20 Years of ICF-International Classification of Functioning, Disability and Health: Uses and Applications around the World

doi:10.3390/ijerph191811321

Review

. 2022 Sep 8;19(18):11321.

doi: 10.3390/ijerph191811321.

20 Years of ICF-International Classification of Functioning, Disability and Health: Uses and Applications around the World

Matilde Leonardi¹, Haejung Lee², Nenad Kostanjsek³, Arianna Fornari¹, Alberto Raggi¹, Andrea Martinuzzi⁴, Manuel Yáñez⁵, Ann-Helene Almborg⁶, Magdalena Fresk⁶, Yanina Besstrashnova⁷, Alexander Shoshmin⁷, Shamyr Sulyvan Castro⁸, Eduardo Santana Cordeiro⁹, Marie Cuenot¹⁰, Christine Haas¹¹, Soraya Maart¹², Thomas Maribo^{13

14}, Janice Miller¹⁵, Masahiko Mukaino¹⁶, Stefanus Snyman^{17

18}, Ulrike Trinks¹⁹, Heidi Anttila²⁰, Jaana Paltamaa²¹, Patricia Saleeby²², Lucilla Frattura²³, Ros Madden²⁴, Catherine Sykes²⁴, Coen H van Gool²⁵, Jakub Hrkal²⁶, Miroslav Zvolský²⁶, Petra Sládková²⁶, Marie Vikdal²⁷, Guðrún Auður Harðardóttir²⁸, Josephine Foubert²⁹, Robert Jakob³, Michaela Coenen^{30

31}, Olaf Kraus de Camargo³²

Affiliations

¹ Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy.
² Department of Physical Therapy, College of Health and Welfare, Silla University, Busan 46958, Korea.
³ Classification, Terminology and Standards Unit, World Health Organization (WHO), 1211 Geneva, Switzerland.
⁴ Department of Conegliano-Pieve di Soligo, IRCCS E. Medea Scientific Institute, 31015 Conegliano, Italy.
⁵ General Directorate of Health Information and Research, Ministry of Health, Mexico City 03100, Mexico.
⁶ National Board of Health and Welfare, 10333 Stockholm, Sweden.
⁷ Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 195067 St. Petersburg, Russia.
⁸ Department of Physical Therapy, Universidade Federal do Ceará-UFC, Fortaleza 60020-181, Brazil.
⁹ International Society of Experts and Researchers on Functioning and the ICF, University of São Paulo, São Paulo 05508-220, Brazil.
¹⁰ School of Public Health, École des Hautes Études en Santé Publique (EHESP), 35043 Rennes, France.
¹¹ Jena University Hospital, 07743 Jena, Germany.
¹² Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa.
¹³ Department of Public Health, Aarhus University, 8000 Aarhus, Denmark.
¹⁴ DEFACTUM, Corporate Quality-Central Denmark Region, 8000 Aarhus, Denmark.
¹⁵ Canadian Institute for Health Information (CIHI), Ottawa, ON K2A 4H6, Canada.
¹⁶ Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Toyoake 470-1101, Aichi, Japan.
¹⁷ Centre for Community Technologies, Nelson Mandela University, Gqeberha 6019, South Africa.
¹⁸ WHO-FIC Collaborating Centre, South African Medical Research Council, Cape Town 8000, South Africa.
¹⁹ The German Institute for Medical Documentation and Information (DIMDI), 51149 Cologne, Germany.
²⁰ Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland.
²¹ School of Health and Social Studies, JAMK University of Applied Sciences, 40200 Jyväskylä, Finland.
²² Department of Sociology, Criminology, and Social Work, Bradley University, Peoria, IL 61625, USA.
²³ Classification Area, Azienda Sanitaria Universitaria Giuliano Isontina, 34128 Trieste, Italy.
²⁴ Faculty of Health Sciences, University of Sydney, Sydney, NSW 2006, Australia.
²⁵ National Institute for Public Health and the Environment, 3721 Bilthoven, The Netherlands.
²⁶ Institute of Health Information and Statistics of the Czech Republic, 128 01 Prague, Czech Republic.
²⁷ Centre Head of NordClass, Department of Classifications and Terminology in Healthcare, The Norwegian Directorate of e-Health, 0277 Oslo, Norway.
²⁸ Directorate of Health, 105 Reykjavik, Iceland.
²⁹ Census and Disability Analysis Office for National Statistics, Swyddfa Ystadegau Gwladol, Newport SA42, UK.
³⁰ Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Chair of Public Health and Health Services Research, LMU Munich, 80539 Munich, Germany.
³¹ Pettenkofer School of Public Health, 80539 Munich, Germany.
³² CanChild-Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 4L8, Canada.

