Number of cases of temporary disability. Morbidity with temporary disability. Accounting and reporting documentation and evaluation of indicators. Frequency of diseases. Health index. Accounting documents and rules for filling them out

Morbidity with temporary disability occupies a special place in population morbidity statistics due to its high socio-economic significance. Reducing the incidence of workers and employees is a great reserve for increasing labor productivity at any enterprise.

Reducing labor losses contributes to the protection of the health of workers and employees, and also allows saving money on social insurance. Morbidity with temporary loss of ability to work has a feature that distinguishes it from the general morbidity of the population, since not all diseases do not always lead to loss of ability to work. The study and analysis of morbidity with temporary disability does not provide an exhaustive description of the health of workers, however, it makes it possible to identify the impact of morbidity on working ability.

This morbidity may be the result of a violation of the organization of work, chronic overwork, the harmful effects of a complex of production factors, deficiencies in the provision of medical and preventive care, etc. The level and structure of this type of morbidity is influenced by various factors. The incidence of illness with temporary disability has a close connection with the age, gender, professional, length of service of workers, working and living conditions, and the quality of medical and labor examination. In addition, it can be a criterion for the effectiveness of measures of a socio-economic, hygienic and medical nature.

In plans for the socio-economic development of an enterprise, initial data on the incidence of workers with temporary disability are the basis for improving sanitary and hygienic working conditions and improving the quality of medical care.

The unit for recording morbidity with temporary disability is a case of loss of ability to work due to a disease. The accounting document in which each case of such a disease is registered is a certificate of incapacity for work. This document is also a document

ment legal (is the basis for the patient’s failure to fulfill his labor obligations to the employer), financial (on its basis, disability benefits are calculated and paid to the patient within the framework of social insurance) and statistical (when developing certificates of incapacity for work, it is possible to obtain indicators characterizing the incidence of illness with temporary loss of ability to work) .

The reporting form for morbidity with temporary disability is form No. 16-VN. This document is intended for operational purposes of recording and analyzing temporary disability of workers. The specifics of its preparation and the order of presentation are specified in the instructions.

This reporting form contains information on the number of cases and days of temporary disability in absolute numbers. Based on these absolute values, a number of relative and average values ​​can be calculated, allowing comparison of indicators for individual lines (causes of disability), professional groups, time periods, etc.

The main indicators that can be calculated based on the report information are the following:

1. Number of cases of disability per 100 workers: absolute number of cases of disability x 100

average number of employees

Number of days of disability per 100 workers: absolute number of days of disability x 100

average number of employees

3. Average duration of one case of disability: absolute number of days of disability absolute number of cases of disability

4. Morbidity structure indicator:

absolute, number of cases (or d.) easy. according to d. ill. x 100% absolute number of cases (or days) in general for all diseases

These indicators are calculated:

For all reasons (illness, caring for the sick, vacation in connection with sanatorium treatment, quarantine);

By disease;

By disease class;

For certain reasons.

The indicator of the number of cases of disability per 100 workers (frequency indicator) indicates the level of morbidity among workers. The indicator of the number of days of disability per 100 workers characterizes, mainly, the severity of the disease, and also has a certain economic significance. The average duration of a disability case expresses the severity of the disease and the quality of the disability assessment.

When calculating indicators, you should remember that you must use the average annual number of employees, which is defined as half the sum of employees at the beginning and end of the month. The average annual number of employees per year can be determined in two ways:

1) by summing the number of employees at the beginning of each month (including the beginning of January of the next year) and dividing this amount by 13;

2) summing up monthly data on the average number of employees and dividing the sum by 12.

Calculation of morbidity rates of female genital organs should be based on the number of women.

The structure of morbidity allows us to determine the place (significance) of a particular disease among all diseases.

Additionally, to characterize labor losses due to temporary disability, the following indicators can be calculated.

1. The share of those who conditionally did not work during the reporting period (percentage of those who conditionally did not work during the reporting period):

absolute number of days of incapacity x 100%

average annual number of employees x number of calendar days. days report, year

In the absence of data on the number of employees, you can calculate:

2. Number of absences from work per working day:

absolute number of days of incapacity for work

number of calendar days in a year

When performing a comparative analysis of morbidity indicators with temporary disability across enterprises or over time, it should be remembered that the indicators must be calculated on qualitatively homogeneous populations of workers, i.e. comparison of indicators is possible if the enterprises being compared are the same in terms of age, gender, occupation, length of service composition, since these signs affect the level of indicators. If the composition of the workforce is heterogeneous, the use of a statistical method for standardizing indicators is justified.

