Data Aggregation ?Combining of sets of protected health information by a business associate to permit data analysis.

Database Management System (DBMS) - The separation of data from the computer application that allows entry or editing of data.

Data Condition - A description of the circumstances in which certain data is required.

Data Content - Under HIPAA, this is all the data elements and code sets inherent to a transaction, and not related to the format of the transaction.

Data Mapping - The process of matching one set of data elements or individual code values to their closest equivalents in another set of them. This is sometimes called a cross-walk.

Data Use Agreement (DUA) - HIPAA Regulation states that a health care entity may use or disclose a "limited data set" if that entity obtains a data use agreement from the potential recipient and can only be used for research, public health or healthcare operations. Relates to privacy rules of HIPAA. A satisfactory assurance between the covered entity and a researcher using a limited data set that the data will only be used for specific uses and disclosures. The data use agreement is required to include the following information: to establish that the data will be used for research, public health or health care operations (further uses or disclosure are not permitted); to establish who is permitted to use or receive the limited data set; and to provide that the limited data set recipient will: (1) not use or further disclose the information other than as permitted by the data use agreement or as required by law; (2) use appropriate safeguards to prevent use or disclosure of the information other than as provided in the agreement; (3) report to the covered entity any identified use or disclosure not provided for in the agreement; (4) ensure that any agents, including a subcontractor, to whom the limited data sets are provided agree to the same restrictions and conditions that apply to the recipient; and (5) not identify the information or contact the individuals.

Data Warehouse - A specific database (or set of databases) containing data from many sources that are linked by a common subject (e.g., a plan member).

Days (Or Visits) Per Thousand - A standard unit of measurement of utilization. Refers to an annualized use of the hospital or other institutional care. It is the number of hospital days that are used in a year for each thousand covered lives. The formula used to calculate days per thousand is as follows: (# of days/member months) x (1000 members) x (# of months). An indicator calculated by taking the total number of days (for inpatient, residential, or partial hospitalization) or visits (for outpatient) received by a specific group for a specific period of time (usually one year). A measure used to evaluate utilization management performance.

Day Outlier - A patient with an atypically long length of stay compared with other patients in a particular diagnosis related group.

DBMS - See Database Management System

DCI - See Duplicate Coverage Inquiry

Decedents - Deceased individuals. Afforded privacy rights under the HIPAA Privacy Rule, even though not considered "human subjects" protected under the Common Rule. As is the current practice, all research protocols involving the review of medical records of deceased subjects or of living and deceased subjects require review and approval by the HRC/IRB and can be conducted without informed consent and authorization only if the protocol satisfies the criteria for a waiver. If the research includes access to the records of decedents, the investigator will be asked to document that the decedents will only be used for research and that the information is necessary for the research. The covered entity may require the investigator to provide proof of death.

Decision Support Systems - Computer technologies used in healthcare that allow providers to collect and analyze data in more sophisticated and complex ways. Activities supported include case mix, budgeting, cost accounting, clinical protocols and pathways, outcomes, and actuarial analysis.

Deductibles - Amounts required to be paid by the insured under a health insurance contract, before benefits become payable. Different components of a health plan may have separate deductibles. Usually expressed in terms of an "annual" amount.

Deductible Carry Over Credit - Charge incurred during the last three months of a year that may be applied to the deductible and which may be carried over into the next year.

Defensive Medicine - Doctors in recent years have admitted to and have been accused of prescribing additional tests or procedures to justify their care, strengthen support for their decisions or simply to corroborate their diagnosis. This defensiveness is a result of lawsuits, malpractice claims and the onslaught of external UR entities questioning care decisions. Defensive medicine is said to be one of the primary causes of the increasing cost of health care. Many physicians and the AMA fight for tort reform to reduce the need for defensive medicine. However, patient groups and patient advocates, not in favor of tort reform, explain that the right to sue for malpractice is a valid method of holding physicians accountable for mistakes made.