3.6: Key Terms

access

the ability to obtain healthcare services when and where they are needed

Beveridge model

single-payer national health service

Bismarck model

social health insurance model

cardiologist

secondary provider who specializes in heart-related conditions

charity care

free or discounted healthcare provided to individuals who are uninsured or underinsured

community hospitals

all hospitals that are not federal hospitals and offer both short-term and/or specialty care available to the general public

deductible

the amount of money a patient must pay annually before their insurance begins to cover the cost of their care

dermatologist

secondary provider who specializes in skin-related conditions

disparities

differences that negatively impact one group over another

extrinsic

factors external to an individual, such as issues that are political, cultural, or systemic

for-profit

hospitals and other healthcare organizations that are run as businesses and funded in part by investors who expect to receive a share of the profits from the business in return for the money they invest

gastroenterologist

secondary provider who specializes in conditions related to the digestive tract

health literacy

the ability of an individual to locate, comprehend, and use health-related material and make healthcare decisions

healthcare debt

money owed by patients related to healthcare activities

healthcare delivery organization

a single facility or group of facilities that provide medical care for some portion of a population

independent practice

a physician’s office, owned and operated by a single physician with a small staff

integrated delivery system (IDS)

a network of providers and agencies who collaborate with each other to provide care to individuals in a community

intrinsic

factors internal to an individual, such as beliefs and values

level of care

amount and complexity of care a patient requires

medical home

primary care space that functions as a comprehensive primary care deliverer, coordinates care across the other levels, and ensures quality of care and efficiency for the patient

multispecialty group practice

a group practice that includes providers from multiple specialties

national health insurance

single-payer national health insurance

not-for-profit (NFP)

organizations, such as hospitals and other healthcare groups, that are funded in part by donations and do not have to pay local, state, or federal taxes but are required to provide charity care and serve their communities

out-of-pocket model

market-driven health care

Patient Protection and Affordable Care Act (ACA)

a law passed by the U.S. Congress designed to improve access to health insurance and health care for all Americans

population level

all individuals in a group; can be defined by shared demographics like geography, culture, or economic group; for example, U.S. citizens, teenagers, or individuals living below the poverty line

premium

the fees that individuals pay on a regular basis for their health insurance and that may be taken out of their checks by their employer

primary care provider (PCP)

any physician or other provider (such as nurse practitioner or physician’s assistant) who provides broad, basic health care focused on prevention, screening, and mild to moderate health conditions and coordinates care among levels of the healthcare system

primary health care

level of care focused on prevention of illness and maintenance of health, includes wellness care, sick care, immunizations, screening, and referral

private

an institution that is run and funded by a group other than the government and can be either a for-profit or a not-for-profit institution

private health institutions

organizations run and funded by a group other than the government, including both for-profit and not-for-profit organizations, such as doctors’ offices, pharmacies, and same-day surgery centers

profits

money remaining after all bills, including staff salaries, loans, and taxes, are paid

provider shortage

not having enough providers for a given population

public

an institution that is run and largely funded by the government and is for the good of the people it serves

public health institutions

healthcare organization run and largely funded by the government for the good of the people they serve; provide direct patient care, set healthcare policy for all affiliated organizations, and are actively involved in caring for health at a population level

pulmonologist

secondary provider who specializes in lung-related conditions

restricted hours

limited availability of physician offices and healthcare facilities, most commonly Monday through Friday during the day only

safety-net hospital

a healthcare facility that is required to provide care for an individual regardless of their ability to pay

secondary care provider

physician, nurse practitioner, physician assistant, mental health professional, or allied health professional with advanced training in a specific organ or system of the body

secondary health care

(acute or hospital care) when a patient’s condition requires specialty care or diagnosis

single-specialty group practice

a physician practice of two or more physicians in which all providers have the same specialty, such as primary care or urology

stakeholder

individual with an interest in the success of an organization, such as an investor in a business or a nurse in a hospital

state and local government healthcare institutions

healthcare organizations funded entirely or in part with public money (collected taxes) and charitable donations and controlled by the state/local government in which they are built

state and local health departments

critical public health institutions providing a range of services including immunizations, monitoring of communicable diseases, and provision of health education classes

taxes

money paid to the local, state, or federal government for property and the purchase of goods

tertiary care provider

the specialist of the specialists with advanced training in procedures, diagnostics, and treatments

tertiary health care

level of care focused on treatment of critically ill patients, those with rare or complicated diseases or injuries, or patients requiring advanced tools, diagnostics, or procedures

urologist

secondary provider who specializes in conditions related to the urinary tract

vital records

birth, marriage, divorce, and death certificates