Case Management Glossary

Active care -

Modes of treatment/care requiring "active" involvement, participation, and responsibility on the part of the patient in recovery and rehabilitation.

Acute -

Describes a condition which arose during a period of 3 weeks prior to the patient seeking treatment.

Assessment -

An examination performed with the intent of arriving at a qualitative or quantitative description of a patient's condition. The terms includes any evaluation procedure performed for the purpose of obtaining information regarding the patient's state or condition. Disease (condition specific) assessments are outcome procedures that run the gamut from physiological tests to questionnaires. They are designed to elicit information about the specific signs and symptoms and other clinical characteristics of diseases or conditions. Condition specific assessments are usually more limited in scope than general health assessments. General health assessments are usually questionnaires completed by patients and scored for a number of attributes deemed important to the overall concept of health; i.e., decreased pain, improved mobility, improved psychological status.

Chronic -

Describes a condition which arose more than three months prior to the patient seeking treatment.

Complicated case -

A case where the patient, because of one or more identifiable factors, exhibits regression or delayed recovery in comparison with expectations from the natural history.

Diagnosis -

I) The art and science of determining the nature and cause of a disease and differentiating among the diseases and illnesses. The process of determining health status and the factors responsible for producing it.

II) A decision regarding the nature of the patient's complaint; the art or act of identifying a disease or condition from its signs and symptoms.

III) The formal statement concerning the identification of the patient's condition.

Disability -

Inability to engage in any substantial gainful activity by reason of any determinable physical or mental impairment.

Duration of Care -

The length of the treatment schedule (in days, weeks, or months) required to either correct the patient's condition or to achieve maximum medical improvement.

Efficacy -

The degree of the benefit of treatment when compared to the risk. It is based on subjective and objective evaluations of both the relief of pain and return to function, and the time and effort to achieve them.

Elective Care -

Treatment/care that is discretionary and at the option of the patient who wishes to promote or maintain optimum function with preventative/ maintenance care.

Frequency of Care -

The number of times a patient is treated over a given period and the interval between treatments.

Impairment -

The loss, loss of use or derangement of any body part, system, or function. Permanent impairment is impairment that has become static or well-stabilized with or without treatment and is not likely to remit despite treatment.

Maximum Medical Recovery/Treatment -

The return to pre-injury/illness status or the minimum level of symptomatology or disability attainable on a given treatment/care approach. It may also be referred to as Maximum Therapeutic Benefit or Maximum Chiropractic Improvement.

Natural History -

The anticipated clinical course of recovery for uncomplicated disorders without therapeutic intervention.

Passive Care -

The application of treatment/care procedures by the caregiver to a patient who has little or no involvement in bringing about recovery and rehabilitation.

Physician/Patient Dependence -

A dysfunctional relationship where the patient's needs exceed the limits of a professional relationship. There is a loss of balance within the relationship, and the patient becomes overly reliant/dependent on the doctor for a myriad of needs and voids in his/her life.

Preventative/Maintenance Care -

Elective care given at regular intervals designed to maintain maximum health and promote optimal function. It may incorporate screening procedures designed to identify developing risk problems pertaining to the patient's health status and give advice on same.

Reasonable -

Not extreme or excessive.

Reliability -

The ability of an outcome procedure to consistently give the same value upon repeated measurements of the same phenomenon. Reliability depends both upon accuracy and precision which may be adjusted separately for some instruments. Reliability must be established in order to ensure that variation in an outcome assessment over time reflects a true change rather than measurement error.

Restorative/Corrective Care -

Treatment beyond acute care that serves to restore a measure of health.

Sincerity of Effort -

A patient's efforts to a test that is genuine and free from feigning or embellishment.

Sub-acute -

Describes a condition that arose more than three weeks and less than three months from the patient seeking treatment.

Supportive Care -

Necessary treatment/care for patients who have reached maximum therapeutic benefit, and for whom periodic trials of withdrawal have led to deterioration and failure to sustain previous therapeutic gains. This form of care is initiated when the clinical problem recurs.

Therapeutic Necessity -

Therapeutic necessity exists when planned treatment/ care is likely to produce benefit in the management of a patient with a disorder evidenced by recognized signs and symptoms.

Treatment Plan -

That element of case management in which a health care regimen appropriate to the diagnosis or clinical impression is identified and initiated.

Uncomplicated Case -

A case where the patient exhibits progressive recovery from an illness or injury at a rate greater than, or equal to, the expectation from the natural history.

Validity -

The property of information derived from a test or measurement that assures that it represents the intended function or structure. The extent to which a measurement method measures what it is intended to do.

Vertebral Subluxation Complex -

A term used to describe an alteration in normal spinal function. It is characterized by a complex interaction of kinesiopathological, neuropathophysiological, histopathological and biomechanical changes in the spinal joints and their associated structures.

The chiropractic adjustmentAdjustment/Manipulation or manipulation is a specific form of direct articular manipulation using either long or short leverage techniques with specific contacts and is characterized by a dynamic thrust of controlled velocity, amplitude and direction.

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