| Accessibility (of health services) |
include aspects of health services or health facilities that enhance the ability of people to reach a health professional, in terms of location, time and ease of approach. |
| Accountability |
is defined according to its necessary elements: a clear mandate, with the necessary resources and adequate incentives for its fulfilment, and tended to through regular supervision. |
| Accountability arrangements |
make explicit the ways in which actors are expected to perform and interact according to their mandated roles and responsibilities. |
| Accreditation (facilities) |
is a process by which an authorized body, usually non-governmental organization, assesses and recognizes an organization as achieving pre-determined and published standards, demonstrated through an independent, external, periodic, on-site peer assessment of that organization's level of performance. Accreditation standards are usually regarded as optimal and achievable and are designed to encourage continuous improvement efforts within the accredited organizations. Accreditation is often a voluntary process in which organizations choose to participate. See also certification. |
| Actors (in health) |
are broadly characterized as those individuals, organizations, groups or coalitions that have the capacity to exert influence over policy or decision-making or are mandated with the responsibility to carry out a particular aspect of a given health system function. |
| Allied health professionals |
are diverse group of health care professionals who provide necessary services to patients in addition to, or in place of, services provided by physicians, nurses and paramedical practitioners. |
| Ambulatory care sensitive conditions |
are defined as those conditions for which hospitalization can be avoided with timely and effective care in ambulatory settings. |
| Ambulatory care |
comprise those health services provided to patients who are not confined to an institutional bed as inpatients during the time the services are rendered. Ambulatory care includes medical services of general (primary) and specialized (secondary) nature. Examples of facilities that provide ambulatory services are: primary care clinics and physician's' offices, hospital-based outpatient clinics, ambulatory surgical centres, public health clinics, imaging centres, ambulatory behavioural health and substance abuse clinics and physical therapy and rehabilitation centres. |
| Assessment |
defines a formal evaluation of a process or system, either quantitative or qualitative. |
| Ambulatory multi-profile (specialty) group practices / polyclinics (HP.3.4.9) |
comprise establishments that are engaged in providing a wide range of outpatient services, by a medical and paramedical staff, and often support staff too, usually bringing together several specialities and/or serving specific function of primary care and/or secondary care. |
| Budgeting |
defines a process of elaborating a detailed plan for the future showing how resources will be acquired and used during a specific time period, expressed in formal, measurable terms. |
| Capital expenditure |
are costs for resources that last more than one year, such as building, vehicles, computers, pre-service training. See also recurrent expenditure. |
| Cardiovascular disease risk assessment |
refers to a comprehensive risk assessment in adults with no known cardiovascular disease using simple risk-scoring tools. This can help identify those at high risk and initiate early preventive interventions. The level or risk can help guide decisions about whether to initiate preventive interventions and treatment intensity. WHO guidelines are detailed in the HEARTS Technical package published by WHO. |
| Cardiovascular disease risk prediction charts |
are used to determine the level of risk for developing CVD over a defined period (e.g. 10 years). Calculations consider the combined effect of multiple risk factors, including age, gender, smoking status, blood pressure and total cholesterol or body mass index. WHO guidelines are detailed in the HEARTS Technical package published by WHO. See also WHO/ISH cardiovascular risk prediction charts. |
| Cardiovascular disease risk stratification |
consists of the categorization and management of people according to their likelihood or chance for a cardiovascular event (heart attack or stroke). WHO guidelines are detailed in the HEARTS Technical package published by WHO. |
| Care coordinator |
is a dedicated health professional who acts as the key point of contact, from health promotion and disease prevention to targeted referral to specialist care. The care coordinator coordinates patient care throughout the entire continuum of care. The role of a dedicated coordinator is often allocated to a nursing professional. See also case manager. |
| Care pathway or care map |
refers to an aid (in addition to clinical guideline) that maps the patient pathway through the care system. It plans for the management of patient care that set goals for the patients and provide the sequence of interventions that physicians, nurses and other health professionals should carry out in order to reach the desired goals in a given time period. See also clinical guidelines and clinical protocols. |
| Care plans |
are a personalized record (written and/or electronic form) of the outcome from care planning discussions and decisions taken with the aim to address an individual's full range of needs. |
| Carers/family carers |
refer to individuals who provide unpaid care for a member or members of their family, friends or community. They can be any relative (spouse, adult children, daughters- and sons-in-law), friend or neighbour who provides of a broad range of assistance with personal care or basic activities of daily living to people with functional limitations. They may provide regular, occasional or routine care, that can either be 'hands-on' or they can be involved in organizing care delivered by others, sometimes even at distance. They can live with, or separately from the person receiving care. This is in contrast with a provider associated with a formal service system, whether paid or on a volunteer-basis (formal caregiver). |
| Case manager |
arranges for the provision of continuous care across different services through the integration and coordination of services based on individual needs and system resources. The fundamental difference with a care coordinator is that the case manager not only ensures the continuum of care by focusing on the transition between levels of care, but also ensures the integration and utilization of system resources (e.g. insurance, payment schemes, social care arrangements etc.). See also care coordinator. |
| Catchment area |
refers to a geographic area defined and served by a health programme or facility which is delineated based on population distribution, national geographic boundaries, and transportation accessibility. |
| Certification of an organization/facility, or part of an organization/facility |
refers to a process by which an authorized body, either governmental or nongovernmental organization, evaluates and recognizes an organization/facility as meeting pre-determined requirements or criteria. It usually implies that the organization/facility has additional services, technology, or capacity beyond those found in similar organizations/facilities. See also accreditation and licensure. |
| Certification of individual practitioners |