Analysis of morbidity with temporary disability based on official statistics is limited to a comparison of the most important indicators (cases, days of disability, average duration of the case) by industry, by department of the enterprise, by professional and social groups. A mandatory element of the analysis is a dynamic comparison by year and quarter (comparison with the corresponding quarters of the previous year). When dynamically analyzing morbidity indicators with temporary disability over several years, it makes sense to calculate the average annual indicators and the average annual growth rate of indicators for the analyzed series of years.

Special The morbidity with temporary loss of ability to work, or the morbidity of working contingents (IWUT), is subject to recording and analysis.

Collect information about VUT in one of the following documents:

Outpatient card f. 025-6(7)/у-89

Unified patient's card f.025-8/u-95

Ticket for a completed case of temporary disability f.025-9/u-96

Outpatient card f.025-10/u-97, if computer counting

Book of registration of certificates of incapacity for work f. No. 36/у

In order to summarize the data on the health care facility’s health and safety conditions, form 16-VN “Information on the causes of temporary disability” is filled out. This report is intended for operational purposes of accounting and analysis of temporary disability of workers. For the analysis of VUT, the following is calculated:

Morbidity rate indicator = Number of cases of acute illness on primary sick leave / Average number of employees X 100

Indicator of severity of the disease = Number of days of vocational training for primary illnesses and their continuations / Average number of employees X 100

Average duration of one case of disability = Number of days of disability/Number of cases of disability

It is necessary to study VUT monthly, only then can the causes of diseases be identified. When analyzing PVUT, one should compare the morbidity rates of individual workshops with each other, with the average rates for the entire plant, with the rates of other enterprises in the same industry, the seasonality of morbidity, etc.

ZVUT has not only a social-gig meaning, but also a social-economy meaning, i.e. reflecting the morbidity of workers.

In reports with PVUT, not only diseases with PVUT are taken into account, but also disability due to pregnancy, childbirth, quarantine, and patient care.

This type of morbidity includes those cases of illness among workers, employees, and collective farmers that resulted in absence from work. Thus, in this case we are talking about the incidence of working contingents.

The unit of observation when studying morbidity with temporary disability is each similar case that occurred in a worker in a given year. The accounting document is a certificate of incapacity for work (sick leave), which is not only a legal document certifying temporary release from work, but also a financial one. At each enterprise and institution, trade union committees and doctors of medical units (or trusted doctors) draw up a quarterly report in Form No. 16-VN. This report is sent to the city, regional (territorial, republican) committee of the trade union of the sector of the national economy to which this enterprise or institution belongs. Based on quarterly reports, semi-annual and annual reports on temporary disability are compiled. Reporting form No. 16-VN provides data on the number of workers at a given point, the number of cases of loss of ability to work (according to primary certificates of incapacity for work) and the number of calendar days of incapacity for work (according to primary certificates of incapacity and continuations) that occurred among workers over reporting period" (quarter, year).

Analysis of these indicators makes it possible to judge the dynamics of morbidity at a given enterprise (by quarter of the year and over a number of years), to carry out a comparative assessment with other enterprises in the industry, to identify diseases that occupy the main place in the morbidity of workers, and on this basis to plan the necessary treatment - health and sanitary measures.

At the same time, the possibility of using the form Hi 16-VN for an in-depth study of morbidity with temporary disability are limited. It does not allow us to establish who gets sick and how often at a given enterprise, since it reflects only information about registered cases of diseases, and not about sick individuals.

Using this form, it is impossible to assess the impact on the incidence of such important factors as gender, age, profession and length of service. In recent years, the method of studying morbidity with temporary disability based on personal records has become widespread in the activities of medical institutions serving industrial enterprises.

For each employee of the enterprise, a special accounting document (“Personal Employee Card”) is filled out, which indicates his last name, first name, patronymic, and gender. age, profession and work experience (general and in this profession). During the year, employees of the medical and sanitary unit copy from sick leave sheets and enter into these cards information about all cases of loss of capacity for work by each worker, indicating the diagnosis and the duration of his release from work.

