On the organization of interdepartmental interaction of institutions of medico-social expertise and rehabilitation of disabled people in the region (on the example of the Perm territory)

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Abstract

BACKGROUND: Currently, a rehabilitation system for people with disabilities is actively developing at the federal and regional levels. Institutions of medical and social expertise occupy an important place in it, developing an individual program of rehabilitation or habilitation (IPRН) and evaluating the results of its implementation.

AIM: Assess the need of persons recognized as disabled for rehabilitation measures, analyze the organization of interdepartmental interaction of institutions for medical and social examination and rehabilitation of disabled people at the regional level.

MATERIALS AND METHODS: A retrospective analysis of the needs of persons recognized as disabled for rehabilitation measures within the framework of IPRH for five years (2018–2022) was carried out according to the Federal state information system “Uniform automated vertically integrated information and analytical system on conducting medico-social examination” of Main Bureau of Medical and Social Expertise in Perm Territory, forms Federal State Statistical Observation № 7-Sobes “Information on the medical and social examination of persons aged 18 years and older”, № 7-D (Sobes) “Information on the medical and social examination of children under the age of 18”. The indicators of the effectiveness of rehabilitation based on the results of re-examination at the ITU bureau were studied, and an analysis of organizational technologies of interdepartmental interaction on issues of rehabilitation or habilitation of disabled people in the region was given. Statistical data processing was carried out using Microsoft Office Excel 2010.

RESULTS: The analysis showed that, against the backdrop of a high need for medical rehabilitation, in the region there were higher indicators of the need for disabled people in social rehabilitation measures, technical means of rehabilitation, and information on adaptive physical education and sports compared to the Russian average. An assessment of the effectiveness of the implementation of rehabilitation measures shows that in 2022 it was almost possible to achieve the level of indicators of 2019 (“pre-Covid”) for both children and adults. As part of interdepartmental interaction, specialists from the main bureau and executive authorities, branches of the Social Fund of Russia, the Center for Comprehensive Rehabilitation of Disabled People, and public organizations quickly resolve problematic issues, conduct training seminars and conferences, and organize interdisciplinary research.

CONCLUSION: The study made it possible to identify regional features of the structure of the need of persons with disabilities for rehabilitation or habilitation measures, as well as to analyze organizational approaches and technologies of interdepartmental interaction between the Main Bureau of Medical and Social Expertise and institutions subject to rehabilitation.

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About the authors

Yulia A. Mavlikaeva

Main Bureau of Medical and Social Expertise in Perm territory; Perm State Medical University named after Academician E.A. Wagner; Perm State National Research University

Author for correspondence.
Email: mavlikaeva@mail.ru
ORCID iD: 0000-0002-5865-8521

md, dr. sci. (med.), assistant professor

Russian Federation, Perm; Perm; Perm

Olga A. Plotnikova

Main Bureau of Medical and Social Expertise in Perm territory; Perm State Medical University named after Academician E.A. Wagner

Email: plotnikovaoa@mail.ru
ORCID iD: 0009-0002-9104-6380
Russian Federation, Perm; Perm

