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Max Rady College of Medicine

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You are now viewing entries beginning with the letter D (143 entries)

1.	DA acronym for Dissemination Area (DA)
2.	Daily Peak Bed Occupancy (DPBO) The maximum number of ICU beds simultaneously occupied at any time during that day.
3.	Data Dictionary A data dictionary is a meta-document which identifies and describes the files/tables in a database, including the relationship between these files/tables, as well as the internal structure and content of each. The data dictionary includes a detailed desc...
4.	Data Installation The process of transferring data files and related documentation from an external agency and converting it to a format appropriate for use in the MCHP data repository. This process includes a series of data quality checks and cleaning steps.
5.	Data Management Process Method to acquire and incorporate databases into the Repository housed at MCHP. The six steps are: formulate the request and receive the data, become familiar with the data structure and content, apply the data to SAS®, evaluate th...
6.	Data Preparation The process of preparing an MCHP-installed database for use in a study. This process, like data installation, can require some "cleaning" (beyond that necessary for installation), and/or a series of exclusions typically made for studies using MCHP data.
7.	Data Quality The quality of data is measured according to its reliability and validity; the completeness and accuracy of a data set. It is usually measured by comparing the data set to another data set identified as the "gold standard", and assessing the level of agre...
8.	Data Quality Framework Part of MCHP's formalized process of data quality evaluation for data housed in the Manitoba Population Research Data Repository. The framework, developed by Lix et al. (2012), depicts measures of database- and project-specific data quality. The Data Q...
9.	Data Suppression At MCHP, data are suppressed (not revealed or published) when the number of persons or events involved is five or less in order to avoid potential identification of individuals in an area. Data are not suppressed when the actual event count is zero. This ...
10.	Database An organized set of data optimally accompanied by a data dictionary, usually stored in a computer, that allows easy storage, retrieval, and analysis.
11.	Database Hospitals (DBH) Hospitals included in the WICUDB, specifically the Health Sciences Centre, St. Boniface General Hospital, Seven Oaks General Hospital, Concordia Hospital, Victoria General Hospital, and Grace Hospital.
12.	Database-Specific Quality A type of quality evaluation and a component in the MCHP Data Quality Framework. This component encompasses concepts of accuracy, internal validity, external validity, timeliness, and interpretability, all used to assess the general usability of a databas...
13.	Day Care Procedures See Outpatient Surgical Care.
14.	Day Procedure A "same day" elective surgical procedure where the patient is not admitted to the hospital as an inpatient.
15.	Day Procedure Groups (DPG™) A classification system for ambulatory care provided in hospitals, most commonly surgical procedures that can be performed without the need for an overnight stay. Patients are assigned a code according to the principal or most significant procedure record...
16.	Day Surgery / Outpatient Surgery The number of hospitalizations for day surgery procedures per 1,000 residents in a given year. This includes surgeries and procedures for which patients do not typically stay overnight in the hospital. Since a person could receive multiple surgeries in a ...
17.	Day Surgery Costs Estimated using the Canadian Institute for Health Information (CIHI) Day Procedure Grouper (DPG™) to classify cases and to apply appropriate weights (CIHI 1994). The Day Procedure Group (DPG™) weight is multiplied by the Cost per Weighted Case (CWC)...
18.	Days "Open" to Home Care A Home Care episode defined as length (in days) during a given year that an individual was assessed as needing home care services. Start and end dates are used for this calculation.
19.	Days in a Personal Care Home (PCH) Days in a PCH are the total number of days residing in a PCH. In Martens et al. (2015), the weighted rate of days residing in a PCH per survey respondent aged 70 and older was calculated one, three, five, and 10 years post survey. Instit...
20.	Days in Hospital Days in hospital is defined as the total length of stay of Manitoba residents during all inpatient hospitalizations discharged within a period. Inpatient stays which extended after the cutoff date were truncated to the number of days spent in hospital wi...
21.	Days of Home Care Service Received See Home Care, Days of Service Received glossary term.
22.	Days of Hospital Care The total number of days of hospital care used by all residents of a given region within a specified time period.
23.	Days of Medication Therapy Two estimated average days of medication therapy are available: Number of Defined Daily Doses (DDD) per user-year and Number of Prescribed Daily Doses (PDD) per user-year.
