MEDICAL EXPENDITURE PANEL SURVEY
HOUSEHOLD COMPONENT
MAIN STUDY

GLOSSARY

JANUARY 2008

Table of Contents

A - B - C - D - E - F - G - H - I - J - K - L - M - N - O - P - R - S - T - U - V - W - X - Y

A

AARP: American Association of Retired Persons is a voluntary association of older persons which sponsors several health insurance plans.

Abscess: Refers to care for a localized area of swelling inside a tooth.

Accessible Restrooms: Special arrangements to make the room equipped with toilets and wash basins available to the person, such as locating them on a certain floor, widening doorways, lowering sinks, raising toilets, etc.

Accidents: Physical problems because of some sort of external trauma to the body such as a fall or being in an auto accident. This refers to unexpected and undesirable events. Accidents may include poisonings, where the condition results from swallowing, breathing, or coming in contact with some poisonous substance or gas. Poisoning may also occur from an overdose of a substance that is nonpoisonous when taken in normal doses. Illnesses and other types of problems due to a natural process in the body, such as any type of disease, should not be included.

Accident (Dental): Refers to dental problems that arose from some sort of external trauma to the mouth, such as being hit and having a tooth loosened, or falling and chipping a tooth. Do not include visits for routine examination or for work on problems that arose due to natural processes in the mouth, such as cavities or gum disease.

Accident Insurance: Pays for medical services related to injuries of accidental nature. Since the coverage is limited to accidents, such as car accidents, the study does not consider this coverage to be health insurance.

Activities of Daily Living (ADLs): Those activities that are required to maintain the basic level of life such as getting in or out of bed or a chair, walking, eating, going to the bathroom, bathing or showering, or dressing.

Actual Hours Worked Per Week: The number of hours actually worded during a typical work week. Hours worked will include overtime if the RU member worked overtime for most of the weeks during the reference period. The actual hours worked is often not the same as the hours on which the person's salary is based. In this question, we want the actual hours spent working on the job, whether the hours are paid or not. However, unpaid hours spent traveling to and from work are never included in hours worked per week.

Acupuncture: The Chinese practice of inserting needles into specific exterior body locations to relieve pain, induce surgical anesthesia, or for therapeutic purposes. It is considered to be an alternative medicine.

Acupuncturist: Person who uses a technique for relieving pain, treating medical conditions, inducing regional anesthesia, or improving general well-being, in which thin needles are inserted into the body at specific points.

AD&D: Accidental Death and Dismemberment Insurance is an insurance plan which provides payment in the event of death or dismemberment (e.g., loss of an arm or eyesight) resulting from an accidental cause.

ADAP: The AIDS Drug Assistance Program provides medications for the treatment of HIV diseases, and may help to pay for health insurance. The program is available in all 50 states.

Adenoidectomy: Surgical removal of the adenoids.  

Administrative Support Occupations, Including Clerical: Includes occupations concerned with preparing, transcribing, transferring, systematizing, and preserving written communications and records, collecting accounts, gathering and distributing information, operating office machines and electronic data-processing equipment, storing, distributing, and accounting for stores of materials, operating telephone switchboards, distributing mail and delivering messages, and performing other administrative and clerical duties. Examples include secretaries, computer operators, reproduction clerks, mail clerks, typists, hotel clerks, receptionists, library clerks, telephone operators, mail carriers, dispatchers, bank tellers, proof-readers, data entry keyers, teacher aids, etc.

Admission: Formal acceptance of a patient by a hospital or other health care institution in order to provide care. An admission may be scheduled in advance because the illness or injury is not life-threatening or an admission may take place immediately because of a serious or life-threatening illness or injury.

Adoption: When a person or family takes a child (who is not their biological child) into their home through legal means and raises them as their own.

Adult Day Care: Daytime care given to the elderly or adults with severe mental or physical conditions. The adults arrive at the facility where they spend the day and then return to their homes at night. Each occurrence (day) should be classified as an event.

Adult Education: Adult education classes should not be included as regular school unless such schooling has been counted for credit in a regular school system. If a person has taken adult education classes but not for credit, these classes should not be counted as regular school. Adult education courses given in a public school building are part of regular schooling only if their completion can advance a person toward an elementary school certificate, a high school diploma (or GED), or college degree.

Agricultural, Forestry, Fishing, and Related Occupations: Includes occupations concerned with the production, propagation, gathering, or catching of animals (land and aquatic), animal products, plant products (crop, timber, and ornamental), the provision of services associated with agricultural production, and game farms, fisheries and wild like conservation. Examples include crop farmers, dairy farmers, bee keepers, farm hands, farm machinery operators, orchard and vineyard workers, crop pickers, livestock workers, ranchers, plant nursery workers, gardeners, groundskeepers, animal caretakers, dog groomers, forestry workers, loggers, fishers, hunters, trappers, etc.

AHRQ: The Agency for Health Care Research and Quality, part of the United States Public Health Service and co-sponsor of MEPS. Formerly known as the Agency for Health Care Policy and Research (AHCPR).

AIDS (Acquired Immunodeficiency Syndrome): A terminal disease caused by the Human Immunodeficiency Virus (HIV) that makes persons with AIDS more susceptible to certain diseases, such as pneumonia, Kaposi's sarcoma, and meningoencephalitis.

AIDS Drug Assistance Program: see ADAP.

Aids/Special Equipment: In the phrase "aids or any other special equipment", the key word is "special". Special equipment includes any device that is not used by the general population to perform a specific activity. Examples include canes, orthopedic braces, railings, telephone amplifiers, shower seats, etc. (See QxQs for additional discussion and examples.)

Aleut (Eskimo): Includes persons having origins in any of the original peoples of Alaska and northern Canada who maintain cultural identification through tribal affiliation or community recognition.

Alimony: An allowance that the court orders paid to a person by his/his spouse or former spouse after a legal separation or divorce or while legal action is pending.

Allergy Shot: A shot designed to reduce symptoms by making the patient immune to the cause of an allergy they have.

All Follow-up Care Received: This is the situation where the person has received all the care recommended by the provider.

Allowed (Approved) Charges: A charge that is a covered expense or benefit in a health insurance program.

Already Paid: The person or family assumes the source has sent in the payment to the provider/pharmacy/place for the care or services received.

Alterations: Alterations or modifications to the person’s home or automobile to help him/her function better with his/her impairment or physical problem. Examples of changes to the home include ramps, handrails, elevators, or stair lifts. Examples of changes to the automobile include special controls, mirrors, doors, or wheelchair lifts.

Alternative/Complementary Care: Approaches to health care that are different from those typically practiced by medical doctors in the U.S. Included in this type of care are acupuncture, nutritional advice or lifestyle diets, massage therapy, herbal remedies, bio-feedback training, meditation, imagery, or relaxation techniques, homeopathic treatment, spiritual healing or prayer, hypnosis, and traditional medicine, such as Chinese, Ayurvedic, American Indian, etc.

Ambulance Services: Any charges associated with the use of an emergency vehicle used for transporting patients to a health care facility after injury or illness. Includes three basic types of emergency transportation: ground or surface, helicopter, and airplane.

American Indian: Includes persons having origins in any of the original peoples of North America south of Canada and who maintain cultural identification through tribal affiliation or community recognition.

Amount You Pay (You Pay for Health Care): Includes deductibles, copayments, and coinsurance as well as other amounts not reimbursed by the insurance company. Does not include amounts the family has been or will be reimbursed for by the insurance company.  

Amounts to Include (for Earnings or Loss from Own Farm): Include income or loss associated with being the sole proprietor of a farm. Farm business costs and expenses are deductible from farm gross business receipts in arriving at farm net profit or loss. Gains and losses from these sources are calculated on Schedule F.

Amounts to Include (for Interest from Savings Accounts, Bonds, NOW Accounts, Money Market Accounts, or Similar Types of Investments): Include interest income from seller-financed mortgages, banks, savings and loan associations, money market certificates, credit unions, savings bonds, etc. These amounts can be found on forms 1099-INT or 1099-OID.

Amounts to Include (for Net Gain/Loss from Estates or Trusts, Partnerships, S Corporations, Royalties, or Rental Income): Gains and losses from these sources are calculated on Schedule E of a Federal income tax return.

• Estate or Trust: Includes income that was the beneficiaries' share of fiduciary income from any estate or trust, for example, income required to be distributed, amounts credited to beneficiaries' accounts from fiduciary income, and any "accumulation distribution" made by the fiduciary of a "complex trust" for income accumulated in prior tax years.
   
• Partnership or S Corporation: Since partnerships and S corporations are not taxable entities, their net profit or loss is taxed, in general, directly to the members of the partnership or shareholders in the S corporation. This income includes the taxpayer's share of the ordinary gain or loss of the enterprise and certain payments made to the taxpayer for the use of capital or as a salary.
   
• Rental Income: Income or loss less amounts for depreciation, repairs, improvements and other allowable expenses related to the rented property.
   
• Royalties: Income from oil, gas and other mineral rights, patents, and literary, musical or artistic works.

Amounts to Include (for Net Gain/Loss from Sale of Property or Other Assets): Both sales of capital and non-capital assets are to be included. In general, capital assets for tax purposes include all property held for personal use or investment. Examples of such assets are personal residences, furniture, automobiles, and stocks and bonds. Net gains or losses from the sale of capital assets are reported on Schedule D. Net capital gains also include capital gain distributions reported directly on Form 1040 if the tax filer did not have other gains or losses to report on Schedule D. Property other than capital assets generally includes property of a business nature, and net gains or losses from the sale of such assets is reported on Form 9747.