ICD-10

A system for grouping diseases and pathological conditions, reflecting the current stage of development of medical science. It is a normative document that defines the rules for systematizing observations when studying productivity. causes of death and activities of health care institutions. The first ICD (list of causes of death), proposed by J. Bertillon in 1893, was adopted by the International Statistical Institute. Since 1900, regular revisions of the classification have been carried out approximately once every 10 years. In the USSR in 1981-1982. The ICD ninth revision was introduced. The last tenth revision of the ICD was in 1993.

International classification of disease th (ICD) is a system for grouping diseases and pathological conditions, reflecting the current stage of development of medical science. The ICD is the main regulatory document for studying the health status of the population in countries that are members of the World Health Organization.

Thus, it should be noted that the ICD is in constant development and improvement.

Further integration of medical information systems in different countries of the world is associated with the development of the International Nomenclature of Diseases (IND), the development of which has been carried out by the Council of International Medical Scientific Organizations since 1970. The goal of the IND is to assign each nosological unit a recommended international name, taking into account specificity, unambiguity, and etiology.

In contrast to nomenclature, the main task of the ICD is to group similar pathological conditions for the purpose of subsequent analytical processing. In the ICD, all diseases are divided into classes, classes into blocks, blocks into headings (encrypted with three characters), headings into subcategories (encrypted with four characters or more). ICD 10 consists of three volumes.

First volume(Edition in Russian - in two books) contains a complete list of three-digit headings and four-digit sub-headings, a list of headings under which countries submit information on diseases and causes of death to WHO, as well as special lists for the statistical development of mortality and morbidity data.

Second volume includes a description of ICD-10, its goals, scope of application, instructions, rules for using ICD-10 and coding of causes of death and diseases, as well as basic requirements for statistical presentation of information. Specialists may also find the history section of ICD interesting .

Third volume consists of an alphabetical list of diseases and the nature of damage (injuries), a list of external causes of damage, tables of drugs and chemicals (about 5.5 thousand items).

What are the main innovations in the ICD tenth revision compared to the ninth revision. In ICD-10, purely classes have been increased (from I 7 to 21). The class of diseases of the nervous system and organs is divided into classes VI “Diseases of the nervous system”, VII “Diseases! :a and its adnexal apparatus” and VIII “Diseases of the ear and mastoid process”. The auxiliary E-code was replaced by an independent class XX “External causes of morbidity and mortality”, and the V-code by class XXI “Factors influencing the health status of people visiting health care institutions”.

The total number of blocks in ICD-10 has been increased to 258. ICD-10 continues to develop the clinical focus of systematizing diseases. Diseases that pose the greatest problems for healthcare (myocardial infarction, cerebrovascular accidents, etc.) are collected in separate sections. A systematization of the most common diseases according to their types has been introduced.

The new classification provides the ability to evaluate some diseases by severity by introducing a code for multiple lesions of organs and systems. The tradition of double coding has been preserved, which allows special studies to evaluate the most damaged organs in infectious and some other diseases. The new classification retained special categories for ill-defined diseases and ill-defined diagnoses. This can help the health care manager evaluate the quality of the diagnostic process in the institution.

The ICD differs from the nomenclature of diseases in certain grouping principles.

The classification is structured in such a way that a limited number of headings covers most known diseases.

Diseases of particular importance to health care are placed in separate sections and located at the beginning of classes or blocks. Rubrics for mixed or unspecified diseases are minimized. Subheadings whose codes (fourth character) end with a number "8", usually mean “other” conditions and multiple lesions, and the number “.9” usually means the same thing. as the main heading, but the status is not specified. 1b of this provision has exceptions. For example, code 9 in the headings E10 - E14 Diabetes mellitus means “no complications.” .8 - “unspecified complications”, a.7 - - “multiple complications”. Thus, ICD-10 puts forward strict requirements for the formulation of the diagnosis, without which it is impossible to select the exact code that most fully reflects the essence of the disease being coded or the cause of death.

ICD principles

A disease of particular significance for health care and high prevalence is presented in a separate section.

The ICD is intended for practical use, so “it allows for a number of compromises between classifications.