refers to a process by which an authorized body, either governmental or nongovernmental organization, evaluates and recognizes the individual as meeting pre-determined requirements or criteria. It implies that the individual has received additional education and training and demonstrated competence in a specialty area beyond the minimum requirements set for licensure. See also licensure. |
| Clinical practice guidelines |
refer to systematically developed, evidence-based recommendations that support the health professionals and patients to make decisions about the most appropriate, efficient care in specific clinical circumstance. See also care pathway and clinical protocols. |
| Clinical protocols |
are defined as an agreed framework outlining the care to be provided to patients according to a type of care, describing why, where, when and by who the care is given. See also care pathway and clinical guidelines. |
| Co-insurance |
is a cost-sharing requirement whereby the insured person pays a share of the cost of the medical service (e.g. 10%). |
| Consumer groups |
include associations and organizations that represent the rights of consumers and advance their interests. |
| Consumer health related group |
include consumer groups with a specific focus/special interest on health related activities and topics. |
| Consumption-based reimbursement scheme |
adjusts the level of reimbursement with the expenses for medicines of a patient within a time period (increasing reimbursement with rising consumption). |
| Continuous professional development |
refers to learning opportunities during a health professional's career, ideally designed as inquiry-based, practice-based and problem-based learning opportunities to promote reflection, problem-solving, self-directed learning, and professional responsibility, as well as focused on relevant issues faced by the workforce. It includes continuing medical education, continued professional education and in-service training. |
| Controlled blood pressure |
is defined as a blood pressure of 120mm Hg systolic and a blood pressure of 80mm Hg diastolic. When systolic blood pressure is equal or above 140 mm Hg and/or diastolic blood pressure is equal to or above 90 mm Hg the blood pressure is considered to be raised or high. |
| Coordination |
is defined as the extent to which services in a specific episode of care and the provision of services at intervals over time and across the lifespan promote the best results. |
| Co-payment |
is a fixed sum (e.g. $15) or a percentage of the tariff (e.g. 10%) paid by an insured individual for the consumption of itemized health care services (e.g. per hospital day, per prescription item). |
| Dental practices (HP.3.2) |
comprise independent establishments of health professionals who hold a university-level degree in dental medicine or a qualification at a corresponding level and are primarily engaged in the independent practice of general specialised dentistry. These practitioners operate private or group practices in their own offices and either provide comprehensive preventive, reconstructive or emergency care or specialise in a single field of dentistry. |
| Dentist |
refers to a health professional that diagnoses, treats and prevents diseases, injuries and abnormalities of the teeth, mouth, jaws and associate tissues by applying the principles and procedures of modern dentistry. Occupations included in this category require completion of university-level training in theoretical and practical dentistry or a related field. |
| Dieticians and nutritionists (ISCO-08 2265) |
are health professionals who assess, plan and implement programmes to enhance the impact of food and nutrition on human health. Part of this subgroup are clinical dieticians, nutritionists, public health nutritionists, etc. |
| Discharge letter |
refers to the form completed by the provider releasing the patient containing information regarding procedures undertaken, diagnosis and treatment. |
| Discharge planning |
refers to the process by which an admitted inpatient's needs on discharge are anticipated, planned for or arranged. |
| Disease-specific reimbursement scheme |
determines eligibility and reimbursement rate based on the underlying disease treated. A medicine may be reimbursed at different rates for the treatment of different diseases. |
| Dispensarization |
is a method for monitoring the health of selected population groups through screening (case-detection) and systematic treatment and follow-up. It is prevalent in members of the Commonwealth of Independent States. |
| District level |
refers to a second level administrative division that has jurisdiction over an urban/rural area that can cover several municipalities. |
| District paediatric doctors (part of ISCO-08 2211) |
are a type of generalist medical practitioners often found in countries of the Commonwealth of Independent States. |
| District therapeutists (part of ISCO-08 2211) |
are a type of generalist medical practitioners often found in countries of the Commonwealth of Independent States. |
| Domains |
capture the dynamics between areas for action to optimally reason and sequence strategic efforts to transform health services delivery. In the European Framework for Action, domain cluster areas for action according to: populations and individuals, services delivery processes, system enablers, and change management. When translated into a monitoring framework of health services delivery, the domains reflect the capacity of primary care in terms of structures and model of care, the performance of primary care in terms of care contact, outputs and health system outcomes, and health outcomes in terms of impact. |
| Effectiveness |
is defined as the extent to which services are delivered in line with the current evidence-based, for the optimal delivery of services for desired outcomes. It measures the extent to which a specific intervention, procedure, regimen or service, when deployed in the field in routine circumstances, does what is intended to do for a specified population. |
| Efficiency |
is the capacity to produce the maximum output for a given input. |
| Electronic health records |
are defined as real-time, patient-centred records that provide immediate and secured information to authorized users and that play a vital role in universal health coverage by supporting the diagnosis and treatment of patients through provision of rapid, comprehensive and timely patient information at the point of care. |
| Eligibility for reimbursement coverage |
are criteria based on which expenses on medicine are fully or partially paid for by a public payer. Four schemes are considered: product-specific, disease-specific, population-groups-specific and consumption-based. |
| Essential medicines list |
is developed by the WHO and serves as a guide for the development of national and institutional essential medicine lists. It is updated and revised every two years by the WHO Expert Committee on Selection and Use of Medicines. The latest update, published on 6 June 2017, marks the 40th Anniversary of this flagship WHO tool. |
| Evaluation |
is defined as the systematic and objective assessment of the relevance, adequacy, progress, efficiency, effectiveness and impact of a course of actions, in relation to objectives and taking into account the resources and facilities that have been deployed. |
| Facility/institution ownership type |
