Activities of daily living (ADLs): Activities of daily living (ADLs) are basic activities that support survival, including eating, bathing, and toileting. See Instrumental activities of daily living (IADLs).
In the Medicare Current Beneﬁciary Survey, ADL disabilities are measured as difficulty performing (or inability to perform because of a health reason) one or more of the following activities: eating, getting in/out of chairs, walking, dressing, bathing, or toileting.
Asset income: Asset income includes money income reported in the Current Population Survey from interest (on savings or bonds), dividends, income from estates or trusts, and net rental income. Capital gains are not included.
Assistive device: Assistive device refers to any item, piece of equipment, or product system, whether acquired commercially, modiﬁed, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.
Body mass index (BMI): This is a measure of body weight adjusted for height that correlates with body fat. A tool for indicating weight status in adults, BMI is generally computed using metric units and is deﬁned as weight divided by height2 or kilograms/meters2. The categories used in this report are consistent with those set by the World Health Organization. For adults 20 years of age and over, underweight is deﬁned as having a BMI less than 18.5; healthy weight is deﬁned as having a BMI of at least 18.5 and less than 25; overweight is deﬁned as having a BMI equal to 25 or greater; and obese is deﬁned as having a BMI equal to 30 or greater. To calculate your own body mass index, go to http://www.nhlbisupport.com/bmi. For more information about BMI, see “Clinical guidelines on the identiﬁcation, evaluation, and treatment of overweight and obesity in adults.”58
Cause of death: For the purpose of national mortality statistics, every death is attributed to one underlying condition, based on information reported on the death certiﬁcate and using the international rules for selecting the underlying cause of death from the conditions stated on the death certiﬁcate. In addition to the underlying cause, all other conditions reported on the death certificate are captured and coded and are referred to as multiple causes of death. Cause of death is coded according to the appropriate revision of the International Classiﬁcation of Diseases (ICD). Effective with deaths occurring in 1999, the United States began using the Tenth Revision of the ICD (ICD–10). Data from earlier time periods were coded using the appropriate revision of the ICD for that time period. Changes in classiﬁcation of causes of death in successive revisions of the ICD may introduce discontinuities in cause-of-death statistics over time. These discontinuities are measured using comparability ratios. These measures of discontinuity are essential to the interpretation of mortality trends. For further discussion, see the “Mortality Technical Appendix” available at http://www.cdc.gov/nchs/data/statab/techap99.pdf.
Cause-of-death ranking: The cause-of-death ranking for adults is based on the List of 113 Selected Causes of Death. The top-ranking causes determine the leading causes of death. Certain causes on the tabulation lists are not ranked if, for example, the category title represents a group title (such as “Major cardiovascular diseases” and “Symptoms, signs, and abnormal clinical and laboratory ﬁndings, not elsewhere classiﬁed”) or the category title begins with the words “Other” and “All other.” In addition, when a title that represents a subtotal (such as “Cancer”) is ranked, its component parts are not ranked. Causes that are tied receive the same rank; the next cause is assigned the rank it would have received had the lower-ranked causes not been tied (i.e., they skip a rank).
Cigarette smoking: Information about cigarette smoking in the National Health Interview Survey is obtained for adults age 18 and over. Although there has been some variation in question wording, smokers continue to be deﬁned as people who have ever smoked 100 cigarettes and currently smoke. Starting in 1993, current smokers are identiﬁed by asking the following two questions: “Have you smoked at least 100 cigarettes in your entire life?” and “Do you now smoke cigarettes every day, some days, or not at all?” (revised deﬁnition). People who smoked 100 cigarettes and who now smoke every day or some days are deﬁned as current smokers. Before 1992, current smokers were identiﬁed based on positive responses to the following two questions: “Have you smoked at least 100 cigarettes in your entire life?” and “Do you smoke now?” (traditional deﬁnition). In 1992, cigarette smoking data were collected for a half sample with one-half the respondents (a one-quarter sample) using the traditional smoking questions and the other half of respondents (a one-quarter sample) using the revised smoking question. The statistics reported for 1992 combined data collected using the traditional and the revised questions. The information obtained from the two smoking questions listed above is combined to create the variables represented in Tables 26a and 26b.
Current smoker: There are two categories of current smokers: people who smoke every day and people who smoke only on some days.
Former smoker: This category includes people who have smoked at least 100 cigarettes in their lifetimes but currently do not smoke at all.
