Development of a World Health Organization indicator and corresponding questions to measure effective coverage of rehabilitationResearch in context
Summary: Background: Rehabilitation services are essential health services that should be made available to a population. Measuring effective coverage requires the assessment of whether a population's health services needs are met and whether they are met through quality interventions that pro...
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Elsevier
2025-07-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537025002494 |
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| author | Wouter De Groote Pierre Côté Jessica J. Wong Sheilah Hogg-Johnson Tara Chen Linamara Battistella George K.C. Wong Jan Hartvigsen Jill A. Hayden Rajani Mullerpatan Farooq A. Rathore Hana Alsobayel Margareta Nordin Dan Kajungu Jae-Young Lim Rafael Lozano Antony Duttine Melanie Cowan Leanne Riley Somnath Chatterji Alarcos Cieza |
| author_facet | Wouter De Groote Pierre Côté Jessica J. Wong Sheilah Hogg-Johnson Tara Chen Linamara Battistella George K.C. Wong Jan Hartvigsen Jill A. Hayden Rajani Mullerpatan Farooq A. Rathore Hana Alsobayel Margareta Nordin Dan Kajungu Jae-Young Lim Rafael Lozano Antony Duttine Melanie Cowan Leanne Riley Somnath Chatterji Alarcos Cieza |
| author_sort | Wouter De Groote |
| collection | DOAJ |
| description | Summary: Background: Rehabilitation services are essential health services that should be made available to a population. Measuring effective coverage requires the assessment of whether a population's health services needs are met and whether they are met through quality interventions that produce the desired health gain. We propose a global indicator and corresponding questions to measure effective coverage of rehabilitation through population-based surveys. Methods: An indicator to measure effective coverage of rehabilitation requires a clear definition of rehabilitation service need, utilization, and quality. These terms are defined for a tracer health condition with impact on functioning and for which rehabilitation services are beneficial. We selected chronic primary low back pain as the tracer health condition. Following technical input from experts early 2023, we drafted and cognitively tested a set of questions from August till November 2023 to provide key data points for calculating the number of people living with chronic primary low back pain who received rehabilitation services. To determine whether quality rehabilitation services have been delivered, the health gain or benefit can be measured using a valid functioning measure with a known Minimal Important Change value, i.e. a minimal improvement that is meaningful to the client. We selected the shorter version of World Health Organization Disability Assessment Schedule 2.0 to meet this criterion. Findings: The proposed global indicator is defined as the proportion of adults with chronic primary LBP experiencing limitations in functioning that benefited from rehabilitation. There are eight corresponding questions to calculate the number of adults with chronic primary LBP experiencing limitations in functioning and utilizing rehabilitation services. The assessment of a benefit of received rehabilitation services is based on a change in functioning that is greater than the Minimal Important Change measured with World Health Organization Disability Assessment Schedule 2.0 12-item (simple scoring). The Minimal Important Change was set at 6 points following a secondary analysis of studies reporting on rehabilitation outcomes for people with chronic low back pain. Interpretation: We propose a global tracer indicator for measuring effective coverage of rehabilitation at the population level that is captured through population-based surveys. This global indicator uses chronic primary low back pain as the tracer health condition and World Health Organization Disability Assessment Schedule 2.0 12-item to assess whether quality interventions have been provided that produce the desired health gain. Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. |
| format | Article |
| id | doaj-art-ae2cb086bc9049e98f5a2414f59b7d3d |
| institution | Matheson Library |
| issn | 2589-5370 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj-art-ae2cb086bc9049e98f5a2414f59b7d3d2025-07-02T04:50:38ZengElsevierEClinicalMedicine2589-53702025-07-0185103317Development of a World Health Organization indicator and corresponding questions to measure effective coverage of rehabilitationResearch in contextWouter De Groote0Pierre Côté1Jessica J. Wong2Sheilah Hogg-Johnson3Tara Chen4Linamara Battistella5George K.C. Wong6Jan Hartvigsen7Jill A. Hayden8Rajani Mullerpatan9Farooq A. Rathore10Hana Alsobayel11Margareta Nordin12Dan Kajungu13Jae-Young Lim14Rafael Lozano15Antony Duttine16Melanie Cowan17Leanne Riley18Somnath Chatterji19Alarcos Cieza20Sensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, Rehabilitation and Disability, World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland; Corresponding author. Department for Noncommunicable Diseases, Rehabilitation and Disability World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland.Institute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario, CanadaInstitute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario, CanadaInstitute for Disability and Rehabilitation Research, Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe Street North, Oshawa, Ontario, Canada; Department of Research and Innovation, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, CanadaDepartment of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-Sen University, ChinaDepartment of Physical Medicine and Rehabilitation, Faculty of Medicine, University of São Paulo, BrazilThe Hong Kong Society for Rehabilitation, Jockey Club Geriatric Rejuvenation Hub, 7 Sha Wan Drive, Pokfulam, Hong KongCenter for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark; Chiropractic Knowledge Hub, Camusvej 55, 5230, Odense M, DenmarkDepartment of Community Health & Epidemiology, Dalhousie University, 5790 University Avenue, B3H 1V7, Halifax, Nova Scotia, CanadaSchool of Physiotherapy, Center of Human Movement Science, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, IndiaArmed Forces Institute of Rehabilitation Medicine, Abid Majeed Road, Rawalpindi, 46000, PakistanDepartment