is a classification for ownership. There are three types: publicly owned facilities owned or controlled by a governmental unit or another public corporation (where control is defined as the ability to determine the general corporate policy); not-for-profit privately owned facilities that are legal or social entities created for the purpose of producing goods and services, whose status does not permit them to be a source of income, profit or other financial gain for the unit(s) that establish, control or finance them; and, for-profit privately owned facilities that are legal entities set up for the purpose of producing goods and services and are capable of generating a profit or other financial gain for their owners. |
| Facilities providing ambulatory health care / providers of ambulatory health care (HP.3) |
comprise establishments that are primarily engaged in providing health care services directly to outpatients who do not require inpatient services. This includes both offices of general medical practitioners and medical specialists and establishments specializing in the treatment of day-cases and in the delivery of home care services. Health professionals in ambulatory health care primarily provide services to patients who visit the health professional’s office, or the practitioners visit the patients at home. Consequently, these establishments do not usually provide inpatient services. This item has five subcategories, including: medical practices, dental practices (HP.3.2), other health care practitioners, ambulatory health care centres and providers of home health care services (HP3.5). |
| Feldscher (part of ISCO-08 2240) |
are a type of paramedical practitioners. |
| Final diagnosis |
refers to the confirmation of a diagnosis not just the preliminary diagnosis that requires the patient to visit another physician. |
| First contact visit |
is considered when the patient is visiting the physician for the first time for the particular health problem and the visit was not by referral. In this case the physician is acting as the entry point into the care system. |
| Follow-up consultations/visits |
include services offered to manage condition after diagnosis. |
| Foot vibration perception by tuning fork |
measures the sensitivity to vibration and is important for early diagnosis of diabetic neuropathy and prevention of diabetic foot amputation. |
| Formulary |
refers to a list of drugs, usually by their generic names, and indications for their use. A formulary is intended to include a sufficient range of medicines to enable medical practitioners to prescribe all medically appropriate treatment for all reasonably common illnesses. |
| Full-time equivalent employment |
is defined as total hours worked divided by average annual hours worked in full-time jobs. Depending on data availability on working hours, full-time equivalent level may also be calculated in the following ways: (i) a worker with a full-time employment contract should be counted as 1 FTE. Concerning workers who do not have a full-time employment contract, full-time equivalent should be measured by the number of hours of work mentioned in each contract divided by the normal number of hours worked in full-time jobs; (ii) a worker with a full-time employment contract should be counted as 1 FTE. Concerning workers with part-time contracts, the practice in many countries is simply to consider that 2 part-time workers = 1 FTE. |
| Gatekeeper |
is a primary care health professional who has responsibilities for the provision of primary care as well as for the coordination of specialized care and referral. |
| General medical practitioners/family medicine doctors/primary care doctors (part of ISCO-08 2211) |
are a type of generalist medical practitioners |
| Generalist medical practitioners (ISCO-08 2211) |
are physicians including family and primary care doctors, who do not limit their practice to certain disease categories or methods of treatment and may assume responsibility for the provision of continuing and comprehensive medical care to individuals, families and communities. Occupations included in this category require completion of a university-level degree in basic medical education plus postgraduate clinical training or equivalent for competent performance. Medical interns who have completed their university education in basic medical education and are undertaking postgraduate clinical training are included here. Although in some countries ''general practice'' and ''family medicine'' may be considered as medical specializations, these occupations should always be classified here. In Commonwealth of Independent States, district paediatric doctors and district therapeutists are included in this category. |
| General practice/family medicine |
is the discipline of medicine for the provision of comprehensive and continuing care to individuals in the context of their family and community. The scope of family medicine encompasses all ages and both sexes. Providers often include generalist medical practitioners, physician's assistants, family nurses. |
| HbA1c |
is the glycated haemoglobin test used in the diagnosis of diabetes mellitus. WHO-backed expert report recommending the acceptability of this test as an additional test to diagnose diabetes is found here http://www.who.int/diabetes/publications/diagnosis_diabetes2011/en/. |
| HEADS assessment |
is a check-list approach which health workers could use to understand the adolescent they are working with. The rapid assessment includes questions that provide information on the psychological and social dimensions of the adolescent's life including: family life, interests and education performance, eating and exercise habits, hopes for the future, social and recreational activities, whether they smoke or use other psychoactive substances, thoughts and feelings about their sexual activity, and how they feel and whether they have thought of hurting themselves. The acronym stands for Home Education Eating Exercise Ambition Activities Drug-use Sexuality Suicide. |
| Health associate professionals (ISCO-08 32) |
are part of the wider occupational group of Technicians and Associate Professionals. They support the diagnosis and treatment of illness, disease, injuries and impairments; as well as the implementation of health care plans typically established by medical, nursing and other health professionals. The types of tasks usually performed by health associate professionals include: testing and operating medical imaging equipment; administering radiation therapy; performing clinical tests on specimens of bodily fluids and tissues; preparing medications and other pharmaceutical compounds under the guidance of pharmacists; designing, fitting, servicing and repairing medical and dental devices and appliances; providing nursing and personal care and midwifery support services; and using herbal and other therapies. This category includes medical and pharmaceutical technicians (ISCO-08 321), nursing and midwifery associate professionals (ISCO-08 322). |
| Health professionals (ISCO-08 22) |
are professionals who establish and undertake research and develop and apply scientific knowledge in a range of health and related fields including: medicine, complementary medicine, dentistry, optometry, environmental health and occupational health. Specific occupations within the health professionals group include: physicians, nursing and midwifery professionals; paramedics; opticians; dentists; speech therapists; dieticians; psychiatrists, and; other health professionals. The tasks undertaken by health professionals involve: conducting research and obtaining scientific knowledge through the study of human and animal disorders; diagnosing illnesses and ways of treating them; the planning, management and evaluation of the care of patients; advising on or dispensing and applying preventive and curative measures; promoting health; and, preparing scientific papers and reports. This category includes medical doctors (ISCO-08 221), nursing and midwifery professionals (ISCO-08 222), paramedical professionals (ISCO-08 224). |