Nonsmoker: This category includes people who have never smoked at least 100 cigarettes in their lifetime.
Civilian population: See Population.
Civilian noninstitutionalized population: See Population.
Death rate: The death rate is calculated by dividing the number of deaths in a population
in a year by the midyear resident population. For census years, rates are based on unrounded census counts of the resident population as of April 1. Death rates are expressed as the number of deaths per 100,000 people. The rate may be restricted to deaths in speciﬁc age, race, sex, or geographic groups or from speciﬁc causes of death (speciﬁc rate), or it may be related to the entire population (crude rate).
Dental services: In the Medicare Current Beneficiary Survey (Indicators 30 and 34), the Medical Expenditure Panel Survey (MEPS), and the data used from the MEPS predecessor surveys used in this report (Indicator 33) this category covers expenses for any type of dental care provider, including general dentists, dental hygienists, dental technicians, dental surgeons, orthodontists, endodontists, and periodontists.
Earnings: Earnings are considered money income reported in the Current Population Survey from wages or salaries and net income from self-employment (farm and nonfarm).
Emergency room services: In the Medical Expenditure Panel Survey (MEPS) and the data used from the MEPS predecessor surveys used in this report (Indicator 33), this category includes expenses for visits to medical providers seen in emergency rooms (except visits resulting in a hospital admission). These expenses include payments for services covered under the basic facility charge and those for separately billed physician services. In the Medicare Current Beneficiary Survey (Indicators 30 and 34) emergency room services are included as a hospital outpatient service unless they are incurred immediately prior to a hospital stay, in which case they are included as a hospital inpatient service.
Fee-for-service: This is the method of reimbursing health care providers on the basis of a fee for each health service provided to the insured person.
Group quarters: A group quarters is a place where people live or stay, in a group living arrangement that is owned or managed by an entity or organization providing housing and/or services for the residents. This is not a typical household-type living arrangement. These services may include custodial or medical care as well as other types of assistance, and residency is commonly restricted to those receiving these services. People living in group quarters are usually not related to each other. The group quarters definitions used in the 2010 Census are available in Appendix B at: http://www.census.gov/prod/cen2010/doc/sf1.pdf.
Head of household: The Survey of Consumer Finances (SCF) estimates wealth for the “Primary Economic Unit” which is similar to the Census Bureau’s Household. The “Primary Economic Unit” is the economically dominant single person or couple (whether married or living together as partners) and all other persons in the household who are financially interdependent with the economically dominant person or couple. If a couple is economically dominant in the PEU, the head is the male in a mixed sex couple or the older person in a same-sex couple. If a single person is economically dominant, that person is designated as the family head in this report.
Health care expenditures: In the Consumer Expenditure Survey (Indicator 12), health care expenditures include out-of-pocket expenditures for health insurance, medical services, prescription drugs, and medical supplies. In the Medicare Current Beneficiary Survey (Indicators 30 and 34), health care expenditures include all expenditures for inpatient hospital, medical, nursing home, outpatient (including emergency room visits), dental, prescription drugs, home health care, and hospice services, including both out-of-pocket expenditures and expenditures covered by insurance. Personal spending for health insurance premiums is excluded. In the Medical Expenditure Panel Survey (MEPS) and the data used from the MEPS predecessor surveys used in this report (Indicator 33), health care expenditures refers to payments for health care services provided during the year. (Data from the 1987 survey have been adjusted to permit comparability across years; see Zuvekas and Cohen.51) Out-of-pocket health care expenditures are the sum of payments paid to health care providers by the person, or the person’s family, for health care services provided during the year. Health care services include inpatient hospital, hospital emergency room, and outpatient department care; dental services; office-based medical provider services; prescription drugs; home health care; and other medical equipment and services. Personal spending for health insurance premium(s) is excluded.
Health maintenance organization (HMO): An HMO is a prepaid health plan delivering comprehensive care to members through designated providers, having a ﬁxed monthly payment for health care services, and requiring members to be in a plan for a speciﬁed period of time (usually 1 year).
Hispanic origin: See speciﬁc data source descriptions.
