TY - JOUR
T1 - Developing a disability determination model using a decision support system in Taiwan
T2 - A pilot study
AU - Chi, Wen Chou
AU - Liou, Tsan Hon
AU - Wennie Huang, Wen Ni
AU - Yen, Chia Feng
AU - Teng, Sue Wen
AU - Chang, I. Chiu
N1 - Funding Information:
This study was supported by a grant from the Department of Health, Executive Yuan, Taiwan ( 101M4100 ). We thank all the experts who participated in the task force. The Taiwanese ICF Team leaders include the following people: Yen-Nan Chiu, Tien-Chen Liu, Lu Lu, Shyh-Dye Lee, Hua-Fang Liao, Kwan-Hwa Chang, Fu-Sung Lo, Tai-Lung Cha, Ben-Sheng Chang, Shu-Jen Lu, Ting-Fang Wu, Ti-Li Kao, and Kuo-Lung Lee.
PY - 2013/8
Y1 - 2013/8
N2 - Background/Purpose: The aims of our study were to: (1) develop the Disability Grading Decision Support System (DGDSS) and to (2) compare the new International Classification of Functioning, Disability, and Health (ICF)-based disability determination tool (ICF-DDT) with the diagnosis-based disability determination tool (D-DDT). Methods: A total of 9357 patients recruited from 236 accredited institutions were evaluated using the ICF-DDT and the D-DDT, and the presence, severity, and category of the disability identified using the two determination tools were compared. In the DGDSS, the ICF-DDT consisted of four models comprising nine modules to determine the presence and the severity of the disability. The differences between models (modules) are the different combinations of World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and Scale of Body Functions and Structures. Results: Compared with the D-DDT, more patients were determined to be disability-free when using the ICF-DDT. Module 1-1 had the highest profoundly severe rate, and module 2-2 had the highest mild and moderate disability rates. Module 2-1 had the highest severe disability rate. Module 1-1 resulted in the smallest difference, and module 3-1 resulted in the largest difference, compared with the D-DDT. Feedback from users suggested that the DGDSS is a robust system if the original data are accurate. Conclusion: The presence, severity, and category of the disability determined using the ICF-DDT and the D-DDT were significantly different. The results of the DGDSS provide information for policymakers to determine the optimal allocation of social welfare and medical resources for people with disabilities.
AB - Background/Purpose: The aims of our study were to: (1) develop the Disability Grading Decision Support System (DGDSS) and to (2) compare the new International Classification of Functioning, Disability, and Health (ICF)-based disability determination tool (ICF-DDT) with the diagnosis-based disability determination tool (D-DDT). Methods: A total of 9357 patients recruited from 236 accredited institutions were evaluated using the ICF-DDT and the D-DDT, and the presence, severity, and category of the disability identified using the two determination tools were compared. In the DGDSS, the ICF-DDT consisted of four models comprising nine modules to determine the presence and the severity of the disability. The differences between models (modules) are the different combinations of World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and Scale of Body Functions and Structures. Results: Compared with the D-DDT, more patients were determined to be disability-free when using the ICF-DDT. Module 1-1 had the highest profoundly severe rate, and module 2-2 had the highest mild and moderate disability rates. Module 2-1 had the highest severe disability rate. Module 1-1 resulted in the smallest difference, and module 3-1 resulted in the largest difference, compared with the D-DDT. Feedback from users suggested that the DGDSS is a robust system if the original data are accurate. Conclusion: The presence, severity, and category of the disability determined using the ICF-DDT and the D-DDT were significantly different. The results of the DGDSS provide information for policymakers to determine the optimal allocation of social welfare and medical resources for people with disabilities.
KW - Decision support system (DSS)
KW - Disability and Health (ICF)
KW - Disability eligibility
KW - International Classification of Functioning
KW - World Health Organization (WHO)
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U2 - 10.1016/j.jfma.2013.06.005
DO - 10.1016/j.jfma.2013.06.005
M3 - Article
C2 - 23871551
AN - SCOPUS:84883559233
SN - 0929-6646
VL - 112
SP - 473
EP - 481
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 8
ER -