| Health information system |
provides the underpinnings for decision-making and has four key functions: (i) data generation, (ii) compilation, (iii) analysis and synthesis, and (iv) communication and use. The health information system collects data from health and other relevant sectors, analyses the data, ensures their overall quality, relevance and timeliness, and converts the data into information for health-related decision-making. |
| Health insurance |
is a contract between the insured and the insurer to the effect that in the event of specified events (determined in the insurance contract) occurring the insurer will pay compensation either to the insured person or the health service provider. There are two major forms of health insurance. One is private health insurance, with premiums based on individual or group risks. The other is social security, whereby in principle society's risks are pooled, with contributions by individuals usually dependent on their capacity to pay. |
| Health literacy |
is defined as the achievement of a certain level of knowledge, personal skills and confidence to take action to improve personal and community health by changing personal lifestyles and living conditions. |
| Health needs |
refer to objectively determined deficiencies in health that require health services, such as health protection, health promotion, disease prevention, diagnosis, treatment, management, long-term care, rehabilitation and palliative care. |
| Health needs assessment |
refers to a systematic procedure for determining the nature and extent of problems experienced by a specified population that affect their health, either directly or indirectly. Needs assessment makes use of epidemiological, sociodemographic and qualitative methods to describe health problems and their environmental, social, economic and behavioural determinants. |
| Health professional association |
represents the interests of health professionals and specialties by supporting national health policy development, engaging in negotiations on pay and working conditions of members, supporting continuous professional development, developing undergraduate and post-graduate education curricula and/or the development of clinical practice guidelines. This role is distinguished from health professional regulators, representing the interests of patients. |
| Health promotion |
refers to any combination of health education and related organizational, political and economic interventions designed to facilitate behavioural and environmental adaptations that will improve or protect health. |
| Health service |
refers to any service (i.e. not limited to medical or clinical services) aimed at contributing to improved health or to the diagnosis, treatment and rehabilitation of individuals. |
| Health services delivery processes |
are defined as the unique processes inherent to the health services delivery function that contribute to the performance of health services delivery. These processes include: selecting services, designing care, organising providers, managing services and improving performance. |
| Health technology assessment |
is the systematic evaluation of the properties, effects or other impacts of health care technology. It is intended to inform decision-makers about health technologies and may measure the direct or indirect consequences of a given technology or treatment. |
| Health workforce registry |
refers to a national registry with individual data of health workforce. It is meant to provide a count of and information on all health care personnel that either have worked or are currently working at national or sub-national levels, including private sector. |
| Incentives |
refer to rewards reinforcing positive performance and removing barriers that perversely effect desired performance to inspire and motivate health professionals, organizations and patients to work towards defined objectives. |
| Incident reporting |
refers to a quality of care process for reporting undesirable clinical outcomes resulting from some aspect of diagnosis or treatment, and not an underlying disease. It may also be referred to as Critical Incident Report/adverse event reporting. |
| Integrated health and social care plan |
is a dynamic document based on an assessment which outlines the types and frequency of care services that a client receives. It may include strategies, interventions, continued evaluation and actions intended to help a person to achieve or maintain goals. Integrated health and social care plan provides coordination of care across the system's different functions, activities and operating units. It encompasses horizontal and vertical integration including discharge management and rehabilitation arrangements, a transfer letter to primary/community care services/rehabilitation, etc. |
| Legally recognized groups |
refer to organizations/associations that are formalized as a registered agent according to the country's bylaws of incorporated business or non-profit entities. |
| Licensure |
defines the process by which a governmental authority grants permission, usually following inspection against minimal statutory standards, to an individual practitioner or healthcare organization to operate or to engage in an occupation or profession. Licensure to individuals is usually granted after some form of examination or proof of education and maybe renewed periodically. Licensure to organizations is granted following an on-site inspection to determine if minimum health and safety standards have been met. See also accreditation and certification. |
| Maintenance programme |
in terms of medical equipment, can be implemented in a number of ways including establishing service contracts with device manufacturers, independent service organizations, carrying out maintenance activities by employees of the facility, service contractors or other external service providers. A comprehensive maintenance programme includes identifying an inventory, choosing a methodology and allocating financial, physical and human resources to the programme. |
| Managing facilities |
is defined as the process of planning and budgeting, aligning resources, overseeing implementation and monitoring of results to maintain a degree of consistency and order in the delivery of services and act upon observed deviations from plans, problem-solving and troubleshooting as needed. |
| Medical device |
is an article, instrument, apparatus or machine that is used in the prevention, diagnosis or treatment of illness or disease, or for detecting, measuring, restoring, correcting or modifying the structure or function of the body for some health purpose. Typically, the purpose of a medical device is not achieved by pharmacological, immunological or metabolic means. |
| Medical equipment |
is a medical device requiring calibration, maintenance, repair, user training, and decommissioning - activities usually managed by clinical engineers. Medical equipment is used for the specific purposes of diagnosis and treatment of disease or rehabilitation following disease or injury; it can be used either alone or in combination with any accessory, consumable, or other piece of medical equipment. Medical equipment excludes implantable, disposable or single-use medical devices. |