Home health care/services/visits: Home health care is care provided to individuals and families in their places of residence for promoting, maintaining, or restoring health or for minimizing the effects of disability and illness, including terminal illness. In the Medicare Current Beneficiary Survey and Medicare claims data (Indicators 29, 30, and 34), home health care refers to skilled nursing care, physical therapy, speech language pathology services, occupational therapy, and home health aide services provided to homebound patients. In the Medical Expenditure Panel Survey (Indicator 33), home health care services are classified into the “Other health care” category and are considered any paid formal care provided by home health agencies and independent home health providers. Services can include visits by professionals including nurses, doctors, social workers, and therapists, as well as home health aides, homemaker services, companion services, and home-based hospice care. Home care provided free of charge (informal care by family members) is not included.
Hospice care/services: Hospice care is a program of palliative and supportive care services providing physical, psychological, social, and spiritual care for dying persons, their families, and other loved ones by a hospice program or agency. Hospice services are available in home and inpatient settings. In the Medicare Current Beneficiary Survey (MCBS) (Indicators 30 and 34) hospice care includes only those services provided as part of a Medicare benefit. In MCBS Indicator 30 (Medicare), hospice services are included as part of the “Other” category. In MCBS Indicator 34 (Medicare), hospice services are included as a separate category. In the Medical Expenditure Panel Survey (MEPS) (Indicator 33), hospice care provided in the home (regardless of the source of payment) is included in the “Other health care” category, while hospice care provided in an institutional setting (e.g., nursing home) is excluded from the MEPS universe.
Hospital care: Hospital care in the Medical Expenditure Panel Survey (Indicator 33) includes hospital inpatient care and care provided in hospital outpatient departments and emergency rooms. Care can be provided by physicians or other health practitioners. Payments for hospital care include payments billed directly by the hospital and those billed separately by providers for services provided in the hospital.
Hospital inpatient services: In the Medicare Current Beneficiary Survey (Indicators 30 and 34) hospital inpatient services include room and board and all hospital diagnostic and laboratory expenses associated with the basic facility charge, as well as emergency room expenses incurred immediately prior to inpatient stays. Expenses for hospital stays with the same admission and discharge dates are included if the Medicare bill classified the stay as an “inpatient” stay. Payments for separate billed physician inpatient services are excluded. In the Medical Expenditure Panel Survey (Indicator 33) these services include room and board and all hospital diagnostic and laboratory expenses associated with the basic facility charge, payments for separately billed physician inpatient services, and emergency room expenses incurred immediately prior to inpatient stays. Expenses for reported hospital stays with the same admission and discharge dates are also included.
Hospital outpatient services: These services in the Medicare Current Beneficiary Survey (Indicators 30 and 34) include visits to both physicians and other medical providers seen in hospital outpatient departments or emergency rooms (provided the emergency room visit does not result in an inpatient hospital admission), as well as diagnostic laboratory and radiology services. Payments for these services include those covered under the basic facility charge. Expenses for in-patient hospital stays with the same admission and discharge dates and classified on the Medicare bill as “outpatient” are also included. Separately billed physician services are excluded.
Hospital stays: Hospital stays in the Medicare claims data (Indicator 29) refers to admission to and discharge from a short-stay acute care hospital.
Housing cost burden: In the American Housing Survey, housing cost burden is defined as expenditures on housing and utilities in excess of 30 percent of household reported income.
Housing expenditures: In the Consumer Expenditure Survey’s Interview Survey, housing expenditures include payments for mortgage interest; property taxes; maintenance, repairs, insurance, and other expenses; rent; rent as pay (reduced or free rent for a unit as a form of pay); maintenance, insurance, and other expenses for renters; and utilities.
Incidence: Incidence is the number of cases of disease having their onset during a prescribed period of time. It is often expressed as a rate, for example, the incidence of measles per 1,000 children ages 5 to 15 during a speciﬁed year. Incidence is a measure of morbidity or other events that occur within a speciﬁed period of time. See Prevalence.
Income: In the Current Population Survey, income includes money income (prior to payments for personal income taxes, Social Security, union dues, Medicare deductions, etc.) from: (1) money wages or salary; (2) net income from nonfarm self-employment; (3) net income from farm self-employment; (4) Social Security or Railroad Retirement; (5) Supplemental Security Income; (6) public assistance or welfare payments; (7) interest (on savings or bonds); (8) dividends, income from estates or trusts, or net rental income; (9) veterans’ payment or unemployment and worker’s compensation; (10) private pensions or government employee pensions; and (11) alimony or child support, regular contributions from people not living in the household, and other periodic income. Certain money receipts such as capital gains are not included.