24.	Days Open of Home Care The total number of days an individual receives home care services. Start and end dates of home care use are used for this calculation.
25.	DDD acronym for Defined Daily Dose (DDD)
26.	De-Identified Data See De-Identified Individual Level Information glossary term.
27.	De-identified Individual Level Information "De-identified Individual Level Information means information about an individual that has been modified or from which identifying or potentially identifying information has been removed in a way that minimizes the likelihood that an individual's identity...
28.	Death See Mortality.
29.	Death in Low Mortality Medical CMGs This is the number of in-hospital deaths among patients in medical Case Mix Groups (CMGs)™ with an expected mortality rate of less than 1% based on the CIHI Benchmarking database. Examples of diagnoses within these CMGs include viral meningitis, seizur...
30.	Death in Low Mortality Surgical CMGs This is the number of in-hospital deaths among patients in surgical Case Mix Groups (CMGs)™ with an expected mortality rate of less than 1% based on the CIHI Benchmarking database. Examples of procedures within these CMGs include: ventricular shunt rev...
31.	Death Rates Mortality rates for all causes of death, calculated separately for males and females for all ages.
32.	Death Record See Record of Death.
33.	Decision Tree Analysis (DTA) A statistical approach used to understand how several variables interact to place people or objects into pre-defined groups. Output from DTA is typically presented as a decision tree. At each branch of this tree an outcome is provided (i.e., based on a co...
34.	Deep Vein Thrombosis (DVT) A deep vein thrombosis is a blood clot (thrombus) that develops in a deep vein, usually in the leg. This can happen if the vein is damaged or if the flow of blood slows down or stops. DVTs can occur if a patient experiences prolonged bed-rest or surgery w...
35.	Defined Daily Dose (DDD) One of four measures of intensity of pharmaceutical use, defined daily dose (DDD) is the assumed average maintenance dose per day for a drug product when used for its major indication in everyday practice. It standardizes the measurement of drug utilizati...
36.	Delayed Childbearing Women aged 35 and older giving birth for the first time.
37.	Dementia Dementia is a group of illnesses that involve memory, behavior, learning, and communication problems. The problems are progressive, which means they get worse overtime (Fransoo et al., 2013). For more information see: National Institute of ...
38.	Dementia Prevalence The percent of residents aged 55 and older with dementia, including organic psychotic conditions, cerebral degenerations, and senility, over two 5-year periods. See the Dementia concept for the operational defi...
39.	Demographic Data Personal characteristics of members of a population or study sample, including age and gender.
40.	Demographic Profile One of 6 major categories of the Health Status Indicators, dividing the population of Manitoba by age.
41.	Demographic Projections Forecast trends in population characteristics for possible implications on public policy. Three characteristics include: percent of population that are registered Indians, the percent of the population over 65, and median age.
42.	Demographic Series A set of demographic indicators that identify the proportion of each province's population that falls within specific groups known to have high health care needs, including: percentage of population over 65, Registered Indians, median age (actual and proj...
43.	Demographics See Demographic Data.
44.	Denominator at Risk The denominator at risk for a given indicator is the number of patients in hospital who actually have a low probability of complications or of experiencing an event where patient safety may have been compromised. Patients who are at greater risk for compl...
45.	Dental Extraction The removal of a tooth from the mouth. Severe tooth decay is the most common reason for dental extractions. In MCHP research, this is limited to procedures taking place in a hospital and is measured only for children under the age of six (0-5 years old)...
46.	Dental Extractions Among Young Children The number of dental extractions performed on residents aged 0 to 5 per 1,000 residents aged 0 to 5 years. Please see the Dental Extraction glossary term for more information, including the ICD and CCI...
47.	Dental Surgeries Dental surgeries were identified using Hospital Abstracts or Medical Services data sources. Note: the hospital abstract must indicate that the patient received general anesthesia or a dental anesthesia claim must have been made during the hospital ...
48.	Dependency Assessment Supplement (DAS) A standardized tool used in Manitoba that identifies PCH residents as having one of four levels of care.
49.	Depression Depression is a mood disorder characterized by persistent feelings of sadness, despair, and discouragement. It is closely associated with a lack of confidence and self-esteem, an inability to express strong feelings. These feelings interfere with daily l...
