Absenteeism
Time taken off from work. May be classified separately as employee sick leave, personal days, mental health days, jury duty, vacation, holidays, family illness or bereavement, Family and Medical Leave Act, workers compensation program days, short-term disability, or long-term disability. Substance abuse program theory should be used to determine which of these types of absenteeism are appropriate for analysis of the impact of a substance abuse prevention or early intervention program. Absenteeism does not include telecommuting and working off-site.
Access
The extent to which services are available for individuals who need care. Ease of access depends on several factors, including availability and location of appropriate care and services, transportation, hours of operation, and cultural factors, including languages and cultural appropriateness. For many populations access also includes insurance coverage.
Accessible services
Services that are affordable, located nearby, and open during evenings and weekends. Staff is sensitive to and incorporates individual and cultural values. Staff is also sensitive to barriers that may keep a person from getting help. For example, an adolescent may be more willing to attend a support group meeting in a church or club near home than to travel to a mental health center. An accessible service can handle consumer demand without placing people on a long waiting list.
Accreditation
An official decision made by a recognized organization that a health care plan, network, or other delivery system complies with applicable standards.
Activity Therapy
Includes art, dance, music, recreational and occupational therapies, and psychodrama.
Acute Care
Medical treatment rendered to individuals whose illnesses or health problems are life- threatening or debilitating, requiring immediate response, and are short-term or episodic in nature. Acute care facilities are those hospitals that predominantly serve persons requiring these kinds of services.
Addiction
A chronic, relapsing disease characterized by compulsive drug-seeking and abuse and by long-lasting chemical changes in the brain.
Addition
The number of persons admitted, readmitted, or transferred to a specified service during the reporting period.
Adjusted Community Rating (ACR)
A community rating impacted by group- specific demographics and the group's prior experience. Also known as prospective rating.
Administrative Costs
Costs not linked directly to the provision of medical care. Includes marketing, claims processing, billing, and medical record keeping, among others.
Administrative Services Only Organization (ASO)
A healthcare organization that provides administrative support services only for a self-funded plan or startup MCO.
Adverse Selection
A tendency for utilization of health services in a population group to be higher than average. From an insurance perspective, adverse selection occurs when persons with poorer-than-average life expectancy or health status apply for, or continue, insurance coverage to a greater extent than do persons with average or better health expectations.
AIDS (Acquired Immune Deficiency Syndrome)
The final and most serious stage of HIV disease, which causes severe damage to the immune system. The Centers for Disease Control has defined AIDS as beginning when a person with HIV infection has a CD4 cell (also called "t-cell", a type of immune cell) count below 200. It is also defined by numerous opportunistic infections and cancers that occur in the presence of HIV infection. AIDS is the fifth leading cause of death among persons between ages 25 and 44 in the United States. About 47 million people worldwide have been infected with HIV since the start of the epidemic. The Human Immunodeficiency Virus (HIV) causes AIDS. The virus attacks the immune system and leaves the body vulnerable to a variety of life- threatening illnesses and cancers. Common bacteria, yeast, parasites, and viruses that ordinarily do not cause serious disease in people with fully functional immune systems can cause fatal illnesses in people with AIDS. Most individuals infected with HIV will progress to AIDS, if not treated. However, there is a tiny group of patients who develop AIDS very slowly or never at all. These patients are called non-progressors and many seem to have a genetic difference which prevents the virus from attaching to certain immune receptors. The symptoms of AIDS are primarily the result of infections that do not normally develop in individuals with healthy immune systems. These are called "opportunistic infections." Patients with AIDS have had their immune system depleted by HIV and are very susceptible to such opportunistic infections. Common symptoms are fevers, sweats (particularly at night), swollen glands, chills, weakness, and weight loss.
Alcohol
A liquid distilled product of fermented fruits, grains and vegetables. Used as solvent, antiseptic and sedative. Moderate potential for abuse. Also know as booze, juice, brew, vino, and sauce.
Alcohol Abuse During Pregnancy
Alcohol Abuse During Pregnancy is dangerous. Alcohol can have a number of harmful effects on the baby. The baby can be born mentally retarded or with learning and behavioral problems that last a lifetime. We don't know exactly how much alcohol is required to cause these problems. We do know, however, that these alcohol-related birth defects are 100- percent preventable, simply by not drinking alcohol during pregnancy. The safest course for women who are pregnant or trying to become pregnant is not to drink alcohol at all.