| mHealth |
is defined as the use of mobile technologies to support health information and medical practices, often incorporated into services such as health call centres or emergency number services. |
| Midwife(ves) (associate professionals) (ISCO-08 3222) |
implement care, treatment and referral plans already established by medical, midwifery and other health professionals. |
| Midwife(ves) (professionals) (ISCO-08 2222) |
plan, manage, provide and evaluate midwifery care services before, during and after pregnancy and childbirth. They provide delivery care for reducing health risks to women and new-born children, working autonomously or in teams with other health care providers (health professionals in online version). |
| Model of care |
is defined as an evolving conception of how services should be delivered. The evolution of the model of care implies changes to services delivery processes in response, including in the design of care, organization of providers, management of services and continuous performance improvement. |
| Multidisciplinary team |
in primary care comprise of various primary care professionals: generalist medical practitioners, nurses, feldshers, specialist nurses, managers, support staff, family medicine and other primary care specialists. |
| Municipal level |
refers to a local administrative subdivision of the government that administers a city. |
| Narrow specialists |
are specialized physicians in countries of the Commonwealth of Independent States and Eastern Europe often working in polyclinics and outpatient departments of hospitals. They usually have less clinical training than specialist medical practitioners, and instead a brief training course for initial specialization. They primarily provide medical treatment, while the generalist medical practitioner performs the follow-up with the patient. |
| National cancer screening programme |
refers to a government-endorsed programme whereby screening is offered. NGO-led programmes or national recommendations for screening at the patient's cost, do not qualify as a national screening programme. |
| Nurses (associate professionals) (ISCO-08 3221) |
provide basic nursing and personal care for people in need of such care due to effects of ageing, illness, injury or other physical or mental impairment. They generally work under the supervision of, and in support of, implementation of health care, treatment and referral plans established by medical, nursing and other health professionals. The distinctions between nursing and midwifery professionals and associate professionals should be made on the basis of the nature of the work performed in relation to the tasks specified in this definition and in the relevant unit group definitions. The qualifications held by individuals or that predominate in the country are not the main factor in making this distinction, as training arrangements for nurses and midwives vary widely between countries and have varied over time within countries. |
| Nurse practitioner/advanced practice nurses |
are nurses (professionals) (part of ISCO-08 2221) who have acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he has the credentials to practise. A master's degree is recommended for entry level. |
| Nurses (professionals) (ISCO-08 2221) |
provide treatment, support and care services for people who are in need of nursing care due to the effects of ageing, injury, illness or other physical or mental impairment, or potential risks to health. They assume responsibility for the planning and management of care of patients, including the supervision of other health care workers, working autonomously or in teams with medical doctors and others in the practical application of preventive and curative measures. Nurses (professionals) include general practice nurses, district nurse, specialist nurse and nurse practitioners. |
| Nurses and midwives offices (part of HP.3.3) |
(e.g. health post) are providers of ambulatory health care and comprise independent health professionals, in this case nurses and midwives, that operate in their own office without a generalist or specialist physicians. |
| Occupational therapists (part of ISCO-08 2269) |
are health professionals who provide diagnostic, preventive, curative and rehabilitative health services. Among other tasks they can develop and implement treatment plans for injuries, illnesses and other physical and mental impairments; can administer therapeutic care and treatment to patients; can recommend environmental adaptations in the home, leisure, work and school environments on an individual or a group basis to enable individuals with functional limitations to perform their daily activities and occupations. |
| Offices of generalist medical practitioner (HP.3.1.1) |
comprise establishments of health professionals who hold the degree of a doctor of medicine or a corresponding qualification and are primarily engaged in the independent practice of general/family medicine. Although in some countries "general practice" and "family medicine" may be considered as medical specialisations, these occupations should always be classified here. Generalist medical practitioner solo practice refers to offices held by a single practitioner. Ambulatory group practice refers to centres of multiple general medical practitioners. |
| Offices of medical specialists (HP.3.1.2 and HP.3.1.3) |
(e.g. practices of independent psychiatrists, offices of psychotherapists, offices of cardiologists, ophthalmologists, ENT, paediatricians of specialised care, etc.) comprises establishment of health professionals holding a degree of doctor of medicine with a specialisation in mental medicine, a corresponding qualification or a medical doctor with a specialisation other than general medicine (equivalent to ISCO-08 Code 2212). |
| Other ambulatory health care centres (HP.3.4) |
(e.g. family planning centers, free-standing ambulatory surgery centers, dialysis care centres) comprise establishments that are engaged in providing a wide range of outpatient services by a team of medical and paramedical staff, often along with support staff, that usually bring together several specialities. They differ from offices of medical specialists (HP.3.1.3) by their multi-specialisations, the complexity of the medical-technical equipment used and the range of types of health professionals involved. |
| Out-of-pocket payments (OOP) |
are payments for goods or services that include: (i) direct payments: payments for goods or services that are not covered by any form of insurance; (ii) cost sharing: a provision of health insurance or third-party payment that requires the individual who is covered to pay part of the cost of health care received; and (iii) informal payments: unofficial payments for goods and services that should be fully funded from pooled revenue. |
| Outpatient consultations/visits |
include consultations/visits at the physician's office, consultations/visits in the patient's home, consultations/visits in outpatient departments in hospital, but excludes telephone contacts, visits for prescribed laboratory tests, visits to perform prescribed and scheduled treatment procedures, e.g. injections, physiotherapy, etc. visits to dentists, visits to nurses. |
| Outpatient departments of hospitals (part of HP.1) |
(general hospitals providing out-patient, day care services) comprise licensed establishments that are primarily engaged in providing medical, diagnostic and treatment services that include physician, nursing and other health services that provide day care, outpatient and home health care services as secondary activities. |
