The Use of Functional Status Assessment Within the Framework of the International Classification of Primary Care

Abstract

Health is not an operational concept, function of patients is. Family physicians deal with individuals at those moments in time when they are patients. Function is defined by the Classification Committee of WONCA as the ability of a person to perform in, adapt to, and cope with the given environment, measured both objectively and subjectively over a stated time period. Illness behavior, problem behavior, and health-seeking behavior all refer to specific aspects of function. This is a general concept in family medicine, notwithstanding international differences in the social and cultural context of primary care. It is also accepted that aspects of life, such as spiritual matters, education, socioeconomic conditions, and the political situation, do not directly belong within the frame of reference of family medicine. When the function of patients is disturbed or threatened in the context of a disease or a health problem, physicians and patients can play their respective roles best. As a consequence, it is logical to relate the health problem, the patient’s reasons for encounter, and medical interventions to function within the same frame of reference. The International Classification of Primary Care (ICPC) provides a framework to classify reasons for encounter, diagnoses, and interventions. It would be of great advantage if elements of the patient’s function could be incorporated in the ICPC.