized community group and may be specialized or comprehensive. The most common types of home health care are nursing services; speech, physical, occupational and rehabilitation therapy; homemaker services; and social services.

hospice — a program that provides palliative and supportive care for terminally ill patients and their families, either directly or on a consulting basis with the patient's physician or another community agency. The whole family is considered the unit of care, and care extends through their period of mourning.

hospital — an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and nonsurgical. In addition, most hospitals provide some outpatient services, particularly emergency care. Hospitals may be classified by length of stay (short term or long term), as teaching or nonteaching, by major type of service (general, psychiatric or specialties, such as tuberculosis, maternity, pediatric, or ear, nose and throat) and by type of ownership or control (federal, state or local government, and for profit or nonprofit). The hospital system is dominated by the short-term, general, nonprofit community hospital, often called a voluntary hospital.

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