中国康复理论与实践2025，Vol.31Issue(4)：382-390,9.DOI:10.3969/j.issn.1006-9771.2025.04.002
基于ICF架构比较4种残疾标准分类分级方法
Comparison of classification and grading approach in four selected disability standards using ICF framework
摘要
Abstract
Objective Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF),this paper compared the classification and grading methods of disability standards in four areas in China,focusing on definition,classification,grading,coding systems and assessment tools. Methods Four disability standards including Disability Assessment and Code for Life Insurance(insurance standard),Classification of Disability Degrees for Human Body Injury(judicial standard),Grading of Disability for Work-Related Injuries and Occupational Diseases(work-related injury standard),and Classification and Grading of Dis-abilities for Persons with Disabilities(disability eligibility standard)were systematically analyzed.Each standard was reviewed to identify core elements of disability definitions,classification,and grading methods.Content analysis was used to extract and compare the definitions,classification,grading,coding systems,and assessment tools.The strengths,weaknesses,and practical limitations of each standard were analyzed using the ICF frame-work. Results There were different in disability definitions,classification and grading,coding systems,and assessment tools across the standards.In terms of definitions,the insurance standard emphasized ICF's body structure and function impairments;the judicial standard defined disability as limitations in life and work capacity due to bodily injury,covering ICF's body structure and function,activity and participation;the work-related injury standard focused on loss of labor capacity due to work-related injuries,involving body structure and function,activity and partici-pation;the disability eligibility standard refered to the ICF model,defining disability as impairments in body function and structure,and activity limitations and participation restriction.Regarding classification and grading,the insurance standard divided disabilities into eight categories based on body structure and function,with ten grades of disability severity;the judicial standard first graded disabilities into ten levels and then classified as in-jury site;the work-related injury standard divided disabilities into five categories based on clinical disciplines,grading from one to ten;the disability eligibility standard divided disabilities into seven categories,each with four grades.For coding systems and assessment tools,the insurance standard used ICF coding system,while the disability standard for persons with disabilities used a numerical coding system other from ICF,and the other standards did not use coding systems.Assessment tools varied significantly.The use of World Health Organiza-tion Disability Assessment Schedule(WHODAS 2.0)was proposed but not applying it in grading. Conclusion This study has systematically compared and analyzed four typical disability-related standards in China using the ICF framework.Personal Insurance Disability Assessment and Coding,Grading of Disability Caused by Bodily Injury,and Classification and Grading of Disabilities for Persons with Disabilities are all promulgated af-ter 2011,and adopt ICF concepts and methods to define and classify disabilities,considering body function and structure,activity and participation,and environmental factors.However,due to different purposes,their grading methods and levels vary:except for Classification and Grading of Disabilities for Persons with Disabilities,which uses a four-level grading system,the other standards use a ten-level system,primarily based on body func-tion and structure.In disability assessment,the recommended methods differ by category,showing significant variability.Due to differing classification and grading methods,disability data from various standards are lack in comparability.The international trend advocates for a unified disability standard framework based on ICF and ICD-11 to enhance the comparability and exchangeability of disability data.关键词
国际功能、残疾和健康分类/残疾/人身保险伤残评定及代码/人体损伤致残程度分级/劳动能力鉴定职工工伤与职业病致残等级/残疾人残疾分类和分级分类
临床医学引用本文复制引用
田益凡,陈迪,邱卓英,杨亚茹,吕军,董向兵..基于ICF架构比较4种残疾标准分类分级方法[J].中国康复理论与实践,2025,31(4):382-390,9.基金项目
1.中国康复科学所中央级公益性科研院所基本科研业务费项目(No.CRSI2024CZ-1) （No.CRSI2024CZ-1）
2.国家社会科学基金重大项目(No.17ZDA078) （No.17ZDA078）
3.国家重点研发计划项目(No.2021YFC2701004) （No.2021YFC2701004）
4.国家自然科学基金面上项目(No.72274038) Supported by The Fundamental Research Funds for Central Public Welfare Research Institutes,conducted by China Rehabilitation Science Institute(No.CRSI2024CZ-1),National Social Science Fund of China(Major)(No.17ZDA078),National Key Research and Development Program of China(No.2021YFC2701004),and National Natural Science Foundation of China(General)(No.72274038) （No.72274038）
