MEDICAL AND SOCIAL EXPERTISE AND CRITERIA FOR LIMITING THE DEGREE OF LOSS OF LIFE OF PATIENTS WITH HYPOTHYROIDISM

Fetisova N. M., Vernigorodsky V. S., Vernigorodskaya M. V.

SOCIAL MEDICINE AND ORGANIZATION OF HEALTHCARE PROTECTION

Scentific article

The questions of labor examination of patients with hypothyroidism are often complex, because they require a comprehensive assessment of not only the severity of hypothyroidism and its complications, but also the presence of concomitant diseases, the course of which during hypothyroidism significantly deteriorates. There may be cases when in itself a hypothyroidism, or separately taken concomitant diseases in a patient with hypothyroidism, formally do not give grounds for establishing a disability group, but together they limit their livelihoods. The purpose of our study was to study medical and social expertise and to define clear criteria for limiting the degree of loss of life of patients with hypothyroidism. Object and methods. The medical-expert documentation of 746 patients and invalids was investigated as a result of postoperative hypothyroidism and 414 patients and invalids due to idiopathic hypothyroidism in the Vinnytsia region. Results and discussion. The decision on disability is based on an assessment of the complex of clinical, psychological, social and professional factors. It takes into account the nature of the disease, the degree of violation of the functions of the organism, the effectiveness of treatment and rehabilitation measures, the state of compensatory and adaptive capabilities of the body, clinical and labor forecast, the ability to social adaptation, the need for various types of social assistance, personal settings, specific conditions and content of work, education and training, age, necessity, employment, and so on. In order to objectively assess the state of health and the degree of social adaptation at the inspection in MSEC in each case, a comprehensive review of all organs and systems of the organism, the study of data laboratory and functional methods of research, analysis of the required documents. Attention is paid to the social and living conditions of the person being examined, the economic situation in the area of residence, the possibility of social adaptation is being studied. In each case, an expert judgment is based on a set of medical and social criteria, the main of which is the diagnosis and prognosis. Without an assessment of the nature and severity of the disease, functional impairment, it is very difficult to determine not only the degree of severity of life limitation, but also the clinical and labor forecast. To predict and improve the medical and social expertise we have proposed a method for predicting the disability group in patients with hypothyroidism, which consists in using the developed formula of the prognostic index taking into account the weight coefficients of a number of indicators. Conclusions 1. Analysis of the dynamics of disability indicates an increase in its severity, mainly among women of working age, due to the disadvantages of organizing the examination and treatment of patients with this pathology, ignoring the influence of concomitant cardiovascular disease on the course of the main disease, and therefore on the level disability in this contingent of patients. 2. Prevalence of hypothyroidism, disability of the able-bodied population, determine the scientific and practical significance of the development of an individual program for the rehabilitation of these patients.

rehabilitation, limitation of vital functions, hypothyroidism

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«Bulletin of problems biology and medicine» Issue 4 part 1 (146), 2018 year, 241-245 pages, index UDK 616.441.64:616-036.865

10.29254/2077-4214-2018-4-1-146-241-245