Dictionary

D

Decision UtilityTermDecision-Based Utility, Anticipated Utility

The value an individual assigns to an outcome at the moment of choosing it, based on anticipated experience, unlike experienced utility.

DecommissioningConceptService Withdrawal, Technology Retirement

Decommissioning is the formal step that ends funding or provision of a health service or technology, in full or for some patients, once judged low value.

DeductibleConceptInsurance Excess, Upfront Payment Threshold

A deductible is the amount an insured person must pay for covered health care in a period before the insurance plan starts to pay its share.

Deductible CarryoverTermDeductible Roll-Over, Carryover Provision

A provision letting amounts already paid toward a deductible late in one plan year also count toward the following year's deductible.

Deemed StatusTermDeemed Compliance, Accreditation Deeming

A regulatory designation where an accredited facility is automatically considered to have met government conditions of participation, without a separate survey.

Deep Learning HealthConceptDeep Learning, Neural Network Health

Deep learning health, or deep learning in health care, uses many-layered neural networks on images, records and text for diagnosis and risk prediction.

Deep Molecular ResponseTermDMR, Deep Molecular Remission

A response criterion in chronic myeloid leukaemia indicating an even greater reduction in detectable disease-associated genetic material than a major molecular response.

Deep Vein ThrombosisTermDVT, Venous Clot

A condition in which a blood clot forms within a deep vein, usually the leg, risking travel to the lungs as a pulmonary embolism.

Default EffectConceptDefault Bias

The default effect is the tendency to stay with a pre-selected option, so opt-out schemes for organ donation or HIV testing raise uptake over opt-in.

Default InterventionTermDefault Option Policy, Opt-Out Default

A policy tool establishing a pre-selected option that applies automatically unless an individual opts out.

DeficitTermFiscal Shortfall, Spending Shortfall

A shortfall occurring when spending exceeds available revenue within a budget period, requiring borrowing, reserve depletion, or subsequent cuts.

Deficit ReductionTermDeficit Cutting, Fiscal Consolidation

Policies aimed at closing the gap between spending and revenue within a budget, through increased revenue, reduced spending, or both.

Degrees of FreedomConceptdf, Degree of Freedom

Degrees of freedom (df) count values left free to vary after estimation and set the t, chi-squared or F curve for tests in trials and meta-analyses.

Delayed CareTermCare Delay, Postponed Care

A coping strategy in which a household postpones seeking needed healthcare due to cost concerns, risking a worsening condition.

Delayed OutcomeTermLagged Outcome, Deferred Outcome

A clinical or economic outcome that manifests only after a substantial period following treatment, such as a late-occurring side effect.

Deliberative ProcessConceptDeliberation, Reasoned Deliberation

A deliberative process is structured group discussion where experts and stakeholders weigh evidence and values to guide HTA or priority-setting decisions.

Delphi MethodConceptDelphi Technique, Delphi Panel

The Delphi method is an expert survey run in anonymous rounds with group feedback, used in health economics to agree judgements or estimate model inputs.

Delta AdjustmentTermDelta Sensitivity Analysis, Delta Imputation

A sensitivity analysis technique shifting the assumed outcome for patients with missing trial data by a specified amount to test conclusions' robustness.

Delta MethodConceptDelta Approximation, Taylor-Series Variance, Taylor Series Method, First-Order Approximation

The delta method approximates the variance of a function of estimated parameters, such as an ICER or mean survival, using a first-order Taylor expansion.

DemandConceptPurchase Willingness

Demand is the schedule of quantities of a good or service, such as health care, that people are willing and able to buy at each price over a given period.

Demand CurveConceptDemand Schedule, Price-Quantity Curve

A demand curve shows how much of a good or service, such as health care, is demanded at each price, other factors held fixed. It usually slopes downward.

Demand for HealthConceptHealth Demand, Grossman Demand

Demand for health is the idea, from the Grossman model, that people value health as a capital stock, so their demand for healthcare is derived from it.

Demand ForecastingConceptUtilisation Forecasting, Service-Demand Projection

Demand forecasting projects future use of health services and medicines, and the staff needed, from past utilisation, population change and other drivers.

Demand InducementConceptInduced Demand, Physician-Induced Demand

Demand inducement is a provider's use of an information advantage to shift a patient's demand for care away from the patient's best interests.

Demand ManagementTermDemand-Side Management, Utilisation Control

Strategies used to influence and manage the level and timing of healthcare service utilisation, such as triage and appointment scheduling.

