Dictionary
The Dictionary provides concise definitions of health economics terms, arranged alphabetically for quick reference. Use it to understand unfamiliar terminology or confirm the meaning of a specific term.
A
- AMA Discharge
- A hospital discharge occurring against medical advice, where a patient chooses to leave before clinicians recommend, despite informed risk disclosure.
- Average Length of Stay
- A measure found by dividing total patient-days within a facility by discharges over the same period, an indicator of efficiency.
B
- Bad Debt
- Healthcare charges a provider is unable to collect from a patient who was expected to pay but did not.
- Balance Billing
- The practice of a provider billing a patient for the difference between their charge and what insurance actually paid, typically for out-of-network care.
- Balance Billing Protection
- A regulatory safeguard preventing providers from billing patients the difference between their charge and insurance payment, particularly for emergency care.
- Bed Turnover
- A measure of how frequently a hospital bed is used by different patients, calculated by dividing discharges by average available beds.
- Billed Charges
- The amount a provider bills for a service, which often bears little relation to actual cost or the amount an insurer ultimately pays.
C
- Case Management Hospital
- A collaborative hospital process assessing, planning, coordinating, and monitoring a hospitalised patient's care needs, often including discharge planning.
- Charge
- The amount a healthcare provider bills for a service, which often bears little relation to the actual cost of providing it.
- Charge Master
- An internal list maintained by a facility specifying the standard billed price for every service and supply, the starting point for patient bills.
- Community Rating
- A method setting premiums that charges all enrollees within a community the same rate, or within narrow limits, regardless of individual risk.
- Cost-to-Charge RatioCCR
- A ratio, typically from hospital accounting reports, used to convert billed charges into an estimate of the actual cost of providing a service.
- Customary Charge
- The typical amount a provider bills for a service based on established pricing practice, historically used before prospective payment systems.
D
- Day Surgery
- A surgical procedure performed on an outpatient basis, with the patient discharged home the same day rather than staying overnight.
- Direct Medical Cost
- A direct cost incurred specifically for the provision of medical care, such as physician fees, hospital charges, or medication.
- Discharge Disposition
- The specific destination a patient transitions to upon leaving hospital, such as home, a nursing facility, or hospice care.
- Discharge Instructions
- Written or verbal guidance given to a patient leaving a facility, detailing follow-up care, medication instructions, and warning signs to watch for.
- Discharge Management
- The processes an organisation uses to prepare and coordinate a patient's transition out of a hospital or facility.
- Discharge Planning
- The process of preparing a patient for transition out of a facility, assessing ongoing care needs and arranging follow-up services.
- Discharge Planning Review
- An evaluation of the process and adequacy of planning to prepare a patient for transition out of hospital, assessing follow-up arrangements.
- Discharge Process
- The formal sequence of steps transitioning a patient out of hospital, covering final assessment, medication reconciliation, and follow-up arrangements.
- Discharges
- The total number of patients formally released from inpatient care within a facility over a defined period, a throughput measure.
E
- Expired
- A clinical discharge status designation indicating a hospitalised patient died during their admission, used in administrative and quality reporting.
- External Reference Pricing
- A pricing policy in which a country sets or negotiates a drug's price based on prices charged for it in a defined set of other countries.
F
- Flow Management
- Strategies optimising the movement of patients through a facility from arrival through treatment to discharge, minimising unnecessary delays.
H
- Home Discharge
- A hospital discharge in which a patient returns directly home, rather than transitioning to another institutional care setting.
- Hospice Discharge
- The conclusion of a patient's hospice enrolment, whether from death, improved condition no longer meeting eligibility, or the patient's own choice.
I
- Innovation Premium
- The additional price a manufacturer charges for a genuinely novel treatment relative to existing alternatives, reflecting incremental clinical benefit and development investment.
- Inpatient Management
- The clinical and administrative processes coordinating and delivering care to hospitalised patients, covering admission, coordination, and discharge planning.
- International Reference Pricing
- A pricing policy setting a country's drug price with explicit reference to prices charged for the same product in a defined basket of countries.
- IRF Discharge
- The conclusion of a patient's stay at an inpatient rehabilitation facility, transitioning to home, a lower level of care, or elsewhere.
L
- Length of Stay
- The total duration of a single patient's hospital admission, from the date of admission to the date of discharge.
- Length Of Stay Management
- Strategies used to appropriately manage and, where clinically suitable, reduce hospitalisation duration, through care coordination and discharge planning.
- LTACH Discharge
- The conclusion of a patient's stay at a long-term acute care hospital, transitioning to a lower level of care or elsewhere.
P
- Patient Flow
- The movement of patients through a healthcare facility from arrival through treatment to discharge, encompassing the transitions along the way.
- Premium Design
- The methodology an insurer uses to determine premium charges, including rating factors such as age, geography, and rating approach.
- Premium Setting
- The overall process by which an insurer determines the specific premium amount to charge, incorporating actuarial analysis and regulatory rules.
- Price Cap
- A government-imposed upper limit on the price a manufacturer may charge for a drug, used as direct price regulation in some systems.
- Price Control
- A government-imposed limit on the price charged for a good or service, set as either a ceiling or a floor.
- Price Premium
- The additional amount a manufacturer charges for a treatment relative to an existing comparator, reflecting the treatment's demonstrated incremental clinical benefit.
- Price Schedule
- A comprehensive listing specifying the predetermined price a payer or provider will charge or reimburse for each specific service.
R
- Readmission
- A subsequent hospital admission occurring within a defined period, commonly thirty days, after a patient's discharge from a prior stay.
- Readmission Measure
- A quality indicator tracking the rate of hospital readmission within a defined period, commonly thirty days, following a prior discharge.
- Readmission Rate
- A measure of the proportion of patients readmitted to hospital within a defined period, commonly thirty days, after a prior discharge.
- Resource-Based Value
- A payment concept tying reimbursement to actual resources, such as time and skill, required for a service, rather than historical charges.
- Retrospective Payment
- A methodology reimbursing a provider based on actual costs or charges incurred, determined after care has been provided, unlike prospective payment.
- Retrospective Query
- A request from a documentation specialist to a physician made after discharge, seeking clarification to ensure accurate coding of a completed record.
S
- Semi-Variable CostMixed Cost
- A cost containing both a fixed and a variable component, such as a utility bill with a base charge plus a per-unit fee.
- SNF Discharge
- The conclusion of a patient's stay at a skilled nursing facility, transitioning to home or another care setting.
T
- Tax
- A compulsory financial charge imposed by government on individuals or organisations, used to fund public expenditure including healthcare.