Abstract
BackgroundThe International Classification of Functioning, Disability and Health (ICF) is embraced as a framework to conceptualize human functioning and disability. Health professionals choose measures to represent the domains of the framework. The ICF coding classification is an administrative system but multiple studies have linked diverse clinical assessments to ICF codes. InterRAI-HC (home care) is an assessment designed to assist planning of care for patients receiving home care. Examining the relationship between the ICF and the interRAI HC is of particular interest because the interRAI assessments are widely used in clinical practice and research, are computerized, and uploaded to databases that serve multiple purposes including public reporting of quality in Canada and internationally. The objective of this study was to examine the relationship between the interRAI HC (home care) assessment and the ICF. Specifically, the goal was to determine the proportion of interRAI HC items that can be linked to each of the major domains of the ICF (Body Function, Body Structure, Activities and Participation, and the Environmental Factors), the chapters and the specific ICF codes.MethodsThree coders who were familiar with both the home care assessment and the ICF independently assigned ICF codes to inter-RAI HC items. Subsequently, a series of teleconference meetings were held to reach consensus on the primary code and much later consensus was used to finalize codes for additional items added to the interRAI HC.ResultsFollowing exclusion of administrative and diagnostic sections, 175 interRAI items were examined for potential assignment of codes. Of these 52 were assigned codes related to body function, 43 to activities and participation, 34 to environment, 1 to body structure, 17 to not coded, and 26 to not defined. Considering all 3-digit ICF codes, interRAI items addressed 43.2% of Body Function and 50.6% of Activities and Participation codes.ConclusionThe conceptual overlap in content, offers an excellent opportunity to operationalize the ICF domains and the codes particularly in the areas of Body Function and Activities and Participation. Use of measures such as the interRAI assessments with common elements across settings facilitates standardized reporting for organizations, regions and nations.
Highlights
The International Classification of Functioning, Disability and Health (ICF) is embraced as a framework to conceptualize human functioning and disability
The initial sections of the interRAI home care assessment include identification numbers, reason for assessment and reference date for the assessment as well as other items referring to personal factors for which the ICF has no codes
We excluded 23 diagnostic items that were more appropriately linked to the International Classification of Disease (ICD) and the 14 items that related to treatments and procedures such as oxygen therapy and ventilator use that were most probably covered by coding procedure manuals
Summary
The International Classification of Functioning, Disability and Health (ICF) is embraced as a framework to conceptualize human functioning and disability. The ICF coding classification is an administrative system but multiple studies have linked diverse clinical assessments to ICF codes. The goal was to determine the proportion of interRAI HC items that can be linked to each of the major domains of the ICF (Body Function, Body Structure, Activities and Participation, and the Environmental Factors), the chapters and the specific ICF codes. Clinicians and researchers refer to the ICF framework in choosing measures to represent various domains [1] but there is no incentive to use the 1424 ICF codes in daily practice and the ICF is a classification system rather than a measurement system. Iezzone and colleagues [4] have suggested that software be used to recode assessments used in daily practice to ICF codes in order to obtain common information on functional status in medical records without burdening clinicians or administrative staff with having to recode clinical assessments
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