50.	Dermatologist A physician that deals with the diagnosis and treatment of skin diseases (Miller, 2003).
51.	Descriptive Analyses Descriptive statistics are procedures for summarizing, organizing, graphing, and, in general, describing quantitative information. Often contrasted with inferential statistics, which is used to make inferences about a population based on information about...
52.	Determination of Mortality Causes of death were determined from provincial vital statistics that use death certificates (also known as the Medical Certificate of Death). The "main cause of death" is used in rate calculations. Only one "cause" can be given, even with persons with mu...
53.	Determination of Rates The statistical rates used to measure the Health Status Indicators: crude mortality rate, crude hospitalization rate, crude physician visit rate, age-specific mortality rate, indirect adjusted rate, standardized mortality / morbidity ratio (SMR) - provinc...
54.	DI acronym for Diagnostic Imaging (DI)
55.	Diabetes / Diabetes Mellitus A chronic condition in which the pancreas no longer produces enough insulin (Type I Diabetes) or when cells stop responding to the insulin that is produced (Type II Diabetes), so that glucose in the blood cannot be absorbed into the cells of the body. The...
56.	Diabetes Care: Prevalence of Annual Eye Exams Individuals with diabetes are at a greater risk of damage to the retina than the general population. In the later stages of diabetes, individuals may develop diabetic retinopathy (non-inflammatory damage to the retina), which causes the swelling of blood ...
57.	Diabetes Education Resource for Children and Adolescents (DER-CA) Data The Diabetes Education Resource for Children and Adolescents (DER-CA) data contains information on children diagnosed with either youth onset Type 1 Diabetes (T1DM) or Type 2 Diabetes (T2DM) diabetes in Manitoba who are referred to the DER-CA program. ...
58.	Diabetes Incidence The average number of new cases of residents aged 19 and older with diabetes (Type I and II) per 100 person-years. See the Diabetes - Measuring Prevalence concept for more information on the operational defin...
59.	Diabetes Mortality This indicator measures the crude and adjusted mortality rate for residents age 19 and older with and without diabetes. Individuals were categorized as with or without diabetes in a three-fiscal-year period, and their mortality rate was calculated in the ...
60.	Diabetes Prevalence For more informatio, see: Diabetes Treatment Prevalence glossary term; Diabetes - Measuring Prevalence concept.
61.	Diabetes Treatment Prevalence The number of individuals with at least two physician visits or one hospitalization with a diabetes diagnosis (ICD-9-CM = 250; ICD-10-CA = E10 - E14) within a three-year period. Other research has defined this differently using medications and laborato...
62.	Diagnosis Identification of a patient's illness or disease, often coded using a standardized classification system, such as ICD-9-CM or DSM-IV (for mental health disorders). For each patient discharged from hospital, there can be several diagnoses reported, includi...
63.	Diagnosis Related Group (DRG™) An American case-mix classification system that groups together patients who are similar clinically in terms of diagnosis and treatment, and in their consumption of hospital resources, thus allowing comparisons of resource use across hospitals with varyin...
64.	Diagnosis Related Groups (DRG™) Weights Defines the relative weight for each different DRG when determining resource consumption, in relation to an arbitrarily defined standard case.
65.	Diagnostic and Statistical Manual of Mental Disorders (DSM) This manual, published by the American Psychiatric Association, provides a standard classification of all mental health disorders to aid in their diagnosis and treatment. It consists of three major components: the diagnostic classification, the diagnostic...
66.	Diagnostic Imaging (DI) Describes the various modalities (such as x-rays, ultrasounds, MRIs, and angiograms) that are used to form the foundation of the diagnosis of many conditions.
67.	Diagnostic Quality Indicators (QIs) Diagnostic QIs were assessed by counting how frequently select ICD-9-CM diagnostic codes appeared in the administrative healthcare data during an ambulatory care physician visits and/or a hospital admission. The six Diagnostic QIs include: hip fractures, ...