The diseases are grouped as follows:

Epidemic diseases;

Constitutional, or general, diseases;

Local diseases grouped by anatomical location;

Developmental diseases;

ICD-10 is not intended and is not suitable for indexing individual clinical cases.

There are some difficulties in using the ICD to study financial issues such as billing or resource allocation.

CURRENT STATE. TRENDS AND FEATURES OF ZAB-TI:

General health: 1.6-nn org breath-21.5/o 2.6-in blood circulation 11.4% 3-in eyes-9.2%

The level of general labor in 2003 was 1712.5 (1655.3-2OO2) per 1000 of us (RF-1411.3). The total salary of adults is 1582.8, children - 2000.2

Primary income in 2003 was 896.1 (870.6-2002) per 100 of us. Primary childhood cancer - 1468.9

Primary production line: 1. b-ni org breath-35.7%. 2. injuries and poisoning - 15.5%. 3.b-no genitourinary s-we-7.7%

Scheme for studying our buildings: legislation on the protection of our buildings. Conditions of collective life: work, life. rest, nutrition, migration processes, level of education and culture. Organization of medical assistance. Social economic factors: for 6. disabled physical development, whether it is natural for us, the composition of our health. Natural-climatic: natural resources, climate level, physiogeographic level. Biological: gender age, constitution, descent.

At the regional level, the potential of residents' housing depends on: the provision of educational institutions, medical personnel, medical equipment. education, sufficiency of funding and material support, availability of assistance; ecology of the region and its impact on its inhabitants; Income level of residents. Inequalities in the distribution of availability of services Z.O. and their availability.

In general, the level of housing in the living conditions of a family is determined by the following group of basic features: nutrition - balance, caloric content, sufficiency, regularity, housing - heating, the presence of sewerage, centralized water supply, insufficient space; lifestyle (in connection with social and professional status and standard of living) - bad habits; financial accessibility of medical care, medicines, professional opportunities.

WHO has identified 10 main goals of the “health for all in the 21st century” strategy: 1. strengthening equity in health care. 2. improving opportunities for survival and quality of life. 3. reversing global trends in relation to 5 major pandemics (inf b-ey, nennf b-ey, injuries and violence, alcoholism and drug addiction, tobacco smoking). 4. complete or partial elimination of certain diseases (poliomyelitis, etc.). 5. improving access to water, sanitation, food and housing. 6. promoting healthy and countering unhealthy lifestyles. 7. improving access to comprehensive, high-quality medical and sanitary care. 8. support for scientific research in the field of Z.O. 9. implementation of global and national systems of medical information and epidemic surveillance. 10 development, implementation and monitoring of policies to achieve<д-я для всех» в странах.

DISABILITY: DEFINITION.IST INFO:

It is one of the most important criteria for health. Until 1995, in our country the concept of a disabled person was identified with a permanent disability. Inv 2gr-nettrudosp-en 1gr-else" and needed care. They were deprived of employment rights. 3gr-was a worker, but they were reluctant to be hired. In 95, the law "Social protection of assets of the Russian Federation", for the first time in practice was on - “disabled child”.

9714 0

Temporary disability includes such conditions of the body when disturbances caused by illness and making it difficult to perform professional duties are reversible and transient. The study of morbidity with temporary disability of various contingents of the working population is of great scientific, practical, as well as economic importance.

The characteristics of the work of individual professional groups of engineers have a “specific” impact on their health. Diseases of the cardiovascular system, nervous system, etc. occupy a large proportion in the structure of diseases of employees. The emergence of these diseases is facilitated not only by the modern lifestyle of the urban population, the decrease in the level of physical activity, which is most pronounced in the group of engineering and technical workers, but also by the characteristics of work activity.

We conducted a study of morbidity with temporary disability of engineers and managers of the plant management and main departments of the plant by registering cases and the number of days of temporary disability in special “Cards for the Study of Temporary Disability”. 1261 people were under observation.

The bulk of workers in both groups were people with work experience at the enterprise of 5-9 and 10-19 years - 67.9% and 64.9%, respectively. Among the engineering workers of shop services, there were more people with more than 10 years of work experience (76.0%) than among plant management engineers (61.7%), and with more than 20 years of experience - 26.3% and 16.8%, respectively. When comparing indicators of temporary disability, we took these differences into account and calculated standardized indicators directly by gender and length of service. The composition of plant management engineers by gender and length of service was taken as the standard.

