350 J . P . Engkasan et al .
Table II . Framework for the classification of rehabilitation services and the specification of clinical assessment schedules ( CLASs ). For each of the 7 types of rehabilitation services and corresponding specializations of rehabilitation services ( 7 specialized post-acute rehabilitation services and 8 specialized outpatient rehabilitation services ) a proposal for a default ICF Set and a proposal for optional the International Classification of Functioning , Disability and Health ( ICF ) sets are shown . They will serve as the starting point for national consensus conferences aiming to specify the CLASs for these rehabilitation services
Framework for the classification of rehabilitation services in Malaysia Patient group receiving specific rehabilitation services
Rehabilitation in acute care
General post-acute rehabilitation
Specialized postacute rehabilitation
( 7 specializations )
General outpatient rehabilitation
Specialized outpatient rehabilitation
( 8 specializations )
Rehabilitation in primary care
Vocational rehabilitation
Hospitalized patients across a range of health conditions ICF Generic-6 Set 1 ICF Generic-6 Score 2
Hospitalized patients across a range of health conditions ICF Generic-30 Set 3
ICF Generic-30 Score 4 ( one and two component versions )
Hospitalized patients with a specific health condition or age 7 specializations : neurological conditions , acquired brain injury ( ABI ), spinal cord injury ( SCI ), musculoskeletal conditions , cardiovascular conditions , amputation , and paediatrics
Patients living in the community and presenting with 1 out of a range of health conditions referred to an outpatient facility of a hospital irrespective of health condition
• after acute or post-acute care or
• by a doctor practicing outside the hospital Patients living in the community and presenting with a specific health condition referred to an outpatient facility of a hospital
• after acute or post-acute care
• by a doctor practicing outside the hospital 8 specializations : neurological conditions , ABI , SCI , musculoskeletal conditions , cardiovascular conditions , amputation , pain , and paediatrics
Selected default ICF set ( s ) Selected optional ICF set ( s )
ICF Generic-30 Set ICF Generic-30 Score + ICF Core Sets 5 ICF Core Sets Scores 6
ICF Generic-30 Set ICF Generic-30 Score
ICF Generic 30 Set ICF Generic-30 Score + ICF Core Sets 7 ICF Core Sets Scores 8
Patients living in the community and presenting with 1 out ICF Generic-7 Set 9 of a range of health conditions to a community health clinic ICF Generic-7 Score 10
• after acute , post-acute care or outpatient care
• an acute health condition
• an episode of a chronic health condition
Patients living in the community presenting with a range of health conditions referred to a vocational rehabilitation service in diverse settings .
• The person must be insured by SOCSO
• Post-acute referrals by primary treating doctors or rehabilitation physicians
• Chronic case by PRM doctors , general practitioners , disability case manager , welfare officers , recommended by medical board and self-referral
ICF Core Set Vocational Rehabilitation WORQ ( 40 )
ICF Acute Core Sets
• Neurological ( 31 )
• Cardiopulmonary ( 32 )
• Musculoskeletal ( 33 )
ICF Post-Acute Core Sets ( 34 )
• Neurological ( 35 )
• Cardiopulmonary ( 36 )
• Musculoskeletal ( 37 )
• Geriatric ( 38 ) Documentation of comorbidity ICF Post-Acute Core Sets
• Neurological ( 35 )
• Cardiopulmonary ( 36 )
• Musculoskeletal ( 37 )
• Geriatric ( 38 ) Documentation of comorbidity ICF Core Sets for Chronic Conditions ( 11 , 39 )
Documentation of comorbidity ICF Core Sets for Chronic Conditions ( 11 , 39 )
ICF Generic-30 Set ICF Generic-30 Score
Documentation of comorbidity ICF Core Sets for Chronic conditions ( 11 , 39 )
1 ICF Generic-6 Set : This contains the 7 categories of the ICF Generic Set ( ICF Generic-7 ) ( 41 ) minus d850 remunerative employment . As
remunerative employment is not applicable in acute care , the version of the ICF Generic Set with 6 categories is most suitable . It enables clinicians to follow a patient ’ s functioning along the continuum of care from acute to post-acute care and to the community ( rehabilitation in primary care and specialized outpatient care ). 2 ICF Generic-6 Score : Informed by the lessons learned from the Chinese experience in developing a scoring algorithm and corresponding transformation tables . A transformation table for Malaysia will be calculated based on data collection at UMMC , Cheras Rehabilitation Hospital and SOCSO . 3 ICF Generic-30 Set : This contains the 30 categories of the ICF Generic Set for Rehabilitation ( 42 ). It enables rehabilitation professionals to follow a patient ’ s functioning from post-acute care to outpatient care and to vocational rehabilitation across the wide range of health conditions requiring rehabilitation . 4 ICF Generic-30 Score : The scoring algorithm for the ICF Generic Set for Rehabilitation is currently in development . It will provide a score including 29 categories . Remunerative employment ( d850 ) is reported separately as it does not fit on the same dimension . There is also a 2-component version that differentiates the body functions categories from the activities and participation categories .
5 ICF Core Sets for health condition groups , specific health conditions or patient groups suitable for the specialized post-acute context :
• Neurological rehabilitation or Neuro-medical rehabilitation : ICF Core Set for Neurological Conditions in the post-acute context ( 35 ), the Brief ICF Core Set for Stroke ( 43 ) or a combination of both .
• ABI ( Aquired Brain Injury ): Brief ICF Core Set for Traumatic Brain Injury ( TBI ) ( 44 ).
• SCI post-acute : Brief ICF Core Set for SCI in the post-acute context ( 45 ), the Brief ICF Core Set for SCI in the long-term context ( 46 ), and the Statistical ICF Core Set for SCI ( 47 ) or any combination of all 3 ICF Core Sets .
• Musculoskeletal conditions : ICF Core Set for Musculoskeletal Conditions ( 37 ).
• Cardiovascular conditions : ICF Core Set for Cardiopulmonary Conditions ( 36 ), the Brief ICF Core Set for Ischemic Heart Disease ( 48 ) or a combination of both .
• Amputation Rehabilitation : ICF Core Set for Lower Limb Amputation under development ( 49 ).
• Multiple sclerosis : ICF Core Set for Multiple Sclerosis ( 50 ).
• Paediatric patients : An ICF Generic Set for the paediatric population is in the planning stage .
6 ICF Core Set Scores for health condition groups , specific health conditions or patient groups suitable for the specialized post-acute context :
A first ICF Core Set Score is in the planning for SCI . Other scores are envisioned for the future . 7 ICF Core Sets for health condition groups , specific health conditions or patient groups suitable for the specialized outpatient context : As described in 5 , with the addition of pain , for which the ICF Core Set for Chronic Widespread Pain ( 51 ) is proposed . 8 ICF Core Set Scores for the outpatient context : as described in 6 .
9 ICF Generic-7 Set : In the outpatient context , all 7 categories of the ICF Generic Set including remunerative employment ( d850 ) are relevant .
10 ICF Generic-7 Score : The scoring algorithm includes 6 categories of the ICF Generic Set . Remunerative employment ( d850 ) should be reported separately as it does not fit on the same dimension as the other 6 ICF categories of the ICF Generic Set-7 .
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