Acronym   
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Definition
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Details
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| AAC | Austin Automation Center | The Austin Automation Center is a Federal data center. Most VA data are housed at AAC, including the National Patient Care Database (NPCD) and Decision Support System (DSS) National Data Extracts. |
| APC | Ambulatory Payment Classifications | Centers for Medicare and Medicaid Services (CMS) was mandated through the Omnibus Budget Reconciliation Act of 1986 to develop a prospective payment system (PPS) for outpatient services. All services paid under the new PPS are classified into groups called Ambulatory Payment Classifications or APCs. Services in each APC are similar clinically in terms of the resources they require. A payment rate is established for each APC. Depending on the services provided, hospitals may be paid for more than one APC in a single encounter. |
| AWP | Average Wholesale Price | AWPs are average wholesale pharmaceutical prices. Common sources of AWPs are the Red Book and MediSpan. |
| BIRLS | Beneficiary Identification and Records Locator System | BIRLS is a set of databases indexed by social security number. With BIRLS, a researcher can find information on veterans who obtained burial benefits from VA (for mortality studies), who receive a monetary benefit for Aid and Attendance (e.g., to defray the cost of the Community Residential Care program), or who had accounts for VA educational benefits (to determine the extent of contact with VA for other services besides healthcare). BIRLS contains other data as well, such as the type and amount of benefits paid to C&P (compensation and pension) recipients. |
| BPA | Blanket Purchase Agreement | BPAs are contracts between VA and pharmacy supply manufacturers. They enable individual VA facilities to obtain additional discounts for particular medications or supplies based on the volume prescribed or used. The BPA may include additional programs and services as well. Many are negotiated for specific customer groups under the VA Federal Supply Schedule (FSS) program. |
| CAC | Cost Adjusted Charges | Charges obtained from hospital bills or discharge data are frequently higher than actual costs. One can adjust the charges by multiplying reported charges by a department-level cost-to-charge ratio. We refer to the adjusted charges as cost-adjusted charges (CAC). |
| CCS | Clinical Classifications Software | CCS is a tool for clustering patient diagnoses and procedures into clinically meaningful categories. This software was developed by the Agency for Healthcare Quality and Research [link: http://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp]. |
| CDAs | Cost Distribution Accounts | The VA Cost Distribution Report includes patient care departments such as medicine, admitting screen, or ambulatory surgery. It also includes indirect departments such as building management. Expenditures for these departments are listed in cost distribution accounts (CDAs) |
| CDR | Cost Distribution Report | The CDR contains estimates of the costs expended by each patient care department in a VA medical center. Costs are distributed into Cost Distribution Accounts |
| CHCE | Center for Healthcare Evaluation | |
| CMS | Centers for Medicare and Medicaid Services | CMS is a federal agency within the U.S. Department of Health and Human Services. CMS is responsible for the Medicare program and works with the States to run Medicaid [link: http://www.cms.gov]. |
| COPD | Chronic Obstructive Pulmonary Disease | COPD is comprised primarily of two related diseases: chronic bronchitis and emphysema. In both diseases, the flow of air through the airways and out of the lungs is obstructed. The condition is permanent and worsens over time. |
| CPI | Consumer Price Index | The CPI measures the price paid by consumers for a fixed group of goods and services. Changes in the CPI over time constitute a common measure of inflation. |
| CPT | Current Procedural Terminology | CPT codes are five-digit numbers used to represent the universe of medical and psychiatric services given to patients. They are revised each year to reflect advances in medical technology. The 2002 revision contained 8,107 codes and descriptors. VA uses CPT codes to identify ambulatory care procedures only; ICD-9 codes are used for inpatient procedures. |
| CSPCC | Cooperative Studies Program Coordinating Center | |
| DHCP | Decentralized Hospital Computer Program | |
| DRG | Diagnosis Related Group | Diagnostic Related Group The DRG system is an inpatient classification system based on several factors: principal diagnosis; secondary diagnosis; surgical factors; age; sex; and discharge status. Under the Medicare prospective payment system, hospitals are paid a set fee for treating patients in a single DRG category, regardless of the actual cost of care for the individual. |
| DSS | Decision Support System | The VHA Decision Support System (DSS) is an automated management information system that tracks health care utilization (VHA workload) and assigns an approximate cost to it. Each VA facility has a separate implementation of DSS. The source of DSS data are the VISTA systems at each VA facility. On a quarterly basis, DSS staff at the VA Austin Automation Center extract data from the DSS systems at each facility. After creating additional data fields, they create a series of extracts that cover all VA facilities. |
| E&M | Evaluation and Management | E&M is a set of CPT codes that refer to Evaluation and Management services. |
| FFS | Federal Supply Schedule | FFS is a set of federal contracts for supplies, including medical supplies and pharmaceuticals. FSS prices are available to any federal agency. Additional quantity and tier discounts are available for certain products; these appear on the "FSS Tier" schedules. |
| FMS | Financial Management System | FMS is the electronic general ledger for VA. Its purpose is to track obligations and expenditures by facility and time period (month, quarter and fiscal year). Cost centers and subaccounts (budget object codes) are used to organize the data by purpose, such as labor costs, medical supplies, and overhead. |
| GHC | Group Health Cooperative | GHC is a not-for-profit health maintenance organization (HMO). It is a staff-model HMO, meaning that its physicians are salaried employees. |
| HCFA | Healthcare Financing Administration | As of July 1, 2001, HCFA was renamed the Centers for Medicare and Medicaid Services. See the entry for CMS. |