When comparing morbidity levels with temporary disability for all diseases over the 5 years studied, it turned out that they remained higher for engineering and technical personnel of shop services than for engineering and technical personnel of plant management.

Standardization by gender and length of service did not change the ratio of indicators of temporary disability.

Temporary disability, both in the number of cases and by days, in all the years studied was higher among engineering workers of shop services than among engineering workers of plant management. The average level of incapacity for engineers of shop services was 79 cases, 790 days, and for engineers of plant management, respectively, 74 cases and 676 days per 100 workers. It should be noted that as a result of the clinical examination of this contingent carried out under our leadership, the incidence of illness with temporary loss of ability to work has decreased slightly over the indicated years.

The increased incidence of engineering and technical personnel in shop services is explained by less favorable working conditions than in the plant management. Engineers and heads of shop services are in the shops from 15 to 40% of their working time, and foremen and site managers are in the shops up to 60% of their working time.

Engineering and technical workers in workshops are likely to develop diseases characteristic of their respective industries. Thus, in engineering workshops where there is a high concentration of coolant aerosols in the air of the working area, medical examinations revealed a tendency to diseases of the upper respiratory tract (pharyngitis, laryngitis, etc.). Among the causes of loss of ability for engineers and managers, influenza, acute respiratory viral infections, pneumonia and other respiratory diseases occupy a significant place. Of the listed nosological forms, the incidence rates of pneumonia and chronic respiratory diseases are slightly higher among engineers and heads of shop services - 2.27 cases and 41.8 days per 100 workers versus 1.4 cases and 25.7 days of disability among engineers and plant management managers ( Table 1).

Standardization by gender and length of service did not change the ratio of indicators. The composition of the engineering and technical personnel of the plant management was adopted as the standard. Thus, for influenza, temporary disability when standardized by gender among engineers of shop services was 11.4 in cases, 64.5 in days, and 12.3 and 67.6 in days, respectively. The picture is the same for pharyngitis and tonsillitis, pneumonia and chronic respiratory diseases, diseases of the gastrointestinal tract, sensory organs, nerves and peripheral ganglia and some other diseases.

Table 1

Indicators of temporary disability of engineers and managers of plant management and shop services standardized by gender and length of service (per 100 employees)

Thus, the incidence of illness with temporary disability of engineering and technical personnel of shop services for the above nosological forms of diseases, even with the same gender and length of service, would be higher than the engineering and technical personnel of the plant management, as evidenced by standardized indicators.

We further studied temporary disability from a professional perspective. The company's engineering staff was divided into 3 professional groups: managers, engineers and craftsmen.

The age-sex characteristics of these groups have already been discussed in the section characterizing the incidence of diseases according to the data on appeal.

The study of temporary disability of persons belonging to the specified professional groups showed that the highest average long-term levels were identified in the group of engineers, in second place were foremen, and in third place were managers (Table 2).

table 2

Temporary disability of engineers and managers (per 100 employees)

Standardization of indicators of temporary disability by gender and age showed that with the same age and sex composition as managers, the temporary disability of engineers and foremen would be even higher. The higher level of temporary disability of persons of these professional groups compared to managers is explained by the significant frequency of influenza, ARVI and colds, the spread of which is due to large crowding in office premises, where there is less than 4.5 m2 of space per worker. The reason for the low rates of temporary disability among managers is their high responsibility and lack of time, which is why they do not always seek medical help and, as a rule, do not issue a certificate of incapacity for work.

In this study, we were primarily interested in the frequency of temporary disability due to cardiovascular diseases. In the structure of the causes of temporary disability of managers for this group of diseases, the first place belongs to vascular diseases (40.9% of cases and 40.5% of days), the second place belongs to hypertension (29.1% of cases) and coronary disease (21.3% of days) . The main reasons for temporary disability of engineers also turned out to be vascular diseases (40.5% of cases and 27.0% of days), hypertension (35.5% and 25.4%, respectively). Temporary disability of masters is caused by hypertension (60.0% of cases and 66.9% of days), as well as rheumatism (23.3% and 14.5%, respectively).

