Content Comparison of Long-Term Care Instruments Based On The International Classification of Functioning, Disability And Health (ICF)

Abstract Background: Aging crisis is proposing a huge challenge to the whole Chinese social welfare system, however a national Long-term Care (LTC) Instrument has not established yet. The objective of this study was to analyze and compare the content of six selected LTCs based on the linkage of the International Classification of Functioning, Disability and Health (ICF), so as to provide insights for the development of Chinese national LTC instrument in the future. Methods: Two trained health professionals performed the linkage according to the refined ICF linking rules. The main concepts included in the items of three international LTC instruments, namely Minimum Data Set 3.0 (MDS 3.0), Initial Assessment Instrument(IAI), and New Assessment Tool for Determining Dependency on Nursing Care (NBA), as well as three Chinese instruments, namely Disability Assessment of Long-Term Care (DA-LTC), Specification for Elderly Care Unified Need Assessment in Shanghai Version 2.0 (SEC-UNA 2.0), and pictorial-based Longshi Scale (LS) were selected and linked to the ICF categories. The six selected LTC instruments were analyzed and compared at the levels of ICF components, chapters, and categories. Results: The main concepts of 340 valid items of the six LTC instruments were linked to 112 different ICF categories. Within the ICF framework, the “Activities and Participation” component was most frequently addressed in the LTC instruments followed by the “Body functions” component, and the percentages were 0.52 and 0.38, respectively. At the ICF chapters level, “b1 mental functions,” “d4 mobility,” and “d5 self-care” were the core of the LTC instruments. In addition, the contents of the six selected LTC instruments differed greatly. Conclusions: The ICF provides a useful external reference for the analysis and comparison of different LTC instruments. The findings suggest that key elements to determine eligibility for LTC in China need to be further identified. It is anticipated that this study will provide new insights for the development of Chinese national LTC instruments.