Glossary
Aboriginal and/or Torres Strait Islander: A person of Aboriginal and/or Torres Strait Islander descent who identifies as an Aboriginal and/or Torres Strait Islander. See also First Nations people.
Aboriginal and Torres Strait Islander health practitioner: A person who has completed a Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care (Practice) and is registered with the Aboriginal and Torres Strait Islander Health Practice Board of Australia. The practitioner may undertake higher levels of clinical assessment and care within their agreed scope of practice.
Aboriginal and Torres Strait Islander health worker: An Aboriginal and/or Torres Strait Islander with a minimum qualification in the field of primary health-care work or clinical practice. This includes Aboriginal and Torres Strait Islander health practitioners who are one speciality stream of health worker. Health workers liaise with patients, clients and visitors to hospitals and health clinics, and work as a team member to arrange, coordinate and deliver health care in community health clinics.
Aboriginal Community Controlled Health Services: Primary health-care services initiated and operated by local First Nations communities to deliver comprehensive, holistic and culturally appropriate health care to the community that controls it through a locally elected board of management. These services range from large multi-functional services employing several medical practitioners to small services that rely on nurses and/or Aboriginal health workers. For more information, see the National Aboriginal Community Controlled Health Organisation (NACCHO) website. See also Indigenous-specific primary health care organisations.
acute: A term that describes a medical condition that comes on suddenly and lasts for a limited time.
acute otitis media (AOM): The general term for both acute otitis media without perforation and acute otitis media with perforation. It is the presence of fluid behind the tympanic membrane plus at least one of the following: bulging tympanic membrane, fever, ear pain or irritability. See also tympanic membrane.
admission: The process whereby the hospital accepts responsibility for the patient’s care and/or treatment. Admission follows a clinical decision based upon specified criteria that a patient requires same-day or overnight care or treatment. See also METEOR ID: 327206.
admitted patient: A patient who undergoes a hospital’s formal admission process to receive treatment and/or care. This treatment and/or care is provided over a period of time, and can occur in hospital and/or in the person’s home (for hospital-in-the-home patients). See also METEOR ID: 268957.
age-standardisation: A way to remove the influence of age when comparing populations with different age structures. This is usually necessary because the rates of many diseases vary strongly with age. The age structures of the different populations are converted to the same ‘standard’ structure, and then the disease rates that would have occurred with that structure are calculated and compared.
allied health professional: A health professional who is not a doctor, nurse or dentist. Allied health professionals include (but are not limited to) audiologists, chiropractors, occupational therapists, optometrists, osteopaths, pharmacists, physiotherapists, podiatrists, psychologists and speech pathologists.
antenatal: The period from conception up to the time of birth. Synonymous with prenatal.
audiologist: A person who provides hearing diagnostic assessments and rehabilitative services, including counselling, speech reading and hearing aid fitting. They also assess and support other ear-related conditions, such as balance problems. Audiologists have a masters degree in audiology.
audiometrist: A medical technician who provides hearing diagnostic services and hearing aid fitting. Audiometrists must complete a 2-year diploma. They have a narrower scope of practice than audiologists.
audiometry nurse: A registered nurse accredited through the Australian College of Nursing. Audiometry nurses work mostly in Community Health Centres offering a range of hearing health assessments and education.
bilateral hearing loss: Hearing loss in both ears.
bimodal hearing: Hearing that combines the benefits of a hearing aid in one ear and a cochlear implant in the other. Bimodal hearing can make the best of hearing in the ear without the cochlear implant and hearing technology for situations with background noise.
child: A person aged 0–14 unless otherwise stated.
cholesteatoma: A cyst formed due to accumulation and abnormal growth of ear skin cells in a retraction pocket or through a perforation of the tympanic membrane, or in the middle ear space. Due to hyperproliferation of the skin cells, the cyst grows, becoming space occupying, often with infection. A cholesteatoma caused by middle ear disease most often occurs in the attic region of the tympanic membrane. Cholesteatomas, where untreated, are arguably the most destructive form of middle ear disease.
chronic: Describes something that is persistent and long lasting.
chronic diseases/conditions: A diverse group of diseases/conditions, such as heart disease, cancer and arthritis, which tend to be long lasting and persistent in their symptoms or development. Although these features also apply to some communicable diseases (infectious diseases), the term is usually confined to non-communicable diseases.
chronic suppurative otitis media (CSOM): Persistent ear discharge through a perforation in the tympanic membrane lasting 2 weeks or more. On otoscopy, the perforation must be viewed and be greater than or equal to 2% of the pars tensa (the tense part of the tympanic membrane).