In the Medicare Current Beneﬁciary Study, income is for the sample person, or the sample person and spouse if the sample person was married at the time of the survey. All sources of income from jobs, pensions, Social Security beneﬁts, Railroad Retirement and other retirement income, Supplemental Security Income, interest, dividends, and other income sources are included.
Income, household: Household income from the Medical Expenditure Panel Survey (MEPS) and the MEPS predecessor surveys used in this report was created by summing personal income from each household member to create family income. Family income was then divided by the number of people that lived in the household during the year to create per capita household income. Potential income sources asked about in the survey interviews include annual earnings from wages, salaries, or withdrawals; Social Security and VA payments; Supplemental Security Income and cash welfare payments from public assistance; Temporary Assistance for Needy Families, formerly known as Aid to Families with Dependent Children; gains or losses from estates, trusts, partnerships, C corporations, rent, and royalties; and a small amount of other income. See Poverty Indicator 33: Out-of-Pocket Health Care Expenditures.
Income ﬁfths: A population can be divided into groups with equal numbers of people based on the size of their income to show how the population differs on a characteristic at various income levels. Income ﬁfths are ﬁve groups of equal size, ordered from lowest to highest income.
Inpatient hospital: See Hospital inpatient services.
Institutions: For the 2010 Census, the Census Bureau defined institutions as adult correctional facilities, juvenile facilities, skilled-nursing facilities, and other institutional facilities such as mental (psychiatric) hospitals and in-patient hospice facilities. See Population.
Institutionalized population: See Population.
Instrumental activities of daily living (IADLs): IADLs are indicators of functional well-being that measure the ability to perform more complex tasks than the related activities of daily living (ADLs). See Activities of daily living (ADLs).
In the Medicare Current Beneﬁciary Survey. IADLs are measured as difﬁculty performing (or inability to perform because of a health reason) one or more of the following activities: heavy housework, light housework, preparing meals, using a telephone, managing money, or shopping.
Long-term care facility: In the Medicare Current Beneficiary Survey (MCBS) (Indicators 20 and 36), a residence (or unit) is considered a long-term care facility if it is certified by Medicare or Medicaid; has three or more beds, is licensed as a nursing home or other long-term care facility, and provides at least one personal care service; or provides 24-hour, 7-day-a-week supervision by a non-family, paid caregiver. In MCBS (Indicators 30 and 34), a long-term care facility excludes “short-term institutions” (e.g., sub-acute care) stays. See Short-term institution (Indicators 30 and 34), and Skilled nursing home (Indicator 29).
Mammography: Mammography is an X-ray image of the breast used to detect irregularities in breast tissue.
Mean: The mean is an average of n numbers computed by adding the numbers and dividing by n.
Median: The median is a measure of central tendency, the point on the scale that divides a group into two parts.
Medicaid: This nationwide health insurance program is operated and administered by the states with Federal ﬁnancial participation. Within certain broad, federally determined guidelines, states decide who is eligible; the amount, duration, and scope of services covered; rates of payment for providers; and methods of administering the program. Medicaid pays for health care services, community-based supports, and nursing home care for certain low-income people. Medicaid does not cover all low-income people in every state. The program was authorized in 1965 by Title XIX of the Social Security Act.
Medicare: This nationwide program provides health insurance to people age 65 and over, people entitled to Social Security disability payments for 2 years or more, and people with end-stage renal disease, regardless of income. The program was enacted July 30, 1965, as Title XVIII, Health Insurance for the Aged of the Social Security Act, and became effective on July 1, 1966. Medicare covers acute care services and post-acute care settings such as rehabilitation and long-term care hospitals, and generally does not cover nursing home care. Prescription drug coverage began in 2006.
Medicare Advantage: See Medicare Part C.
Medicare Part A: Medicare Part A (Hospital Insurance) covers inpatient care in hospitals, critical access hospitals, skilled nursing facilities, and other post-acute care settings such as rehabilitation and long-term care hospitals. It also covers hospice and some home health care.
Medicare Part B: Medicare Part B (Medical Insurance) covers doctor’s services, outpatient hospital care, and durable medical equipment. It also covers some other medical services that Medicare Part A does not cover, such as physical and occupational therapy and some home health care. Medicare Part B also pays for some supplies when they are medically necessary.
Medicare Part C: With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). These plans were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, the types of plans allowed to contract with Medicare were expanded, and the Medicare Choice program became known as “Medicare Advantage.” In addition to offering comparable coverage to Part A and Part B, Medicare Advantage plans may also offer Part D coverage.
