Functional status measures for integrating medical and social care

PURPOSE: Identify standard self-report questions about functioning suitable for measuring disability across integrated health and social services. THEORY: Functional activities can be validly grouped according to the International Classification of Functioning, Disability and Health (ICF) chapters of mobility, self-care, and domestic life. METHODS: Cross-sectional analysis using information on 112,601 persons interviewed as part of the United States National Health Interview Survey on Disability. We combined related sets of questions and tested the appropriateness of their groupings through confirmatory factor analyses. Construct validity was addressed by seeking to confirm clinically logical relationships between the resulting functional scales and related health concepts, including number of physician contacts, number of bed days, perception of illness, and perception of disability. RESULTS: Internal consistency for the summed scales ranged from 0.78 to 0.92. Correlations between the functional scales and related concepts ranged from 0.12 to 0.52 in directions consistent with expectations. CONCLUSIONS: Analyses supported the 3 ICF chapters. DISCUSSIONS: The routine collection of this core set of functions could enhance decision-making at the client, professional, organizational, and policy levels encouraging cooperation among the medical and social service sectors when caring for people with disabilities.