68.	Diagnostic Services Manitoba (DSM) Diagnostic Services Manitoba (DSM) is the organization that used to provide public sector laboratory testing and diagnostic health care services to Manitobans. The services provided by Diagnostics Services Manitoba (DSM) are now provided by
69.	Dialysis A treatment for people in the end stage of chronic renal insufficiency (kidney failure). This treatment cleans the blood and removes wastes and excess water from the body. See the Renal Failure concept for more...
70.	Dialysis Initiation Dialysis initiation was identified and defined by the occurrence of one or more physician visits with one of several physician tariff codes related to dialysis treatment. See the Renal Failure concept for a list ...
71.	Different Drugs / Medications A "different" drug / medication is defined at the 4th level of the Anatomical Therapeutic Chemical (ATC) classification system to denote the chemical / therapeutic / pharmacological subgroup not the drug molecule.
72.	Differential Susceptibility Hypothesis The theory, posited by Jay Belsky, that "individuals vary in the degree they are affected by experiences or qualities of the environment they are exposed to. Some individuals are more susceptible to such influences than others - not only to negative but ...
73.	Diffusion research The study of the factors necessary for successful adoption and implementation by additional stakeholders and the targeted population of an evidence-based intervention that has been successfully implemented in some sites, resulting in widespread use.
74.	DIN acronym for Drug Identification Number (DIN)
75.	Dino-Clusters See Expanded DIagNOsis Clusters (EDC).
76.	Diphtheria (D or d) An acute, infectious disease often characterized by fever, sore throat, and difficulty breathing, which is caused by the bacterium Corynebacterium diphtheriae .
77.	Direct Costs of Inpatient Care Those costs that can be identified as being directly attributable to inpatient services. Examples would include nursing services, drugs and other medical supplies. Direct costs exclude those costs that are shared by all hospital users, for example, inform...
78.	Direct Services Services performed by home care staff in the client's home.
79.	Direct Standardization of Rates The specific rates in a study population are averaged, using as weights the distribution of a specified standard population. The directly standardized rate represents what the crude rate would have been in the study population if that population had the s...
80.	Directly Managed Housing Subsidized housing properties that are owned and managed by Manitoba Housing and Community Development (Manitoba Housing).
81.	Disability Any restriction or lack of ability (resulting from an impairment) to perform an activity in the manner or within the range considered normal for a human being (World Health Organization, 1980). The impairment may be physical, sensory or mental and may be ...
82.	Disability Among Youth A set of disabling medical conditions derived from the World Health Organization, which, when diagnosed in youths 0-24 years of age, disadvantaged since birth and not treated with modern techniques, frequently result in early death. The list includes: cer...
83.	Disability Status Classified into four categories in Manitoba Family Services income assistance records: mental health, mental retardation, physical disability, and other disability.
84.	Discharge See Separation(s).
85.	Discharge Abstract Database (DAD) A data file maintained by Canadian Institute for Health Information (CIHI) containing information about almost every case that is discharged from an acute care hospital in Canada. CIHI uses these data to assign individual cases to case mix groups (CMGs
86.	Discharge Abstracts See Hospital Abstracts Data.
87.	Discharge Diagnosis The first diagnosis, considered the most important reason contributing to the hospital stay.
88.	Discharge Efficiency A key hospital performance indicator that reflects the degree to which hospitals meet general targets for the timely discharge of patients. This measure takes into account the types of patients treated (e.g. age, gender, Treaty Status) and length of stay ...
89.	Discharge Outcomes An event used to describe the outcome of hospital discharge (see Separation(s)), including: 1). discharge home; 2). discharge to nursing home (see Personal Care Home (PCH)); 3). died in hospital; or 4). transfer to other institution (acute or chronic care...
90.	Discharge Screens An InterQual criteria that prevents the patient from being discharged from an acute care setting before they are clinically stable.
91.	Discrete Medical Condition The definition for Extended Disease Cluster (EDC) in the Johns Hopkins Adjusted Clinical Group® (ACG®) classification system was applied to group diagnosis codes that represented discrete clinical conditions or problems, for example hypertension, ...
92.	Discretionary Care See Discretionary Nature of Services.
93.	Discretionary Diagnosis Classification of all three-digit ICD codes into one of 3 categories (low, medium, or high), based on the extent to which there was room for physician discretion in the decision to hospitalize.