Medicare Part D: Medicare Part D subsidizes the costs of prescription drugs for Medicare beneficiaries. It was enacted as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and went into effect on January 1, 2006. Beneficiaries can obtain the Medicare drug benefit through two types of private plans: beneficiaries can join a Prescription Drug Plan (PDP) for drug coverage only or they can join a Medicare Advantage plan (MA) that covers both medical services and prescription drugs (MA-PD). Alternatively, beneficiaries may receive drug coverage through a former employer, in which case the former employer may qualify for a retiree drug subsidy payment from Medicare.
Medigap: See Supplemental health insurance.
National population adjustment matrix: The national population adjustment matrix adjusts the population to account for net underenumeration. Details on this matrix can be found on the U.S. Census Bureau website: http://www.census.gov/population/www/censusdata/adjustment.html.
Noninstitutional group quarters: For the 2010 Census, the Census Bureau defined noninstitutional group quarters as facilities that house those who are primarily eligible, able, or likely to participate in the labor force while resident. The noninstitutionalized population lives in noninstitutional group quarters such as college/university student housing, military quarters, and other noninstitutional group quarters such as emergency and transitional shelters for people experiencing homelessness and group homes. For more information on noninstitutional group quarters, please see Appendix B at http://www.census.gov/prod/cen2010/doc/sf1.pdf.
Obesity: See Body mass index.
Ofﬁce-based medical provider services: In the Medical Expenditure Panel Survey (Indicator 33), this category includes expenses for visits to physicians and other health practitioners seen in office-based settings or clinics. “Other health practitioner” includes audiologists, optometrists, chiropractors, podiatrists, mental health professionals, therapists, nurses, and physician’s assistants, as well as providers of diagnostic laboratory and radiology services. Services provided in a hospital based setting, including outpatient department services, are excluded.
Other health care: In the Medicare Current Beneficiary Survey (Indicator 34), this category includes short-term institution, hospice, and dental services. In the Medical Expenditure Panel Survey (MEPS) (Indicator 33) other health care includes home health services (formal care provided by home health agencies and independent home health providers) and other medical equipment and services. The latter includes expenses for eyeglasses, contact lenses, ambulance services, orthopedic items, hearing devices, prostheses, bathroom aids, medical equipment, disposable supplies, alterations/modifications, and other miscellaneous items or services that were obtained, purchased, or rented during the year.
Other income: Other income is total income minus retirement beneﬁts, earnings, asset income, and public assistance. It includes, but is not limited to, unemployment compensation, worker’s compensation, alimony, and child support.
Outpatient hospital: See Hospital outpatient services.
Out-of-pocket health care costs: These are health care costs that are not covered by insurance.
Overweight: See Body mass index.
Pensions: Pensions include money income reported in the Current Population Survey from Railroad Retirement, company or union pensions (including proﬁt sharing and 401(k) payments), IRAs, Keoghs, regular payments from annuities and paid-up life insurance policies, Federal government pensions, U.S. military pensions, and state or local government pensions.
Physician/Medical services: In the Medicare Current Beneficiary Survey (Indicator 34), this category includes visits to a medical doctor, osteopathic doctor, and health practitioner as well as diagnostic laboratory and radiology services. Health practitioners include audiologists, optometrists, chiropractors, podiatrists, mental health professionals, therapists, nurses, paramedics, and physician’s assistants. Services provided in a hospital-based setting, including outpatient department services, are included.
Physician/Outpatient hospital: In the Medicare Current Beneficiary Survey (Indicator 30), this term refers to “physician/medical services” combined with “hospital outpatient services.”
Physician visits and consultations: In Medicare claims data (Indicator 29), physician visits and consultations include visits and consultations with primary care physicians, specialists, and chiropractors in their offices, hospitals (inpatient and outpatient), emergency rooms, patient homes, and nursing homes.
Population: Data on populations in the United States are often collected and published according to several different deﬁnitions. Various statistical systems then use the appropriate population for calculating rates.
Resident population: The resident population of the United States includes people resident in the 50 states and the District of Columbia. It excludes residents of the Commonwealth of Puerto Rico and residents of the outlying areas under United State sovereignty or jurisdiction (principally American Samoa, Guam, Virgin Islands of the United States and the Commonwealth of the Northern Mariana Islands). An area’s resident population consists of those persons “usually resident” in that particular area (where they live and sleep most of the time). The resident population includes people living in housing units, nursing homes, and other types of institutional settings. People whose usual residence is outside of the United States, such as the U.S. military and civilian personnel as well as private U.S. citizens living overseas, are excluded from the resident population.
