N

WICC

WONCA International Classification Committee


N Bentzen (ed)

WONCA international glossary for general/family practice
Fam. Pract. 1995 12: 267


A, B, C, D, E-F, G-H, I-J-L, M-N, O-P, Q-R, S-T, U-Z

 

E & F

 

Term

Text

EFFECTIVENESS

A measure of the success in achieving a clearly stated health objective in relation to a patient or a defined population.

EFFICACY

The extent to which a specific intervention, procedu-re, regimen or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control-led trial.

EFFICIENCY

The effects or end-results achieved in relation to the effort expended in terms of money, resources and/or time.

EMPIRICAL

Knowledge based on evidence from clinical observation or the result of an experiment.

EMPIRICAL STANDARDS

Those derived from statistical averages obtained from similar settings.

EMERGENCY CALL SERVICE

A service which provides urgent medical care out of hours for patients whose primary physician is off duty or absent from his practice.

ENABLING FACTORS

Circumstances affecting the nature of a me-dical problem and its meaning for the patient, which enhances the presentation of the problem.

ENCOUNTER

Any professional interchange between a patient and one or more members of a health care team. One or more problems or diagnoses may be identified at each encoun-ter. Analyses of en-counter data should distinguish en-counters from pro-blems.
1. Direct encounter : An en-counter in which there is face to face meeting of patient and pro-fes-sional. This can be further divided into :
1. 1. Office encounter : (surgery encounter, consultation) A direct encounter in the health care provider's office or surgery.
1. 2. Home encounter : (house call, home visit) A direct encounter occurring at the patient's resi-dence (this includes home or a friend's home where a patient is visiting, hotel, room, etc. )
1. 3. Hospital encounter : a direct encounter in the hospital setting. One encounter is counted for each patient visit. Hospital encounters are further subdivided :
1. 4. Inpatient encounter - a direct encounter with a patient admitted to the hospital.
1. 5. Outpatient encounter - a direct encounter with a patient not admitted to the hospital, either in the emer-gency room or in the out-patient clinic.
2. Indirect encounter : an encounter in which there is no physical or face to face meeting between the patient and the health care professional. These encounters may be subdivided by the mode of communication, eg tele-phone, letter or through a third party.

ENCOUNTER RATES

Encounter rates may be tabula-ted using various numerators and denominators and it is important to define clearly the content of each. Thus, for numerators, direct encounters must be distinguished from indirect and first encounters from repeat encounters. For denominators, the met-hods used to define the practice popula-tion should be specifi-ed.

ENDEMIC

PROBLEM The constant presence of a health problem within a given area or population group, ie the prevalence of a problem.

ENVIRONMENT

All external conditions which can influence the health status of the individual or the population. It is sub-divided into physical, social, cul-tural, natural, artificial etc.

EPIDEMIC

An outbreak of a disease that affects many people, the number of cases increasing rapidly over a certain period of time (day, week, month or year) and spreading from place to place. When it occurs worldwide, it is referred to as a PANDEMIC, eg AIDS.

EPISODE

'An episode of care', as used in ICPC, is the period from the first presentation of a health problem or illness to a health care pro-vider until the completion of the last encounter for that same health problem or illness. A new episode begins with the first encounter for the initial occurrence of an illness or recurrence of an illness following a disease-free inter-val.
From the patient's point of view an episode extends from the onset of symptoms to their complete resolution.
It can be subdivided according to its course over time :
1. Acute : (short-term) an episode of care with a duration of four weeks or less.
2. Subacute : an episode of care with a dura-tion of between four weeks and six months.
3. Chronic : (long-term) an episode lasting six months or more.

EPISODIC CARE

Health care confined to the management of presenting problems.

EPISODE OF CARE

Includes all encounters for the management of a specific health problem.

ERROR

A false or mistaken result obtained in a study, for example, due to bias. The error can be :
1. Random error is the portion of variation in a measure-ment that has no apparent connection to any other measurement or variable, generally regarded as due to chance.
2. Systematic error often has a recognizable source, eg a faulty measuring instrument or pattern, eg it is consistently wrong in a particular direction.

ERROR, TYPE I

The error of rejecting a true null hypothesis.

ERROR, TYPE II

The error of failing to reject a false null hypothesis.

ESTABLISHED

Proven or placed beyond dispute.

ESTIMATE

A statement referring to a measurement that is believed to be approximate rather than exact.

ETIOLOGY

See AETIOLOGY.

EXAMINATION, CLINICAL

This may be unique to each coun-try or cultural group.
1. Complete : The term `complete examination` refers to the examination which contains those elements of pro-fessional assessment, which, by consensus of a group of local doctors, reflects the `usual standard of care`.
2. Partial : The term `partial examina-tion` refers to the ex-amina-tion of a specific organ, system or function or to a general examination, which is limited and in-complete.

