中国康复理论与实践2025，Vol.31Issue(7)：772-780,9.DOI:10.3969/j.issn.1006-9771.2025.07.004
基于ICF和ICD-11的中国5种肢体残疾相关标准比较研究
Comparative study of five physical disability-related standards in China based on ICF and ICD-11
摘要
Abstract
Objective To systematically compare five physical disability-related standards widely used in the fields of insurance,work related injury,forensic appraisal,and disability evaluation.The comparison covers definition,coding,classi-fication,grading,and assessment methods to reveal each standard's framework and methodology,and to provide evidence for integrating and optimizing physical disability standards. Methods Based on International Classification of Functioning,Disability and Health(ICF)and International Classifica-tion of Diseases,11th Revision(ICD-11),we analyzed and compared five physical disability-related standards,including Disability Assessment and Code for Life Insurance(Insurance Standard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Standard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disabili-ty Classification Standard).We examined definition,coding systems,classification,grading scales and assess-ment. Results According to the ICF framework,at the level of body functions and structures,physical disability mainly in-volved neuromusculoskeletal and movement related functions(b7),including joint and bone functions(b710-b729),muscle functions(b730-b749),and movement functions(b750-b789).At the activities and participation level,it primarily concerned mobility(d410-d499)and self care(d510-d599).Related conditions were commonly found in Certain infectious or parasitic diseases(01),Diseases of the nervous system(08),Diseases of the muscu-loskeletal system or connective tissue(15),Developmental anomalies(20),and Injury,poisoning or certain other consequences of external causes(22),etc.Among the five standards,only Disability Classification Standard ex-plicitly defined physical disability,yet its terminology did not followed ICF categories.Regarding coding,only the Insurance Standard adopted ICF codes;and the other four used self devised coding systems.The sub catego-ries in these physical disability standards did not fully cover all ICF categories relevant to physical disability.In terms of grading,Disability Classification Standard used a four level grading,whereas the other four standards employed ten level grading.Concerning assessment,all five emphasized evaluation of body structures and func-tions and involved daily activity capacity;however,WHO Disability Assessment Schedule(WHODAS 2.0)for comprehensive functional assessment,had not been proposed for evaluation of general functioning. Conclusion China has developed different physical disability standards to meet diverse needs.There are differences in definition,structure and content.It is necessary to revise and refine the relevant components of physical disabili-ty,including definition,classification,grading,coding and assessment,based on ICF and ICD-11,and to intro-duce WHODAS 2.0 as a comprehensive functional assessment tool.关键词
肢体残疾/分类/分级/评定/国际功能、残疾和健康分类Key words
physical disability/classification/grading/assessment/International Classification of Functioning,Disability and Health分类
医药卫生引用本文复制引用
叶海燕,杨亚茹,邱卓英,王忠彦,陈迪,宋桂芸,王方永,田益凡,刘叶..基于ICF和ICD-11的中国5种肢体残疾相关标准比较研究[J].中国康复理论与实践,2025,31(7):772-780,9.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-22) （No.CRSI2024CZ-22）
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) The Fundamental Research Funds for Central Public Welfare Research Institutes,conducted by China Rehabilitation Science Institute(No.CRSI2024CZ-22),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）