As can be seen from table. 3, temporary disability of managers due to cardiovascular diseases in cases is more than twice as high, in days - 2.5-4.9 times, than the same indicator for engineers and craftsmen. Managers suffer from vascular diseases, hypertension and coronary heart disease more often and longer than engineers and foremen. The average duration of one case of coronary heart disease among managers stands out especially sharply - 38.9 days, while this figure was 17.4 days for engineers, 18.5 days for foremen, although the number of cases of temporary disability of managers and engineers is approximately the same. This indicates the significant severity of coronary heart disease among managers.

Table 3

Temporary disability of various groups of managers and engineers for cardiovascular diseases (per 100 employees)

MODULE 3.8. EXAMINATION OF TEMPORARY DISABILITY

MODULE 3.8. EXAMINATION OF TEMPORARY DISABILITY

Purpose of studying the module: study the organization of the examination of temporary disability and the procedure for preparing documents certifying temporary disability.

After studying the topic, the student must know:

Basic concepts of examination of temporary disability;

Organization of examination of temporary disability in medical institutions;

Types of temporary disability;

Rules for issuing, procedure for preparing documents certifying temporary disability;

Statistical indicators of morbidity with temporary disability;

Methodology for calculating morbidity rates with temporary disability.

The student must be able to:

Calculate, analyze and interpret statistical indicators of morbidity with temporary disability;

Prepare documents certifying temporary disability;

Use the acquired knowledge in the practical activities of a doctor.

3.8.1. Information block

Temporary disability - the state of the human body caused by illness, injury and other reasons in which dysfunction is accompanied by the inability to perform professional duties in normal production conditions for a certain period of time, i.e. are reversible.

Examination of temporary disability - one of the types of medical examination, the main purpose of which is to assess the patient’s health status, the quality and effectiveness of the treatment, the ability to carry out professional activities, as well as determining the degree and timing of temporary disability.

Documents certifying temporary disability and confirming temporary release from work (study) are the “Certificate of Incapacity for Work”, in some cases - certificates of the established form, for example “Certificate of temporary disability of a student, student of a technical school, vocational school, illness, quarantine and other reasons for the absence of a child attending school or a preschool institution” (f. 095/u).

The main statistical document registering diseases with temporary disability is “Information on the causes of temporary disability” (form 16-VN). This document allows you to analyze the level and structure of individual diseases in cases and days of incapacity for work. In order to unify the formation of the state statistical report of a medical institution, the “Coupon for a completed case of temporary disability” (f. 025-9/u-96) is used.

The organization of the examination of temporary disability, the procedure for issuing certificates of incapacity for work, the analysis of morbidity with temporary loss of ability to work are set out in section 8 of chapter 3 and sections 2, 3 of chapter 20 of the textbook. The procedure for filling out a certificate of incapacity for work is given in Appendix 10.

3.8.2. Tasks for independent work

1. Study the materials of the relevant chapters of the textbook, module, recommended literature.

2.Answer security questions.

3. Analyze the standard problem.

4.Answer the module test questions.

5. Solve problems.

3.8.3. Control questions

1. Define the concept of “temporary disability examination”.

2.What is the examination of temporary disability?

3.List the types of temporary disability.

4.Name the documents certifying temporary disability.

5.Name the procedure for issuing a certificate of incapacity for work in case of illness, injury, poisoning, as well as some other consequences of external causes.

6.What is the procedure for issuing a certificate of incapacity for caring for a sick family member?

7.How is a certificate of incapacity for work issued in cases of pregnancy and childbirth?

8. How is a certificate of incapacity for work issued for the period of sanatorium treatment, prosthetics and during quarantine?

9.Name the morbidity rates with temporary disability. Give the calculation formula.

3.8.4. Reference task

Initial data

1. At one of the industrial enterprises with 1215 employees, 840 cases of illness and 9200 days of temporary disability were registered during the year.

2. Smirnova Lyubov Ivanovna, 52 years old, accountant of Vympel LLC, living at the address: Voronezh, st. Lebedeva, 45, apt. 126, contacted city clinic No. 2, located at: Voronezh, st. Lebedeva, 5. After examination by general practitioner M.A. Pavlova. A diagnosis was made: hypertensive crisis. Treatment has been prescribed. The certificate of incapacity for work was issued from March 25 for 18 days.

Exercise

1. Based on the presented initial data, calculate and analyze morbidity rates with temporary disability.

2. Draw up a certificate of incapacity for work in accordance with the rules for filling out a certificate of incapacity for work and the attached sample (Appendix 10).

