The rehabilitation outcomes and medical expenditures of stroke patients in the neurology and rehabilitation departments using the International Classification of Functioning, Disability and Health′s Rehabilitation Set
10.3760/cma.j.cn421666-20240929-00804
- VernacularTitle:基于国家标准的ICF-RS评估神经内科和康复科脑卒中住院患者康复结局和医疗支出
- Author:
Xiu XU
1
;
Tanyao JIANG
;
Tiebin YAN
;
Sizhen CHEN
;
Na YU
;
Xiangyang CHEN
;
Xinting ZHANG
;
Zhongping ZHANG
Author Information
1. 暨南大学祈福医院，广州 511495
- Publication Type:Journal Article
- Keywords:
International Classification of Functioning, Disability and Health, Rehabilitation Set;
Stroke;
Neurology departments;
Rehabilitation departments;
Medical
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2025;47(9):847-852
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the outcomes of stroke treatment in neurology and rehabilitation departments using the International Classification of Functioning, Disability and Health′s Rehabilitation Set (ICF-RS).Method:The functional status of stroke survivors before and after treatment in the neurology and rehabilitation departments was evaluated using the ICF-RS (30 items). Each patient′s functioning was graded (normal, mild, moderate or severe dysfunction) by an experienced clinical evaluator and also by the intelligent evaluation model in the ICF-RS app. Medical expenditure data during hospitalization were extracted from the hospital′s case records. Rank sum tests compared the functional changes in a patient before and after their rehabilitation. Kappa coefficients were computed to evaluate the consistency of the functional grades assigned by the evaluators and the app.Results:Before the rehabilitation treatment, all 30 items of the ICF-RS were abnormal for all of the patients from the neurology and rehabilitation departments. After their rehabilitation treatment, 25 items had improved significantly for the neurology patients and 8 had improved significantly for those from the rehabilitation department. After their rehabilitation treatment, the average functional improvement among the neurology patients was 25%. For the rehabilitation patients it was 13%. The total expenditure for every 1% improvement in function was Y977 for the neurology patients (including Y143 for rehabilitation) and Y1, 481 for the rehabilitation patients (including Y862 of actual rehabilitation). The proportions of rehabilitation expenditure were thus 14% and 58% respectively. The kappa coefficients quantifying overall consistency were both greater than 0.8.Conclusion:The national standard ICF-RS can be used to evaluate functional changes, rehabilitation efficacy and the composition of stroke patients′ medical expenditures in the early stage of neurology and the recovery period in the rehabilitation department. The consistency of the functional level evaluations between the app and human evaluators is good.
