250463 Disability and Vision Rehabilitation: Role of the International Classification of Functioning, Disability and Health (ICF)

Tuesday, November 1, 2011: 10:30 AM

Els R. Nieuwenhuijsen, PhD, MPH, OTR , Dept. of Physical Medicine and Rehabillitation, University of Michigan Health System, Ann Arbor, MI
John Hough, DrPH, MPH, MBA, CHES, CPH, FACE , National Center for Health Statistics, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Hyattsville, MD
Objective: Demonstrate that the conceptual framework manifested in the ICF represents a viable approach for understanding functional status among individuals and populations with vision impairments.

Method: Illustrate ICF coding among persons with vision impairments, using photographic examples. We focus on macular degeneration and diabetic retinopathy as representative vision impairments for which ICF coding makes organizing cases easier and more meaningful. We emphasize that the qualifier-modified ICF codes are proxies for severity of vision impairment.

Outcome: Illustrating what patients with vision impairments see, closely associated with specific qualifier-modified ICF codes, can lead to more efficient summarization of cases using standardized terms.

Conclusion: ICF coding provides sufficient granularity and specificity in describing Seeing Functions, and hence a new way of organizing and summarizing cases for research, surveillance, or rehabilitation assessment.

The World Health Organization published the International Classification of Functioning, Disability and Health (ICF) in 2001 as a classification for describing characteristics of health involving functional impairments, activity limitations, and participation restrictions. ICF Chapter 2, “Seeing Functions,” in the Body Functions domain, provides very specific code stems for impairments of visual acuity functions (b2100), visual field functions (b2101), quality of vision (b2102), and functions of structures adjoining the eye such as the internal eye muscles (b2150), eyelid (b2151), external eye muscles (b2152), and the lachrymal glands (b2153). Any clinician can apply and use ICF codes for nearly any case-counting activity. Therefore, the ICF conceptual framework, and especially ICF coding, are relevant to describing vision health efficiently and in a standardized manner.

Learning Areas:
Basic medical science applied in public health
Chronic disease management and prevention
Other professions or practice related to public health
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1) Articulate that in the conceptual framework of the International Classification of Functioning, Disability and Health (ICF), Seeing Functions can be represented by an array of ICF codes referring to functional status, rather than diagnosis. 2) Differentiate between ICF code stems and ICF qualifier digits, so as to explain how the qualifier digits indicate relative severity of vision impairments. 3) Explain the principle that all four ICF domains (Body Functions, Body Structures, Activities and Participation, Environmental Factors) are presumed to be constantly interacting.

Keywords: Disability, Vision Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I engage in research related to applying the International Classification of Functioning, Disability and Health in rehabiltiation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.