Cochlear implant: A device that can assist people with moderate to profound sensorineural hearing loss for whom hearing aids have only limited benefits. Rather than amplify sounds, a cochlear implant does some of the work of the inner ear and turns sounds into electrical signals, delivering them directly to the nerve endings in the ear. The cochlear implant directly stimulates auditory nerve fibres in the cochlea to bypass impaired sections of the inner ear. While a cochlear implant does not restore normal hearing, it provides a representation of sounds which can be used to understand speech.
community hearing health worker: A person who provides health awareness, clinical, rehabilitation and training services, including conducting ear and hearing screening.
community/primary health care nurse: A nurse working in the community (acute or non‑acute) or primary health-care setting. This often incorporates a wide variety of roles, such as chronic disease management, child and family health and refugee health.
conductive hearing loss: Hearing loss that results from dysfunction of the outer or middle ear that interferes with the efficient transfer of sound to the inner ear.
congenital hearing loss: Hearing loss that is present from or soon after birth. Some causes of congenital hearing loss include genetic factors, infections during pregnancy, premature birth, low birthweight, severe jaundice at birth, and ototoxic medications.
corrected age: A baby’s chronological age minus the number of weeks or months early they were born, to reflect their actual development and growth.
data linkage: The bringing together (linking) of information from 2 or more different data sources that are believed to relate to the same entity (for example, the same individual or the same institution). This linkage can yield more information about the entity and, in certain cases, provide a time sequence – helping to ‘tell a story’, show ‘pathways’ and perhaps unravel cause and effect. The term is used synonymously with ‘record linkage’ and ‘data integration’.
decibels (dB): A unit of measuring for sound, based on a logarithmic scale.
disability groups: A categorisation in the National Disability Insurance Scheme based on factors such as underlying health condition, type of impairment, activity limitations and participation restrictions. The disability groups are reported as hearing impairment, acquired brain injury, autism, cerebral palsy, intellectual disability, developmental delay, global developmental delay, Down syndrome, multiple sclerosis, psychosocial disability, spinal cord injury, stroke, vision impairment, and other.
diseases of the inner ear: These diseases include all conditions affecting the inner ear, they can affect balance and spatial orientation as well as cause hearing loss. Diseases of the inner ear include:
- otosclerosis
- Ménière’s Disease
- Tinnitus
- Vestibular Disorders
- Benign paroxysmal positional vertigo (BPPV)
diseases of the middle ear and mastoid (‘middle ear’): These diseases include all conditions affecting the middle ear and mastoid. The most common is otitis media, a bacterial or viral middle ear infection. Other conditions include:
- perforations of the tympanic membrane
- cholesteatoma, a pocket of skin growth in the middle ear
- mastoiditis, a bacterial infection of the mastoid air cells at the back of the ear often caused by untreated middle ear infections
- and Eustachian tube dysfunction.
dry perforation: The presence of a perforation (hole) in the tympanic membrane without any signs of discharge, infection or fluid behind it. This can also be known as inactive chronic suppurative otitis media (CSOM) or CSOM without discharge.
ear health coordinator: A person who supports Aboriginal Medical Services in focusing on ear health issues, supporting training, skill development and health awareness approaches in primary health care and in improving integration between primary health care and specialist ear health services.
ear toileting: A procedure where a medical professional clears wax, debris or foreign bodies from the ear canal. It is often used in treating patients with recurrent infections of the ear canal.
elective surgery: Planned surgery that can be booked in advance as a result of a specialist clinical assessment resulting in placement on an elective surgery waiting list. METEOR ID: 568780.
elective surgery waiting time: The time that a patient is on a hospital waiting list for planned elective surgery in a public hospital (or private hospital if a public patient is treated there). Patients are placed on a waiting list and assigned an urgency category that indicates the clinically recommended maximum time they should wait for the surgery. The time a patient waits for elective surgery is calculated from the date a patient is placed on the hospital’s waiting list to the date of admission for the surgery. The waiting time is an indication of how easy the service is to access.
emergency department: A hospital facility that provides triage, assessment, care or treatment for non-admitted patients suffering from a medical condition or injury.
ear, nose and throat specialist (ENT specialist or otolaryngologist): A medical doctor who specialises in diagnostic, preventive and surgical treatment for diseases of the ear, nose and throat.