| Paediatricians/district paediatricians/district paediatric doctors |
are considered generalist medical practitioner (ISCO-08 2211) only when they are the first point of contact for children, for example in countries of the Commonwealth of Independent States. In other cases when they consult as a specialist, they are considered specialist medical practitioners (ISCO-08 2212). |
| Paramedical practitioners (ISCO-08 2240) |
are health professionals who provide advisory, diagnostic, curative and preventive medical services more limited in scope and complexity than those carried out by medical doctors. They work autonomously, or with limited supervision of medical doctors, and apply advanced clinical procedures for treating and preventing diseases, injuries and other physical or mental impairments common to specific communities. Examples of occupations: feldsher, advanced care paramedic, clinical officer (paramedical), primary care paramedic. |
| Patient complaint system |
is a formal, systematic and transparent process for receiving, investigating and resolving patients’ expressions of grievances or disputes with the care they received. |
| Patient groups |
include associations and organizations that provide organized insight and represent patient experiences as potential, current and past recipients of health services on general health topics or disease-specific areas. |
| Patient list |
refers to a list of records for each individual registered/assigned to/regularly seen by a provider. The list includes identification information, patient characteristics and may include information on current medical problems and on-going treatments. The list can exist in paper or electronic form. |
| Patient registries |
collect information over time on patients who are diagnosed with a particular disease or who receive particular treatments. |
| Peer review meetings (teams, committees, circles) |
are small groups of health professionals based on voluntary participation and concerned with activities aimed at accessing and continuously improving the quality of patient care. |
| Peer support groups (peer-to-peer support) |
are patient-driven groups on specific topics that encourage individuals to be in direct control of managing their conditions through group work and mutual support allowing them to draw on each other's experiences. |
| Periodic health audits and feedback |
refers to any summary of clinical performance of health care over a specified period of time aimed at providing information to health professionals to allow them to assess and adjust their performance. |
| Pharmacies, retailers and other providers of medical goods (HP.5) |
refers to specialised establishments whose primary activity is the retail sale of pharmaceuticals and other medical goods to the general public for individual or household consumption or utilisation. Pharmaceuticals include both prescribed and non-prescribed medicines, either manufactured or prepared by onsite pharmacists. |
| Pharmacists (ISCO-08 2262) |
are health professionals who store, preserve, compound and dispense medicinal products and counsel on the proper use and adverse effects of drugs and medicines following prescriptions issued by medical doctors and other health professionals. This category includes dispensing chemist (pharmacists in online version) and retail pharmacists but is to the exclusion of pharmaceutical technician and assistant. |
| Pharmaceutical technician and assistants (ISCO-08 3213) |
are health associate professionals who perform a variety of tasks associate with dispensing medicinal products under the guidance of a pharmacist or other health professional. This category includes dispensing technicians, pharmaceutical assistants, pharmaceutical technicians, etc. |
| Physicians/medical doctors |
study, diagnose, treat and prevent illness, disease, injury and other physical and mental impairments in humans through the application of the principles and procedures of medicine. Include generalist medical practitioners, specialist medical practitioners and in countries of the Commonwealth of Independent States narrow specialists. |
| Physiotherapists (ISCO-08 2264) |
assess, plan and implement rehabilitative programmes that improve or restore human motor functions, maximize movement ability, relieve pain syndromes, and treat or prevent physical challenges associated with injuries, diseases and other impairments. |
| Physiotherapist technicians (part of ISCO-08 3255) |
are health associate professionals who provide physical therapeutic treatments to patients n circumstances where functional movement is threated by injury, disease or impairment. Therapies are usually provided according to rehabilitative plans established by a physiotherapists or other health professional. |
| Polyclinics (HP.3.4.9) |
see ambulatory multi-profile (speciality) group practice/polyclinic. |
| Population-groups-specific reimbursement scheme |
selects specific population groups (e.g. children, elderly, pensioners) for higher reimbursement rates or free medicines. |
| Population stratification (based on needs and risks) |
refers to the assessment of health needs for a given population, segmenting for epidemiological, demographic or geographic variables, for the planning and targeting of services to manage needs and proactively address known risk factors. |
| Positive list/reimbursement list |
refers to the list of medicines that may be prescribed at the expense of the third-party payer. |
| Postgraduate education programme |
is part of tertiary education and corresponds to ISCED level 7. It typically varies from 1 to 4 years when following an undergraduate/bachelor's programme (ISCED level 6), or from 5 to 7 years when directly following secondary education, ISCED level 3. |
| Post-natal care check |
is understood as visits for the care of the mother (not the infant). It includes visits by a primary care health professional either at home or in a facility. |
| Practice |
is understood as a provider with more than one generalist medical practitioner. |
| Practising health professionals |
are health professionals who are actively practising medicine in public and private institutions and provide services for individual patients. In case of data not available for practising health professionals, data closest to practising (professionally active health professionals, health professionals with active license) can be used. |
| Primary care health professionals |
are a sub-group of health professionals who provide services in primary care. |
| Primary care |
describes a type of care and setting for health services delivery that supports first-contact, accessible, continued, comprehensive and coordinated care to individuals and communities. See also primary health care. |
| Primary care facilities |
refer to ambulatory care facilities such as primary care centre, office of generalist health professional, ambulatory health care centre, family planning centre, home health care centre, nursing home, and polyclinic; other settings such as walk-in treatment centre, outpatient department of a district/general hospital, ambulance, mobile clinic, laboratory, pharmacy, and palliative care establishment; and, rural-specific facilities such as rural physician ambulatory, feldsher assistance point, midwifery post and rural health house. |
| Primary care performance assessment |
