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edited by AIFA’s Office of Osmed and HTA

Glossary

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OCCUPANCY RATE
A measure of in-patient health facility use, determined by dividing available bed days by patient days. It measures the average percentage of a hospital's beds occupied and may be institution-wide or specific for one department or service.
OFF-LABEL PRESCRIBING
When a medicine or medical device is prescribed outside its licensed indication, to treat a condition or disease for which it is not specifically authorised. [Source: adapted from NICE Glossary]
OFF-PATENT MEDICINE
A medicine is off-patent once the right of making, using and selling an invention protected by a grant for a set period of time expires
OFFICINAL FORMULA
Any medicinal product which is prepared in a pharmacy in accordance with the prescriptions of a pharmacopoeia and is intended to be supplied directly to the patients served by the pharmacy in question. [Source: Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001 on the Community code relating to medicinal products for human use]
ON-PATENT MEDICINE
A branded medicine protected by a grant for a set period of time allowing the manufacturer the sole right to make, use and sell that medicine
ONLY IN RESEARCH (OIR)
Coverage conditional on individual participation in research (i.e. only patients participating in the scientific study are covered). [Source: Carlson JJ , Sullivan SD, Garrison LP, Neumann PJ, Veenstra DL. Linking payment to health outcomes: A taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers. Health Policy. 2010 Aug. 96(3):179-90.] See also: managed entry agreements
ONLY WITH RESEARCH
Coverage conditional on a scheme to conduct a study that informs the use of the medical product in the payer patient population. [Source: Carlson JJ , Sullivan SD, Garrison LP, Neumann PJ, Veenstra DL. Linking payment to health outcomes: A taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers. Health Policy. 2010 Aug. 96(3):179-90.] See also: managed entry agreements
ORDER
Statement in the patient’s permanent medical record describing actions, including medication administration, that an authorised individual wish to be undertaken during a hospital visit. [Source: Global Conference on the Future of Hospital Pharmacy]
ORDER ENTRY
Process by which a medication order is reviewed and processed in preparation for dispensing; may include manual or electronic processes. [Source: Global Conference on the Future of Hospital Pharmacy]
ORIGINAL PRODUCT (ORIGINATOR)
The first version of a medicine, developed and patented by an originator pharmaceutical company which has exclusive rights to marketing the product in the European Union for 15 years. A original product has a unique trade name for marketing purposes, its socalled brand name. [Source: PPRI Glossary]
ORPHAN MEDICINE
A product that it is intended for the diagnosis, prevention or treatment of a life-threatening or chronically debilitating condition affecting not more than five in 10 thousand persons in the European Community, or that it is intended for the diagnosis, prevention or treatment of a life-threatening, seriously debilitating or serious and chronic condition in the Community and that without incentives it is unlikely that the marketing of the product in the Community would generate sufficient return to justify the necessary investment and that there exists no satisfactory method of diagnosis, prevention or treatment of the condition in question that has been authorised in the Community or, if such method exists, that the product will be of significant benefit to those affected by that condition. [Source: Regulation (EC) No 141/2000 of the European Parliament and of the Council of 16 December 1999 on orphan medicinal products]
OUT-OF POCKET MAXIMUM (ANNUAL CEILING)
The maximum amount (e.g. a certain percentage of income) that an insured person has to pay for all covered health care services for a defined period (often a year). [Source: PPRI Glossary]
OUT-OF POCKET PAYMENTS (OPP) (1)
Payments made by a health care consumer that are not reimbursed by a third party payer. They include cost-sharing and informal payments to health care providers. Cost-sharing: a provision of health insurance or third party payment that requires the individual who is covered to pay part of the cost of health care received. This is distinct from the payment of a health insurance premium, contribution or tax which is paid whether health care is received or not. Cost-sharing can be in the form of deductibles, co-insurance or co-payments: Deductibles: Amounts required to be paid by the insured under a health insurance contract, before any payment of benefits can take place. Usually expressed in terms of an "annual" amount. Once the deductible is reached, the insurers then pays up to 100% of approved amounts for covered services provided during the remainder of that benefit year. Co-payment: cost-sharing in the form of a fixed amount to be paid for a service. Co-insurance: cost-sharing in the form of a set proportion of the cost of a service. [Source: OECD. A System of Health Accounts]
OUT-OF POCKET PAYMENTS (OPP) (2)
The amount a person has to pay for all covered health care services for a defined period (often a year). It includes: Fixed co-payments: A out-of-pocket payment in the form of a fixed amount (like for example a prescription fee) to be paid for a service, a medicine or a medical device. Percentage co-payments: Cost-sharing in the form of a set proportion of the cost of a service or product. The patient pays a certain fixed proportion of the cost of a service or product, with the third party payer paying the remaining proportion. Deductibles: Initial expense up to a fixed amount which must be paid out-of pocket for a service or over a defined period of time by an insured person; then all or a percentage of the rest of the cost is covered by a third party payer. [Source: PPRI Glossary] Please note that the PHIS project uses for its indicators and templates (PHIS Hospital Pharma Reports) Out-of pocket payment (2) definition.
