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The past uses of the ICF's predecessor, the ICIDH, provide some examples of the likely applications of the ICF. These include:
statistical applications - specification, collection and recording of data (e.g. in population surveys, studies, management information systems)
research - to support the measurement of outcomes, quality of life, and environmental factors
clinical use - to shape needs assessment (e.g. vocational, rehabilitation) and evaluate outcomes
social policy analysis - in general policy design and implementation, social security, planning, and compensation systems
educational applications - in curriculum design, and to raise awareness of the multidimensional nature of disability and undertake social action (WHO 2001:5).
Badley (1993) highlighted the inherent usefulness of the ICIDH to the fields of health and health care, social care, social security, employment, education and training, survey research and statistics, listing the following general applications:
clinical diagnosis and rehabilitation assessment
record keeping in health and rehabilitation settings
development of medical and health monitoring systems
program evaluation and development
promotion of linguistic agreement
concept development in field of disablement studies
development of research programs
formation of disability policy
data collection in survey research and database development.
The Collaborating Centre for the WHO Family of International Classifications in the Netherlands publishes a regular newsletter which, over the years, has documented a vast range of uses of the ICF and its predecessor the ICIDH (for instance, WHO-FIC Collaborating Centre in the Netherlands 2002).
Specific examples of application in the United States by different disciplines are described in Nieuwenhuijsen (1995). These examples reflect the diverse use of the ICF as a framework in areas such as:
outcome-based approaches to education
measurement of functional gains in elderly blind people, resulting from rehabilitation services
the development of the Craig Handicap Assessment and Reporting Technique (CHART) to measure the degree to which impairments may limit activities and restrict participation
the collection of data to enhance strategies preventing work-related back disabilities among nurses
back-coding of national datasets to review and enhance equal opportunities for, and full participation of, students in special education.
In a discussion on ICF applications, Stucki et al. (2002) stated that the ICF is 'likely to become the generally accepted framework to describe functioning in rehabilitation'.
People attending a 1994 Australian workshop on the ICIDH and the measurement of disability identified a wide range of areas that would benefit from national consistency in disability concepts and measurement (AIHW 1994):
consumers interested in ways of better relating data on needs for services and the provision of services
service providers and planners interested in relating needs, eligibility criteria and resource allocation
people and policy makers interested in equity and wanting agreed broad definitions of disability in order to define and monitor exclusion and inclusion
clinicians of many disciplines who wished to relate disability outcomes and the 'severity' of functioning to appropriate interventions, and to relate their clinical practice to experience in the wider population
national and international statisticians interested in being able to estimate prevalence (the proportion of the population with a disability), needs for support and outcomes in informative and comparable ways (it was noted that the ICIDH had already been widely been used to develop national surveys in Australia and elsewhere)
policy makers in a wide range of fields (e.g. aged care, insurance, compensation and income security) who wished to improve their data and to be able to relate it to data collected in other fields.
The ICF - inquiries made
Since 1994, the AIHW has received inquiries about the ICF and its predecessor, the ICIDH, from a wide range of disciplines. Although some of these inquiries have simply been requests for information about the classification, others have indicated the potential or proposed use of the ICF as a framework for a specific undertaking (Table 3.1).
Health and health care have been among the main disciplines investigating the use of the ICF. Researchers and practitioners in the fields of ageing research, speech pathology and geriatric medicine have proposed an examination of the ICF's suitability as a framework for outcomes measurement (e.g. rehabilitation, sub-acute care), service prioritisation, clinical practice and medical teaching. Assessment tools based on the ICF, or some of its components, have also been discussed, specifically to describe health conditions and their effects, to recognise conditions of care essential to people with long-term illnesses, and to measure participation.
Outside the health field, information on the ICF has been requested from people with particular interests in social work, housing, physical activity and education. The definition and/or classification of disability has been a particular focus, e.g. to describe the potential consequences of domestic violence (on women and unborn children) and to classify athletes competing in disabled games. Support needs for students with disabilities was another area where ICF was being evaluated as a framework for 'assessment for support' procedures in education.
Further information about major current uses is provided in Section 10, which will be a regularly updated feature of this guide.
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