Article

Casemix models for funding activity in health care and assessing
performance depend on data based on uniformity of resource utilisation. It has
long been an ideal to relate the measure of value more to patient outcome than
output. A problem frequently expressed by clinicians is that measures of activity
such as Functional Independence Measure (FIM) and Barthel Index scores may not
sufficiently represent the aspirations of patients in many care programs. METHOD:
Firstly, the key features of the International Classification of Functioning,
Disability and Health are outlined. Secondly, the use of ICF dimensions in
Australia and other countries is reviewed. Thirdly, a broader set of domains with
potential for casemix funding models and performance reporting is considered.
RESULTS: In recent years, the ICF has provided a more developed set of domains
against which outcome goals can be expressed. Additional dimensions could be used
to supplement existing data. Instances of developments in this area are
identified and their potential discussed. CONCLUSIONS:
A well-selected set of
data items representing the broader dimensions of outcome goals may provide the
ability to more meaningfully and systematically measure the goals of both
curative and rehabilitation care against which outcome should be measured. More
information about patient goals may be needed.

Langue : ANGLAIS