Resident noninstitutionalized population: The resident noninstitutionalized population is the resident population residing in noninstitutional group quarters. See also the definitions of Resident population and Noninstitutional group quarters.
Civilian population: The civilian population is the U.S. resident population not in the active- duty Armed Forces.
Civilian noninstitutionalized population: This population includes all U.S. civilians residing in noninstitutional group quarters. See also the definitions of Civilian population and Noninstitutional group quarters.
Institutionalized population: For the 2010 Census, the Census Bureau defined institutional group quarters as facilities that house those who are primarily ineligible, unable, or unlikely to participate in the labor force while resident. The institutionalized population is the population residing in institutional group quarters such as adult correctional facilities, juvenile facilities, skilled-nursing facilities, and other institutional facilities such as mental (psychiatric) hospitals and in-patient hospice facilities. People living in noninstitutional group quarters are the noninstitutionalized population. For more information on institutional and noninstitutional group quarters, please see Appendix B at http://www.census.gov/prod/cen2010/doc/sf1.pdf.
Poverty: The official measure of poverty is computed each year by the U.S. Census Bureau and is defined as having income less than 100 percent of the poverty threshold (i.e., $10,458 for one person age 65 and over in 2010).59 Poverty thresholds are the dollar amounts used to determine poverty status. Each family (including single-person households) is assigned a poverty threshold based upon the family’s size and the ages of the family members. All family members have the same poverty status. Several of the indicators included in this report include a poverty status measure. Poverty status (less than 100 percent of the poverty threshold) was computed for “Indicator 7: Poverty,” “Indicator 8: Income,” “Indicator 17: Sensory Impairments and Oral Health,” “Indicator 22: Mammography,” “Indicator 32: Sources of Health Insurance,” and “Indicator 33: Out-of-Pocket Health Care Expenditures” using the official U.S. Census Bureau definition for the corresponding year. In addition, the following income-to-poverty categories are used in this report.
Indicator 8: Income: The income categories are derived from the ratio of the family’s money income (or an unrelated individual’s money income) to the poverty threshold. Being in poverty is having income less than 100 percent of the poverty threshold. Low income is income between 100 percent and 199 percent of the poverty threshold (i.e., $10,458 and $20,915 for one person age 65 and over in 2010). Middle income is income between 200 percent and 399 percent of the poverty threshold (i.e., between $20,916 and $41,831 for one person age 65 and over in 2010). High income is income 400 percent or more of the poverty threshold.
Indicator 22: Mammography: Below poverty is defined as having income less than 100 percent of the poverty threshold. Above poverty is grouped into 3 categories: (1) income between 100 percent and 199 percent of the poverty threshold (2) income between 200 percent and 399 percent of the poverty threshold and (3) income equal to or greater than 400 percent of the poverty threshold.
Indicator 32: Sources of Health Insurance: Below poverty is defined as having income less than 100 percent of the poverty threshold. Above poverty is grouped into two categories: (1) income between 100 percent and 199 percent of the poverty threshold and (2) income equal to or greater than 200 percent of the poverty threshold.
Indicator 33: Out-of-Pocket Health Care Expenditures: Two income categories were used to examine out-of-pocket health care expenditures using the Medical Expenditure Panel Survey (MEPS) and MEPS predecessor survey data. The categories were expressed in terms of poverty status (i.e., the ratio of the family’s income to the Federal poverty thresholds for the corresponding year), which controls for the size of the family and the age of the head of the family. The income categories were (1) poor and near poor and (2) other income. The poor and near poor income category includes people in families with income less than 100 percent of the poverty line, including those whose losses exceeded their earnings, resulting in negative income (i.e., the poor), as well as people in families with income from 100 percent to less than 125 percent of the poverty line (i.e., the near poor). The other income category includes people in families with income greater than or equal to 125 percent of the poverty line. See Income, household.
Prescription drugs/medicines: In the Medicare Current Beneficiary Survey (Indicators 30, 31, 34) and in the Medical Expenditure Panel Survey (Indicator 33), prescription drugs are all prescription medications (including refills) except those provided by the doctor or practitioner as samples and those provided in an inpatient setting.
