The report is available in English with a French summary - KCE

44 Musculoskeletal & Neurological Rehabilitation KCE reports 57
4 REGISTERED DATA AND PATIENT PROFILES
4.1 BACKGROUND
In chapter 3 an extensive description has been made of the different scales used to
measure outcomes of rehabilitation within the scope of organizational/financing purposes.
Rehabilitation scales and/or datasets are already in use in some countries in order to
classify patients for organizational/financing purposes.
The approval of ICF as an internationally accepted classification of functioning, has
stimulated the analysis of existing measures and scales. Major efforts on this part are being
done by the “ICF branch of WHO”. A systematic review by this group 118 made an inventory
of different measures used in acute and post-acute rehabilitation and compared it to ICF.
The authors conclude that at this stage no real standard validated scales measuring (clinical
and functional) characteristics of rehabilitation patients are readily available that cover
most/all aspects of ICF. At the same time ICF-concepts covered by the individual
rehabilitation scales vary a lot. This means that currently, no existing validated
rehabilitation scale is able to differentiate rehabilitation units and pathologies on basis of
the (clinical and functional) characteristics of patient populations, and at the same time fit
to the ICF-model.
The use of ICF itself as a managerial and financial tool is still under development (see
chapter 3); and many problems still have to be solved.
Taking into account these observations, this chapter has a practical purpose. In Belgium,
the only formal registration system currently used in the hospital sector, including
indicators of functionality of the patient, is the minimum nursing data set. A quick scan of
literature was performed to assess to what degree current nursing registration systems
could be used to describe and compare patient populations in rehabilitation settings and
to what degree these datasets could be used for rehabilitation managerial purposes. In a
second part we illustrate how profiles of Belgian minimum nursing data can differentiate
the characteristics of rehabilitation facilities. A third part brings some examples of
internationally accepted. Rehabilitation scales that are in use in some Belgian rehabilitation
centres and sometimes are already used for organizational purposes at the level of the
own hospital.
4.2 A QUICK SCAN OF AVAILABLE LITERATURE
4.2.1 Methods
A quick scan of the databases Medline (through PubMed), CDC, CRD, Econlit and Cinahl
was done in November 2006.
Following search terms were used: Rehabilitation, Rehabilitation Science, Rehabilitation
research, Rehabilitation centers, Disability evaluation, Severity of disability, International
classification of functioning, disability and health or disability, Patient classification,
minimum data set, Research instruments, Rehabilitation or Clinical assessment tools,
outcome assessment, Functional assessment , Rehabilitation patients, FIM(keyword),
subacute care, Barthel Index, Disability evaluation, Functional status, Functional
assessment, Instrument validation, Clinical assessment tools, Brain injuries, or Cerebral
Vascular accident or Activities of daily living, Physiotherapy, Physical therapy.
The search was general. The selection of the articles was based on the title and abstract.
As could be expected, the majority of literature found on nursing data sets focuses on the
use of datasets for nursing issues and on the ability to use large clinical nursing datasets to
assess the effectiveness of nursing interventions. There is an extensive literature on
nursing terminology, on information models and standards for nursing datasets h . All
h The FOD-MVG 2 report makes an extensive overview of internationally available nursing data sets and scales