Public Health

Public Health : 

Public Health Kurt K. Hubbard, PhD(c), OTD, OTR/L & www.who.int/classification/icf

Public Health Issues : 

Public Health Issues Mobilize community partnerships to identify and solve health problems Develop policies and plans that support individual and community health efforts Enforce laws and regulations that protect health and assure safety

Public Health Essentials : 

Public Health Essentials Monitor health status to identify community health problems Diagnose and investigate health problems and health hazards in the community Inform, educate and empower people about health issues

Public Health Essentials : 

Public Health Essentials Link people to needed personal health services and assure the provision of health care when otherwise unavailable Assure a competent public health and personal health care workforce Evaluate effectiveness, accessibility and quality of personal and population-based health services Research for new and innovative solutions to health problems

Public Health Services : 

Public Health Services

Public Health Core Areas : 

Public Health Core Areas Public Health Workforce Information, data, and Communication systems Organizational & Systems Capacity

Public Health Infrastructure : 

Public Health Infrastructure

Aim of Public Health and Health Promotion : 

Aim of Public Health and Health Promotion to provide a scientific basis for consequences of health conditions via clinical reports and research to establish a common language to improve communications to permit comparison of data across: countries health care disciplines services time

Codes for Communication : 

Codes for Communication to provide a systematic coding scheme for health information systems: Used for PT/OT reimbursement IDC codes (International Classification of Diseases) CPT codes (Current Procedural Terminology ) ICF: International Classification of Functioning, Disabilities and Health

ICF : 

ICF Systematically revised in the last decade large international and multidisciplinary participation extensive field testing guided by scientific principles taxonomic guidelines: logic and terminology practical utility: feasibility, ease of use, ethical guidelines reliability, validity and comparability Useful tool for Health Information Systems evaluation: needs, outcomes, costs, quality, satisfaction service provision, social policy, training

Why Use Codes and Classifications? : 

Why Use Codes and Classifications? Primary Aim: International comparability of health information Basic principles: scientific and transcultural Interrelated use: Coherent, agreed and appropriate Versatility: responds to current or developing health information needs of different users Foundation classes: categories of conceptual & metric equivalence Coding Rules: Transparent and reliable Standards: Uniform and meets “international / national standards

ICF Related to the Clients we Treat : 

ICF Related to the Clients we Treat Human Functioning - not merely disability Universal Model - not a minority model Integrative Model - not merely medical or social Interactive Model - not linear progressive Context - inclusive - not person alone Cultural applicability - not western concepts Operational - not theory driven alone Life span coverage - not adult driven

Slide 13: 

Body functions vs impairments Body Structures Activities vs activity limitation prior to 1981 = disability Participation vs handicap Human Functioning not disability alone

Participation or Handicap? : 

Participation or Handicap? neutral language “politically correct” correct use intervention opportunity positive aspects

Medical versus Social Model : 

Medical versus Social Model PERSONAL problem vs social problem medical care vs social integration individual treatment vs social action professional help vs individual & collective responsibility personal vs environmental adjustment manipulation behaviour vs attitude care vs human rights health care policy vs politics individual adaptation vs social change

Slide 16: 

Health Condition (disorder/disease) Interaction of Concepts: ICF 2001

Contextual Factors : 

Contextual Factors Person gender age other health conditions coping style social background education profession past experience character style Environment Products Close milieu Institutions Social Norms Culture Built-environment Political factors Nature

Cultural Applicability : 

Cultural Applicability Conceptual and functional equivalence of classification Translatability Usability International Comparisons

Comparability: equivalence across cultures : 

Comparability: equivalence across cultures Conceptual equivalence: similar understanding /meaning of concepts Functional equivalence: similar domains Metric equivalence: similar measurement characteristics

ICF Components : 

ICF Components Body Functions & Structures Activities & Participation Environmental Factors Barriers Facilitators Functions Structures Capacity Performance

Slide 21: 

Body Functions and Structures Skin and related structures Functions of the skin and related structures Structures related to movement Neuromusculoskeletal and movement-related functions Structures related to the genitourinary and reproductive systems Genitourinary and reproductive functions Structures related to the digestive, metabolic and endocrine systems Functions of the digestive, metabolic and endocrine systems Structures of the cardiovascular, immunological and respiratory systems Functions of the cardiovascular, haematological, immunological and respiratory systems Structures involved in voice and speech Voice and speech functions The eye, ear and related structures Sensory functions and pain Structures of the nervous system Mental functions

Activities and Participation : 

Activities and Participation 1 Learning & Applying Knowledge 2 General Tasks and Demands 3 Communication 4 Movement 5 Self Care 6 Domestic Life Areas 7 Interpersonal Interactions 8 Major Life Areas 9 Community, Social & Civic Life

Environmental Factors : 

Environmental Factors 1. Products and technology 2. Natural environment and human- made changes to the environment 3. Support and relationships 4. Attitudes 5. Services, systems and policies

ICF Applications : 

ICF Applications Health sector Social security Education sector Labor sector Economics & development sector Legislation & law

ICF in health & disability statistics : 

ICF in health & disability statistics Common Domains Mobility - Cognition Self Care - Usual Activities Link data from both health and disability Environmental Factors Comparability Utilization patterns Comparison of different interventions Consumer satisfaction Service performance: outcomes & cost-effectiveness Clinical terminology

Policy Making : 

Policy Making Assessment of population health Impact of disability economic social Evidence-base for policy makers on different policy interventions responsiveness of services efficiency performance assessment

Research Applications : 

Research Applications Caregiver training: ESBP: Cost-effectiveness of interventions Unified approaches

Public Health Achievements : 

Public Health Achievements