includes publications (on paper or online) that systematically report on the performance of primary care in general, or important parts of the primary care system. These performance assessments may be used for monitoring, target setting and / or accountability. The focus of assessments is rather broad than detailed. Assessments do not include studies that evaluate specific interventions or programmes or studies that were solely done for academic purposes. A primary care assessment may also be part of an assessment of the health system in general. In replying to this question, please consider not only specific assessments dedicated to primary care, but also exercises that are part of larger reports or reports on specific forms of care (e.g. general practitioners, paediatricians, dentists, etc.). See also assessment. |
| Primary health care |
refers to the approach elaborated in the 1978 Declaration of Alma-Ata based on the principles of equity, participation, intersectoral action, appropriate technology and a central role played by the health system for the delivery of services that are made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. |
| Primary health care expenditure |
is currently being defined at the global level but it includes the following: all expenditures for providers who only provide primary health care services; expenditures for primary health care preventive services provided by additional providers; a proportion of overall capital costs; and, a proportion of administrative expenditures. |
| Product specific reimbursement scheme |
determines eligibility based on the medicine in question; a medicine is either considered as reimbursable or as non-reimbursable. |
| Provider |
groups together all organization arrangements of health professionals (practice with more than one health professional, solo practices, etc.). |
| Provider payment: bundled payments |
combine otherwise separate payments to providers into a single fee covering the care required for a person or defined population with multimorbidity for a predefined period. Payments can be bundled across providers and services and the price for the bundle can be set or negotiated. |
| Provider payment: capitation |
refers to a payment in which all providers in the payment system are paid, in advance, a predetermined fixed rate to provide a defined set of services for each individual enrolled with the provider for a fixed period. |
| Provider payment: fee-for-service |
is the case when providers are paid for each individual service provided. Fees are fixed in advance for each service or group of services. |
| Provider payment: global budget |
refers to the allocation of a payment fixed to a health care provider to cover the aggregate costs over a specific period to provide a set of services that have been broadly agreed on. A global budget may be based on inputs or outputs, or a combination of the two. Typically, providers have flexibility to make decisions about how to allocate funds across expenditure categories. |
| Provider payment: pay-for performance |
refers to a mechanism where the payment to providers is modified upwards or downwards based on the degree of target achievement reached. |
| Providers of ancillary services (HP.4) |
include establishments that provide specific ancillary type of services directly to outpatients under the supervision of health professionals and are not included within the episode of treatment by other providers. They include medical and diagnostic laboratories such as diagnostic imaging centres, medical x-ray laboratories, medical pathology laboratories, clinical laboratories. |
| Providers of preventive care (HP.6) |
comprise organisations that primarily provide collective preventing programmes and campaigns/public health programmes for specific groups of individuals or the population-at-large, such as health promotion and protection agencies or public health institutes as well as specialised establishments providing primary preventive care as their principal activity. |
| Providers of home health care services (HP.3.5) |
comprise establishments that are primarily engaged in providing skilled nursing services in patients' homes, along with a range of the following: personal care services: medical social services, support in medications, use of medical equipment and supplies, counselling; 24-hour home care; occupational and vocational therapy; dietary and nutritional services; speech therapy; audiology; and high-tech care, such as intravenous therapy. |
| Public health professionals (ISCO-08 2212) |
are specialists working to improve the public health deficits by providing health surveillance through promoting the development of indicator-based comprehensive health monitoring systems; promoting health behaviour and lifestyles, and reducing risk factors; working to help reduce inequity in health; helping to decision-making in health care among different players. |
| Public health services |
refer to health services targeted at the population as a whole, These include, among others, health situation analysis, health surveillance, health promotion, prevention services, infectious diseases control, environmental protection and sanitation, disaster preparedness and response, and occupational health. |
| Purchaser of health care |
refers to financing agents as defined in the System of Health Account, i.e. the "final payer". Depending on the country and type of service, purchasers either pay the provider directly or reimburse the patient after he/she receives care. |
| Quality improvement teams/committees |
refers to a group of individuals within a practice charged with carrying out improvement efforts. The team may report to management. Teams should meet regularly to review performance data, identify areas in need of improvement and carry out and monitor improvement efforts. |
| Quality of care |
refers to health system improvements sought for care that is effective, efficient, accessible, acceptable/patient-centered, equitable and safe. |
| Rapid tuberculosis diagnosis using WHO recommended rapid test |
refers to the Xpert MTB/ RIF assay is the test endorsed by WHO to be used in countries most affected by tuberculosis. The test provides an accurate diagnosis for many patients in about 100 minutes, compared to previous tests which were required up to three months to receive results. More information regarding the test, frequently-asked questions and fact sheet can be found on the WHO tuberculosis programme's web page: http://www.who.int/tb/features_archive/new_rapid_test/en/. |
| Recurrent expenditures |
are costs that refer to inputs which last less than one year and are regularly purchased for continuing an activity, such as salaries, drugs and supplies, repair maintenance, and others. See also capital expenditure. |
| Referral guidelines |
intend to map out the linkages across the different levels of the health system to ensure that health needs are addressed irrespective of the health system level at which care was first sought. It facilitates forward and backwards management of cases across different levels of care. |
| Referral form |
is a standardized form throughout the network of service providers that ensures that the same essential information is provided whenever a referral is initiated. It is normally designed to facilitate communication in both directions - the initiating facility completes the outward referral, referral letter, and at the end of care, the receiving facility completes the back referral to the original facility, reply letter. |
| Referral letter |