PMID: 36141593
PMCID: PMC9517056
DOI: 10.3390/ijerph191811321

Review

20 Years of ICF-International Classification of Functioning, Disability and Health: Uses and Applications around the World

Matilde Leonardi et al. Int J Environ Res Public Health. 2022.

. 2022 Sep 8;19(18):11321.

doi: 10.3390/ijerph191811321.

Authors

Affiliations

¹ Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy.
² Department of Physical Therapy, College of Health and Welfare, Silla University, Busan 46958, Korea.
³ Classification, Terminology and Standards Unit, World Health Organization (WHO), 1211 Geneva, Switzerland.
⁴ Department of Conegliano-Pieve di Soligo, IRCCS E. Medea Scientific Institute, 31015 Conegliano, Italy.
⁵ General Directorate of Health Information and Research, Ministry of Health, Mexico City 03100, Mexico.
⁶ National Board of Health and Welfare, 10333 Stockholm, Sweden.
⁷ Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 195067 St. Petersburg, Russia.
⁸ Department of Physical Therapy, Universidade Federal do Ceará-UFC, Fortaleza 60020-181, Brazil.
⁹ International Society of Experts and Researchers on Functioning and the ICF, University of São Paulo, São Paulo 05508-220, Brazil.
¹⁰ School of Public Health, École des Hautes Études en Santé Publique (EHESP), 35043 Rennes, France.
¹¹ Jena University Hospital, 07743 Jena, Germany.
¹² Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa.
¹³ Department of Public Health, Aarhus University, 8000 Aarhus, Denmark.
¹⁴ DEFACTUM, Corporate Quality-Central Denmark Region, 8000 Aarhus, Denmark.
¹⁵ Canadian Institute for Health Information (CIHI), Ottawa, ON K2A 4H6, Canada.
¹⁶ Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Toyoake 470-1101, Aichi, Japan.
¹⁷ Centre for Community Technologies, Nelson Mandela University, Gqeberha 6019, South Africa.
¹⁸ WHO-FIC Collaborating Centre, South African Medical Research Council, Cape Town 8000, South Africa.
¹⁹ The German Institute for Medical Documentation and Information (DIMDI), 51149 Cologne, Germany.
²⁰ Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland.
²¹ School of Health and Social Studies, JAMK University of Applied Sciences, 40200 Jyväskylä, Finland.
²² Department of Sociology, Criminology, and Social Work, Bradley University, Peoria, IL 61625, USA.
²³ Classification Area, Azienda Sanitaria Universitaria Giuliano Isontina, 34128 Trieste, Italy.
²⁴ Faculty of Health Sciences, University of Sydney, Sydney, NSW 2006, Australia.
²⁵ National Institute for Public Health and the Environment, 3721 Bilthoven, The Netherlands.
²⁶ Institute of Health Information and Statistics of the Czech Republic, 128 01 Prague, Czech Republic.
²⁷ Centre Head of NordClass, Department of Classifications and Terminology in Healthcare, The Norwegian Directorate of e-Health, 0277 Oslo, Norway.
²⁸ Directorate of Health, 105 Reykjavik, Iceland.
²⁹ Census and Disability Analysis Office for National Statistics, Swyddfa Ystadegau Gwladol, Newport SA42, UK.
³⁰ Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Chair of Public Health and Health Services Research, LMU Munich, 80539 Munich, Germany.
³¹ Pettenkofer School of Public Health, 80539 Munich, Germany.
³² CanChild-Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 4L8, Canada.

