Glossary of Terms

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Accreditation - An evaluative process in which a healthcare organization undergoes an examination of its policies, procedures and performance by an external private sector organization ("accrediting body") to ensure that it is meeting predetermined criteria. It usually involves both on- and off-site surveys.
Acute Care Hospital - A hospital that provides inpatient medical care and other related services for surgery, acute medical conditions or injuries (usually for a short term illness or condition).
Acute Myocardial Infarction (AMI) - A condition (also called a heart attack) that occurs when the arteries leading to the heart become blocked and the blood supply is slowed or stopped. When the heart muscle can't get the oxygen and nutrients it needs, the part of the heart tissue that is affected may die.
Additional Measures - Measures included in the Hospital Quality Alliance measure set, reflecting care for discharges occurring on or after April 1, 2004 (2nd quarter 2004).

Acute Myocardial Infarction

Heart Failure

Pneumonia

American Hospital Association (AHA) - The national organization that represents and serves all types of hospitals, health care networks, and their patients and communities. AHA takes part in national health policy development, legislative and regulatory debates, and legal matters. AHA provides education for health care leaders and is a source of information on health care issues and trends.
American Osteopathic Association (AOA) - A member association representing approximately 52,000 osteopathic physicians (D.O.s). The AOA serves as the primary certifying body for D.O.s, and is the accrediting agency for all osteopathic medical colleges and health care facilities. The AOA writes a performance report on each hospital that it checks. You can call or write to AOA to find out a hospital's level of accreditation.
Angioplasty - In angioplasty, a catheter is used to insert a balloon that is inflated to open a blocked blood vessel. Percutaneous transluminal coronary angioplasty (PTCA) is one of several procedures used to open a blocked blood vessel, known collectively as a percutaneous coronary intervention or PCI.
Angiotensin Converting Enzyme (ACE) Inhibitor - A medicine used to treat heart attacks, heart failure, or a decreased function of the left heart. They stop production of a hormone that can narrow blood vessels. This helps reduce the pressure in the heart and lower blood pressure.
Antibiotic - Medicine used to fight bacteria in the body.
Atherectomy - A procedure where a blade or laser on a catheter cuts through and removes blockages in blood vessels. It is one of several procedures used to open a blocked blood vessel (known as a Percutaneous Coronary Intervention or PCI).
Beta Blocker - A type of medicine that is used to lower blood pressure, treat chest pain (angina) and heart failure, and to help prevent a heart attack. Beta blockers relieve the stress on the heart by slowing the heart rate and reducing the force with which the heart muscles contract to pump blood. They also help keep blood vessels from constricting in the heart, brain, and body.
Blood Culture - A blood test that shows if there are bacteria in the blood, and what type of bacteria it is. It helps your doctor decide which antibiotic to use to treat a bacterial infection.
Centers for Medicare & Medicaid Services (CMS) - The federal agency that runs the Medicare program for the aged and disabled. In addition, CMS works with the states to run the Medicaid program for low-income individuals. CMS works to make sure that the people in these programs are able to get high quality health care.
Certification (Medicare-Certified) - State government agencies inspect health care providers, including hospitals, nursing homes, dialysis facilities and home health agencies, as well as other health care providers. These providers are certified if they pass inspection. Being certified is not the same as being accredited. Medicare or Medicaid only pays for care provided by certified or accredited providers.
Critical Access Hospital (CAH) - A small, geographically remote facility that provides limited outpatient and inpatient hospital services to people in rural areas. The designation was established by law, for special payments under the Medicare program. To be designated as a CAH, a hospital must be located in a rural area, provide 24-hour emergency services; have an average length-of-stay for its patients of 96 hours or less; be located more than 35 miles (or more than 15 miles in areas with mountainous terrain) from the nearest hospital or be designated by its State as a "necessary provider". Hospitals may have no more than 25 beds.
Department of Health And Human Services (DHHS) - A division of the U.S. government that administers many of the social programs at the Federal level dealing with the health and welfare of the citizens of the United States. CMS is an agency within DHHS.
Diastolic Pressure - The lowest pressure in the artery when the heart is filling with blood. In a blood pressure reading, the diastolic pressure is the second number recorded.
Hospital Quality Alliance: Improving Care Through Information (HQA) - In December 2002, the American Hospital Association (AHA), Federation of American Hospitals (FAH), and Association of American Medical Colleges (AAMC) launched the Hospital Quality Alliance (HQA), a national public-private collaboration to encourage hospitals to voluntarily collect and report hospital quality performance information. This effort is intended to make important information about hospital performance accessible to the public and to inform and invigorate efforts to improve quality. CMS and the Joint Commission participate in the HQA, along with the AHA, the FAH, the AAMC, the American Medical Association, the American Nurses Association, the National Association of Children's Hospitals and Related Organizations, American Association of Retired People, American Federation of Labor and Council of Industrial Organizations, the Consumer-Purchaser Disclosure Project, the Agency for Healthcare Research and Quality and the National Quality Forum.
Inpatient Hospital Services - Services provided to patients admitted to a hospital that includes bed and board, nursing services, diagnostic or therapeutic services, and medical or surgical services.
Joint Commission On Accreditation Of Healthcare Organizations (JCAHO) - An organization that evaluates and accredits health care organizations and programs in the United States. JCAHO is an independent, not-for-profit organization. JCAHO looks at how well a hospital treats patients and how good a hospital's staff and equipment are. A hospital is accredited by JCAHO if it meets certain quality standards. These checks are done at least every 3 years. Most hospitals take part in these accreditations.

