Handicap assessment: setting the grounds for an effective intervention in the community

Many instruments have been invented specially since the 70's to study and measure the consequences of illness and trauma; many of them simply evaluate the severity of lesions and the prediction of mortality, others evaluate morbidity. Nevertheless, none of these instruments evaluate the handicap globally. The classification of the World Health Organization, despite the fact that it contemplates the handicap in all its aspects, does not distinguish its different levels rigorously and it is not a valid instrument to quantify handicaps. The authors comment on their research and proposals for identification and quantification of the handicap. Three levels, related to "Body", "Capacities" and "Life situations", have been described and through them a useful inventory was created (published in 1998). This inventory makes it possible to establish a true medical-social and global evaluation of handicaps, providing a uniform record of the consequences of diseases, trauma or physiological features of the individual and a useful instrument for public health intervention and the promotion of human well-being.