International Classification of Functioning, Disability and Health

The International Classification of Functioning, Disability and Health (ICF) is a conceptual framework that provides standardized terminology for and classification of the consequences of diseases. The classification was first published for trial purposes in 1980 as the International Classification of Impairments, Disabilities and Handicaps (ICIDH). Since its publication, the classification has been used in a variety of areas and has specific applications in clinical diagnosis, rehabilitation assessment, disability policy planning and survey research. Under the auspices of the World Health Organization (WHO), ICIDH was revised and renamed ICF in 2001. CIHI coordinated Canadian input to the revision process.

Scope of ICF

ICF is a classification of health and health-related domains classified from body, individual and societal perspectives that describe

  • Body functions and structures
  • Activities and participation
  • Environmental factors

Benefits of ICF

ICF provides a common language and framework for the description of human functioning and disability as an important component of health and social care. This standardization of language supports

  • Improved communication between sectors and people with disabilities
  • The comparison of data nationally and internationally
  • Coverage of the whole life span
  • Use in service event data sets as well as survey questionnaires

ICF offers a conceptual framework for information that is applicable to personal health care, including prevention, health promotion, and the improvement of participation by removing or mitigating societal hindrances and encouraging the provision of societal supports and facilitators. It is also useful for the study of health care systems, in terms of both evaluation and policy formulation.

ICF coding structure

The ICF classification is organized in a hierarchical scheme. The components of Body Functions and Structure, Activities and Participation and Environmental Factors are classified independently. Within each component, the categories are arranged in a stem–branch–leaf scheme, so that a lower-level category shares the attributes of the higher-level categories of which it is a member. Categories, which are the unit of classification, are mutually exclusive. More than one category can be used to describe an individual’s functioning.

ICF uses an alphanumeric system in which the letters b, s, d and e are used to denote Body Functions and Body Structures, Activities and Participation and Environmental Factors. These letters are followed by a numeric code that starts with the chapter number (1 digit), followed by the second level (2 digits), and the third and fourth levels (1 digit each). The ICF codes are complete only with the presence of a qualifier, which denotes a magnitude of the level of health (e.g., severity of the problem). Qualifiers are coded as 1, 2 or more numbers after a period (or separator).