Prevalence: Prevalence is the number of cases of a disease, infected people, or people with some other attribute present during a particular interval of time. It is often expressed as a rate (e.g., the prevalence of diabetes per 1,000 people during a year). See Incidence.
Private supplemental health insurance: See Supplemental health insurance.
Public assistance: Public assistance is money income reported in the Current Population Survey from Supplemental Security Income (payments made to low-income people who are age 65 and over, blind, or disabled) and public assistance or welfare payments, such as Temporary Assistance for Needy Families and General Assistance.
Quintiles: See Income ﬁfths.
Race: See speciﬁc data source descriptions.
Rate: A rate is a measure of some event, disease, or condition in relation to a unit of population, along with some speciﬁcation of time.
Reference population: The reference population is the base population from which a sample is drawn at the time of initial sampling. See Population.
Respondent-assessed health status: In the National Health Interview Survey, respondent-assessed health status is measured by asking the respondent, “Would you say [your/subject name’s] health is excellent, very good, good, fair, or poor?” The respondent answers for all household members including himself or herself.
Retiree Drug Subsidy: The Retiree Drug Subsidy is designed to encourage employers to continue providing retirees with prescription drug benefits. Under the program, employers may receive a subsidy of up to 28 percent of the costs of providing the prescription drug benefit.
Short-term institution: This category in the Medicare Current Beneficiary Survey (Indicators 30 and 34) includes skilled nursing facility stays and other short-term (e.g., sub-acute care) facility stays (e.g., a rehabilitation facility stay). Payments for these services include Medicare and other payment sources. See Skilled nursing facility (Indicator 29), Nursing facility (Indicator 36), and Long-term care facility (Indicators 20, 30, 34, and 37).
Skilled nursing facility stays: Skilled nursing facility stays in the Medicare claims data (Indicator 29) refers to admission to and discharge from a skilled nursing facility, regardless of the length of stay. See Skilled nursing facility (Indicator 29).
Skilled nursing facility: A skilled nursing facility (SNF) as defined by Medicare (Indicator 29) provides short-term skilled nursing care on an inpatient basis, following hospitalization. These facilities provide the most intensive care available outside of inpatient acute hospital care. In the Medicare Current Beneficiary Survey (Indicators 30 and 34) “skilled nursing facilities” are classified as a type of “short-term institution.” See Short-term institution (Indicators 30 and 34), and Long-term care facility (Indicators 20, 30, 34, and 36).
Social Security beneﬁts: Social Security beneﬁts include money income reported in the Current Population Survey from Social Security old-age, disability, and survivors’ beneﬁts.
Standard population: This is a population in which the age and sex composition is known precisely, as a result of a census. A standard population is used as a comparison group in the procedure for standardizing mortality rates.
Supplemental health insurance: Supplemental health insurance is designed to ﬁll gaps in the original Medicare plan coverage by paying some of the amounts that Medicare does not pay for covered services and may pay for certain services not covered by Medicare. Private Medigap is supplemental insurance individuals purchase themselves or through organizations such as AARP or other professional organizations. Employer-or union-sponsored supplemental insurance policies are provided through a Medicare enrollee’s former employer or union. For dual-eligible beneficiaries, Medicaid acts as
a supplemental insurer to Medicare. Some Medicare beneﬁciaries enroll in HMOs and other managed care plans that provide many of the beneﬁts of supplemental insurance, such as low copayments and coverage of services that Medicare does not cover.
TRICARE: TRICARE is the Department of Defense’s regionally managed health care program for active duty and retired members of the uniformed services, their families, and survivors.
TRICARE for Life: TRICARE for Life is TRICARE’s Medicare wraparound coverage (similar to traditional Medigap coverage) for Medicare-eligible uniformed services beneﬁciaries and their eligible family members and survivors.
Veteran: Veterans include those who served on active duty in the Army, Navy, Air Force, Marines, Coast Guard, uniformed Public Health Service, or uniformed National Oceanic and Atmospheric Administration; Reserve Force and National Guard called to Federal active duty; and those disabled while on active duty training. Excluded are those dishonorably discharged and those whose only active duty was for training or State National Guard service.
Veterans’ health care: Health care services provided by the Veterans Health Administration (Indicator 35) includes preventive care, ambulatory diagnosis and treatment, inpatient diagnosis and treatment, and medications and supplies. This includes home- and community-based services (e.g., home health care) and long-term care institutional services (for those eligible to receive these services).