WONCA International Classification Committee

GATEKEEPER

A medical professional who provides primary care for patients and whose referral is necessary for obtaining secondary care paid for by the public or an insurance.

GENERAL POPULATION

Refers to the total population including all persons irrespective of the state of their health. Consists both of the healthy population and the patient population.

GENERAL PRACTITIONER

See FAMILY PHYSICIAN.

GENERAL PRACTICE

A medical specialty which deals with unselected health problems in individuals and families and is the first contact to the medical profession in the health care system.

GENERIC

Used in relation to health outcome it means a general health outcome measure rather than a disease specific.

GLOSSARY

List of technical or special words explaining their meanings.

GOLD STANDARD

This term has two meanings :
1. A term which describes the optimal structure, procedure or outcome of the general prac-titioner's profes-sional work. Often used to indicate what by peers are regarded as good profes-sional standard in general practice. As such it acts as the ruler with which a given structure, procedure or outcome is compared when esti-mating the QUALITY OF CARE.
2. A diagnostic procedure that is considered as conclusive evidence for the presence of a health problem.

GROUNDED THEORY

A theory that is discovered, developed and provisionally verified from data that has been gained systematically and analyzed during the course of research.

GROUP PRACTICE

A practice in which the patient population is cared for by a number of associated/affiliated physi-cians. The principal responsibility for sub-groups of the population may be assigned to one or more physicians, but the group accepts the responsibility for con-tinuity of patient care. In a legal sense, however, the in-dividual physician usually has the ultimate responsibility for each patient.
1. Single-specialty group : A group practice in which all physician members belong to the same speciality.
2. Multi-specialty group : A group practice in which the physician members belong to more than one speciality.

GUIDELINES

In medicine used as advice on procedures from medical authority on health care management.

GUTTMAN SCALE

A cumulative scale in which each item consists of increasingly more severe or extreme items (Can you climb the stairs? Can you walk a km?). In a perfect Guttman Scale, each person's response to items in the scale can be determined from the total scale score.

HANDICAP

A disadvantage for a given individual resul-ting from an impairment or a disability that limits or prevents the fulfilment of a role that is normal (depending on age, sex, and social and cultural factors) for that individu-al.

HAWTHORNE EFFECT

The effect upon the persons being studied (usually positive or beneficial) of simply being under study. This know-ledge can influence the behaviour of the persons under study. This effect can be used in a study design eg. action research. The name derives from work studies car-ried out in the Western Electric Plant, Hawthorne, Il-linois, 1949.

HEALTH

A state of optimal physical, mental, and social well- being and not merely the absence of disease or infirmity (WONCA modified WHO definition which talks about "complete. . . . well-being").

HEALTH BEHAVIOUR

The way the individual combines knowledge, practice and attitudes to influence health. It can be positive, thus preserving or even promoting good health, or negative, causing deterioration in the health of the individual or population.

HEALTH CARE

Assessment, health maintenance, therapy, educa-tion, promotion of health, prevention of health problems, and related ac-tivit-ies, provided by qualified professionals, to improve or maintain health status.

HEALTH CARE EVALUATION

Control of quality,

HEALTH CARE PROCEDURES

Activities directed at, or performed on an individual with the object of improving health or relieving a health problem or injury, or making a diag-nosis. Some kind of method and systematic application is involved.

HEALTH CARE PROVIDER

A qualified person who renders health care services. Besides the primary physician, other health care provi-ders incl-ude qualified graduates (pro-fes-sionals and para-professionals) of disciplines other than medicine, who also render health care. These in-clude, for example, den-tists, pharmacists, physician as-sistants, physiothera-pists, nurse practitioners, graduate nurses, public health nurses, psychologists, and other persons who are involved in health maintenance.

HEALTH CARE SYSTEM

The organisational struc-ture through which health care is provided.

HEALTH CARE TEAM

A group of health care providers, who may represent several disciplines, and ancillary staff, working co-operatively to provide health care.

HEALTH DIMENSION

A theoretical component of health such as physical or mental health.

HEALTH EDUCATION

The process by which patients or groups of people learn how to prevent health problems and preserve or promote health. It can be a personal activity, as when the doctor tells a patient about the relationship between his symptoms and his life-style, and it can be impersonal through television or other media to everybody and not only to the individuals for whom the information is relevant.

HEALTH INDEX

The health of a population expressed by a numerical figure, which can be composed of infant mortality, sickness leave, consumption of medicine, mortality rates, disease frequencies and other health indicators or vital statistical information.

HEALTH INDICATOR

A recorded variable which gives important overall information about the health of a given population. Examples are infant mortality rates, incidence of notifiable diseases, absentee days.

HEALTH OUTCOME MEASURES

Measurement instruments to assess the health status, functioning, well-being, and/or health related quality of life of persons. Most instruments are standardized and validated research tools, but a few can be used in daily practice. HEALTH OUTCOME MEASURES can be generic or disease-specific. Most measures require the assessment by the patient. Examples of generic instruments are : Dartmouth COOP/WONCA charts, the 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). Examples of disease-specific measures are : the Arthritis Impact Measurement Scale (AIMS) and the Functional Living Index : Cancer (FLIC).

HEALTH PROBLEM

See PROBLEM.

HEALTH-RELATED QUALITY OF LIFE

Functional status, perceptions of well-being, and life satisfaction which are related to a person's health.

HEALTH SERVICES

The services which are delivered by health care providers or others under their responsibility, to maintain, promote or restore the health of a patient or the population which is served by the service.

HEALTH SERVICE RESEARCH

The study of all aspects of the health care system in order to understand its influence on need, demand, cost, outcome etc. Analysis is often divided up into :
1. Structure - analysis of resources, facilities, training and manpower.
2. Process - analysis of where, by whom and what is provided.
3. Outcome - analysis of the results for the patients, to what degree they benefit from the intervention.
4. Output - analysis of the number of patients treated as inpatients and as outpatients, number of staff etc.

HEALTH STATISTICS

All data which describe aspects of health in a population.

HEALTH STATUS

The defined well-being of a person in terms of physical, mental, and social condition or function.

HEALTH STATUS INDEX

See HEALTH OUTCOME MEASURES, FUNCTIONAL STATUS INDEX.

HEALTH SURVEY

A survey which provides information about health matters in a popula-tion.

HIERARCHICAL

The characteristic of entities being arranged in a graded series. The ICPC is organised on the basis of three digits, alpha numerical rubrics which are defined by chapter and components. More preci-se-ly defined elements from five digit categor-ies can be lumped together to the three digit level, and elements from a three digit level can be split into a four or five digit level.

HOSPITAL PRACTICE

A practice conducted within the confines of a hospital. The source of patients, method of reimbursement and relationships with ancillary staff are ex-treme-ly vari-able, and should be defined for each specific instance.

HOUSEHOLD

A person or group of persons occupying a dwelling place :
1) one person household, ie a person living alone in a room, a suite of rooms, or a housing unit;
2) a multiper-son household, ie a group of two or more persons who combine to occupy the whole or part of a housing unit. The group may be composed of a family or of unrelated persons, or both. They will normally eat their main meal together.

HYPOTHESIS

An idea based on observation or reflection which predicts certain relations, structures or occurrences. A HYPOTHESIS is a specified construement of reality that should be tested on empirical data to verify or falsify the HYPOTHESIS.