Body structures cluster

Identifying and definitional attributes

• Community Services (retired), Standard 16/10/2006
• Disability, Standard 13/08/2015
• Health, Standard 29/11/2006

This data cluster is one of four clusters that make up the Functioning and Disability DSS. To ensure a complete description of human functioning it is recommended that this cluster be collected along with the following three clusters over time and by a range of health and community care providers:

1. Body functions cluster
2. Activities and participation cluster
3. Environmental factors cluster

Body structures are anatomical parts of the body such as organs, limbs and their components.

The Body structures cluster collects information on the presence and extent of impairment, the nature of the change and the location of the impairment for the eight body structure domains listed below:

1. Structures of the nervous system
2. The eye, ear and related structures
3. Structures involved in voice and speech
4. Structures of the cardiovascular, immunological and respiratory systems
5. Structures related to the digestive, metabolism and endocrine systems
6. Structures related to genitourinary and reproductive systems
7. Structures related to movement
8. Skin and related structures

Impairments of body structures, as defined in the ICF, are problems in body structure such as a loss or significant departure from population standards or averages. The ICD uses impairment as 'signs and symptoms', a 'component of disease' or sometimes 'reason for contact with health services'.

Impairments are recorded in terms of their extent or magnitude, nature and/or location. Determination of impairment is undertaken primarily by those qualified to evaluate physical and mental functioning or structure according to population standards or averages.

Impairments should be detectable or noticeable by others or the person by direct observation or by inference from indirect observation. Impairments are not the same as the underlying pathology, but are manifestations of that pathology.

Impairments can be temporary or permanent; progressive, regressive or static; intermittent or continuous. The deviation from the population norm may be slight or severe and may fluctuate over time. Impairments may result in other impairments.

Impairments may be part, or an expression of a health condition, but do not necessarily indicate that a disease is present or that the individual should be regarded as sick.

The use of this cluster to collect information on impairments should enhance data quality for medical purposes as well as for a range of purposes related to understanding human functioning. This data cluster should be complementary to information on diseases.

The information collected in the Body structures cluster may also indicate the sorts of interventions that could result in improved functioning. This could be in the form of rehabilitation, health-related interventions, equipment, or support for example.

Collection and usage attributes

The Person—body structure, code (ICF 2001) AN[NNNN] is a data element supported by the value domain Body structure code (ICF 2001) AN(NNNN) that represents a neutral list of structures from the ICF. This data element can be used to record positive or neutral body structure, as well as impairment of a specified body structure when used in conjunction with Person—extent of impairment of body structure, code (ICF 2001) N.

It is optional to record the location and nature of the impairment using Person—nature of impairment of body structure, code (ICF 2001) X and Person—location of impairment of body structure, code (ICF 2001) X respectively.

There are numerous possible methods for collecting body structures and impairments. A decision could be made to collect information:

• about every domain;
• on domains of particular relevance; or
• on a number of domains which are prioritised according to specified criteria.

This cluster is based on the International Classification of Functioning, Disability and Health (ICF). The ICF was endorsed by the World Health Assembly in 2001 as a reference member of the WHO Family of International Classifications and of the Australian Family of Health and Related Classifications (endorsed by the National Health Information Management Group in 2002).

The ICF provides a framework for the description of human functioning and disability. The components of ICF are defined in relation to a health condition. A health condition is an ‘umbrella term for disease (acute or chronic), disorder, injury or trauma’ (WHO 2001). A health condition may be recorded, for example, as:

• Episode of care principal diagnosis, code (ICD-10-AM 5th Ed) ANN{.N[N}
• Episode of care additional diagnosis, code (ICD-10-AM 5th Ed) ANN{.N[N}

Source and reference attributes

Australian Institute of Health and Welfare (AIHW) which is the Australian Collaborating Centre for the World Health Organization Family of International Classifications.

Relational attributes