94.	Discretionary Nature of Services Recognition that some services are discretionary in nature, and as such, cause variation among rates of admission to hospital in different regions. Three categories for inpatient hospital care are defined: high variation medical conditions, surgical condi...
95.	Discretionary Procedures "Those that may nor be necessary at all, those for which there is no general agreement about indications (e.g. hysterectomy for non-malignant conditions of the uterus), and those for which alternative, non-surgical treatment options are available (e.g. va...
96.	Disparity Rate Difference (DRD) Disparity Rate Difference (DRD) is one measure of a socioeconomic gap, subtracting the rate of the lowest neighbourhood income group from the rate of the highest neighbourhood income group (i.e., R1 minus R5 or U1 minus U5). This is sometimes referred to ...
97.	Disparity Rate Ratio (DRR) Disparity Rate Ratio (DRR) is one measure of a socioeconomic gap, dividing the rate of the lowest neighbourhood income group by the rate of the highest neighbourhood income group (i.e., R1/R5 or U1/U5). This is sometimes referred to in the text as the "ra...
98.	Dispensed Medications The act of providing a patient with a supply of medications, usually by a pharmacist. To be differentiated from medications that are prescribed by physicians. Drug information available at the Manitoba Centre for Health Policy (MCHP) assesses medications...
99.	Dispensing Fees The total fees charged on a per prescription basis by pharmacists for prescriptions dispensed.
100.	Disposition Status The status of the patient recorded at the conclusion of an Emergency Department (ED) or Urgent Care (UC) facility visit. Disposition status options included in this report are: discharged home, expired, admitted to an inpatient bed, ...
101.	Disproportion See Cephalopelvic Disproportion (CPD) glossary term.
102.	Dissemination Area (DA) "A dissemination area (DA) is a small, relatively stable geographic unit composed of one or more adjacent dissemination blocks with an average population of 400 to 700 persons based on data from the previous Census of Population Program. It is the small...
103.	Dissemination research The study of how the targeted distribution of information and intervention materials to a specific audience can be successfully executed so that increased spread of this knowledge achieves greater use and has increased impact.
104.	Distance to a Major Hospital All individuals are classified as either living near to or remote from a major urban or rural hospital according to an established postal code assignment method.
105.	Distance to Hospital A method to determine the distance to a hospital, based on postal code, hospital number, and municipal code.
106.	Districts See Regional Health Authority (RHA) Districts glossary term.
107.	Diverticulosis Diverticulosis is a condition diagnosed by the presence of diverticula (small pouches that bulge outward through the colon or large intestine). For more information, see MedlinePlus® - ...
108.	Division scolaire franco-manitobaine (DSFM) The school division in Manitoba that is responsible for French-language schools since 1994. French immersion schools are not included in the DSFM (See French-Immersion (FL2) School Program).
109.	Divorce The marital status variable in the Manitoba Health Insurance Registry Data contains marital status information that parents have voluntarily reported to Manitoba Health. For more information, please read t...
110.	Dosage Form The dosage form in which the product (DIN) is administered (e.g. tablet, liquid. suppository, solution). A product (brand) name can have more than one dosage form; each dosage form with have its own DIN. There are two sources currently available for ident...
111.	Dose Intensity Dose intensity, measured using Defined Daily Dose (DDD) and Prescribed Daily Dose (PDD), can be used in several ways, the primary one being to describe the population's use of pharmaceuticals. The PDD is a measure of the average daily amount of a drug tha...
112.	Double Counting A procedure recorded as being done on the same person, on the same date or within a 3 day period, at two different hospitals. The patient was likely transferred to another hospital to have the procedure performed.
113.	Down Syndrome A genetic disorder characterized by mental retardation and other physical defects resulting from the presence of an extra copy of chromosome number 21.
114.	Downsizing Relates to cutbacks in hospital funding and bed closures within acute care hospitals.
115.	DPD acronym for Drug Product Database (DPD)
116.	DPG™ acronym for Day Procedure Group (DPG™)
117.	DPIN acronym for Drug Program Information Network (DPIN)
118.	DRG Weights acronym for Diagnosis Related Group (DRG)™ Weights
119.	DRG™ acronym for Diagnosis Related Group (DRG)™
120.	Drop Out see School Withdrawal.
121.	Drug Benefits Management Drug benefits managers in Canada use Prescribing Protocols, Special Authority Policies, and Reference Based Pricing Policies in an attempt to manage choices among therapeutically similar but chemically distinct products.