Eustachian tube: an opening connecting the middle ear with the nasal-sinus cavity that helps to balance pressure in the middle ear.
First Nations people: People who have identified themselves, or have been identified by a representative (for example, their parent or guardian) as being of Aboriginal and/or Torres Strait Islander origin. See also Aboriginal or Torres Strait Islander.
full-time equivalent (FTE) workforce or workload: A standard measure of the size of a workforce that takes into account both the number of workers and the hours that each works. For ENT specialists, an FTE of 1 is assumed to be 40 hours in a week. For example, if a workforce comprises 2 people working full time 40 hours a week and 2 working half time 20 hours a week, this is the same as 3 working full time – that is, an FTE of 3.
general practitioner (GP): A medical practitioner who provides comprehensive and continuing care to patients and their families within the community. They can conduct ear checks, manage the treatment of many ear conditions, and provide referrals to specialist services.
grommet: A small tube surgically placed across the eardrum to re-establish ventilation to the middle ear. It is also called a ‘ventilation tube’, ‘pressure equalisation tube’ or a ‘tympanostomy tube’.
hearing: The sense for perceiving sounds, including regions within the brain where the signals are received and interpreted.
hearing aid: A device to help people with ongoing hearing loss to make the best use of the hearing they have. They do not change a person’s hearing, but they make speech louder and clearer so it is easier to hear.
hearing impairment: A term that describes the degree of impairment associated with hearing loss in the ‘better hearing ear’, using a scale of mild, moderate, severe and profound. It is essentially based on how loud sounds need to be for them to be heard.
hearing loss: Any hearing threshold response outside the normal range, to any sound stimuli, in either ear. Hearing loss in a population describes the number of people who have abnormal hearing. Hearing loss may affect one ear (unilateral hearing loss) or both ears (bilateral hearing loss). This includes conductive, sensorineural and other forms of hearing loss. Audiometry is used to test a person’s ability to hear various sound frequencies.
hospitalisation: An episode of hospital care that starts with the formal admission process and ends with the formal separation process. An episode of care can be completed by the patient’s being discharged, being transferred to another hospital or care facility, dying, or by a portion of a hospital stay starting or ending in a change of type of care (for example, from acute to rehabilitation).
household: A group of one or more persons who usually reside in the same dwelling.
Indigenous: A person of Aboriginal and/or Torres Strait Islander descent who identifies as an Aboriginal and/or Torres Strait Islander. Used interchangeably with Aboriginal and Torres Strait Islander. See also Aboriginal or Torres Strait Islander and First Nations people.
Indigenous-specific primary health-care organisations: Primary health-care organisations that receive funding from the Department of Health to provide primary health‑care services mainly to Aboriginal and Torres Strait Islander people. The primary health-care organisations include Aboriginal Community Controlled Health Services, state and territory managed organisations, Primary Health Networks and other non‑government organisations.
Indigenous status: A term that describes whether or not a person identifies as being of Aboriginal and/or Torres Strait Islander origin.
infant: A child aged under 1 year.
International Classification of Diseases and Related Health Problems (ICD): The World Health Organization's internationally accepted classification of death and disease. The 11th revision (ICD-11) is currently in use. The Australian modification of the ICD-11 (ICD-10-AM) is used for diagnoses and procedures recorded for patients admitted to hospitals.
level of function: A term used about a person’s disability for accessing the National Disability Insurance Scheme – their disability must substantially reduce their functional capacity to undertake one or more of the following activities: moving around, communicating, socialising, learning, or undertaking self-care or self-management tasks. Functional capacity may affect participation at home, at school, at work or in social situations. Level of function indicates the impact an NDIS participant's disability has on how a person is able to perform tasks and actions in a life area, as represented by a ‘severity score’. ‘High functioning’ indicates lower service and support requirements with a lower severity score, and ‘low functioning’ indicates higher service and support requirements with a higher severity score.
mastoid: Part of the skull located behind the ear.
mastoidectomy: A procedure that involves removing diseased mastoid air cells. Air cells are air-filled cavities made of bone located in the mastoid. Mastoid cells often become diseased as a result of an ear infection that has spread to the skull. A mastoidectomy can also be used to remove cholesteatoma, a buried pocket of skin growth in the middle ear often caused by repeated middle ear infections.
median: The middle number; found by ordering all data points and picking out the one in the middle (or if there are two middle numbers, taking the average of those two numbers).
median waiting time: The mid-point in waiting times for patients who received elective surgery after being placed on a public waiting list. Half of all patients who received a particular type of elective surgery waited less than or equal to the median number of days, while half were on the list for longer than the median waiting time.
