Vol 20, No 4 (2017)

Articles
UNRESOLVED ISSUES IN THE PROVISION OF MEDICAL-SOCIAL ASSISTANCE TO DISABLED ELDERLY PERSONS
Horkova O.V., Karasaeva L.A.
Abstract
The legislative provision of social services and rehabilitation of the disabled elderly was studied. There were determined special legislative, methodological and technical problems lying in the imperfection of the model of medical-social and rehabilitation services. Organizational problems of interagency cooperation authorities and institutions in the implementation of rehabilitation and social services to disabled elderly persons were revealed. Main directions of the improvement of the system of medical-social assistance and rehabilitation are proposed.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):172-175
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A VARIANT OF EXPERT ASSESSMENT OF BALANCE AND GAIT FUNCTIONS IN PATIENTS AFTER STROKE
Prokopenko S.V., Abros’kina M.V., Ondar V.S., Kaygorodtseva S.A.
Abstract
The article presents the results of approbation of the complex of objective evaluation of equilibrium and walking functions, including such functional scales as Berg Balance Scale, Dynamic Gait Index, hardware methods of computer stabilometry and laser analyzer of kinematic parameters of walking in groups of patients with poststroke vestibulo-atactic syndrome and hemiparesis syndrome. The proposed complex allows objectively and informatively to assess the state of static and dynamic balance, the risk of falls during walking, changes in the walking pattern in neurological patients. The complex is recommended for the dynamic assessment of patients’ condition during neurorehabilitation.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):176-180
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MEDICO-SOCIAL CHARACTERISTIC OF PATIENTS WITH MULTIPLE SCLEROSIS IN UFA
Ivanova E.V., Bakhtiyarova K.Z., Safronova E.V.
Abstract
The analysis of the structure and dynamics of total disability due to multiple sclerosis in the city of Ufa from 2010 to 2016 years. 256(48,5%) patients including 72% out of them of working age have the persistent disability. The majority of persons with disabilities (57%) have secondary-progressive course of the disease. The average age of persons with disabilities due to multiple sclerosis accounted of 47.3 ± 11.6 years, the average score on the EDSS of persons with disabilities was 5.3 ± 1.3 points, the average duration of the disease before the appearance of signs of persistent disability accounts of 9.8 ± 8.2 years. Economic losses due to disability from multiple sclerosis in Ufa amounted to 3 543 493 849,15 RUB.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):181-184
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ANALYSIS OF THE ACTIVITY OF THE DOCTORAL COMMISSION OF LARGE HOSPITAL-POLYCLINIC ASSOCIATION ON THE REFERRAL OF PATIENTS TO MEDICAL-SOCIAL EXPERTISE
Guseva N.K., Berdutin V.A., Zubeev P.S., Baranova S.V.
Abstract
The peculiarity of the current stage of the development of medical and social expertise (MSE) is, first of all, the ratification of the Convention on the Rights of Persons with Disabilities in the Russian Federation. An attempt to ensure the participation of citizens with restrictions in activities in the civil, political, social and cultural life of the society required significant changes and additions to the regulatory and legislative framework of the Russian Federation that regulates various aspects of the life of Russian citizens. Changes in regulatory and legislative acts increase the role and importance of medical organizations in MSE in terms of establishing and formulating a medical diagnosis of the patient, determining the nature and persistence of disorders of the body’s functions, developing and implementing intra-institutional rehabilitation programs for people with disabilities. In this regard, it is important to take into account the readiness of medical organizations to respond promptly to changes in expert legislation and to make contributions into the provision of the continuity, consistency, succession and complexity of the expert - rehabilitation process. The purpose of this study was to identify the main trends in the work of disability evaluation boards of medical organizations on the example of a large hospital-polyclinic association for the referral of patients for MSE. It was succeed to clarify out that to date the procedure for referral citizens to MSE in the association is well managed, targeted at individuals, both of senior and middle ages and their need for examination, taking into account results of rehabilitation. During the period of observation, there was noted the gain in the number of people referred for MSE, mainly at the expense of persons referred for the reassessment, which is related both with the severity of the contingent appealing to the organization and using modern treatment technologies requiring a long rehabilitation period and with the accumulation of a contingent disabled people. Therefore, in examination persons of the older age group, the participation of geriatricians will probably be necessary.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):185-191
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THE ANALYSIS OF PRIMARY DISABILITY OWING TO A DIABETES MELLITUS IN MOSCOW IN DYNAMICS FOR 2013-2016
Zapariy N.S., From A.Y., Sidorova E.M., Kosheleva O.V.
Abstract
Age features, structure of the severity and the dynamics of primary disability owing to diabetes mellitus in Moscow for the last 4 years are studied. The comparison with indices in Central Federal District and the Russian Federation was carried out.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):192-194
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CHARACTERISTICS OF INDIVIDUAL INDICES OF THE DISABILITY OF ELDERLY AND SENILE PEOPLE IN THE RUSSIAN FEDERATION IN DYNAMICS
Grinin V.M., Shestemirova E.I.