122.	Drug Classification Systems Two systems used to classify or group drugs include: 1) the American Hospital Formulary Service (AHFS) Pharmacologic-Therapeutic Classification System and 2) the Anatomical Therapeutic Chemical (ATC) Classification System. The AHFS system is more commonly...
123.	Drug Costs / Expenditures see Expenditures for Pharmaceuticals.
124.	Drug Data Support Files This drug-based file, updated annually, was created at MCHP to enable creation of DIN lists over time from a given set of drug names or ATC classes. Value-added pieces include carrier listings specific to the Province of Manitoba for active and discontinu...
125.	Drug Efficacy The benefit a drug brings when it is taken in the context of a clinical trial or an ideal setting. This is in contrast to the effectiveness known as the benefit from a drug that the population receives when the drug is prescribed, dispensed and taken unde...
126.	Drug Identification Number (DIN) An eight digit number, assigned by the Therapeutic Products Directorate of Health Canada, to each drug approved for use in Canada in accordance with the Food and Drug Regulation. The same drug (e.g. Amoxicillin, 250 mg capsules) can have several different...
127.	Drug Identification Number (DIN) Master File Contains a list of all Drug Identification Numbers (DINs), one record per DIN, prepared annually by Manitoba Health as part of the Drug Program Information Network (DPIN) system. Consisting of approximately 700,000 records, this list includes DINs from ca...
128.	Drug Interaction A drug interaction is defined as the modification of the effects of 1 drug by the prior or concomitant administration of another.
129.	Drug Product A finished dosage form (tablet, capsule, etc, …) unique to the level of active ingredient, dosage form, strength and supplier type.
130.	Drug Product Database (DPD) The Drug Product Database (DPD) contains product specific information on drugs approved for use in Canada. It is available on the Health Canada Internet Website in the form of several data sets, which combined, form the DPD.
131.	Drug Program Information Network (DPIN) DPIN is an electronic, on-line, point-of-sale drug system. It links all community pharmacies (but not pharmacies in hospitals or nursing homes/personal care homes) and captures information about all Manitoba residents, including most prescriptions dispens...
132.	Drug Program Information Network (DPIN) Data An electronic, on-line, point-of-sale prescription drug database that connects Manitoba Health and pharmacies in Manitoba. The DPIN system generates complete drug profiles for each client including all transactions at the point of distribution. Informatio...
133.	Drug Reimbursement Policies The mechanisms used to reimburse pharmacies for products dispensed. Two commonly used drug reimbursement policies include: Maximum Allowable Cost pricing and Actual Acquisition Cost. These policies differ across provinces.
134.	Drug Therapy Prescribing pharmaceuticals to a patient as a means to regulate or improve their condition.
135.	Drug Use See Pharmaceutical Use.
136.	Drug Utilization Indicator A measure of how the population uses a drug (pharmaceutical). Examples of indicators include: access (the proportion of residents who are dispensed at least one prescription per year; such residents are called "pharmaceutical users"), intensity of use (to...
137.	Drug Utilization Review (DUR) Historically, DUR is a structured, ongoing organizationally authorized quality assurance process designed to ensure that drugs are used appropriately, safely and effectively.
138.	DSM The DSM acronym has multiple meanings, either: Diagnostic and Statistical Manual of Mental Disorders (DSM); OR Diagnostic Services Manitoba (DS...
139.	Dummy Claims See Shadow Billing
140.	Dummy Variables A dichotomous variable constructed from an originally qualitative (or quantitative) variable. The number of dichotomous variables one needs equals G-1, where G is the number of original categories.
141.	Duplicate Records Records that are duplicated on most of the commonly used variables in the hospital discharge abstracts data. A record can still be a duplicate, despite some slight differences in variable values. This is especially true if hospital record number is coded ...
142.	Duration of (Pharmaceutical) Use Is the total exposure (usually measured in days) to medication, requiring the need to know not only when a drug is started but also how long a person is exposed to the drug.
143.	DVT acronym for Deep Vein Thrombosis (DVT)

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