Solution

To analyze morbidity with temporary disability at one of the industrial enterprises, we calculate the following indicators.

1. Statistical indicators of morbidity due to temporary disability

1.1. Number of cases of temporary disability per 100 workers =

1.2. Number of days of temporary disability per 100 workers =

1.3. Average duration (severity) of a temporary disability case =

2. To register temporary disability, the attending physician has the right to issue a certificate of incapacity for work upon initial application for a maximum period of up to 10 days and extend it individually for a period of up to 30 days. In this example, the doctor issues a certificate of incapacity for work for 7 days - from 25.03 to 31.03, then extends it for another 7 days - from 01.04 to 07.04, and subsequently from 08.04 to 11.04. From 12.04 the employee must start work.

We enter the results of calculating statistical indicators into a table and compare them with the recommended values ​​or the existing average statistical indicators given in Section 8 of Chapter 3 of the textbook and recommended literature, after which we draw appropriate conclusions.

Table. Comparative characteristics of statistical indicators of morbidity with temporary disability

Conclusion

At this industrial enterprise, the indicator of the number of cases of temporary disability (69.1) is higher, and the number of days of temporary disability (757.2) per 100 workers is lower than the corresponding indicators on average for the Russian Federation. The average duration of one case of temporary disability (11) is lower than the similar indicator in the Russian Federation.

3.8.5. Test tasks

Choose only one correct answer.

1. Under what conditions can persons engaged in private medical practice be granted the right to issue certificates of incapacity for work?

1) if you have a specialist certificate;

2) if there is an agreement with municipal or state medical institutions;

3) for injuries, poisoning and other acute diseases;

4) if you have a license to engage in medical activities and conduct an examination of temporary disability;

5) in cases of emergency medical care.

2. What to do if upon discharge from the hospital the patient remains temporarily unable to work?

1) close the sheet and send it to the clinic;

2) issue a certificate for 3 days;

3) extend the certificate of incapacity for work for up to 10 days;

4) extend the certificate of incapacity for work for a period of no more than 4 days;

5) issue a certificate for a period of no more than 10 days.

3. How is disability determined due to injury?

1) a certificate of incapacity for work is issued on the day the temporary incapacity for work is established;

2) a certificate of incapacity for work is issued from the day of contacting a doctor for the entire period of incapacity for work;

3) a certificate of incapacity for work is issued from the 6th day of incapacity for work, a certificate is issued for the first 5 days;

4) a certificate of incapacity for work is issued from the 11th day of incapacity for work;

5) for any injuries, a certificate is issued for the entire period of incapacity.

4. For how long is a certificate of incapacity for work issued for caring for a sick child at home?

1) for 3 days, then a certificate is issued for up to 10 days;

2) for 7 days, then a certificate is issued for 3 days;

3) for a period of up to 10 days, after which a certificate is issued;

4) for a period of up to 14 days, after which a certificate is issued;

5) for the entire period of illness of a child under 7 years of age.

5. In what cases is a certificate of incapacity for work issued to care for a healthy child?

1) upon departure of the mother (father) for sanatorium treatment;

2) when quarantine is imposed on this child;

3) when imposing quarantine on a nursery or kindergarten;

4) during hospitalization of a person caring for a child under 3 years of age;

5) during inpatient treatment of a person caring for a child under 5 years of age.

6. For how long is a certificate of incapacity for work issued for uncomplicated pregnancy and childbirth?

1) for 56 calendar days;

2) for 70 calendar days;

3) for 126 calendar days;

4) for 140 calendar days;

5) for 170 calendar days.

7. What data is needed to calculate the average duration of a temporary disability case?

1) the number of days of temporary disability; number of sick persons;

2) the number of days of temporary disability; Population;

3) the number of days of temporary disability; number of cases of temporary disability;

4) the number of days of temporary disability; average annual number of employees;

8. Name the type of temporary disability in which a certificate of incapacity for work is issued for the entire period of follow-up treatment, but not more than 24 calendar days:

1) injury;

2) quarantine;

3) prosthetics;

4) caring for the sick;

5)sanatorium-resort treatment.

9. After what period of time after the opening of a certificate of incapacity for work, are long-term ill patients sent to medical examination with an obvious unfavorable clinical and work prognosis?