Amounts to Include (for Non-Farm Business or Practice): Include income or loss associated with being the sole proprietor of a non-farm business, including self-employed members of a profession. Business costs and expenses are deductible from gross receipts or gross sales in arriving at net profit or loss. Compensation of the sole proprietor is taxable income and, therefore, not allowed as a business deduction in computing net income. The net gain or loss is computed on Schedule C or C-EZ.  

Amounts to Include (for Private Pensions, Military Retirement, Other Federal Employee Pensions, State or Local Government Pensions or Annuities): Payments from pensions and annuities, including payments (distributions) from retirement plans, life insurance annuity contracts, profit-sharing plans, employee savings plans, disability pensions received after the tax filer has reached the minimum retirement age set by his/her employer.

Amounts to Include (for Total Charge for Medical Event): Any and all amounts paid directly (e.g., out-of-pocket, up-front) to the provider/pharmacy/place for the care or services received. This includes all amounts that may have been reimbursed later by any provider or insurance company.

Amounts to Include (for Wages or Salary, Tips, Commissions, or Bonuses): This includes all income from wages, salary, commissions, and bonuses and is shown in Box 2 of the tax filer’s W-2 form. Tips, scholarships, fellowship grants, and dependent care benefits should also be included.

Ancestry/National Origin: A person's ancestry or national origin refers to the nationality that distinguishes the customs, characteristics, language, common history, etc. of the person and his/her ancestors. The country from which a person "comes", where s/he is born, or his/her descent.

Anemia: A deficiency of the oxygen carrying material in the blood (hemoglobin). Anemia is often accompanied by a reduced number of red blood cells, which causes an unnatural paleness, weakness, and shortness of breath.

Anesthesia: The loss of sensation induced by an anesthetic and limited to a specific area (local anesthesia) or involving a loss of consciousness (general anesthesia).

Another Household: This includes any place of private residence including apartments, townhouses, houses, co-ops, mobile homes, boarding rooms, etc.

Another Household - Not Full-Time Military: Person was living in another household and was not on full-time active duty in the Armed Forces. This includes persons who were living in a different household. Do not include persons who were living in an institution or were living away at school, either grades 1-12 or post-secondary, in this category.

It is important to determine if the person being asked about was on full-time active duty in the military (i.e., the Armed Forces of the United States). Do not include persons who were on full-time active duty in the military in this category.

Another Household or Military Facility - Full-Time Military: Person was living in another household or military facility and was on full-time active duty in the Armed Forces. This includes persons who were living in another household or in a military facility. Do not include persons who were living in an institution or were living away at school, either grades 1-12 or post-secondary, in this category.

It is important to determine if the person being asked about was on full-time active duty in the military (i.e., the Armed Forces of the United States). Include only persons who were on full-time active duty in the military in this category. Person who are considered to be ON FULL-TIME ACTIVE DUTY IN THE ARMED FORCES includes:

• Persons on full-time active duty in the Army, Navy, Air Force, Marine Corps, or Coast Guard unit presently activated as part of the regular Armed Forces.
• Persons in the Reserve Forces on a six-month active service (in connection with the provisions of the Reserve Force Act of 1955).

Anyone's Previous Employer (COBRA) - Health Insurance: Health insurance purchased or obtained that covered an RU member during the reference period through any former employer. An RU member must have worked for this employer at some point in the past. This health insurance must continue through COBRA.

Anyone's Previous Employer (Not COBRA) - Health Insurance: Health insurance purchased or obtained that covered an RU member during the reference period through any former employer. An RU member must have worked for this employer at some point in the past.

Anything in Writing: A document that indicates the charges for services provided by a medical provider. This usually takes the form of a bill or statement listing the charges for a particular service or item. Also include receipts for payments.

Area Probability Sample: A sample design that begins with the process of enumeration (listing of households). Once listing is complete, sampling statisticians select a sample of households to be screened from all the listed households. Based on key household characteristics, a dwelling unit or DU is selected for inclusion in a study. The sample is constructed so that every DU listed in each Primary Sampling Unit (PSU) has a known chance of being selected for the study. The National Health Interview Survey (NHIS) is an area probability sample.

Armed Forces: Non-civilian members of any of the armed services of the federal government (Army, Navy, Air Force, Coast Guard, Marines).

Arthritis: An inflammation of one or more joints of the body, usually with pain, redness, and stiffness. Rheumatoid arthritis is a chronic disease that can affect joints in any part of the body. The immune system mistakenly causes the joint lining to swell. Osteoarthritis is the most common type of arthritis. It occurs when the cartilage wears away, and can occur in any joint, but often affects the hands, knees, hips, and joints in the spine. Osteoarthritis is sometimes called degenerative joint disease.

Asian (Pacific Islanders): Includes persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, India, Japan, Korea, the Philippine Islands, and Samoa.

Assisted Living: This is a newer organization of care or help for elderly persons particularly, but can also be found for persons with disabilities.

Association (or Group) - Health Insurance: Includes many types of organizations, but principally groups like the American Association of Retired Persons (AARP), church groups, or clubs. It also may include professional associations. These are organizations of individuals that share an interest or common   characteristic or a professional affiliation (for example, the American Medical Association). Membership may include the right to buy health insurance through the organization or association.

Asthma: Asthma is a lung problem that makes breathing difficult. Asthma causes attacks of wheezing, but there are also time periods with relatively normal breathing. Treatment for mild asthma (rare attacks) typically includes use of inhalers on an as-needed basis. Treatment for significant asthma (symptoms occur at least every week) typically includes the regular use of anti-inflammatory medications, usually inhaled steroids and bronchodilators.

Asthma Attack: When you have an asthma attack, your airways narrow in response to some sort of irritation or “trigger,” making breathing difficult. The muscles around the airways also tighten, further closing off breathing. The resulting symptoms include coughing, wheezing, shortness of breath, and a tight feeling in the chest. In a severe attack, breathing may be blocked. Asthma “attacks” range from mild to life-threatening and can last minutes to days.

Audiologists: Medical persons who evaluate and treat patients with impaired hearing and balance. This includes the fitting and dispensing of hearing aids.

Aunt: The sister of one's father or mother or the wife of one's uncle.

Authorization Form: Replaces the MEPS permission form. The authorization form complies with the requirements of HIPAA and prescribed elements of informed consent including:

• What can be disclosed - A description of the information to be used or disclosed that identifies the information in a specific and meaningful fashion.
• To whom the information can be disclosed
• Purpose of the disclosure
• .Expiration date - includes of authorization
• Signature and date
• Proxy relationship to individual
• Right to revoke authorization
• Consequences of refusing to sign
• Disclosure after release - A statement that information used or disclosed pursuant to the authorization may be subject to re-disclosure by the recipient and no longer be protected by the privacy rule. As stated on our MEPS authorization form, the Public Health Service Act protects the confidentiality of information released by providers.

Authorization Form Booklet: The booklet replaces the Permission Form Booklet. This version has been revised to include information on HIPAA and the prescribed elements of informed consent. The Authorization Form Booklet is to be given to respondents during the Closing Section of the interview when asking for authorization forms to be signed. It contains a series of questions and answers frequently asked by respondents as well as directions for filling out and signing authorization forms.

Automatic Door(s): Doors that open mechanically on their own.

Away at School Status: Students under 24 who live away at school, but who consider their parents' household their usual residence. Students may live away at boarding school, post-secondary school (e.g., college, vocational school), etc.

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B

Bachelor's Degree: An educational degree given by a college or university to a person who has completed a four-year course or its equivalent in the humanities or related studies (B.A.) or in the sciences (B.S.).

Base RU: Also referred to as Standard RU or “A” RU. It most often consists of the key RU members who lived together at the time of the NHIS interview when the MEPS sample was selected. New (split) RUs and Student RUs are identified from the Base RU at Round 1.

Bathing: The overall complex behavior of getting water and cleaning the whole body. The RU member bathes without help if no other person is involved in any part of the process of taking a sponge, shower, or tub bath to wash the whole body. (Note that sponge baths count as bathing.) Help or supervision includes washing a part of the person's body, preparing the bath water, helping person get in tub, etc. (See QxQs for additional discussion and examples.)

Bathing Aids, e.g., Tub or Shower Bench, Hand Held Shower: Items used to assist in the process of bathing, showering, or using the toilet. Bathroom aids include, but are not limited to, portable commodes, raised toilet seats, portable tub seats, handrails, or other bathing equipment.

Bathroom Aids: Items used to assist in the process of bathing, showering, or using the toilet. Bathroom aids include, but are not limited to, portable commodes, raised toilet seats, portable tub seats, handrails, or other bathing equipment.

Beneficiary: A person who is eligible, as a subscriber or dependent, to receive benefits under a health insurance contract. Synonyms include enrollee, eligible individual, insured, member, and participant.

Best/Preferred Respondent: The best or preferred respondent for the interview is the person who is most knowledgeable about the family’s health care and who is keeping records about health care use and   expenses. For ROUND 1, this is likely to be the person who was the respondent for the NHIS interview and, in most cases, was the person contacted on the advance contact effort. For ROUNDS 2-5, the best respondent is the person who was respondent for the previous round’s interview.