of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi ArabiaDepartments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USAMakerere University Centre for Health and Population Research & Iganga Mayuge HDSS, Makerere University, P.O Box 111, Iganga, Kampala, Uganda; Department of Global Health, Stellenbosch University, Stellenbosch, South AfricaDepartment of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumiro 173, Bundang-gu, Seongnam, South KoreaProfessor Emeritus, Health Metrics Sciences, Institute for Health Metrics and Evaluation, School of Medicine, University of Washington, 3980 15th Ave. NE, Seattle, WA, 98195, USA; School of Medicine, National Autonomous University of Mexico, Mexico City, 04510, MexicoSensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, Rehabilitation and Disability, World Health Organization, Avenue Appia 20, 1211, Geneva, SwitzerlandSurveillance, Monitoring and Reporting Unit, Department for Noncommunicable Diseases, Rehabilitation and Disability, World Health Organization, Avenue Appia 20, 1211, Geneva, SwitzerlandSurveillance, Monitoring and Reporting Unit, Department for Noncommunicable Diseases, Rehabilitation and Disability, World Health Organization, Avenue Appia 20, 1211, Geneva, SwitzerlandFormer DNA Unit Head, Department for Data, Analytics, and Delivery for Impact, World Health Organization, Avenue Appia 20, 1211, Geneva, SwitzerlandSensory Functions, Disability and Rehabilitation Unit, Department for Noncommunicable Diseases, Rehabilitation and Disability, World Health Organization, Avenue Appia 20, 1211, Geneva, SwitzerlandSummary: Background: Rehabilitation services are essential health services that should be made available to a population. Measuring effective coverage requires the assessment of whether a population's health services needs are met and whether they are met through quality interventions that produce the desired health gain. We propose a global indicator and corresponding questions to measure effective coverage of rehabilitation through population-based surveys. Methods: An indicator to measure effective coverage of rehabilitation requires a clear definition of rehabilitation service need, utilization, and quality. These terms are defined for a tracer health condition with impact on functioning and for which rehabilitation services are beneficial. We selected chronic primary low back pain as the tracer health condition. Following technical input from experts early 2023, we drafted and cognitively tested a set of questions from August till November 2023 to provide key data points for calculating the number of people living with chronic primary low back pain who received rehabilitation services. To determine whether quality rehabilitation services have been delivered, the health gain or benefit can be measured using a valid functioning measure with a known Minimal Important Change value, i.e. a minimal improvement that is meaningful to the client. We selected the shorter version of World Health Organization Disability Assessment Schedule 2.0 to meet this criterion. Findings: The proposed global indicator is defined as the proportion of adults with chronic primary LBP experiencing limitations in functioning that benefited from rehabilitation. There are eight corresponding questions to calculate the number of adults with chronic primary LBP experiencing limitations in functioning and utilizing rehabilitation services. The assessment of a benefit of received rehabilitation services is based on a change in functioning that is greater than the Minimal Important Change measured with World Health Organization Disability Assessment Schedule 2.0 12-item (simple scoring). The Minimal Important Change was set at 6 points following a secondary analysis of studies reporting on rehabilitation outcomes for people with chronic low back pain. Interpretation: We propose a global tracer indicator for measuring effective coverage of rehabilitation at the population level that is captured through population-based surveys. This global indicator uses chronic primary low back pain as the tracer health condition and World Health Organization Disability Assessment Schedule 2.0 12-item to assess whether quality interventions have been provided that produce the desired health gain. Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.http://www.sciencedirect.com/science/article/pii/S2589537025002494RehabilitationEffective coverageUniversal health coverageHealth system performanceHealth servicesLow back pain |
| spellingShingle | Wouter De Groote Pierre Côté Jessica J. Wong Sheilah Hogg-Johnson Tara Chen Linamara Battistella George K.C. Wong Jan Hartvigsen Jill A. Hayden Rajani Mullerpatan Farooq A. Rathore Hana Alsobayel Margareta Nordin Dan Kajungu Jae-Young Lim Rafael Lozano Antony Duttine Melanie Cowan Leanne Riley Somnath Chatterji Alarcos Cieza Development of a World Health Organization indicator and corresponding questions to measure effective coverage of rehabilitationResearch in context EClinicalMedicine Rehabilitation Effective coverage Universal health coverage Health system performance Health services Low back pain |
| title | Development of a World Health Organization indicator and corresponding questions to measure effective coverage of rehabilitationResearch in context |
| title_full | Development of a World Health Organization indicator and corresponding questions to measure effective coverage of rehabilitationResearch in context |
| title_fullStr | Development of a World Health Organization indicator and corresponding questions to measure effective coverage of rehabilitationResearch in context |
| title_full_unstemmed | Development of a World Health Organization indicator and corresponding questions to measure effective coverage of rehabilitationResearch in context |
| title_short | Development of a World Health Organization indicator and corresponding questions to measure effective coverage of rehabilitationResearch in context |
| title_sort | development of a world health organization indicator and corresponding questions to measure effective coverage of rehabilitationresearch in context |
| topic | Rehabilitation Effective coverage Universal health coverage Health system performance Health services Low back pain |
| url | http://www.sciencedirect.com/science/article/pii/S2589537025002494 |
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