Medical technician: Medical Technicians operate anaesthetic, cardiac, operating theatre and medical testing equipment, perform and assist with laboratory tests, and fill prescriptions in support of Health Professionals.
Medicare: A national, government-funded scheme that subsidises the cost of personal medical services for all Australians and aims to help them afford medical care. The Medicare Benefits Schedule (MBS) is the listing of the Medicare services subsidised by the Australian Government.
Ménière’s disease: A disorder of the inner ear, involving episodes of vertigo, hearing loss and tinnitus, often with nausea and vomiting.
middle ear: Contains three small bones with the function of transmitting sound from the outer ear to the inner ear.
Middle ear procedures: These refer to procedures under the ACHI 11th edition procedure block numbers 307–316 (inclusive), which cover procedures on eardrum and middle ear. Common middle ear procedures include myringotomy and myringoplasty.
mild hearing impairment: On average, the quietest sounds that people can hear with their ‘better’ ear are 21 – 40dB. People with a mild hearing impairment may hear speech, but soft sounds are hard to hear, such as whispers or the consonants on the end of words like ‘shoes’ or ‘fish’. Counselling and hearing aids may be needed.
mixed hearing loss: Hearing loss that has conductive and sensorineural components combined.
moderate hearing impairment: On average, the quietest sounds that people can hear with their ‘better’ ear are 41–70 dB HL. These people are able to hear and repeat words spoken in a raised voice at 1 metre and have difficulty keeping up with conversations without using a hearing aid.
Modified Monash Model: The model measures remoteness and population size on a scale of Modified Monash (MM) categories MM 1 to MM 7, where MM 1 is a major city and MM 7 is very remote. MMM classifications are based on the Australian Statistical Geography Standard – Remoteness Areas.
My Health Record: An online platform for storing a person’s health information, including their Medicare claims history, hospital discharge information, diagnostic imaging reports and details of allergies and medications.
myringoplasty: The repair of a perforation (hole) of the tympanic membrane (eardrum). A perforation can occur due to otitis media, other chronic infections, or a grommet. The surgeon repairs the hole with a graft.
myringotomy: Surgical incision in the eardrum to relieve pressure or drain fluid. This takes place with or without grommet insertion. The procedure involves making a small cut in the eardrum and sucking out the fluid in the middle ear. A grommet is a small ventilation tube designed to allow air to flow into the middle ear and prevent a build-up of fluid. If required, it is inserted into the eardrum once the fluid is drained.
non-Indigenous: A term that describes people who indicated they are not of Aboriginal and/or Torres Strait Islander origin. See also other Australians.
nurse: A person who provides health awareness, clinical, rehabilitation and training services, including conducting ear and hearing screening and coordinating care.
occupational therapist: A person who assesses functional limitations of people resulting from illnesses and disabilities, and provides therapy to enable people to perform their daily activities and occupations.
other Australians: People who indicated they are not of Aboriginal and/or Torres Strait Islander origin and those who did not state their Indigenous status. See also non‑Indigenous.
other disorders of the external ear: Other disorders affecting the outer ear, such as a build-up of wax, stenosis (narrowing) of the external ear canal, deformities of the external ear and other infections of the external ear.
other ear conditions: All other conditions affecting the ear and hearing, such as ear pain and swelling, disorders of the ear related to surgery, and any other disorders of the ear.
other procedures: Procedures that can occur in many areas of the ear and include insertions, removals, excisions, reconstructions and repairs.
otitis externa: An inflammatory condition of the external ear canal that is sometimes known as swimmer’s ear. It is commonly caused by a bacterial or fungal infection, but can be caused by dermatological conditions such as eczema, psoriasis, dermatitis and acne.