PMID: 36141593
PMCID: PMC9517056
DOI: 10.3390/ijerph191811321

Abstract

The International Classification of Functioning Disability and Health (ICF) was approved in 2001 and, since then, several studies reported the increased interest about its use in different sectors. A recent overview that summarizes its applications is lacking. This study aims to provide an updated overview about 20 years of ICF application through an international online questionnaire, developed by the byline authors, and sent to each World Health Organization Collaborating Centers of the Family of International Classifications (WHO-FIC CCs). Data was collected during October 2020 and December 2021 and descriptive content analyses were used to report main results. Results show how, in most of the respondent countries represented by WHO-FIC CCs, ICF was mainly used in clinical practice, policy development and social policy, and in education areas. Despite its applications in different sectors, ICF use is not mandatory in most countries but, where used, it provides a biopsychosocial framework for policy development in health, functioning and disability. The study provides information about the needs related to ICF applications, that can be useful to organize targeted intervention plans. Furthermore, this survey methodology can be re-proposed periodically to monitor the use of the ICF in the future.

Keywords: ICF; biopsychosocial; disability; functioning; health; international classification; public health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
WHO Collaborating Centers that responded to the global survey. Legend: the countries reported in italics are those that did not respond to the survey (Argentina, India, Spain, Belgium, Kuwait, China, Thailand).

**Figure 2**
Main use of ICF in respondent countries (N = 14).

See this image and copyright information in PMC

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References

1. World Health Organization . How to Use the ICF: A Practical Manual for Using the International Classification of Functioning, Disability and Health (ICF); Exposure Draft for Comment. WHO; Geneva, Switzerland: 2013.
1. World Health Organization . The International Classification of Functioning, Disability and Health: ICF. WHO; Geneva, Switzerland: 2001.
1. World Health Organization . International Statistical Classification of Diseases and Related Health Problems. 10th ed. WHO; Geneva, Switzerland: 1992–1994.
1. Cerniauskaitė M., Quintas R., Boldt C., Raggi A., Cieza A., Bickenbach J., Leonardi M. Systematic literature review on ICF from 2001 to 2009: Its use, implementation and operationalisation. Disabil. Rehabil. 2001;33:281–309. doi: 10.3109/09638288.2010.529235. - DOI - PubMed
1. World Health Organization . The Global Burden of Disease: 2004 Update. WHO; Geneva, Switzerland: 2008.

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[1] World Health Organization . How to Use the ICF: A Practical Manual for Using the International Classification of Functioning, Disability and Health (ICF); Exposure Draft for Comment. WHO; Geneva, Switzerland: 2013.

[2] World Health Organization . How to Use the ICF: A Practical Manual for Using the International Classification of Functioning, Disability and Health (ICF); Exposure Draft for Comment. WHO; Geneva, Switzerland: 2013.

[3] World Health Organization . The International Classification of Functioning, Disability and Health: ICF. WHO; Geneva, Switzerland: 2001.

[4] World Health Organization . The International Classification of Functioning, Disability and Health: ICF. WHO; Geneva, Switzerland: 2001.

[5] World Health Organization . International Statistical Classification of Diseases and Related Health Problems. 10th ed. WHO; Geneva, Switzerland: 1992–1994.

[6] World Health Organization . International Statistical Classification of Diseases and Related Health Problems. 10th ed. WHO; Geneva, Switzerland: 1992–1994.

[7] Cerniauskaitė M., Quintas R., Boldt C., Raggi A., Cieza A., Bickenbach J., Leonardi M. Systematic literature review on ICF from 2001 to 2009: Its use, implementation and operationalisation. Disabil. Rehabil. 2001;33:281–309. doi: 10.3109/09638288.2010.529235. - DOI - PubMed

[8] Cerniauskaitė M., Quintas R., Boldt C., Raggi A., Cieza A., Bickenbach J., Leonardi M. Systematic literature review on ICF from 2001 to 2009: Its use, implementation and operationalisation. Disabil. Rehabil. 2001;33:281–309. doi: 10.3109/09638288.2010.529235. - DOI - PubMed

[9] World Health Organization . The Global Burden of Disease: 2004 Update. WHO; Geneva, Switzerland: 2008.

[10] World Health Organization . The Global Burden of Disease: 2004 Update. WHO; Geneva, Switzerland: 2008.

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20 Years of ICF-International Classification of Functioning, Disability and Health: Uses and Applications around the World

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20 Years of ICF-International Classification of Functioning, Disability and Health: Uses and Applications around the World

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