JCAHO writes a "performance report" on each hospital that it evaluates. You can order these reports free of charge.

Left Ventricular Function Assessment - A test to check how well the heart is pumping.
Long-term Care Hospital - A facility, like a nursing home, that provides a variety of services that help people with health or personal needs and activities of daily living (like walking, eating, and going to the bathroom) over a period of time. Most long-term care is custodial care, for which Medicare does not pay.
Measurement - The process of collecting data to assess performance conducted at a single point in time or repeated over time.
Medicaid - A joint federal and state program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most health care costs are covered if you qualify for both Medicare and Medicaid.
Medicare-Certified Hospital - In order to receive any payment from either the Medicare or Medicaid programs, a hospital must meet a set of basic standards for quality of care, called "conditions of participation." Medicare-certified hospitals are reviewed periodically (every three years) to assure that they are continuing to provide services of acceptable quality.

Medicare also considers or "deems" hospitals as Medicare-certified that meet the accreditation requirements of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or the American Osteopathic Association. Most short-term acute care hospitals in the United States choose to be Medicare-certified, either directly or through accreditation.

Medicare Provider Number - Medicare identifies the hospitals with which it works using a unique number. These numbers were used to identify the facilities that reported data for Hospital Compare. If hospitals share a Medicare Provider Number (for example, they bill Medicare for services as a single legal entity), the performance data for those hospitals are, in effect, combined into an aggregate rate representing all of the hospitals represented by the Medicare Provider Number. If you are interested in a hospital that is part of a system or network, you may not be able to find your specific hospital.
Medigap Policy - A Medicare supplement insurance policy sold by private insurance companies to fill "gaps" in Original Medicare Plan coverage. Except in Massachusetts, Minnesota and Wisconsin, there are 10 standardized plans labeled Plan A through Plan J. Medigap policies only work with the Original Medicare Plan.
Osteopathic Doctor - A licensed physician who can do surgery and prescribe drugs who has training in manipulative therapy. Also called a Doctor of Osteopathy or DO.
Oxygenation Assessment - Test that measures the amount of oxygen in your blood to see if you need oxygen therapy.
Percutaneous Coronary Intervention (PCI) - A procedure, such as angioplasty, that opens a blocked blood vessel.
Plan Of Care - A written plan of care created with your physician and hospital staff. It tells what services you will get to reach and keep your best physical, mental, and social well being. The hospital staff keeps your doctor up-to-date on how you are doing and updates your care plan as needed.
Pneumonia - An inflammation of the lungs caused by a viral, bacterial, or fungal infection. This lowers the oxygen level in your blood. Symptoms can include fever, fatigue, difficulty breathing, chills, a "wet" cough, and chest pain.
Pneumonia (pneumococcal) Vaccination - Vaccine given to prevent pneumonia, estimated to protect against 80% of bacteria causing pneumonia.
Provider - A doctor, hospital, health care professional or health care facility.
Psychiatric Hospital - A facility that provides inpatient psychiatric services for the diagnosis and treatment of mental illness on a 24-hour basis, by or under the supervision of a physician.
Quality - Quality health care is how well a doctor, hospital, health plan, or other provider of health care, keeps its members healthy or treats them when they are sick. Good quality health care means doing the right thing at the right time, in the right way, for the right person and getting the best possible results.
Quality Assurance - The process of looking at how well a medical service is provided. The process may include formally reviewing health care given to a person, or group of persons, locating the problem, correcting the problem, and then checking to see if what you did worked.
Quality Improvement Organizations (QIOs) - Groups of practicing doctors and other health care experts who are paid by the federal government to check and improve the care given to Medicare patients. They must review complaints about the quality of care given by: inpatient hospitals, hospital outpatient departments, hospital emergency rooms, skilled nursing facilities, home health agencies, Private Fee-for-Service plans, and ambulatory surgical centers.
Quality Measure - A measure that shows, in percentage form or as a rate, how often a health care provider gives recommended care; that is, the treatment known to give the best results for most patients with a particular condition.
Rehabilitation Hospital - A hospital that specializes in improving or restoring a patient's functional ability through therapies. Sometimes called a post-acute hospital.
"Starter Set" Measures -

Heart Attack

Heart Failure

Pneumonia

Stent - A small wire tube inserted in a blood vessel by a catheter to hold open a blocked blood vessel. One of several procedures to open a blocked blood vessel called a percutaneous coronary intervention (PCI).
Treatment - Something done to help with a health problem. For example, medicine and surgery are treatments.
Treatment Options - The choices you have when there is more than one way to treat your health problem.