Use of the ICF in medical rehabilitation in Germany: claims and reality

Abstract

The International Classification of Functioning, Disability and Health (ICF) is being used in the medical rehabilitation practice in different ways. The World Health Organization (WHO) and many other stakeholders have formulated claims and expectations for its use. Acomparative presentation of the claims of various stakeholders for the use of the ICF with examples in current practice. Database searches (PubMed, REHADAT, and Google Scholar) were conducted for studies concerning claims and the current use of the ICF in practice. There are different requirements regarding the use of the ICF. While lawmakers and social insurance agencies remain very cautious and vague, other stakeholders (research institutions, organizations, stakeholders, service providers) formulate higher expectations and call for greater use of the ICF. In practice, the ICF is used in the form of a bio-psycho-social model, a common language and many different adaptations. The different requirements for the use of ICF demonstrate the motivations and interests of the stakeholders. Signals must now be sent both by politics and by social insurance agencies that go far beyond non-binding declarations. Furthermore it is necessary to systematize and evaluate the many use adaptations that are primarily being used by service providers. Research is needed on the concrete use of ICF-based instruments and its intended and unintended effects.