Bill: A statement from a provider of medical care, a medical laboratory, or a pharmacy that reports the charges for services, drugs, appliances, use of facilities, and other items (for a given patient's care).

Bill Has Not Arrived: The person expects to receive a bill from the health care provider as to the charges owed, however this bill has not arrived.

Bill Sent Directly to Other Source: This situation normally applies where the provider or the person sends the bill to the insurance company in order for the insurance company to pay the health care provider.

Bio-Feedback Training: A technique for learning to monitor and gain control over automatic body functions by using information obtained from various types of machines.

Birthing Center: A facility that provides prenatal, childbirth, and post-natal care, often using family-centered maternity care practices. Common features are a homelike setting and the optional use of a midwife instead of a medical doctor for delivery. May be freestanding or hospital-based.

Bitewings: Photographic images of the teeth obtained through the use of small amounts of radiation. These images are used to discover hidden cavities and flaws in teeth.

Black: Includes persons having origins in any of the black racial groups of Africa.

Bleaching (Dental): A process used to improve the appearance of teeth by using chemical to whiten them.

Blind: Refers to persons who cannot see at all or who only have light perception. It also includes persons who are considered legally blind. Legal blindness is defined as visual acuity of 20/200 or less in the better eye (with the best possible correction) or as a visual field of 20 degrees or less.

Blood Cholesterol Check: A cholesterol check requires taking a blood sample from the person. The blood is then analyzed to determine the level of cholesterol it contains. Cholesterol is a type of fatty substance found in animal fats, blood, nerve tissues, and bile. High levels of cholesterol are thought to be a factor in coronary heart disease.

Blood Pressure Check: A blood pressure check is when a cuff is wrapped around your upper arm and pumped up to check your blood pressure.

Blood Stool Test: A blood stool test is a test that you do at home using a special kit or cards provided by a doctor or other health professional to determine whether the stool contains blood.

Blood Tests: Tests that identify or diagnose health conditions by analyzing a sample of the patient's blood.

Board and Care Homes: A place that offers residents help with activities such as bathing and dressing, but do not provide 24-hour nursing services. (Some residents at a residential care facility may not require such assistance, but it must be available to them.)  

Bonds or Bond Funds (Government, Corporate, Municipal, or Foreign): A certificate of debt issued by a corporation, government (local or federal), or foreign country that guarantees payment of the original investment plus interest by a specified due date.

Bonding (Dental): A process used to improve the appearance of teeth by applying an overlay to cover stained or discolored teeth.

Bonuses: Special cash payments. Sometimes bonuses are given as a reward for an employee's production in excess of a quota or for completion of a job in less than a standard time period. Bonuses may also be paid by the employer to those employees who meet certain criteria (e.g., one year of continuous employment with the establishment) or they may be lump sum payments to all employees (e.g., Christmas bonuses). Payments may be graduated according to a worker's length of service, position in the organization, or a combination of these and other criteria.

Book of Doctors or Medical Places: Printed material that lists which providers are directly associated or affiliated with a health insurance plan.

Braces (Dental): Refers to appliances fitted to some or all teeth to correct irregularly spaced teeth.

Braces for Arm, Leg, or Back: Braces are devices that clasp or connect to the arm, leg or back to provide support or to hold the joint or limb in place.

Braille, Enlarged Print, Audio Tape, or Special Lighting: Braille is a writing and reading system for the blind, where characters are formed by raised dots. Enlarged print means that the document is printed in a character size that is significantly larger than what would normally be used. Audio tape is transfer of written material to tape so that it can be listened to. Special lighting includes lamps or other light sources to improve vision.

Breast Exam: A breast exam is where a doctor or other health professional feels the breast for lumps.

Brother (for Caregiver Supplement): A brother includes biological, adoptive, step, and half brothers. A brother is one's male sibling who shares both of the same biological or adoptive parents. A step-brother is one's stepparent's son by a previous relationship. A half-brother is one's male relative who shares one of the same biological or adoptive parents.

Brother-In-Law: The brother of one's spouse.

Brother/Step-/Half- (for Reenumeration): A brother is one's male sibling who shares both of the same biological or adoptive parents. A step-brother is one's stepparent's son by a previous relationship. A half-brother is one's male relative who shares one of the same biological or adoptive parents.

Business: A business exists when one or more of the following conditions are met: (1) Machinery or equipment of substantial value is in use in conducting business, (2) an office, store or other place of business is maintained, or (3) the business is advertised by listing in the classified section of the phone book, displaying a sign, distributing cards or leaflets, or any other methods which publicize that the work or service is offered to clients.

Business Dissolved/Sold: Voluntary or involuntary cessation of operations by the owners of the business.  

Business Income or Loss (for Tax Filing Purposes): Include income or loss associated with being the sole proprietor of a non-farm business, including self-employed members of a profession. Business costs and expenses are deductible from gross receipts or gross sales in arriving at net profit or loss. Compensation of the sole proprietor is taxable income and, therefore, not allowed as a business deduction in computing net income. The net gain or loss is computed on Schedule C or C-EZ.

Business (Vocational/Trade) School: When determining the highest grade or year of regular school the person ever completed, do not include secretarial school, mechanical or computer training school, nursing school where a Bachelor's degree is not offered, and other vocational trade or business schools outside the regular school system.

By the Job/Mile: Method of payment based on each mile driven or job completed.

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C

CDC (The Centers for Disease Control and Prevention): The Centers for Disease Control and Prevention (CDC) is part of the U.S. Department of Health and Human Services. It is the principal agency in the United States government for protecting the health and safety of all Americans and a co-sponsor of the Medical Expenditure Panel Survey.

Caesarean Section: Surgical operation for delivering a baby by cutting through the mother's abdominal and uterine walls.

Cafeteria Plan: A type of benefit which may be offered as part of an employer's benefit package. A cafeteria plan provides employees with flexibility in choice between taxable and nontaxable benefits. The employer sets a required common core of benefits (usually including health insurance), and the employee can then choose how to allocate remaining benefit dollars. (See also Flexible Spending Account)

CAPI: Computer Assisted Personal Interview.

Capitation: One of the methods of paying providers in a managed care plan. The provider receives a fixed amount for each patient (per "capita" or per "head") for a given period (e.g., a month) in return for providing services. The provider is paid this fixed amount regardless of the amount of services the patient actually receives. For example, the provider is paid $35 each month by the insurer for Patient "X" regardless of whether or not Patient "X" receives care.

Capitation Agreement: An agreement between a provider and a managed care company in which the provider agrees to accept a capitated payment for a defined set of services.

Caps (Dental): An artificial substitute for the part of a tooth above the gumline. Can be made of gold, porcelain, etc.

Case Management: An individualized approach to obtaining the needed services for a person by using an individual who serves as a link between the person and direct service providers. May coordinate care for individuals.

CATSCAN: A computerized x-ray image of the internal body structures, displayable in various cross-sections. This is also referred to as CT imaging.

Cell Culture: A laboratory test, which involves the collection of cells (for example a Pap smear or a throat culture).

Certified Nursing Assistant (CNA): Persons who provide general nursing care to patients at home. This person must have received training in order to be certified to perform these duties. Duties may include things such as administering prescribed medicines and treatment in accordance with approved nursing techniques. They may record significant conditions and reactions and notify their supervisor of the patient's condition and reaction to drugs, treatments, and significant incidents. They may also take the patient's temperature, pulse, blood pressure, and other vital signs to detect deviations from normal.

Certificate of Deposit: A bank certificate acknowledging the receipt of a specified large sum of money in a special kind of time deposit drawing interest and requiring written notice for withdrawal and usually subject to financial penalties if withdrawals are made before the maturity date. Also know as a CD.

CHAMPVA: a health care benefits program for the spouse or widow(er) and for the children of a veteran who is rated permanently and totally disabled due to a service-connected disability, or died of a service-connected disability, or died on active duty and the dependents are not otherwise eligible for TRICARE benefits. Under CHAMPVA, the Veterans Administration shares the cost of covered health care services and supplies with eligible beneficiaries.

Channeler, Clergy, or Spiritualist: A person who treats and maintains physical, mental, emotional, or spiritual health through prayer, mediation, or drawing on the help of powers or beings from another realm.

Charge(s): The dollar amount asked ("charged") for a service by a health care provider. This may not be the actual amount paid to the provider.

Checking Account: A bank account against which the depositor can draw checks for transfer of funds to the name on the check. Checking accounts may or may not bear interest.

Check-up (Dental): Refers to the activity performed by either a dentist or a dental hygienist to determine whether cavities or gum disease have developed, or whether examination by a specialist may be necessary.

Chemotherapy: The treatment of disease through the use of drugs or chemicals designed to have a toxic effect upon the disease-producing microorganism, or to selectively destroy cancerous tissue.

Chicano: Refers to anyone of Mexican birth or descent. It refers to anyone who may call themselves "Mexican, Mexican-American, Chicano, or Tex-Mex."  

CHIP: See State Children's Health Insurance Program (SCHIP).

Child Support: Payments that the court orders a parent to pay to cover the cost of the care of a child who is not living with the parent making the payment.

