National Centre for Classification in Health, Faculty of Health Sciences, University of Sydney, Lidcombe, Australia.
Disabil Rehabil. 2013 Jun;35(13):1074-7. doi: 10.3109/09638288.2012.720349. Epub 2012 Sep 26.
Casemix models for funding activity in health care and assessing performance depend on data based on uniformity of resource utilisation. It has long been an ideal to relate the measure of value more to patient outcome than output. A problem frequently expressed by clinicians is that measures of activity such as Functional Independence Measure (FIM) and Barthel Index scores may not sufficiently represent the aspirations of patients in many care programs.
Firstly, the key features of the International Classification of Functioning, Disability and Health are outlined. Secondly, the use of ICF dimensions in Australia and other countries is reviewed. Thirdly, a broader set of domains with potential for casemix funding models and performance reporting is considered.
In recent years, the ICF has provided a more developed set of domains against which outcome goals can be expressed. Additional dimensions could be used to supplement existing data. Instances of developments in this area are identified and their potential discussed.
A well-selected set of data items representing the broader dimensions of outcome goals may provide the ability to more meaningfully and systematically measure the goals of both curative and rehabilitation care against which outcome should be measured. More information about patient goals may be needed.
用于医疗保健筹资活动和绩效评估的病例组合模型依赖于基于资源利用一致性的数据。将价值衡量标准更多地与患者的结果而不是产出联系起来，一直是一个理想。临床医生经常表达的一个问题是，活动测量，如功能独立性测量（FIM）和巴氏量表评分，在许多护理计划中可能无法充分代表患者的愿望。
首先，概述了国际功能、残疾和健康分类的主要特征。其次，审查了 ICF 维度在澳大利亚和其他国家的使用情况。第三，考虑了更广泛的领域，这些领域有可能用于病例组合资金模型和绩效报告。
近年来，ICF 提供了一套更发达的领域，可用来表达结果目标。可以使用其他维度来补充现有数据。确定了该领域的发展实例，并讨论了其潜力。
选择一组能够代表更广泛结果目标维度的良好数据项，可能能够更有意义和系统地衡量治疗和康复护理的目标，这是需要衡量的结果。可能需要更多关于患者目标的信息。