| HCUP | HealthCare Cost and Utilization Project | HCUP is a family of healthcare databases and related software. HCUP databases bring together the data collection efforts of state data organizations, hospital associations, private data organizations, and the federal government to create a national information resource of patient-level healthcare data. |
| HSR&D | Health Services Research & Development | |
| ICU | Intensive Care Unit | A general intensive care unit is defined as a unit using designated intensive care beds interchangeably for more than one type of patient (e.g. medical, coronary, surgical.) |
| IRB | Institutional Review Board | IRBs review research protocols that involve human subjects. They ensure the ethical and safe treatment of study participants. |
| IRM | Institution Resource Management | IRM is a VA department that helps maintain VA information services. The IRM office at each site oversees access to VISTA and other data resources. |
| MAC | Maximum Allowable Cost | The MAC is the highest price a state Medicaid agency will pay for a particular pharmaceutical. The MAC varies over time and by state. |
| MDC | Major Diagnostic Category | The MDC is a classification system that represents a group of similar Diagnosis Related Groups (DRGs). Each MDC typically involves a single organ system of the body. |
| MDRC | Management Decision Resource Center | |
| MEDPAR | Medicare Provider Analysis Review (file) | The MEDPAR file is a hospital discharge database containing records for Medicare beneficiaries who were discharged in a given year. CMS maintains the MEDPAR database. |
| MEPS | Medical Expenditure Panel Survey | MEPS is the third (and most recent) in a series of national probability surveys conducted by the Agency for Healthcare Research and Quality (AHRQ) on the financing and utilization of medical care in the United States [link: http://www.meps.ahrq.gov]. |
| MUMPS | Massachusetts General Hospital Utility Multiprogramming System | MUMPS is a software system used by VA to create DHCP, the predecessor of VISTA. A MUMPS program is necessary in order to extract raw data from VISTA. |
| NDC | National Drug Code | The NDC serves as a universal product identifier for human drugs. It contains three parts: a five-digit labeler code that identifies the manufacturer; a three-digit product code that identifies the medication; and a three-digit code that identifies the packaging. |
| NDEs | National Data Extracts | The NDEs are datasets generated from the VA Decision Support System (DSS). Extracts containing inpatient and outpatient services are currently available. Pharmacy and laboratory test extracts are under development. |
| NPCD | National Patient Care Database | NPCD is a database of VHA services. It contains four distinct databases: the Patient Treatment File (PTF), the Outpatient Care File (OPC), the IPDB, and the EDR. Researchers access extracts of the four databases rather than drawing data from the NPCD itself. |
| OPC | Outpatient Clinic | |
| PBM/SHG | Pharmacy Benefits Management Strategic Healthcare Grou | PBM/SHG is comprised of clinical pharmacists, data analysts and administrative pharmacy personnel. Its primary mission is to facilitate and coordinate the VA national formulary process. It also creates a database of drug prescriptions and pharmacy supply orders. |
| PRRTP | Psychosocial Residential Rehabilitation Treatment Programs | PRRTP is designed to provide a therapeutic residential environment for treatment for psychiatric conditions and psychosocial readjustment. VA defines PRRTP as inpatient care, and it is often viewed as an alternative to specialty psychiatry and substance abuse inpatient care. |
| PTF | Patient Treatment File | PTF is an automated system for recording and tracking events associated with VHA inpatient care. It is the principal source of inpatient VHA workload data. |
| QUERI | Quality Enhancement Research Initiative | The Quality Enhancement Research Imitative (QUERI) is mandated to translate research discoveries and innovations into better patient care of our nation's veterans and VA systems improvement. |
| RBRVS | Resource Based Relative Value Scale (Medicare) | RBRVS values are weights that are based on the time it takes to provide a service or perform a procedure. They also reflect the minimum training required to provide a given service, this compensates providers for income lost during their years of training. |
| RDIS | Research and Development Information System | |
| RUG | Resource Utilization Group | RUG is a validated instrument to measure nursing home residents' resource use. There are two primary versions: RUG II and RUG III. |
| RVU | Relative Value Unit | A relative value unit (RVU) is a numeric weight assigned to a medical encounter or procedure that provides information on its relative resource use. |
| SE | VA Outpatient File | SE refers to the VA Outpatient Event File SE version. It is a VA database for outpatient care. |
| SMI | Serious Mental Illness | SMI is defined as a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and that has resulted in functional impairment that substantially interferes with or limits one or more major life activities. |
| SSN | Social Security Number | The nine-digit Social Security number is used by the U.S. federal government to track workers' contributions to the Social Security retirement system. Because it is unique to each individual, it is widely used as a personal identification number. Most VA healthcare databases identify patients by their true SSNs or by scrambled versions of them. |
| VA | Department of Veterans Affairs | VA has three main functions: to assist veterans with burial costs, to provide eligible veterans with medical care, and to provide eligible veterans with compensation/pension services. Among health researchers, VA is often used interchangeably with VHA. |
| VHA | Veterans Health Administration | VHA is a division of VA responsible for providing medical care to eligible veterans. |
| VIReC | VA Information Resouce Center | |
| VISN | Veterans Integrated Service Network | The VA medical system is organized into 22 geographic networks known as VISNs. Each VISN contains two or more VAHCSs (VA health care systems) as well as outpatient clinics. |
| VISTA | Veterans Health Information Systems and Technology Architecture | VISTA is the primary repository of clinical, administrative/financial, and infrastructure data in VA. It consists of computer systems at each VA medical center and the national network that links them. Within each VISTA implementation is a large number of separate 'modules' or 'packages' designed to store data on a particular subject and to produce management reports. |
| WAC | Wholesale Acquisition Cost | Wholesale acquisition cost is a value meant to approximate a wholesaler's cost for a particular pharmaceutical. |