Chiropractor: Medical persons who practice a system of medicine based on the principles that the nervous system largely determines the state of health and that disease results from nervous system malfunctioning. Treatment consists primarily of the adjustment and manipulation of parts of the body, especially the spinal column.

Choice of Health Insurance Plans: Many employers/establishments offer, instead of one basic plan, different types of enrollments that attempt to tailor coverage to the needs of the employee. For each enrollment type, there may be a different set of coverage provisions, a separate premium rate, and a varying proportion of total cost assumed by the employer. Plans may be called HMO, PPO, indemnity, high deductible, etc.

Claim: A request to an insurer for payment of health care bills. The request can be initiated by either a covered member or a medical provider.

Cleaning (Dental): Refers to activities performed by a dentist or dental hygienist to maintain healthy teeth and prevent cavities. Cleaning includes scraping tartar deposits off teeth, both above and below the gumline.

Cleaning or Medical Treatment of Wound, Infection, or Burn: Removal of foreign material and dead or damaged tissue from wounds, infections, or burns.

Clergy, Spiritualist, or Channeler: A person who treats and maintains physical, mental, emotional, or spiritual health through prayer, mediation, or drawing on the help of powers or beings from another realm.  

Clerk (Similar to Receptionist or Secretary): A person who assists a medical person in performing clerical tasks, such as scheduling appointments, filing and maintaining medical records, billing, and answering the telephone.

Clinic: Refers to a facility where medical care and advice are given by doctors, nurses, or other medical persons, but is not located at a hospital. (Exclude visits to hospital outpatient departments.)

Clinic Pharmacy: Pharmacy that is located within a clinic.

Clinical Trials: This includes all charges that were paid by the government or a research institute in return for the person's participation in medical research. The research may take the form of clinical trials of an experimental medication, which are part of the government's medical approval process. The person's participation does not necessarily involve a specific health condition.

Closed Panel Program: A managed care program that requires enrollees to use a specific limited number of providers. (The opposite is Open Panel Program.)

COBRA: Insurance provided by a former employer. This is a federal law that allows persons without any other group health insurance to continue their employment-related coverage at group rates for 18 to 36 months after having left a job. However, the primary insured person or policyholder usually has to pay the entire premium.

Coinsurance: Similar to a copayment except that it is defined as a percent of the total charges for the health care service. For example, a beneficiary may pay 20% of charges for a doctor's visit or 10% of charges for a hospital stay.

College Graduate: Use this code if the person obtained a Bachelor’s Degree. Also use this code if the person has some graduate level education, but has not received a graduate degree. However, if the person got a college degree BEYOND a Bachelor’s Degree, use the code for “Graduate Degree.”  

College (or University): Junior college, community college, 4-year college or university, nursing school or seminary where a college degree is offered, and graduate school or professional school that is attended after obtaining a degree from a 4-year institution.

Colonoscopy: A colonoscopy is when a tube is inserted in the rectum to view the bowel for signs of cancer or other health problems.

Comments (Insurance Card): If there is something unusual about an insurance card or some other information which seems important, but does not fit into an entry field, record a comment.

Commissions: A method of incentive payment paid in addition to or in lieu of a base rate, based upon business created or sales confirmed. The commission period and the base rate period need not be of the same length. For example, the commission period could be monthly, daily, or hourly.

Communication Equipment, e.g., TTY/TDD, Communications Board, Speech Synthesizer: Communication equipment are devices used to help a person make his or her thoughts known and to help persons understand others. Examples include a TTY/TDD, a telecommunications device for the deaf which is a portable typewriter that can be coupled to a telephone receiver where the telephone conversation appears as a visual readout above the keyboard; and a communications board which includes any variety of devices with letters or words that permit communication by persons with impaired physical or verbal abilities.

Community Based Hospital: A hospital established primarily to provide services to the residents of the community in which it is located. Most community hospitals are nonprofit, non-federal, and for short-term patients.

Community Health Center: A facility set up to provide health care and social work services in an area where such services are otherwise difficult to obtain.

Companion (Home Health): Persons who care for elderly, disabled, or convalescent persons by attending to the patient's personal needs, reading aloud, playing cards, or other games to entertain the RU member because of the RU member's health problem.

Companionship: Services such as reading, talking, or going for a walk, a drive, or to a restaurant either paid or unpaid.

Company Clinic: A company doctor's office or medical facility which is operated principally for the employees (and sometimes their dependents).

Complementary/Alternative Care: Approaches to health care that are different from those typically practiced by medical doctors in the U.S. Included in this type of care are acupuncture, nutritional advice or lifestyle diets, massage therapy, herbal remedies, bio-feedback training, meditation, imagery, or relaxation techniques, homeopathic treatment, spiritual healing or prayer, hypnosis, and traditional medicine, such as Chinese, Ayurvedic, American Indian, etc.

Completed High School, No College: The person has a high school diploma or received a GED, but did go on to college. College is considered junior college, community college, four-year college or university, nursing school or seminary where a college degree is offered, and graduate school or professional school that is attended after obtaining a degree from a 4-year institution.

Complete Physical: A physical examination performed by a medical doctor where the whole body is examined to determine the state of a person’s health. Usually includes a blood pressure check and taking a sample of the person’s blood for a complete blood count.

Comp Time: Method of compensation for any work in excess of the normal work schedule. In lieu of monetary compensation, "compensatory time" reimburses overtime work with paid time off.

Condition: A condition is a physical or mental health problem that can be identified by a health care professional by examining you and by using tests.

Condition Roster: A person level list of physical or mental health problems that affected the person during his or her reference period. It is first introduced in the Provider Probes section, and can be added to during Utilization, Disability Days, and Prescribed Medicines.

Contact Lenses: A curved shell of glass or plastic worn directly against the eye to correct vision problems.

Context Header: The area at the top of the screen that contains pieces of information (e.g., names, dates, providers, conditions, etc.), between two lines. This information is used for fills when reading the question to the respondent.

Construction Trades and Extractive Occupations: Includes occupations that normally are performed at a specific site, which will change over time. This is different to production workers, where the work is normally delivered to a fixed location. Examples include brickmasons, carpenters, electricians, painters, plumbers, carpet installers, concrete finishers, rail layers, roofers, sheetmetal workers, road pavers, air hammer operator, miners, drillers, explosive workers, etc.

Consultation: Upon request by one medical care person, another medical care person's review of a patient's history, examination of the patient, and recommendations.

Consultation (Dental): Upon request by one dental care person, another dental care person’s review of a patient’s history, examination of the patient, and recommendations.

Convalescent Home: A nursing facility for patients who are recovering from severe illnesses or injuries, or who require continued care for an ongoing illness that is not in an acute stage. This is not the same as a retirement home.

Conventional Indemnity Health Insurance Plan: A traditional group or individual health insurance plan. In conventional indemnity health insurance, the group or individual pays a premium to the insurer to administer, assume risk and pay for a defined benefit package. Features of conventional indemnity health insurance include total choice of provider, enrollee cost sharing, fee-for-service provider reimbursement and full insurer risk. Synonyms are Traditional Indemnity Health Insurance and FFS Health Insurance.

Coordination of Benefits (COB): A claims process which takes place when a person is covered by more than one health insurance policy. The intent of COB is to eliminate duplicate payments and to define a sequence in which coverage applies (primary and secondary).

Copayment: A fixed sum that a person pays for health services, regardless of the actual charge (the insurer pays the rest of the actual charge). For example, the person may pay $10 for each office visit, $75 for each day in the hospital, and $5 for each drug prescription.

Core Street Name: The core name is the street address without the street number, the pre-directional, or any suite identifier. Do not include punctuation in the core street name. Examples of core street names are shown below.

Cost Containment: Activities designed to hold down the cost of health care. Cost containment activities includes coverage for expanded benefits (like outpatient surgery, preadmission testing, and different levels of hospital care), thorough review of claims, development of the continually evolving forms of health care (like HMOs and PPOs) and emphasis on health education and health promotion.

Cost the Same Amount: Sometimes the respondent will not know the actual charge for any (or some) of the visits, but always makes the same copayment for each visit. As long as the visits were for the same condition(s) and/or the same services were received at each visit, code this question as 'YES' (visits were all for the same amount).

Cost Sharing: A provision of a health insurance plan that requires an enrollee to pay a portion of charges for covered services. The most familiar cost sharing provisions are coinsurance, copayments and deductibles.

Could Not Find Work: Unable to secure gainful employment while in an active job search.

Counseling: A treatment technique for certain forms of mental disorders relying principally on talk/conversation between the mental health professional and the patient. Can be individual, family, and/or group therapies. Include care provided by any type of health professional so long as treatment is for mental health. Does not include visits with clergy to discuss personal problems unless clergy provided services through a counseling center and the services were paid for. Any other professional mental health therapist such as a psychiatrist, psychologist, counselor, social worker, etc. would be included.  

Cousin: A child of one's uncle, aunt, or cousin.

Covered Entity: Refers to health care providers, pharmacies, and insurers who are legally required to comply with the Health Insurance Portability and Accountability Act (HIPAA).

Crowns (Dental): An artificial substitute for the part of a tooth above the gumline. Can be made of gold, porcelain, etc.

Cuban: Refers to anyone of Cuban birth or descent.

Currently Employed: Person is employed at this establishment as of the date of the interview.

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D

Daily Wage Rate: The amount a person earns for a regular day of work.

