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20 Musculoskeletal & Neurological Rehabilitation KCE reports 57 The FIM-FRG include probably most of the impairment groups which can induce a rehabilitation process ((+) Criterion A). The FIM-FRG are compounded taking into account impairment group, functional status and patient age ((+) Criterion B). For the selection of diagnoses some principles were respected, which are represented in Figure 2.1 and Figure 2.2. Only diagnoses within the Medical Diagnostic Categories of disorders and diseases related to the neurological system or the musculoskeletal system and the connective tissues were withheld ((+) Criterion A) (Figure 2.1 = green dots). Within these only the top 5 of well defined diagnoses with a high incidence were kept ((+) Criterion C) (Figure 2.2 and Figure 2.1 = green left-right lines). An exception was made for the two impairment categories of spinal cord which were also retained for the reason that a small group of individuals with very specific rehabilitation needs might require a special approach related to organisation and financing (Figure 2.2 and Figure 2.1 = blue right-left lines). Even though traumatic brain injury (TBI) requires a specific rehabilitation service, traumatic brain injury was not included for the purpose of the study due to overlap concerning patients’ profile with spinal cord injury and the clinical characteristics with stroke patients. Moreover, they appear even less frequent than spinal cord injury.
KCE reports 57 Musculoskeletal & Neurological Rehabilitation 21 Figure 2.1: Link of the UDSmr Impairment groups to the FIM-FRG Impairement categories (Version 1994) and the Major Diagnostic Groups 23 . Major Diagnostic Categories 1. Disease and disorders of the nervous system 2. Diseases and disorder of the musculoskeletal system and the connective tissues 3. Diseases and disorders of the respiratory system 4. Diseases and disorders of the circulatory system 5. Major multiple trauma 16) Major multiple trauma No direct equivalent No direct equivalent FIM-FRG Impairment Categories UDSmr Impairment Group Codes (Version 1.1) 1) Stroke Left body (right brain) Right body (left brain) Bilateral No paresis Other stroke 2) Brain dysfunction, nontraumatic Other brain 3) Brain dysfunction, traumatic Open injury Closed injury 4) Spinal cord injury, nontraumatic Paraplegia incomplete Paraplegia complete Quadriplegia incomplete C1-4 Quadriplegia incomplete C5-8 Quadriplegia complete C1-4 Quadriplegia incomplete C5-8 Other non-traumatic SC 5) Spinal cord injury, traumatic Paraplegia incomplete Paraplegia complete Quadriplegia incomplete C1-4 Quadriplegia incomplete C5-8 Quadriplegia complete C1-4 Quadriplegia incomplete C5-8 Other traumatic SC 6) Neurological conditions (otherwise not Multiple sclerosis classified) Parkinsonism Polyneuropathy Other neurologic 7) Lower extremity amputation Single lower extremity above the knee Single lower extremity below the knee Double lower extremity above the knee Double lower extremity above/below the knee Double lower extremity below the knee 8) Other amputation Single upper extremity above the elbow Single upper extremity below the elbow Other amputation 9) Osteoarthritis Osteoarthritis 10) Other arthritis Rheumatoid arthritis Other arthritis 11) Orthopedic: Lower extremity fracture Status post hip fracture Status post femur (Shaft) fracture Status post pelvic fracture Status post major multiple fracture 12) Orthopedic: Lower extremity joint Status post hip replacement replacement Status post knee replacement 13) Other orthopedic Other orthopedic 14) Pulmonary Chronic obstructive pulmonary disease Other pulmonary 15) Cardiac Cardiac 17) Pain 18) Otherwise not classified Brain + spine cord Brain + multiple fracture/amputation Spinal cord + multiple fracture/amputation Other multiple trauma Neck pain Back pain Extremity pain Other pain Burns Spinabifida Other congenital Other disabling impairments
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Dépôt légal : D/2007/10.273/19
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35. Etude relative aux coûts poten
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