Systematic Implementation of World Health Organization Family International Classifications in Rehabilitation: Protocol and Roadmap
10.3969/j.issn.1006-9771.2020.11.001
- VernacularTitle:世界卫生组织国际健康分类家族在康复中系统应用的方案与路线图
- Author:
Jing-yuan JIANG
1
;
Zhuo-ying QIU
2
;
Guo-xiang WANG
1
;
Fu-bing QIU
2
;
Jian YANG
3
;
An-qiao LI
2
;
Hong-zhuo MA
2
;
Ting ZHU
2
;
Mei WANG
4
;
Hong-wei SUN
2
;
Di CHEN
3
;
Qiu-chen HUANG
5
;
Jie-jiao ZHENG
6
;
Ming-sheng ZHANG
7
;
Xiu-e SHI
8
;
Tao TANG
9
;
Tao XU
10
;
Ai-min ZHANG
11
;
Xian-guang WU
11
;
Qiao-yun LIU
12
;
Xiao-fei XIAO
13
;
Qi JING
2
Author Information
1. School of Physical Education and Sport Sciences/Exercise Rehabilitation Research Center, Soochow University, Suzhou, Jiangsu 215021, China
2. China Academy of ICF, Weifang, Shandong 261000, China
3. WHO-FIC Collaborating Center in China, Beijing 100068, China
4. Institute of Health Sciences, Wuhan Sports University, Wuhan, Hubei 430079, China
5. Department of Physical Therapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
6. Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
7. Guangdong Institute of Geriatrics, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, Guangdong 510080, China
8. Rehabilitation Center Hospital of Gansu, Lanzhou, Gansu 730000, China
9. Rehabilitation Hospital of Sichuan Province, Chengdu, Sichuan 611130, China
10. Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
11. Research Institute of Rehabilitation Information, China Rehabilitation Research Center, Beijing 100068, China
12. Department of Rehabilitation Sciences, East China Normal University, Shanghai 200333, China
13. School of Rehabilitation Medicine, Binzhou Medical University, Yantai, Shandong 264003, China
- Publication Type:Research Article
- Keywords:
World Health Organization Family International Classifications;
rehabilitation services;
International Classification of Diseases;
International Classification of Functioning, Disability and Health;
International Classification of Health Intervention
- From:
Chinese Journal of Rehabilitation Theory and Practice
2020;26(11):1241-1255
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore systematic implementation of World Health Organization Family International Classifications (WHO-FICs) in the field of rehabilitation: the theoretical and policy framework at macro level, governance and management mechanism at meso level, and implementation modules at micro levels, respectively. Methods:The policy and theoretical framework of rehabilitation development was discussed based on the international rehabilitation policy documents of WHO, mainly as World Report on Disability, Global Action Plan on Disability and Rehabilitation in Health Service System. Protocol and roadmap of systematic implementation of WHO-FICs, including International Classification of Diseases (ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Intervention (ICHIβ-2) was proposed. Results:With the use of WHO-FICs, the theoretical and policy framework of rehabilitation was constructed, and the contents and principles of modern rehabilitation services were clarified at macro-level. Rehabilitation is an important part of health service, there are six building blocks: i.e. leadership and governance, financing, human resources for health, service providing, medical technology and health information system. It proposed to use knowledge management system of WHO-FICs, including the classification, nomenclature, definitions, descriptions, terminology and coding systems, to standardize rehabilitation evaluation and statistics. The management and governance system of rehabilitation should be implemented using WHO-FICs. Rehabilitation services are based on the bio-psycho-social model and implemented the principles of people-centered and functioning-oriented. The systematic implementation of WHO-FICs in rehabilitation abide by the model of "Evaluation (ICHI)－Evaluation, Description, Classification and Coding of Functioning (ICF)－Disease Classification, Diagnosis and Coding (ICD)－Rehabilitation Intervention (ICHI)", and with the standardized process of "Evaluation (Functioning and unmet needs)－Diagnose (Disease and Functioning)－Planning of Rehabilitation－Intervention－Evaluation of Outcome". The mic-modules of implementation of WHO-FICs in rehabilitation had been constructed. There were 28 categories of diseases, 7 categories of functioning and 6 categories of rehabilitation interventions in rehabilitation proposed by International Society of Physical and Rehabilitation Medicine. According to ICD-11 and ICF, it proposed to use WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), Brief Model Disability Survey (MDS-B) and VB40 Generic Functioning Domains (VB40), and the ICF core-sets in evaluation of functioning and rehabilitation outcome. The implementation of WHO-FICs in management of medical records and reporting realized the standardized management of medical record, encoding of diseases, functioning and intervention, reporting of performance, and provided tools for billing, reimbursement and payment management of rehabilitation. It proposed to develop WHO-FICs based clinical data sets and big data to implement functioning-related Diagnosis Related Groups and case-mix statistics. Conclusion:With the systematic implementation of WHO-FICs in rehabilitation, the policy and theoretical framework at macro level had been developed. The mechanism of management and governance at meso level had been explored. The application modules and approaches at micro level had been established. A scientific and effective overall solution had been proposed to enhance the scientific, standardized, refined and informatization level, strengthen the level and governance capacity, and improve the quality, safety and the coverage of rehabilitation services.