Abstract
To date, the problem of disability, as well as the problem of the aging of the population has not lost its relevance, not only in Russia but also worldwide. So far with the aim of the analysis of the representation of data of disability in elderly persons in the period from 2012 to 2016 there was studied by the official annual statistics on the level of morbidity and disability in the elderly population of the Russian Federation over the past 4 years. In the course of the study there were identified features of these indices with primary disability in persons of the advanced age in Russia, according to the data of Bureau of Health Sociology Examination (BMSE), characterizing the medical and social significance of the problem, which demonstrates the need for changes in the health care organization under consideration of the contingent of the population.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):195-200
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CHARACTERISTICS OF PRIMARY DISABILITY DUE TO DORSOPATHIES IN MOSCOW FOR 2013-2016
Zapariy S.P., Lescay O.A., Krytogolov A.N., Sidorova E.M., From A.Y.
Abstract
The article presents statistical material for the analysis of dynamics of primary disability due to dorsopathies among the adult population of Moscow, on age group and severity of disability in comparison with the figures for the Central Federal district and the Russian Federation for 2013-2016.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):201-203
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ORGANIZATIONAL ACTIVITIES OF THE MAIN BUREAU OF MEDICAL AND SOCIAL EXPERTISE IN SEVASTOPOL IN NEW SOCIAL AND ECONOMIC CONDITIONS
Teterina N.M., Karasaeva L.A.
Abstract
The article presents the results of the activity of the Main Bureau of Medical and Social Expertise for the city of Sevastopol for state services provision to citizens on medical and social expertise. There are presented staffing data, the state of the primary disability in the adult population in it employable sector, indices of rehabilitation of the disabled persons over three years (2013-2015) in the city of Sevastopol in modern conditions after the annexation of Crimea to the Russian Federation. There are highlighted basic directions of the organization and peculiarities in the activities of experts of the Bureau of the Medical and Social Expertise.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):204-207
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THE ASSESSMENT OF THE FORENSIC EXAMINATION OF X-RAY SIGNS OF THE DAMAGE TO BONES AND JOINTS IN THE CASE OF ITEMS OF MEDICAL CRITERIA FOR DETERMINING HEALTH HAZARDS
Klevno V.A., Tarasova N.V.
Abstract
The main evidence-based method of bone fractures and injuries of the surrounding tissues is the results of radiological diagnosis (conventional radiography and computed tomography), provided for forensic medical examinations on a variety of media, which is a prerequisite for faultless judgments by the expert on the nature and severity of the harm done to human health. The aim of the study was to estimate the diagnostic value of different methods of radiation diagnosis to establish the harm to health in accordance with medical criteria in the execution of forensic medical examination of living persons with injuries of bones and major joints. Research materials: data from statistical reporting of the the Bureau of forensic medical examination for the Moscow region over 2011-2016. Results: lack of clear visualization of injuries on radiographs of bones and joints, defects in X-rays images can lead to expert errors in the application of medical criteria in the determination of the severity of the injury. So, according to our data, the number of expert’s errors amounted to 18.2%. Conclusion: computed tomography allows visualize not only bone fractures, but also the condition of surrounding tissues, including bleeding in the meninges and the substance of the brain, which is a prerequisite in the detection the characteristics corresponding to medical criteria.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):208-213
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DEMOGRAPHIC SITUATION IN RUSSIA: MEDICAL AND SOCIAL ASPECTS
Shurgaya M.A., Memetov S.S., Ivanova T.A., Karaeva A.F., Lyalina I.V.
Abstract
Since the beginning of the 90s of the last century, significant structural changes in the country’s economy, the transition from a planned economy to a market economy, which was accompanied by a deterioration in the socioeconomic status of the population, took place in Russia. This adversely affected the health of citizens. The health of the population has progressively worsened, life expectancy has declined, the population has been shrinking at an alarming rate. Since 2006, the dynamics of the main demographic indices in Russia is favorable. There is a tendency to reduce the natural decline in population. Life expectancy indices reflecting the state of health of the population and the death rate increased, reached 71.9 years in the general population in 2016 (among women - 77.1 years, among men - 66.5 years). The demographic situation in Russia is characterized by an aging population. In 2014, the contingent of the older generation (33.8 million - 23.0%) prevailed over the children population (24.7 million - 17.2%) and this ratio is maintained as of January 1, 2017: the population of children is 36 685 thousand people (18.3%), working age population accounts of 83 224 thousand people, the elderly - 36 685 thousand people (25%). The increase in life expectancy is associated with a gain in the incidence and disability of the population, among which leading positions of the disease are occupied by the circulatory disorders, malignant neoplasms, diseases of the musculoskeletal system and connective tissue, and a number of infectious diseases. At the same time, the period of life, living with chronic diseases and restrictions in active activity, lengthens. The indices of the morbidity and disability rate of the population are a reflection of both the level of health and the quality of medical and preventive measures, as well as the state of social protection of a person with a health defect. A differentiated approach to the organization of preventive, curative and rehabilitation measures is important, both at the federal and regional and municipal levels of managing the health and social protection system. Health resources of saving technologies should be aimed at realizing an optimistic demographic scenario - an increase in life expectancy with a parallel increase in the number and proportion of years living in conditions of preserved health and activity.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):214-220
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OTsENOChNYE MATERIALY DLYa PODGOTOVKI K AKKREDITATsII VRAChEY - MEDIKO-SOTsIAL'NYKh EKSPERTOV
Puzin S.N., Bogova O.T., Potapov V.N., Shurgaya M.A., Chandirli S.A., Korshikova Y.I., Memetov S.S., Lapina E.Y., Yakushev A.A.
Abstract

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Medical and Social Expert Evaluation and Rehabilitation. 2017;20(4):221-224
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