OUT-PATIENT CARE
This item comprises medical and paramedical services delivered to out-patients. An out-patient is not formally admitted to the facility (e.g. physician’s private office) and does not stay overnight. An out-patient is thus a person who goes to a health care facility for a consultation/treatment, and who leaves the facility within several hours of the start of the consultation without being “admitted” to the facility as a patient. It should be noted that the term “out-patient” used in the OECD-System of Health Accounts has a wider meaning compared to some national reporting systems where this term is limited to care in out-patient wards of hospitals. In the SHA, all visitors to ambulatory care facilities that are not day cases or over-the-night cases, are considered out-patients. [Source: OECD. A System of Health Accounts]
OUT-PATIENT CLINICS (OUT-PATIENT CARE CENTRES, AMBULATORY CARE CENTRE, INDEPENDENT HEALTH CARE CENTRES, OUT-PATIENT CLINIC, INDEPENDENT OUT-PATIENT HEALTH CLINIC)
Out-patient clinics offer facilities for the out-patient treatment of a patient except hospital out-patient departments or doctors' offices e.g. medical laboratories, physical therapy institutes, radiological facilities, sports medical institutions.
OUT-PATIENT DEPARTMENT (HOSPITAL OUT-PATIENT DEPARTMENT, HOSPITAL OUT-PATIENT WARD, OPD)
Out-patient departments are specialised and/or general units that may be located within all kinds of hospitals, which, however, serve out-patients. Hospital out-patient departments are available for emergency services and for acute specialist care, as well as for after-care and preventive medical check-ups. They may be open 24 hours.
OUT-PATIENT FACILITIES
Out-patient facilities include all possibilities of care which do not require an overnight stay. Those facilities can range from simple doctors' offices that provide primary care, to large, independent hospitals without beds. See also: out-patient care and out-patient clinics
OUT-PATIENT PHYSICIAN (OUT-PATIENT DOCTOR)
Health care provider e.g. in a physician’s office, clinic, or day surgery center (not in-patient, not in hospital). [Source: PPRI Glossary]
OUTCOME
The end result of care and treatment and / or rehabilitation. In other words, the change in health, functional ability, symptoms or situation of a person, which can be used to measure the effectiveness of care / treatment / rehabilitation. Researchers should decide what outcomes to measure before a study begins; outcomes are then assessed at the end of the study. [Source: NICE Glossary]
OUTCOME GUARANTEES
An agreement where the manufacturer provides rebates, refunds, or price adjustments if the product fails to meet the agreed outcome target. [Source: Carlson JJ , Sullivan SD, Garrison LP, Neumann PJ, Veenstra DL. Linking payment to health outcomes: A taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers. Health Policy. 2010 Aug. 96(3):179-90.] See also: managed entry agreements
OUTLIER
A hospital admission requiring either substantially more expenses or a much longer length of stay than average.
OVER PRESCRIBING
If a physician prescribes more medicines than comparable physicians (e.g. with similar patient groups or in the same region). The measurement of over prescribing is of particular importance if the doctor has been approved a pharmaceutical budget. [Source: PPRI Glossary]
OVER-THE-COUNTER (OTC) MEDICINE (OVER-THE-COUNTER PRODUCT)
Medicines which may be dispensed without a prescription and which are in some countries available via self-service in pharmacies a/o other retail outlets (e.g. drug stores). Selected OTC products may be reimbursed for certain indications in some countries. [Source: PPRI Glossary]
OVERHEAD
The general costs of operating an entity which are allocated to all the producing operations of the entity but which are not directly attributable to a single activity. For a hospital, these costs normally include maintenance of the facility, occupancy costs, housekeeping, administration, and others.
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