Daughter/Adopted Daughter: One's female child through birth or adoption.

Daughter-In-Law: The wife of one's son.

Deaf: Refers to inability to hear in both ears without the use of hearing aides. Also can include hearing loss greater than 70 DB (decibels) in the better ear without hearing aides.

Debts: A financial obligation or liability of one person to another or others. Includes formal arrangements such as bank loans as well as private arrangements such as loans from a parent. A debt may or may not include interest on the principal loan amount.

Debts Amount To: Include only the principal balance that has not yet been paid for all debts other than those specifically asked about in previous questions. The respondent should not include items such as interest, property tax, insurance, escrow, etc. that might be included in debt payments.

Deceased: The person is dead.

Deductible: The amount of money an insured person must pay "at the front end" before the insurer will pay. For example, if you have a plan with a $100 deductible, you would be responsible for the first $100 of your health care bills.

Delays in Cognitive or Mental Development: Cognitive or mental development involves the process of knowing things in the broadest sense, including perception, memory, judgment, etc., that is, various learning and understanding activities that involve the mind. Delays include being slow to understand or learn new skills.

Delays in Emotional or Behavioral Development: Emotional and behavioral development refers to young children displaying behaviors appropriate for their age. Delays include children consistently behaving in ways that are not considered appropriate for their age such as being aggressive, hyperactive, or overly anxious. Other delays include throwing temper tantrums, bedwetting, not sleeping through the night, excessively clinging to parents, etc. at ages when most children do not do these things.

Delays in Speech or Language Development: Speech or language development is a very young child’s increasing ability to communicate with others through normal speech as he or she grows up. Delays include a child beginning to speak later than average, or being difficult to understand at an age when most children can communicate clearly.  

Deliver (Delivery): Giving birth to a live baby. It does not include stillbirths.

Delivery at Home: Anywhere the person was living at the time of the delivery. It may be the RU member's home, the home of a friend, a hotel room, etc., but NOT a hospital, nursing home, or other health care facility. Also, code this category even when the delivery at home was assisted by a midwife or some other medical person.

Demographic Data: Descriptive characteristics including gender, age, marital status, race, ethnicity, and education level.

Dental Accident or Injury: A dental problem that arose from some sort of external trauma to the mouth, such as being hit and having a tooth loosened, or falling and chipping a tooth. Do not include visits for routine examinations or for work on problems that arose due to natural processes in the mouth, such as cavities or gum disease.

Dental Assistant: A person who assists a dentist with in-patient care, and may perform other functions in the dental office or laboratory. Most dental assistants are trained by the dentist.

Dental Care: Health care that is related to teeth. Dental care includes general work such as fillings, cleaning, extractions, and also specialized work such as root canals, fittings for braces, etc.

Dental Care Person: See Dental Care Provider.

Dental Care Provider: Medical persons whose primary occupation is caring for teeth, gums, and jaws. Dental care includes general work such as fillings, cleaning, extractions, and also specialized work such as root canals, fittings for braces, etc.

Dental Care Visit: Any visit made during the person's reference period to a dental care provider for the purpose of dental care.

Dental Check-up: Is a visit to a dental care provider to check the health status of the person’s teeth. It often includes examination, x-rays, and/or cleaning and polishing of the teeth.

Dental Hygienist: A person who is licensed to give certain dental services under the supervision of a dentist. These services include: teeth cleaning, x-rays, applying medications, and educating in dental matters.

Dental Insurance: This type of insurance covers the cost of specified aspects of dental care, ranging from coverage of basic diagnostic, preventive, and restorative services to coverage that includes oral surgery and orthodontics.

Dental Surgeon/Oral Surgeon: A dental surgeon is a specialist who deals with diseases, injuries, and defects of the mouth and jaw through invasive procedures. Include specialties like endodontists, prosthodontists and orthodontists. An oral and maxillofacial surgeon (OMFS) is a surgical specialty devoted to the well-defined anatomical region of the mouth, jaws, and the face as well as associated structures. Most oral surgeons are initially qualified in dentistry and have undergone a further 4-6 years of specialty surgical training.

Dental Technician: A person who works in a dental laboratory and prepares dentures and other appliances such as orthodontic devices and crowns to fit dental prescriptions.  

Dental X-rays, Radiographs and Bitewings: All are different names for photographic images of the teeth obtained through the use of small amounts of radiation. These images are used to discover hidden cavities and flaws in teeth.

Dentist: Medical persons whose primary occupation is caring for teeth, gums, and jaws. Dental care includes general work such as fillings, cleaning, extractions, and also specialized work such as root canals, fittings for braces, etc.

Dentures: False teeth that are removable from the mouth.

Dependent (for insurance purposes): A person who is covered by an insurance policy purchased or obtained by another individual (the policyholder).

Dependents (for tax filing purposes): For tax filing purposes, a dependent of the tax filer is someone who meets all of the following criteria:

• is a relative of the tax filer, and
• if married, does NOT file a joint return, and
• is a U.S. citizen or is a resident alien or is a resident of either Canada or Mexico or is the person’s adopted child who is not a U.S. citizen, but who lived with the person all year in a foreign country, and
• has a gross income of less than $2,500, and
• the tax filer had to provide over half the person’s total support in the tax year.

DHHS – The Department of Health and Human Services, part of the United States Public Health Service.

Diabetes: Diabetes is a health problem caused by decreased production of insulin, or by decreased ability to use insulin. Insulin is a hormone produced by the pancreas that is necessary for cells to be able to use blood sugar. Diabetes occurs in several forms, the most common are: Type I, Type II, and gestational diabetes.

Note: Gestational diabetes should not be recorded as a Priority Condition. Gestational diabetes starts or is first recognized during pregnancy. It usually becomes apparent during the 24th to 28th weeks of pregnancy. In many cases, the blood-glucose level returns to normal after delivery.

Diabetic Equipment/Supplies: Any materials a diabetic uses in his/her everyday procedures to maintain their blood sugar at normal levels. Food items do not count as diabetic supplies.

Diagnosis or Treatment for a Health Problem: Diagnosis is an examination or test to detect the presence of a disease or other physical problem. Treatment is any procedure to counteract the effects of a disease or health care problem.

An example of a visit for 'diagnosis and treatment' is a person who had a fever and a sore throat: the provider diagnosed the condition as the flu, and recommended treatment of bed rest and aspirin.

Even if the provider determines the person does not have a health condition or if the provider is unable to determine what the problem is, the visit was for purposes of diagnosis regardless of the outcome of the examination.

If the only care received during the visit was tests such as blood work or x-rays, consider this 'diagnosis or treatment for a health problem' even if there is no known condition. For example, if a woman has a baseline mammogram, this is considered 'diagnosis' even if no condition is suspected or discovered.  

Diagnostic Procedures: Examinations or tests that detect the presence of a disease or physical problem.

Diagnostic Tests: The administration of examinations or tests to detect the presence of a disease or physical problem.

Dietitian: Persons concerned with the application of the principles of nutrition to plan and supervise the preparation and serving of meals. Includes planning menus and diets for special nutritional requirements, participating in research, or instructing in the field of nutrition.

Difficulty Participating in Strenuous Activities: Strenuous activities are those that require great effort or energy, such as running, jumping, climbing, bicycling, etc. Difficulty exists when the person has trouble or becomes distressed when performing the activity. Be sure to keep in the mind the age of the child and expected abilities when coding this question.

Difficulty Talking: Talking is the process of expressing thoughts, feelings, and ideas through spoken words. A person has difficulty talking if he or she speaks very slowly, slurs his or her words, stutters, or is unable to speak due to an impairment or physical or mental health problem.

Difficulty Understanding: Understanding refers to the person’s ability to comprehend or discern. Difficulty exists when the person has trouble with these activities or performs them at a level below his or her age.

Direct Payment: Any source that has paid the provider/pharmacy/place directly, that is, the family was not paid by the source in the anticipation that the family would in turn pay the provider. If this is the case, considered it a reimbursement, not a direct payment.

Disability: An inability to work or carry out roles that individuals are generally expected to be able to do because of limitations in physical or mental functioning caused by impairments, or physical or mental health conditions.

Disability Insurance: This kind of insurance pays all or part of an employee's salary (and possibly medical care costs) if the employee becomes unable to work due to physical or mental disability. The study does not consider this coverage to be health insurance.

Disallowed: A charge for a medical service rejected for coverage by a third party, such as Medicare, Medicaid, or an insurance company. Examples of situations where a charge may be disallowed by a third party are the deductible has not been met, the service is not covered under the person's plan, or the charge does not qualify as "usual and customary."

Disapproved: A charge not covered by a third party payer.

Discharge: The formal release of a patient from a physician's care or from a hospital. Sometimes a discharge is referred to as "signing out."

Discounted: A deduction from a specified sum a provider has charged for health care services. The discount may be accounting for a discrepancy between what the provider "asked" as the total charge and the sum of the amount paid by the person and the amount paid by a third party.

Discounted Fee-for-Service: A method of paying health care providers that is typical of some managed care arrangements. In discounted fee-for-service, providers charge a managed care plan a reduced amount for each service, in return for increased patient volume.  

Disposable Supplies: Includes disposable medical items used in the treatment of a health problem. Disposable supplies include, but are not limited to, ostomy supplies, bandages, dressings, tape, adult diapers, catheters, syringes, and IV supplies.