References

  1. Decree of the Government of the Russian Federation № 3711-r of December 18, 2021 «Concept for the development in the Russian Federation of a system of comprehensive rehabilitation and habilitation of persons with disabilities, including children with disabilities, for the period until 2025». Available at: https://mintrud.gov.ru/ministry/programms/25/kontcepsia Accessed: 20.07.2023. (In Russ).
  2. Decree of the Government of the Russian Federation № 2253-r dated August 16, 2022 «Action Plan for the Implementation of the Concept of Development in the Russian Federation of the System of Comprehensive Rehabilitation and Habilitation of Disabled People, including Disabled Children, for the Period until 2025». Available at: https://mintrud.gov.ru/ministry/programms/25/kontcepsia Accessed: 20.07.2023. (In Russ).
  3. Decree of the Government of the Perm Territory № 20-P of January 19, 2023 «On the approval of the Concept for the development of a system of comprehensive rehabilitation and habilitation of disabled people, including children with disabilities, in the Perm Territory for the period until 2025, «Roadmap» for the development of a system of comprehensive rehabilitation and habilitation of disabled people, including children with disabilities, in the Perm Territory for the period until 2025». Available at: https://www.permkrai.ru/download.php?id=111973 Accessed: 20.07.2023. (In Russ).
  4. Bronnikov VA, Mavlikaeva YA, Sklyannaya KA, Syromyatnikova LI, Engaus RE. Results of the implementation of a pilot project for the development of medical rehabilitation in the Perm Territory. Consilium Medicum. 2019;21(9):95–99. (In Russ). doi: 10.26442/20751753.2019.9.190462
  5. Dymochka MA, editor. Status and dynamics of disability, comprehensive rehabilitation and habilitation of disabled people and children with disabilities in the Russian Federation: annual report. Moscow: FSBI FB ITU Ministry of Labor of Russia; 2022. 436 p. (In Russ).
  6. Dymochka MA, Andreeva OS, Bochkova VA. The need for comprehensive rehabilitation of disabled people from among the adult population of the Russian Federation, for the period 2018–2020. Mediko-social’nye problemy invalidnosti. 2021;(2):8–14. (In Russ).
  7. Dymochka MA, Andreeva OS, Bochkova VA. The need for comprehensive rehabilitation of disabled children in the Russian Federation for the period 2018–2020. Mediko-social’nye problemy invalidnosti. 2021;(2):15–21. (In Russ).
  8. Bronnikov VA, Smychyok VB, Mavlikaeva YuA, Kravtsov YuI, Sklyannaya KA, Plotnikova OA, Wildeman AV. On the unification of methodological approaches to assessing the effectiveness of rehabilitation of patients with stroke consequences at the expert and rehabilitation stages, taking into account the principles of the International Classification of Functioning. Vestnik Vserossijskogo obshchestva specialistov po mediko-social’noj ekspertize, reabilitacii i reabilitacionnoj industrii. 2017;(4):55–69. (In Russ).
  9. Order of the Ministry of Labor of the Russian Federation № 585n of August 27, 2019 «On classifications and criteria used in the implementation of medical and social expertise of citizens by federal state institutions of medical and social expertise» (ed. 06.10.2021). Registered with the Ministry of Justice of the Russian Federation on November 18, 2019, № 56528. Available at: https://mintrud.gov.ru/docs/mintrud/orders/1386 Accessed: 20.07.2023. (In Russ).
  10. Mavlikaeva YuA, Plotnikova OA, Anikeeva TA. The activities of institutions of medical and social expertise in the system of interdepartmental interaction in the implementation of an individual program for the rehabilitation or habilitation of a disabled person, a disabled child (on the example of the Perm Territory). Mediko-social’nye problemy invalidnosti. 2018;(4):21–24. (In Russ).

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. The need for comprehensive rehabilitation measures for persons over 18 years of age recognized as disabled in the Perm region in 2018–2022, %. Note (here and in Fig. 2). МР — medical rehabilitation or habilitation, СР — social rehabilitation or habilitation, ПР — vocational rehabilitation or habilitation, ФиС — physical education and health activities, sports activities, ТСР — technical means of rehabilitation.

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3. Fig. 2. The need for comprehensive rehabilitation measures for persons until 18 years of age recognized as disabled in the Perm region in 2018–2022, %. Note. ППР — psychological and pedagogical rehabilitation or habilitation.

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4. Fig. 3. Organizational model of interdepartmental interaction on the development and implementation of IPRH for a disabled person, a disabled child in the Perm region. Note. ПК — Perm region, ИПРА — individual rehabilitation and habilitation program, ГБ МСЭ — Main bureau of medical and social expertise, ОСФР — Branch of the Social Fund of Russia, ГУФСИН — Main directorate of the Federal penitentiary service, ОИВ — executive authorities, СОН — social services for the population, ПНИ — psychoneurological boarding school, ДИПИ — boarding house for the elderly and disabled, ДДИ — children’s boarding house.

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