EXCLUSIVE

Quality requested for a definition in order to avoid confusion with another one.

EXHAUSTIVE

Quality requested for a classification in order to be able to accept all the terms useful to reach its pur-pose.

EXPECTATION OF LIFE

The average number of years a given person is expected to live, given the mortali-ty rate stays unchanged. Life expectancy is a hypothetical measure which gives information about the health status of a population at a given time.

EXPERIMENT

A controlled study, where the investigator changes one or more conditions and records the effect.

EXPERIMENTAL STUDY

A study where all the conditions can be controlled by the investigator. In general practice it often refers to a study where certain environmental factors are changed, and the effect on the patients is mea-sured.

EXPERT SYSTEMS

A computer program that uses expert knowledge to attain high levels of performance in a problem area. For medicine this program should be symbolically encoded concepts derived from experts in the field of health care.

EXPLANATORY STUDY

A study which tries to explain, rather than just describe, certain aspects of health behaviour, di-sease pattern or human interaction. The research is often referred to as QUALITATIVE as opposed to QUANTITATIVE. The research method uses the interview as a method of retrieving the necessary infor-mation.

EXTERNAL AUDIT

Assessments of performance carried out by persons or authorities not personally involved in the activity under review.

EXTRAPOLATE

Predict a value of a variable outside the range of observed variables.

FALSE NEGATIVE

A negative test result in a person who has a condition which the test is designed to detect. The person is thus mistakenly labelled as unaffected, when in fact he/she is unaffected.

FALSE POSITIVE

A positive test result in a person who does not have a condition which the test is designed to detect. Thus the person is mistakenly labelled as having the condition when he/she is ac-tually unaffec-ted.

FAMILY

A group of individuals related to a person by blood, legal agreement, and/or social obligation.

FAMILY DOCTOR

See FAMILY PHYSICIAN.

FAMILY, EXTENDED

A family group consisting of members beyond the nuclear family.

FAMILY, NUCLEAR

A family of one or at the most two generations, usually husband, wife and children, united through blood, marriage, adoption or equivalent ties.

FAMILY PHYSICIAN

A physician who pro-vides and coordinates personal, primary, and conti-nuing compre-hensive health care to individuals and fami-lies. He/she provides care for both sexes of all ages, for physical, be-havioural, and social problems.

FATALITY RATE

The number of deaths from a health problem recorded dur-ing a defined period, divided by the total number of cases with that health problem during the same period (incidence). This is usually ex-pressed as the rate per 100 cases per year.

FEASIBILITY STUDY

A preliminary study to deter-mine the practicability of the study or health programme, before the actual study or health programme is started.

FEE FOR SERVICE

A fee for each ser-vice or patient encounter provided. Reimbursement may be from the patient and/or a third party.

FOLLOW-UP

Regular observation of the health status or health re-la-ted characteristics of an individual or a group, for whom the doctor has continuing responsibility. It may also be used in relation to patients who have been en-rolled in a study.

FOLLOW-UP ENCOUNTER

An encounter between patient and physician in which an episode previously initiated, is followed up.

FOLLOW-UP STUDY

A study in which an individual or group is followed over time to see what effect a certain intervention has on their health status.

FREQUENCY DISTRIBUTION

The number of respondents who score at each level of a scale. The distribution can be presented cumulative or categorical, in numbers per category or graphical. A distribution can be normal or skewed.

FUNCTION

A quality, trait or fact that is so related to another as to be dependent upon and to vary with this other.

FUNCTIONING

The ability of individuals to perform their normal or usual behaviours and activities which can be observed.

FUNCTIONAL INDEX

A numerical indication of a specific function of a given population derived from a specifi-ed compo-site formula.

FUNCTIONAL INDICATOR

A variable, suscep-tible to direct measurement, which reflects the level of function of persons in a community (these measures may be used as components in the calculation of a function index).

FUNCTIONAL STATUS

The ability of a person to perform and adapt to his/her environment, measured both objectively and subjec-tively over a stated period of time.

FUNCTIONAL STATUS INDEX

A mea-sure designed to describe the level of function of members of a population, which assesses physi-cal function, emotional well-be-ing, social function, activities of daily living, feelings, etc. Examples are the Dartmouth COOP Functional Health Assessment Charts (COOP) which have been developed into the Dartmouth COOP/WONCA Charts (COOP/WONCA), Duke-UNC Health Profile (DUHP), the Duke Health Profile (DUKE), the Nottingham Health Profile (NHP), the Sickness Impact Profile (SIP), and the SF-36 Health Survey (SF-36).


 

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