Constructing the International Classification of Functioning, Disability and Health-based (ICF-based) Individual Needs Assessment System for the Rehabus Services
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Introduction
The research project led by Dr Sam C. C. Chan, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, is commissioned by the Hong Kong Society for Rehabilitation (HKSR). In response to the societal demand of Rehabus, the purpose of the study is to explore the current booking system and operation status of the Rehabus through policy review, individual interviews, focus groups, forums and surveys, so as to improve and optimize the policies and services of the Rehabus.
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What is ICF?
The ICF system provides a comprehensive and unified framework to analyse and to understand the living conditions of people with different types and levels of disabilities in multi-category approach such as body function and structure, activities, participation, environmental factors and personal factors.
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Principal Investigator
Dr Sam Chi Chung Chan (Associate Professor in the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University)
Co-Principal Investigator
Professor Chetwyn Che Hin Chan
(Vice President (Research and Development), The Education University of Hong Kong)
Dr Andrew Man Hong Siu
(Reader in Occupational Therapy, Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, UK)
Dr Will Chi Wen Chien
(Associate Professor in the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University)
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Participate in Our Project
Phase 1: Opinions on Rehabus Services
Completed
Phase 2: Personal Assessment of the Research Project
Completed
Phase 3: Personal Assessment of the Research Project
After preliminary review by Experts according to the individual case received in Phase 2, the following priority criteria are determined:
(1) Body function
(2) Trip purpose
(3) Activity level
(4) Participation level
(5) Environmental factor.
Individual assessments will be conducted online via Zoom. We are here to invite you to participate in Phase 3 for further validate the priority criteria set in Phase 2.
Completed
Stakeholders Engagement
Completed
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Research Information
Relevant Information
Research Introduction
The research project led by Dr Sam C. C. Chan, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, is commissioned by the Hong Kong Society for Rehabilitation (HKSR). In response to the societal demand of Rehabus, the purpose of the study is to explore the current booking system and operation status of the Rehabus through policy review, individual interviews, focus groups, forums and surveys, so as to improve and optimize the policies and services of the Rehabus.
The current practice of the HKSR on prioritizing users’ use of service is based on “first-come-first-served”. This current practice however may not be able to achieve “the most optimal use of public funds for serving those who are the most in need”. In order to improve the inclusiveness, fairness and transparency of the current Rehabus services, the International Classification of Functioning, Disability and Health (ICF) System, which was established by the World Health Organization (WHO) to identify personal and functional factors, will be adopted to optimizing the Rehabus services. Taking all the stakeholders’ perspective into consideration, the research team anticipates that the application of the ICF system in the Rehabus services could meet the public’s expectations and needs comprehensively, in order to provide person-oriented rehabilitation treatment or services.
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Research Progress
Phase 1
Literature review on the theoretical framework and application of the ICF system on transportation services
– ICF framework has been used to provide guidance for policies and operation of healthcare and public services. Yet, it has not been applied for prioritisation of any public services
– ICF was found useful to quantify individuals’ body functions, level of activity and participation, and environmental factors
Investigation of overseas policies and operation of transportation services for persons with disabilities
– Review on the system of the eligibility for using transportation services for individuals with disabilities from the publications of the transport operation organisations in the US, Canada and Taiwan
– The jurisdiction in the selected districts may only adopt one or two factors to determine users’ eligibility and some do not adopt any system for prioritising
– For example, Taiwanese adopted the functional status and environmental factors only for the eligibility determination
– The usage of various components of the ICF into the Rehabus services could provide a multifaceted model for prioritising
Engagements with the government, corporate governance, execution, and user of the Rehabus services
– Different stakeholders are generally open to the idea of using comprehensive ICF concepts to the service prioritisation
– The new system would lead to a fairer service allocation
– Main concern was whether there would be sufficient human resources for conducting ICF-based assessments on current and potential Rehabus users
– The operation team and users suggested that the Government provides more resources to support the newly established system and the related assessments
The collected opinions of stakeholders indicated that the prioritisation of the Rehabus service could be established through the results of the ICF-based assessment, including:
– Body functions
– Characteristics of the trip
– Level of activity
– Level of participation in life situation
– Environmental factors
-Social support
Phase 2
To establish an prototype ICF-based priority system of Rehabus services, this phase aims:
(1) to conduct ICF-based assessments on individuals with various types and severity of disabilities to establish ICF-based case studies
(2) to establish expert panels to review and rank the priority of the Rehabus services of case studies established in order to identify the importance of different ICF factors
A total of 60 persons with disabilities and/ or their carers were recruited to construct ICF-based profiles. The ICF-based profiles were then reviewed by the expert panel to determine the importance and relevance of the different ICF components for Rehabus services prioritisation. The preliminary findings are as follows:
– Body function domain is considered as the most important factor
– Followed by trip purpose, activity domain, participation domain, social support and environmental domain (listed in order)
– Social support and trip purpose are the two non-ICF factors taken into consideration for prioritisation.
Phase 3
Aims to further validate the identified ICF-based assessment and the algorithm-based priority system. The initial three proposed prioritisation algorithms are as follows:
– Proposed Prioritisation Algorithm 1
– Adopting a linear prioritisation approach, includes the 6 factors with the rankings: (1) Body function domain; (2) Trip purpose; (3) Activity domain; (4) Participation domain; (5) Social support; and (6) Perceived environmental domain
– Proposed Prioritisation Algorithm 2 & 3
– Three-tier approach is proposed
– Level of functioning based on the weighted ICF scores (calculated by Body function, Activity domain, participation domain, family/social support, and perceived environmental domain) (family/ social support is a non-ICF factors)
– Trip purpose
– Geographical conditions
– The structure of Two 3-tier Prioritisation Algorithms
– Prioritisation Algorithm 2: Level of functioning – Trip purpose – Geographic conditions
– Prioritisation Algorithm 3: Trip purpose – Level of functioning – Geographic conditions
A larger group of persons with disabilities will be invited for personal assessment, through online recruitment and invitation to various organisations.
The generated ICF-based profiles and priority scores will then be submitted to the expert panel for evaluation with respect to acceptability, fairness and satisfaction, and cost effectiveness
Gather views on the prioritisation algorithms from different stakeholders through stakeholder engagement
– For the content and information of the stakeholder engagement, please click here.
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International Classification of Functioning, Disability and Health (ICF)
The ICF system provides a comprehensive and unified framework to analyse and to understand the living conditions of people with different types and levels of disabilities in multi-category approach such as body function and structure, activities, participation, environmental factors and personal factors (refer to the ICF system framework below). Take a 23-year-old wheelchair user with spinal cord injury as an example:
Body Structure: lumbar vertebrae and related nerves were injured
Body Function: loss of sensation below the waist, loss of lower limb movement
Activities: impaired mobility function, self-care activities with assistance such as having a shower
Participation: Studying at school and social activities
Environmental factors: Barrier-free facilities for traveling, e.g. using wheelchairs and Rehabus Services
Personal factors: family and peer support