Demand PriceTermMarginal Willingness to Pay, Maximum Buyer Price

The maximum price consumers are willing to pay for a given quantity of a good, represented along a standard demand curve.

Demand-Side ControlTermPatient-Side Cost Control, Demand-Side Measure

Cost containment strategies targeting patient-side incentives, such as cost-sharing, to influence utilisation, unlike supply-side controls targeting provider behaviour.

Demographic AdjustmentTermAge-Sex Adjustment, Demographic Risk Adjustment

A risk adjustment method predicting expected costs based on basic characteristics, such as age and sex, without detailed clinical diagnosis information.

Denial ManagementTermDenials Management, Claims Denial Handling

The processes an organisation uses to identify, appeal, and prevent insurance claim denials, minimising revenue loss and administrative burden.

Departure ProcessConceptExit Process, Simulation Exit

The pattern by which entities, such as patients, leave a discrete event simulation after completing the services or processes being modelled.

DependencyTermCare Reliance, Functional Dependence

A state in which a person needs assistance from others to perform daily activities due to physical or cognitive limitations.

Dependent CensoringConceptInformative Censoring, Non-Ignorable Censoring

Dependent censoring occurs when the chance of being censored is linked to a patient's risk of the event, so standard survival estimates can be biased.

Dependent CoverageTermFamily Coverage, Dependant Cover

Health insurance coverage extended to an eligible family member, such as a spouse or child, under a primary policyholder's plan.

DeprescribingTermMedication Withdrawal, Planned Dose Reduction

The planned, supervised process of reducing or stopping a medication no longer beneficial or causing harm, managing polypharmacy and related risk.

Depression BurdenTermDepression Disease Burden, Cost of Depression

The total impact of depression on individuals and society, covering treatment costs, lost productivity, and reduced quality of life.

Depression SymptomsTermDepressive Symptom Score, Depression Symptom Severity

Depression symptoms are the features of depression in the DSM-IV criteria, whose severity health studies and evaluations measure with tools like the PHQ-9.

Derived Demand for HealthcareConceptDerived Healthcare Demand, Demand Derived from Health

Derived demand for healthcare is the idea that people want medical care mainly as an input for producing health, the thing they actually value.

Dermatology EconomicsTermSkin Disease Economics, Economics of Dermatology

The broad application of health economic evaluation to skin conditions and treatment, covering both medical dermatology and skin cancer.

Descriptive EpidemiologyConceptDescriptive Epi, Disease Distribution Analysis

Descriptive epidemiology describes how disease is distributed by person, place and time, supplying the counts, rates and trends used in health economics.

Descriptive StatisticsConceptSummary Statistics, Data Summarisation

Descriptive statistics summarise the centre, spread and shape of data, such as skewed patient costs, whose arithmetic mean sets the total budget.

Design EffectConceptDeff, Variance Inflation from Clustering

The design effect (DEFF) is the ratio of an estimate's variance under a clustered or complex sample to that under a simple random sample of equal size.

Designated Health ServicesTermDHS, Stark-Listed Services

A specific list of service categories subject to physician self-referral restrictions under US law, such as clinical laboratory services.

Detection BiasConcept

Detection bias is systematic error from unequal finding, measuring or judging of outcomes between study groups, often because assessors know allocation.

DeterminantTermDet, Matrix Scalar

A scalar value calculated from a square matrix that indicates properties including invertibility, scaling and the independence of its rows or columns.

Determinant of HealthTermHealth Determinant, Factor Influencing Health

In health economics and public health, a factor that influences the health of individuals or populations, spanning behavioural, social, environmental and biological causes, and shaping the burden of disease that interventions and policy aim to reduce.

Deterministic AnalysisTermFixed-Input Analysis, Point-Estimate Analysis

An analysis in which every model input is assigned a single, fixed value, producing one specific result rather than a distribution.

Deterministic ModelConceptFixed-Parameter Model, Point-Estimate Model

A deterministic model is a health economic model with no random elements, so the same inputs always give the same costs, QALYs and ICER.

Deterministic Sensitivity AnalysisConceptDSA

Deterministic sensitivity analysis (DSA) reruns a health economic model with chosen inputs set to fixed values to see how results and decisions change.

Development Assistance for HealthConceptDAH, Health Aid

Development assistance for health (DAH) is the grants, loans and in-kind aid for health that development agencies give to low- and middle-income countries.

Development Impact BondTermDIB, Outcome-Funded Bond

A financing mechanism where private investors fund a social programme upfront, repaid by an outcome funder only if predefined results are verified.