Primary disability due to diseases of the musculoskeletal system in the Irkutsk region: ten-year dynamics
Background. Diseases of the musculoskeletal system and connective tissue (DMSS) often lead to disability. An analysis of disability indicators is necessary for planning both medical care and rehabilitation measures. Aim.To study the dynamics of primary disability due to DMSS in the Irkutsk region over the past 10 years, its possible causes. Materials and methods. Analyzed for 2010 - 2012 statistical coupons of persons recognized as disabled for the first time due to DMSS, and since 2015 - the database of the Unified Automated Vertically Integrated Information and Analytica System (UAVIAS). The share in % and the level of primary disability per 10 thousand of the adult population were calculated, separately - for the population of working age and retirement age. Results and discussion. In 2010-2019 DMSS in the structure of primary disability of the adult population took 3-4 place. The share of primary disability due to DMSS decreased over the decade from 11.7% in 2010 to 6.1% in 2019. Its level decreased by 2.7 times over the decade: from 10.6 in 2010 to 4.0 by 10 thousand of the population in 2019, among people of working age decreased by 2.4 times, among citizens of retirement age - by 3.8 times. Osteoarthritis (40-43%), dorsopathies (22-30%), and rheumatoid arthritis (10-12%) made the main contribution to primary disability due to DMSS. A detailed analysis of changes in normative documents on the criteria for determining disability for the specified period was carried out, which mainly caused a decrease in both the proportion and the level of primary disability due to DMSS. The quantitative assessment of the severity of persistent disorders of body functions due to DMSS have been clarified by the current order of the Ministry of Labor of Russia dated August 27, 2019 No. 585 (entered into force in 2020), which can lead to an increase in the level of disability due to this pathology, especially arthrosis (but not dorsopathies). Conclusions. The share of primary disability due to DMSS in the Irkutsk region decreased 1.9 times over 10 years, its level per 10 thousand population - 2.7 times, among people of working age - 2.4 times, among citizens of retirement age - 3.8 times. This dynamics was mainly due to changes in the normative documents on the establishment of disability. Refinements of the criteria, approved by the latest order of the Ministry of Labor of Russia dated August 27, 2019, No. 585n, may lead to an increase in the level of disability due to DMSS, especially arthrosis (but not dorsopathies).