otitis media: All forms of inflammation and infection of the middle ear. Active inflammation or infection is nearly always associated with a middle ear effusion (fluid in the middle ear space). It is usually a result of infection, resulting in temporary hearing loss, particularly in children.
otitis media with effusion (OME): The presence of an intact eardrum and middle ear fluid without symptoms or signs of acute infection. Other terms used to describe OME include ‘glue ear’, ‘serous otitis media’ and ‘secretory otitis media’. OME may be episodic or persistent.
otosclerosis: A cause of deafness in adults affecting certain bones in the ears so they cannot conduct sound normally.
otoscopy: a clinical procedure used to examine the ear, especially the external ear canal, eardrum and middle ear.
ototoxic: A term that describes medications or chemicals that have a toxic effect on the ear or its nerve supply. Hearing loss, balance disorders and tinnitus can result from ototoxic medications, which include non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen, certain aminoglycoside antibiotics, salicylates, platinum-based anti-cancer therapeutics, the anti-malarial drug quinine, and some diuretic drugs. Ototoxic chemicals include some solvents, asphyxiants, nitriles, and metals and compounds such as mercury and lead.
outreach: The activity of providing services to any population that might not otherwise have access to those services due to remote location.
paediatrician: A doctor who focuses on the health of infants, children and teenagers. Paediatricians help detect, treat, manage and prevent physical, behavioural and developmental issues that affect children.
perinatal: Pertaining to, or occurring in, the period shortly before or after birth (usually up to 28 days after).
prenatal: The period covering conception up to the time of birth. Synonymous with antenatal.
prevention (of ill health or injury): Action to reduce or eliminate the onset, causes, complications or recurrence of ill health or injury.
primary disability: The impairment that has most impact on daily functioning. National Disability Insurance Scheme participants may have more than one disability; participants have one primary disability and may have multiple additional disabilities recorded. See also reported disability.
primary health care: Services delivered in many community settings, such as general practices, community health centres, Aboriginal health services and allied health practices (for example: physiotherapy, dietetic and chiropractic practices) and come under numerous funding arrangements.
principal diagnosis: The diagnosis established after study to be chiefly responsible for occasioning an episode of patient care (hospitalisation), an episode of residential care or an attendance at the health-care establishment. Diagnoses are recorded using the relevant edition of the International statistical classification of diseases and related health problems, 11th revision, Australian modification (ICD-11-AM).
profound hearing impairment: On average, the quietest sounds that people can hear with their better ear are 91+ dB HL either in soundproof conditions or non-soundproof conditions. These people are unable to hear and understand even a shouted voice. People with profound hearing impairment will need additional rehabilitation: hearing aids may help in understanding words, and cochlear implants, lip‑reading and sometimes signing may be necessary.
remoteness areas: Regions defined by the Australian Statistical Geographical Standard and based on the Accessibility/Remoteness Index of Australia, which uses the road distance to goods and services (such as to general practitioners, hospitals and specialist care) to measure relative accessibility of regions around Australia. The 5 Remoteness Areas are Major cities, Inner regional, Outer regional, Remote and Very remote.
reported disability: The primary disability and all other disabilities reported by a participant in the National Disability Insurance Scheme (NDIS). NDIS participants may have more than one disability recorded – one primary disability and multiple additional disabilities. See also primary disability.
sensorineural hearing loss: Hearing loss that results from dysfunction in the inner ear (especially the cochlea).
severe hearing impairment: On average, the quietest sounds that people can hear with their better ear are 71–90 dB HL, either in soundproof conditions or non-soundproof conditions. These people are able to hear some words when shouted into the ‘better’ ear. Hearing aids are needed; if no hearing aids are available, lip-reading and signing may be necessary.
social determinants of health: The circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies and politics.
speech pathologist: A person who provides diagnostic assessment and management of disorders of communication and swallowing through direct intervention, education, consultancy, advocacy, or a combination of these approaches.
suppurative: A term that describes a situation where pus is produced in response to inflammatory bacterial infections.
tinnitus: A continual noise in the ears or head, such as ringing, buzzing or clicking.
tympanic membrane: The ear drum, a membrane which divides the external auditory canal from the middle ear.
unable to be determined: A term used to describe a situation where a definitive hearing diagnosis is unable to be made, usually due to challenges associated with performing the diagnostic assessment.
unilateral hearing loss: Hearing loss in one ear.