Dividends: Profit from a company that is divided among stockholders, creditors, members of a cooperative, etc. These amounts can be found on form 1099-DIV.

Divorced: Legal cancellation of marriage.

Doctorate Degree: The highest educational degree given by a college or university to a person who has completed a prescribed course of advanced graduate study. Examples include a Doctor of Philosophy (Ph.D.), Doctor of Laws (J.D.), Doctor of Medicine (M.D.), etc.

Doctors' Clinic: A group of doctors who have organized their practice in a clinical setting and work cooperatively; generally, patients either came in without an appointment or make an appointment and see whatever doctor is available.

Does Not Work Overtime: An employee who does not work more than the standard number of hours in a set work schedule, normally 40 hours per week or 8 hours per day, would be coded in this category.

Domestic Worker: Persons who provide cleaning, cooking, or other household chores services for the RU member because of his or her health problem.

Dread Disease Insurance: These plans are limited to only certain types of illnesses such as cancer, stroke, or heart attacks.

Dressing: The overall complex behavior of getting clothes from closets and drawers and then putting the clothes on. Dressing includes getting clothes from the closet and putting them on but does not include undressing. Whether the RU wears nightclothes or street clothes is irrelevant; it is the act of getting clothes and putting them on that matters.

Dressing Aids, e.g., Zipper Pull: Items used to assist in the process of putting on and removing clothes, such as devices for buttoning, pulling up zippers, putting on shoes, etc.

Drowning: Any situation in which a person dies or nearly dies because his nose and mouth are submerged in water too long to allow him to breathe. Drownings can occur in any body of water including pools and bathtubs.

Drug and Alcohol Rehabilitation Center: A facility with an organized professional and trained staff that provides rehabilitative services to drug and alcohol dependent patients.

Drug or Alcohol Treatment: Any program of drug therapy or isolation used to help a patient withdraw from drug or alcohol dependency. An example of this kind of treatment is the prescription of a drug such as methadone to wean the patient from a harder drug.

Drug Store Pharmacy: An independent or chain retail store where the primary business is the service provided by the pharmacy.  

DU: Dwelling Unit. The person or group of persons who live at an eligible address.

DU Member Roster: A list of all the persons in the Dwelling Unit.

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E

Earned Income Credit: An amount that can be deducted from the tax filer’s net income in determining his/her taxable income. It is available to tax filers who do not have any qualifying children, earned less than $9,230 in the tax year, and the tax filer(s) are at least 25 years old on the last day of the tax year.

Ear Tubes (Tympanostomy Tubes): Tubes placed through the ear drum (tympanic membrane) to allow ventilation of the middle ear as part of the treatment of ear infections (otitis media with effusion).

Eclampsia: A toxemia of late pregnancy characterized by convulsions and coma, in addition to the symptoms listed for pre-eclampsia.

ECG (Electrocardiogram): A graphic record of the electrical activity of the heart.

EEG (Electroencephalogram): A graphic record of the electrical activity of the brain

EKG (Electrocardiogram): A graphic record of the electrical activity of the heart.

Elementary School, Grades 1-12 (for Caregiver Supplement): For this study, we have classified grades 1 through 8 as elementary school, and grades 9 through 12 as high school. However, you should note that the final grade of elementary school may be anywhere from grade 5 to grade 8, depending on the school system. So, if the respondent says the person you are asking about completed elementary school, probe to determine what grade that represents.

Elevator: A mechanism for raising or lowering people or things from one level to another.

Eligibility: Refers to whether data should be collected in the current round for the person. (See QxQs for a more detailed description.)

Emergency (e.g., Accident or Injury): Refers to immediate care intended to assess and address an acute problem that has the patient in extreme discomfort or threatens his/her life.  

Emergency Room: A medical department at a hospital that is open 24 hours a day where no appointment is necessary in order to receive care. Medical care may be administered by a physician, nurse, physician assistant, or other medical provider. Do NOT include "urgent care centers," which are owned by, or affiliated with a hospital. Visits made to that type of facility should be coded as an outpatient department.

Emergency Room Visit: Any visit made during the person's reference period to a hospital emergency room.

Emotional Problem: A kind of mental health problem affecting a person's emotional well being.

Employee Assistance Program (EAP): A relatively new program that may be offered as part of an employer's benefit package. An EAP provides confidential assistance to employees with personal problems (substance abuse, physical or behavioral issues) adversely affecting job performance. An EAP is not a form of health insurance, but is often coordinated with health insurance benefits.

Employer Health Care Coalition: A voluntary organization involved with issues of health care costs, quality of care, utilization data analysis and legislative concerns. Originally open only to employers, employer coalition membership now includes health care providers, purchasers of care, consumer members and union groups.

Employer-Sponsored Coverage: Coverage for an individual or family which is generally purchased by their employer or a family member's employer. At least a portion of the premiums are paid by the employer and sometimes a portion is paid by the policyholder.

Employment: Paid work for wages, salary, commission, or pay "in kind". Examples of "pay in kind" include meals, living quarters, or supplies provided in place of wages. This definition of employment includes work in the person's own business, professional practice, or farm, paid leaves of absence (including vacations and illnesses), and work without pay in a family business or farm run by a relative. This definition excludes unpaid volunteer work (such as for a church or charity), unpaid leaves of absences, temporary layoffs (such as a strike), and work around the house.

Endodontist: A dental specialist who performs root canal work and otherwise deals with diseases of the dental pulp and roots.

Enrollee: A person who is eligible, as a subscriber or dependent, to receive benefits under a health insurance contract. Synonyms include beneficiary, eligible individual, insured, member and participant. (See also Subscriber.)

EOB - Explanation of Benefits: A form which explains how benefits are paid by an insurance plan.

Epidural (Spinal): Injection of a local anesthesia into the spinal column in order to anesthetize the abdominal and pelvic area during childbirth. The purpose of an epidural or spinal is to decrease the amount of pain the mother feels during childbirth.  

EPO - Exclusive Provider Organization: Similar to a PPO, it is an arrangement between purchasers and providers to deliver health services to a group of employees/patients. An insurance carrier or employer negotiates discounted fees with providers in return for guaranteeing a certain volume of patients. Unlike a PPO, employees/patients are limited to an exclusive panel of providers and receive no reimbursements for using providers outside of the panel. Providers are usually reimbursed by discounted fee-for-service payments.

Eskimo (Aleut): Includes persons having origins in any of the original peoples of Alaska and northern Canada who maintain cultural identification through tribal affiliation or community recognition.

Establishment Roster: An RU level list of names and addresses of employers, unions, and sources of health insurance associated with the family members.

Estate or Trust (for tax Filing Purposes): Include income that was the beneficiaries' share of fiduciary income from any estate or trust, for example, income required to be distributed, amounts credited to beneficiaries' accounts from fiduciary income, and any "accumulation distribution" made by the fiduciary of a "complex trust" for income accumulated in prior tax years.

Exact Amount (for Overtime): Flat amount not derived from the straight time wage.

Exclusion: A specific illness or treatment that is not covered by a health plan or insurance contract. Generally, exclusions are listed in a separate section of the insurance contract.

Exclusive Provider Organization (EPO): Similar to a PPO, it is an arrangement between purchasers and providers to deliver health services to a group of employees/patients. An insurance carrier or employer negotiates discounted fees with providers in return for guaranteeing a certain volume of patients. Unlike a PPO, employees/patients are limited to an exclusive panel of providers and receive no reimbursements for using providers outside of the panel. Providers are usually reimbursed by discounted fee-for-service payments.

Executive, Administrative, and Managerial Occupations: Includes top and middle management occupations and occupations directly supportive to management which are concerned with achieving the overall objectives of an industrial, commercial, governmental, or other establishment. Top level managers include persons concerned with policy making, planning, staffing, directing and/or controlling activities. Middle managers include persons who plan or organize staff, direct and/or control activities at the operational level. Examples include program administrators, public officials, general managers, financial administrators, school administrators, company presidents, vice-presidents, etc.

Existing Condition: A condition that has been previously reported and recorded in the interview and, therefore, appears on the Condition Roster.

Extra Cash for Hospital Stays: These plans pay a specified amount of cash for each day or week that a person is hospitalized. The cash payment is not related in any way to the person's hospital or medical bills, and can be used for purposes other than paying medical expenses. For example, the extra cash can be used to pay for child care when a parent is ill or to replace income from lost work. This study does not consider this coverage to be health insurance.

Extraction (tooth pulled): Removal of a tooth; includes both adult and baby teeth.

Eyeglasses: Devices worn outside the eye to correct vision problems. A magnifying glass for reading is not considered glasses.  

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F

Facility (Type Provider): The provider is either a place, such as a hospital, clinic, emergency room, laboratory, etc., or the provider is an individual who is associated with a group practice, HMO, clinic, etc.

This category does not include individual providers or facilities all working at the same location, such as a "medical building" which houses several independently functioning medical offices, laboratories, doctors, etc.

Facility for the intellectually disabled: A facility which houses and tends to the daily needs of individuals who have been diagnosed with impaired learning ability and vocational limitations. Do not include "day care" facilities for the intellectually disabled.

Factory: Refers to factory buildings, railway yards, warehouses, workshops, loading platforms of factories or stores, etc. Construction projects (houses, bridges, new roads, etc.) as well as public or commercial buildings undergoing remodeling are also included. Other examples are logging camps, shipping piers, oil fields, shipyards, sand and gravel pits, canneries, and auto repair garages.