Alcohol Dependence
Alcohol Dependence, also known as "alcoholism," is a disease that includes four symptoms: * Craving: A strong need, or compulsion, to drink. * Loss of control: The inability to limit one's drinking on any given occasion. * Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking. * Tolerance: The need to drink greater amounts of alcohol in order to "get high." People who are not alcoholic sometimes do not understand why an alcoholic can't just "use a little willpower" to stop drinking. However, alcoholism has little to do with willpower. Alcoholics are in the grip of a powerful "craving," or uncontrollable need, for alcohol that overrides their ability to stop drinking. This need can be as strong as the need for food or water. Although some people are able to recover from alcoholism without help, the majority of alcoholics need assistance. With treatment and support, many individuals are able to stop drinking and rebuild their lives. Many people wonder why some individuals can use alcohol without problems but others cannot. One important reason has to do with genetics. Scientists have found that having an alcoholic family member makes it more likely that if you choose to drink you too may develop alcoholism. Genes, however, are not the whole story. In fact, scientists now believe that certain factors in a person's environment influence whether a person with a genetic risk for alcoholism ever develops the disease. A person's risk for developing alcoholism can increase based on the person's environment, including where and how he or she lives; family, friends, and culture; peer pressure; and even how easy it is to get alcohol.
Alcohol Withdrawal
Usually occurs in adults, but it may happen in adolescents as well. It occurs when a person who uses alcohol excessively suddenly stops the alcohol use. The withdrawal usually occurs within 5-10 hours after the decrease in alcohol intake, but it may occur up to 7- 10 days later. Excessive alcohol use is generally considered the equivalent of 2-6 pints of beer (or 4 oz of "hard" alcohol) per day for one week or habitual use of alcohol that disrupts a person's life and routines. The likelihood of developing alcohol withdrawal symptoms increases as the number and frequency of drinks increase. The likelihood of developing severe withdrawal symptoms also increases if a person has other medical problems.
Alcoholism
See Alcohol Dependence
Alternative Therapy
An alternative approach to mental health care is one that emphasizes the interrelationship between mind, body, and spirit. Although some alternative approaches have a long history, many remain controversial.
Alzheimer's Disease (AD)
A slowly progressive form of dementia, which is a progressive, acquired impairment of intellectual functions. Memory impairment is a necessary feature for the diagnosis. Change in one of the following areas must also be present for any form of dementia to be diagnosed: language, decision-making ability, judgment, attention, and other related areas of cognitive function and personality. The rate of progression is different for each person. If AD develops rapidly, it is likely to continue to progress rapidly. If it has been slow to progress, it will likely continue on a slow course. The cause of Alzheimer's disease (AD) is not known, but it is not a part of normal aging. Prior theories regarding the accumulation of aluminum, lead, mercury, and other substances in the brain have been disproved. A diagnosis of AD is made based on characteristic symptoms and by excluding other causes of dementia. It can be confirmed by microscopic examination of a sample of brain tissue after death. By causing both structural and chemical problems in the brain, AD appears to disconnect areas of the brain that normally work together. There are two types of AD -- early onset and late onset. In early onset AD, symptoms first appear before age 60. Some early onset disease runs in families and involves autosomal dominant, inherited mutations that may be the cause of the disease. So far, three early onset genes have been identified. Early onset AD is less common, resulting in about 5-10% of cases. Late onset AD, the most common form of the disease, develops in people 60 and older and is thought to be less likely to occur in families. Late onset AD may run in some families, but the role of genes is less direct and definitive. These genes may not cause the problem itself, but simply increase the likelihood of formation of plaques and tangles or other AD-related pathologies in the brain. In the early stages, the symptoms may be very subtle. Symptoms may often include: repeating statements frequently, frequently misplacing items, trouble finding names for familiar objects, getting lost on familiar routes, personality changes, becoming passive and losing interest in things previously enjoyed. AD cannot be cured and the impaired functions cannot be restored. Currently, the progression can be slowed but not stopped. Treatment focuses on attempting to slow the progression; managing the behavior problems, confusion, and agitation; modifying the home environment; and most importantly, supporting the family. As the disease progresses, it may take a greater toll on the family than the patient.
Ambulatory Care
All types of health services provided on an outpatient basis, in contrast to services provided in the home or to persons who are inpatients. While many inpatients may be ambulatory, the term ambulatory care usually implies that the patient must travel to a location to receive services that do not require an overnight stay.
American Indian or Alaska Native
A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliations or community attachment.
Amphetamine
Stimulant drugs whose effects are very similar to cocaine. Amphetamine, dextroamphetamine, methamphetamine, and their various salts are collectively referred to as amphetamines. In fact, their chemical properties and actions are so similar that even experienced users have difficulty knowing which drug they have taken. Methamphetamine is the most commonly abused.
Analgesics
A group of medications that reduce pain. Some of these medicines are also used just before or during an operation to help the anesthetic work better. Codeine and hydrocodone are also used to relieve coughing. Methadone is also used to help some people control their dependence on heroin or other narcotics. Narcotic analgesics may also be used for other conditions as determined by your doctor. Narcotic analgesics act in the central nervous system (CNS) to relieve pain. Some of their side effects are also caused by actions in the CNS. These medicines are available only with your medical doctor's or dentist's prescription. For some of them, prescriptions cannot be refilled and you must obtain a new prescription from your medical doctor or dentist each time you need the medicine. In addition, other rules and regulations may apply when methadone is used to treat narcotic dependence.
