Analysis of the dynamics of primary disability in Ukraine and the implementation of rehabilitation measures for persons with disabilities (2020-2024)

Аннотация

In connection with significant changes in the social policy of European countries, including Ukraine, regarding persons with disabilities and the need to prioritize not a “medical” but a “social” approach to the problem, given the elimination of the entire network of medical and social expert commissions (MSEC) in Ukraine, which were replaced by a new system for assessing a person’s daily functioning, a final analysis of the five-year activity of the medical and social expertise service was conducted. The study's purpose is to analyze statistical indicators of disability and the activities of medical and social expert commissions for 2020-2024. Primary statistical data obtained from regional entities implementing medical and social expertise (MSE) in Ukraine were collected and processed as part of a multi-year medical and statistical observation using reporting form No. 14 “Report on causes of disability, indications for medical, professional and social rehabilitation for 20__” (annual) (approved by order of the Ministry of Health of Ukraine dated July 10, 2007 No. 378, as amended). A continuous sample of all those initially examined by the MSEC and recognized as persons with disabilities from all regions of Ukraine who were examined by the MSEC of Ukraine for the period from 2020 to 2024 was analyzed. The following parameters were studied: the number of persons recognized as persons with disabilities in the country as a whole and by regions, the structure of disability by groups, the structure of disability by nosological forms.  The epidemiological situation regarding primary disability in Ukraine during 2020-2024 remains unfavorable: there is an exponential growth in intensive and extensive indicators of all causes of disability of the population, disability of the population due to general diseases, childhood disability and disability of military personnel is rapidly increasing. The MSEC network available in 2024 was ineffective, part of the MSEC significantly reduced its expert activities, there are significant shortcomings in the objectivity of establishing disability groups and in the implementation of individual disability rehabilitation programs, preventive measures for persons with disabilities. Given the difficult socio-economic situation and martial law in Ukraine, there is an urgent need for systemic changes in the organizational model and mechanisms for expert establishment of disability for citizens of the country, as well as in the implementation of effective measures for the rehabilitation of persons with disabilities. It is advisable to continue in-depth epidemiological monitoring of primary disability in Ukraine by implementing electronic systems for collecting and statistical analysis of primary data using the electronic health care system of Ukraine. Due to the rapid growth of disability rates among military personnel, it is urgent to develop and implement a system of in-depth personalized epidemiological monitoring of disability and implement comprehensive prevention and rehabilitation measures (medical, labor, professional, social) among this category of Ukrainian citizens.