is part of the referral form and can be a stand alone document or included on one form with the reply letter. It is filled out by the initiating facility with information on the patient, the reason for referral and any clinical findings. It is used by the receiving facility to begin a through assessment of the patient and begin the management of the case. |
| Regional/oblast level |
type of first level sub-national administrative division that may include several districts (second level administrative divisions). |
| Reimbursement list |
see positive list. |
| Reply letter |
is part of the referral form and can be a stand alone document or included on one form with the referral letter. It is filled out by the treating facility and contains information on special investigations, findings, diagnosis and treatment. |
| Residential long-term care facilities (HP.2), also known as high dependency care facilities |
are establishments primarily engaged in providing inpatient nursing and rehabilitative services to individuals requiring nursing care. |
| Rural-urban classification |
defines or delimits both urban and rural areas, or urban areas first and the latter by default. The classification may be defined on the basis of population in physical spaces with or without access to key services. In many countries, the criterion is population size or density, which are standard determinants of rurality. Rural areas are those with a low population density, i.e. a low number of inhabitants on a given area of land. Local administrative units may contain combinations of urban and rural populations. Several criteria may be combined (cities, municipalities, metropolitan areas) to define urban areas and define rural areas by exclusion. Rural-urban classification defines or delimits both urban and rural areas, or urban areas first and the latter by default. The classification may be defined on the basis of population in physical spaces with or without access to key services. In many countries, the criterion is population size or density, which are standard determinants of rurality. Rural areas are those with a low population density, i.e. a low number of inhabitants on a given area of land. Local administrative units may contain combinations of urban and rural populations. Several criteria may be combined (cities, municipalities, metropolitan areas) to define urban areas and define rural areas by exclusion. |
| Scenario planning |
defines a process of strategic planning that allows managers to explore various combinations of interventions to better understand what levels of intervention coverage and resources might be needed to achieve the desired results. |
| Screening |
is the presumptive identification of unrecognized disease in an apparently healthy, asymptomatic population by means of tests, examinations or other procedures that can be applied rapidly and easily to the target population. |
| Self-management or self-care |
is defined as the knowledge, skills and confidence to manage one's own health, to care for a specific condition or to recover from an episode of ill health. |
| Settings of care |
describe the varied types of arrangements for services delivery, organized further into different facilities, institutions and organizations that provide care. Settings include ambulatory, community, home, in-patient and residential services, whereas facilities refer to infrastructure, such as clinics, health centres, district hospitals, dispensaries, or other entities, for examples, mobile clinics and pharmacies. |
| Shared decision-making |
is defined as an interactive process in which patients, their families and carers, in collaboration with their health provider(s), choose the next action(s) in their care path following an informed analysis of possible options, their values and preferences. |
| Social workers (part of ISCO-08 2635) |
provide advice and guidance to individuals, families, groups, communities and organizations in response to social and personal difficulties. They assist clients to develop skills and access resources and support services needed to respond to various issues arising from unemployment, poverty, disability, addiction, etc. |
| Specialist medical practitioners |
are physicians who diagnose, treat and prevent illness, disease, injury and other physical and mental impairments using specialized testing, diagnostic, medical, surgical, physical and psychiatric techniques, through application of the principles and procedures of modern medicine. They plan, supervise and evaluate the implementation of care and treatment plans by other health-care providers. They specialize in certain disease categories, types of patient or methods of treatment, and may conduct medical education and research activities in their chosen areas of specialization. Include specialist medical doctors, specialist doctor, etc. |
| Speech therapist (part of ISCO-08 2266) |
is a health professional who evaluates, manages and treats physical disorders affecting human speech, communication and swallowing. They prescribe corrective devices or rehabilitative therapies for speech disorders and related sensory and neural problems, and provide counselling on communication performance. This category includes language therapists, speech pathologists, speech therapists, etc. |
| Stakeholder |
refers to an individual, group or an organization that has an interest in the organization and delivery of health care. |
| Strategy |
refers to a series of time-bound broad lines of action intended to achieve a set of goals and targets set out within a policy programme. |
| Total risk approach |
identifies individuals for prevention, treatment and referral based on a combined risk evaluation that includes age, sex, blood pressure, smoking status, total blood cholesterol and presence or absence of diabetes mellitus. This approach is considered more effective and less costly than informing treatment decisions based on a single factor, such as high arterial blood pressure or high serum cholesterol. |
| Undergraduate/bachelor's programme |
is part of tertiary education and corresponds to International Standard Classification of Education (ISCED) level 6 program. It typically varies from 3 to 4 or more years when directly following upper secondary education (ISCED level 3) or 1 to 2 years when following another ISCED level 6 programme. |
| Vocational training |
refers to a short-cycle tertiary education programme corresponding to ISCED level 5. It may be referred to in many ways, for example: (higher) technical education, community college education, technician or advanced/higher vocational training, associate degree, or bac+2. It is designed for learners to acquire the knowledge, skills and competencies specific to a particular occupation or class of occupations. Successful completion of such programmes leads to labour market-relevant, vocational qualifications acknowledged as occupationally-oriented by the relevant national authorities and/or the labour market . |
| WHO/ISH cardiovascular risk prediction charts |
indicate 10-year risk of a fatal or not fatal major cardiovascular event taking into consideration age, sex, blood pressure, smoking status, total blood cholesterol and presence or absence of diabetes mellitus. There are specific charts for 14 WHO epidemiological subregions. A separate set of charts are available for settings where blood cholesterol cannot be measured. These can be further calibrated at country-level. Detailed information can be found at: http://www.who.int/cardiovascular_diseases/guidelines/Chart_predictions/en/. |