Fall: Any time a person is injured unintentionally because s/he hit the ground or another surface too hard. Do not include falls related to sports. These should be coded as 'sports injuries'.

Family Planning Center: A facility that provides social, educational, or medical services and supplies to help individuals determine family size or prevent unplanned pregnancies. This may include birth control counseling and referral, abortion services and referral, pregnancy testing, sterilization counseling, venereal disease referrals, public education service, and infertility counseling and referrals.

Family Sends in Claim Forms: The RU member or family must pay the full amount of the prescription 'up-front' to the pharmacy or prescription mail-order firm. The family later completes a claim form so his or her insurance company will reimburse all or a portion of the prescription cost.

Family Support Services and Respite Care: Family support services include discussion groups or instruction to help family members care for people with impairments or physical or mental health problems. Respite care is care received for only a limited time by severely disabled or impaired persons (e.g., quadriplegics, developmentally disabled children, or Alzheimer patients) as a way of providing an interval of rest or relief to family members who are the usual primary caregivers at home.

Farm and Business:

• Farm: Includes buildings on the premises of a farm, such as a barn or farm house, or on any land that is part of the farm, such as land under cultivation.
• Business: A business exists when one or more of the following conditions are met: (1) Machinery or equipment of substantial value is in use in conducting business; (2) an office, store or other place of business is maintained, or (3) the business is advertised by listing in the classified section of the phone book, displaying a sign, distributing cards or leaflets, or any other methods which publicize that the work or service is offered to clients.

Farm Income or Loss (for Tax Filing Purposes): Include income or loss associated with being the sole proprietor of a farm. Farm business costs and expenses are deductible from farm gross business receipts in arriving at farm net profit or loss. Gains and losses from these sources are calculated on Schedule F.

Father (for Reenumeration): One's male biological or adoptive parent. Does not include step-father or foster father.

Father-In-Law: The male parent of one's spouse.

Father's Partner: When there are two people living together as married (both same sex or different sexes), this is the relationship of the partner to her/his counterpart's child.  

Federal Employees Health Benefit Program (FEHBP): Voluntary group health insurance plan offered to employees and retirees of the Federal government. An important feature of the FEHBP is the wide range of available plans.

Federal Government: Federal employees include individuals working for any branch of the federal government, as well as elected officials and civilian employees of the armed forces.

Fee-for-Service (FFS): The traditional payment arrangement between a provider and a patient in which a provider charges a specified amount for each encounter or service.

Female Partner: A female in a relationship of two people who are living together as married. This applies both to relationships of people of the same sex and of different sexes.

Fertility Clinic: A facility that provides services designed to aid in the capacity to conceive or induce conception. People sometimes go to fertility clinics when they are having difficulty getting pregnant (or getting someone else pregnant).

FFS - Fee-for-Service: The traditional payment arrangement between a provider and a patient in which a provider charges a specified amount for each encounter or service.

Filing Jointly: When the person files his/her tax return under the tax filing status of ‘married filing joint return.’ This tax filing status can be used by anyone who was married as of December 31st of the tax year (even if person was not living with the spouse at the end of the tax year) or whose spouse died between January 1st of the tax year and April 31st of the following year and the person did not remarry. Reports taxable income of two tax filers: a husband and wife.

Fillings: A substance of plastic, amalgam, gold, etc. which are used to close a cavity in a decayed tooth. The substance is placed directly into the cleaned cavity and then shaped to match the rest of the tooth.

Fire: Include any heated surface or material which would cause a burn specifically because it is hot. Examples would be scalding water, a stove top, and a radiator. Also include chemicals which cause burns.

First Dollar Coverage: A type of health insurance coverage with no deductible. The insurer pays "from the first dollar."

Fixed Bridges: A fixed replacement for one or several natural teeth, attached at each end to a natural tooth.

Flat Fee: A situation where the person is charged a 'lump sum' for a variety of services or a series of visits which relate to the same condition.

Flexible Spending Account (FSA): A benefit which may be offered as part of an employer's benefit package. An FSA provides employees with a choice between increased taxable income and nontaxable funds set aside for medical, dental, legal and day-care services. An FSA is not a type of health insurance but can be used to reimburse health-related expenses (deductibles, copayment and non-covered benefits). (See also Cafeteria Plan.)

Fluoride Treatment: The application of a solution containing the chemical fluoride, which is intended to make the teeth more resistant to tooth decay.

Flu Vaccination: A flu vaccination protects a patient against “influenza,” also called the flu. The vaccine, which may be in the form of a shot given in the arm or a nasal spray, can help to prevent the patient from catching a severe respiratory infection that can be caused by the flu virus.

Follow-up Care: Additional consultations or treatments with a medical provider after the condition had initially been diagnosed and treated.

Follow-up Visit: Includes visits to check on patient's progress after some type of surgery or other medical treatment. This includes visits to verify that patient has fully recovered, to remove stitches or a cast, or to adjust medications.

Food Stamps: The Food Stamps Program enables low-income families to buy eligible nutritious foods with coupons and Electronic Benefits Transfer (EBT) cards in authorized retail food stores.

Foot Doctors (Podiatrists): Medical person who deals with examination, diagnosis, treatment, and prevention of diseases, conditions, and malfunctions affecting the human foot and its related structures.

Forceps: An instrument used to grasp, hold, or pull objects during surgery. In the context of pregnancy and delivery, forceps are used during childbirth to apply to the infant's head and then pull gently in order to pull the infant out from the birth canal.

Foreign Country (FC): Please use the code 'FC' anytime the respondent indicates that the address, provider, job, pharmacy, etc., was not in one of the 50 states. Record the name of the city or province, and the country name in the city field. Record 'FC' in the state field. For example, if your respondent lives in Buffalo, NY and reported that he or she worked in Toronto, Canada, you would record 'Toronto, Canada' in the city field and 'FC' in the state field.

Foreign (Non-U.S.) Government: Individuals who work for a government other than the U.S. This includes all levels of government as long as it is non-U.S. Do not use this answer category for individuals working at some level of non-foreign government, but who work outside the boundaries of the U.S. For example, a person working for the U.S. State Department in Africa.

Foster Care Relationship: A relationship between a substitute family and a minor child who is unable to live with his/her biological parent(s). The minor living in this relationship is considered a "foster child."

A 401(k) is a optional retirement plan supported by many companies. This money is taken out and invested before the employee's paycheck is taxed. The plan is set up by a qualified employer with the primary contributions being deposited by the employee. Often there is a company matching plan where they will also contribute a percentage of the money the employee contributed. While the 401(k) continues to grow, taxes will not be paid on it. When the employee withdraws the money at retirement, he/she will be taxed on the amount in the account. There is a penalty to remove the money prior to retirement age; however, many plans allow the employee to borrow money using the plan as collateral or remove the money without penalty in certain emergencies. These amounts can be found on form 1099-R.

Free Clinic: A neighborhood clinic or health program that provides health services in a relatively informal setting to students, transient youth, and minority groups. Care is provided free or for a nominal charge by staff members who are predominantly volunteers.

Free from Provider (Professional Courtesy/Free Sample): The provider provided the services as a professional courtesy extended from one provider to another or to family members or office staff. This can also include free samples of medicine, or the donation of a provider's services. This does not include visits to public or 'free' clinics where the services are covered by public and/or private funding sources. Such situations should be coded as '10' (No bill sent: Public clinic/health center or private charity).

Free Samples: Limited amounts of a prescription medication which are given out by doctors to patients free of charge, sometimes in lieu of a written or verbal prescription.  

Friend (Home Health Provider): A medical or non-medical person providing some type of home health services to the RU member. This person must fulfill the following requirements:

1. Friend was not paid.
2. Friend is not part of the RU or DU.
3. Friend is not related to the RU member receiving the care.
4. Friend is not providing the care because of an affiliation with a volunteer group.

Full-Time (School Attendance): A person is considered to be attending school full-time if s/he is carrying a full load of class hours in a semester or quarter.

Full-Time Active Duty (with the Armed Forces): This includes persons on full-time active duty in the Army, Navy, Air Force, Marine Corps, or Coast Guard unit presently activated as part of the regular Armed Forces and persons in the Reserve Forces on a six-month active service (in connection with the provisions of the Reserve Force Act of 1955).

Fully Recovered: A person is recovered if he/she has returned to a previous state of health or function that preceded the occurrence of the disease, disability, or accident.

Functional Limitations: A subjective assessment of inability to perform physical or mental tasks associated with usual roles and daily activities that are caused by an impairment or physical or mental health problems. Includes restriction in physical mobility, dexterity, communication, learning ability and cognitive capacity.

Further Treatment or Consultation: This refers to additional medication, tests, examination, surgery, procedures or consultations in addition to the treatments and consultations the patient had already been through.

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G

GED (General Educational Development): An exam certified equivalent of a high school diploma.

General Checkup: A visit to determine the general state of a person's health. Includes physical examinations required to obtain employment, for college entrance, to obtain insurance, periodic (yearly) general checkups, visits to the well-baby clinic, etc. Not included are visits for a checkup or examination for a specific condition such as TB or a heart condition.

General Dentist: A general dentist conducts routine examinations, fills cavities, extracts teeth (except for wisdom teeth), and performs services not done by the specialists listed in the other parts of this question.  

General Educational Development (GED) or High School Equivalency: If the person has not actually completed all four years of high school, but has acquired his/her GED (high school equivalency), count this as you would a high school graduate and enter code "12".

General Exam (Dental): Refers to the activity performed by either a dentist or a dental hygienist to determine whether cavities or gum disease have developed, or whether examination by a specialist may be necessary.

General Health Coverage: Health insurance that covers a broad range of health care services, including those caused by illnesses, disease, etc., as well as, injuries and accidents.

Gestational Diabetes: The onset or recognition of diabetes during pregnancy.

Give Birth to a Baby (mother): Hospital stays due to the emergence and separation of offspring from the body of the mother. Includes normal childbirth (delivery of baby through the birth canal) and cesarean section (surgical operation for delivering a baby by cutting through the mother's abdominal and uterine walls).

Going to School: RU member is no longer employed in order to attend classes at any kind of public or private school, including trade or vocational schools in which students receive no compensation in money or kind, or only minimal educational stipends (fellowship, scholarship).

Government, Corporate, Municipal, Foreign Bonds and Bond Funds: A certificate of debt issued by a corporation, government (local or federal), or foreign country that guarantees payment of the original investment plus interest by a specified future date.

Government-Financed Research and Clinical Trials: This includes all charges that were paid by the government or a research institute in return for the person's participation in medical research. The research may take the form of clinical trials of an experimental medication, which are part of the government's medical approval process. The person's participation does not necessarily involve a specific health condition.

Government Savings Bond: Any of various series of interest-bearing certificates issued by a government (local, state, or federal) promising to pay the holder a specified sum on a specified date, usually maturing over long periods.

Grade or Year (of Regular School): For this study, we have classified grades 1 through 8 as elementary school, and grades 9 through 12 as high school. However, you should note that the final grade of elementary school may be anywhere from grade 5 to grade 8, depending on the school system. So, if the respondent says the person you are asking about completed elementary school, probe to determine what grade that represents.

Completing a given grade in school should be counted as the number of years it normally takes to complete that grade level of education, regardless of how many years it actually took the person to finish. This means that for persons who skipped or repeated grades in elementary school, you will enter the highest grade completed regardless of the number of years they were in school. This rule is true for elementary school through high school and is especially relevant to college. For example, if the person you are asking about is reported as having a 'Bachelor's degree', it should be coded as '16' (College - Fourth Year) regardless of how many years it took him/her to receive it. Code '17' (College - Five or More Years) should be entered only if the person has completed one or more years of graduate or professional school.  

Grades 1-12: Includes elementary school, middle school, and high school (both junior and senior high school). The school can be public, private, military, or parochial.

Graduate Degree: Any college degree BEYOND a Bachelor’s degree including Master’s degrees (e.g., M.A., M.S., etc.) or Doctorate degrees (e.g., Ph.D., J.D., M.D., D.D.S., etc.). If the person has some graduate level education, but has not received a graduate degree, use the “College Graduate” category.

Grandchild: A child of one's daughter or son.

Granddaughter: The female child of one's son or daughter.

Grandfather: The male parent of one's mother or father.

Grandmother: The female parent of one's mother or father.

Grandson: The male child of one's son or daughter.

Grandparent: A parent of one's mother or father, includes grandmother (the female parent of one's mother or father) and grandfather (the male parent of one's mother or father).

Group (or Association) - Health Insurance: Includes many types of organizations, but principally groups like the American Association of Retired Persons (AARP), church groups, or clubs. It also may include professional associations. These are organizations of individuals that share an interest or common characteristic or a professional affiliation (for example, the American Medical Association). Membership may include the right to buy health insurance through the organization or association.

Group Homes: A place that offers residents help with activities such as bathing and dressing, but do not provide 24-hour nursing services. (Some residents at a residential care facility may not require such assistance, but it must be available to them.) This is typically a family type setting which encourages individual participation in household roles and facilitates self-care goals in conjunction with day placement activities and other services. A group home may be Medicaid certified.

Guide Dogs or Other Animal Assistants: Guide dogs are specially trained dogs to assist the blind or partially sighted persons with mobility. There are a variety of animals (dogs, monkeys, etc.) that assist persons with special needs, including alerting the person to various noises, bringing things to them, etc.

Gum Surgery: Procedures or surgeries that treat diseases in the bone, connective tissue, and gums surrounding and supporting the teeth.

Gun: Includes guns that do not shoot bullets, such as BB guns, air rifles, pellet guns. Do not include guns that are clearly intended to be toys, such as water guns, dart and cap guns.

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H

Half Day or More: If a person's work or school day is 9:00 a.m. to 3:00 p.m., for example, and he/she stayed home from work or school for more than 3 hours of that time, we consider this as having missed a half day or more. If a person's work for pay is usually done at home, or if a person does housework for pay, include any half days missed from such work when it is due to illness or injury.

Handlers, Equipment Cleaners, Helpers, and Laborers: Includes occupations helping other workers and performing routine nonmachine tasks. Examples includes helpers within various trades, construction laborers, garbage collectors, baggage handlers, garage and service station attendants, parking lot attendants, vehicle washers and equipment cleaners, hand packers, manual workers, etc.  

Handrails or Ramps: Handrails serve as a support to be held by the hand. Ramps are sloping surfaces that connect different levels.

Hands On (Help with Bathing or Showering): Providing physical help with bathing or showering such as preparing the bath water (either in a tub or shower or in a basin for a sponge bath), helping the person get in or out of the tub or shower, washing any part of the person’s body, shampooing the person’s hair, helping dry the person, etc.

Hands On (Help with Dressing): Providing physical help with dressing such as getting the clothes from the closet or dresser, putting the clothes on the person, zipping or buttoning the clothes, etc.

Hands On (Help with Eating): Providing physical help with eating such as placing the food in the person’s mouth, helping the person guide the fork or spoon to his or her mouth, etc.

Hands On (Help with Getting Out of Bed or a Chair): Providing physical help with getting out of bed or a chair such as lifting the person from the bed or chair or supporting the person as they get up.

Hands On (Help with Getting To/Using Toilet): Providing physical help with toileting such as getting to the bathroom, adjusting clothes, helping person on and off toilet, cleaning the person after elimination, etc.

Have High School Diploma: A certificate that verifies that a person has successfully completed the required courses of a high school curriculum. By "have a high school diploma," we mean did the person graduate from high school rather than literally do they have the document bearing record of graduation.

Head of Household: This is the person in the household who has the primary responsibility for the care of the family.

Head of Household with Qualifying Person: A tax filing status that can be used by anyone who is UNMARRIED and who paid over half of the cost of keeping up a home that was the main home for all of the tax year for any of the following people:

• the person’s parent(s); or
• the person’s UNMARRIED child, adopted child, stepchild, grandchild, etc. (the child does not have to be a dependent); or
• the person’s MARRIED child, adopted child, stepchild, grandchild, etc. (the child must be a dependent); or
• the person’s foster child (the child must be a dependent); or
• any other of the person’s relatives who is a dependent.

This filing status can also be used by someone who is married and who is legally separated from his/her spouse in the tax year and who:

• has lived apart from his/her spouse for the last six months of the tax year, and
• files a separate return from his/her spouse, and
• paid over half of the cost of keeping up his/her home during the tax year, and
• provided his/her home as the main home of his/her child, adopted child, stepchild, or foster child for more than half of the tax year, and
• claimed this child as his/her dependent.

Reports taxable income of one tax filer.

Health Aide: A nursing assistant who provides personal care and home management services to allow patients to live in their own homes. They work under the supervision of a physician or registered nurse and may help patients bathe, exercise, and dress. They may also check the patient's temperature, blood pressure, pulse and respiration rates, and help give medications.

Health Care Purchasing Alliance: An organization which allows individuals or small employers to band together in order to buy insurance at more favorable premium rates. Its basic functions are to bargain with and purchase health insurance on behalf of consumers and to furnish information to consumers on the services provided, evaluations of the quality of care available, and price of competing health care sources.

They may also be referred to as:

• HA: health alliances,
• HIPC: health insurance purchasing corporations,
• HIPC: health insurance purchasing cooperative, or
• HPPC or HICK-PIX: health plan purchasing cooperative.

Health Care Events: Visits to and care received by medical providers.

NOTE: Events are collected through the Provider Probes and can be edited through the Event Driver. Each event is unique and is identified by the following three elements:

1) the RU member;

2) the medical provider; and

3) the date(s) of the visit/service.

Health Clinic: Refers to a facility where medical care and advice are given by doctors, nurses, or other medical persons, but is not located at a hospital.

Health Conditions: Diseases or ailments. A disease is an illness or disorder of the function of the body or of certain tissues, organs, or systems, which is characterized by an identifiable group of symptoms. An ailment is a mild mental or physical disorder. An example of a health condition is influenza; some of its symptoms are fever, chills, and dizziness. Health conditions may be either physical or mental. Be sure to record conditions only; do not record symptoms here unless the respondent cannot give a condition name.

Health Insurance: Health benefits coverage which provide persons with health-related benefits. Coverage may include the following; hospitalization, major medical, surgical, prescriptions, dental, and vision.

Health Insurance or Another Source of Coverage: Any individual company, or organization, be