1) after 2 months;

2) after 3 months;

3) after 4 months;

4) after 6 months;

5) after 12 months.

10. Which medical worker can be given the right to issue a certificate of incapacity for work?

1) the doctor of the ambulance station;

2) the doctor of the hospital emergency department;

3) to the doctor of a rest home, sanatorium;

4) a nurse at a health center;

5) a paramedic at a medical and obstetric station located in a remote area.

11. For what period can the attending physician issue a certificate of incapacity for work simultaneously and independently?

1) for 4 and 15 days;

2) for 3 and 6 days;

3) for 10 and 25 days;

4) for 6 and 30 days;

5) for 10 and 30 days.

12. What data is needed to calculate the indicator “number of cases of temporary disability per 100 workers”?

1) the number of cases of temporary disability; average annual population;

2) the number of cases of temporary disability; average duration of one case;

3) the number of cases of temporary disability; average annual number of employees;

4) the number of cases of temporary disability; number of sick persons;

5) number of days of temporary disability; number of cases of temporary disability.

13. Name the functions of the attending physician in assessing work capacity:

1) establishing the fact of temporary incapacity for work, issuing a certificate of incapacity for work, referral to ITU;

3) establishing the fact of temporary disability, issuing a certificate of incapacity for work, examination of permanent disability;

4) establishing the fact of permanent disability, issuing a referral to a medical commission, examination of temporary disability;

5) establishing the fact of temporary incapacity for work, issuing a certificate of incapacity for work for a maximum of 30 days, sending it to the VK to extend the certificate of incapacity for work.

14. Name the functions of the medical commission for the examination of work ability:

1) consultations with doctors, referral to medical examination, issuance of a conclusion on transfer to another job, quality control of treatment, examination of temporary disability for more than 30 days;

2) consultations with doctors, referral to medical examination, examination of permanent disability, professional unsuitability;

3) consultations with doctors, issuance of certificates of incapacity for work to all patients, examination of permanent and temporary disability;

4) issuance of certificates of incapacity for work, certificates of professional unsuitability, examination of temporary incapacity for work, issuance of a conclusion on the transfer of pregnant women to another job;

5) issuance of a certificate of incapacity for work, extension of a certificate of incapacity for work.

15. What data is needed to calculate the indicator “number of days of temporary disability per 100 workers”?

1) the number of days of temporary disability; average annual population;

2) the number of days of temporary disability; average duration of one case;

3) the number of days of temporary disability; average annual number of employees;

4) the number of days of temporary disability; number of sick persons;

5) number of days of temporary disability; number of working days in a year.

3.8.6. Problems to solve independently

Problem 1

Initial data

1. At one of the industrial enterprises with 945 employees, 782 cases of illness and 8125 days of temporary disability were registered during the year.

2. Kirillov Petr Ivanovich, 45 years old, turner at Kabel JSC, living at the address: Samara, st. Sibirskaya, 91, apt. 120, from 03.04 to 28.04 he underwent inpatient treatment in city hospital No. 1, located at: Samara, st. Altayskaya, 85, with a diagnosis of peptic ulcer, duodenal ulcer. The certificate of incapacity for work was issued by the head of the therapeutic department, M.A. Solovyov. and the attending physician Drozdova N.P.

Problem 2

Initial data

1. At one industrial enterprise with 1,345 employees, 915 cases of illness and 10,170 days of temporary disability were registered during the year.

2. Vera Ivanovna Makarova, 46 years old, seamstress at ST-moda LLC, living at the address: Ulyanovsk, Frunze Ave., 26, apt. 49. From 15.02 during

per 100 employees= Number of cases of temporary disability /

Number of days of temporary disability per 100 workers=Number of days of temporary disability / Average annual number of employees×100

A certificate of incapacity for work is a legal document certifying temporary release from work, and a financial document on the basis of which benefits are paid from social insurance funds. In addition to passport data (last name, first name, patronymic, gender, age), the certificate of incapacity for work contains information about the sick person’s place of work, diagnosis and duration of treatment. The main statistical document registering

diseases with VUT are “Information about the causes of temporary non-

ability to work" (form 16-VN).

Structure - first place - diseases of acute respiratory infections, then - diseases of the nervous system and sensory organs, hypertension, diseases of the musculoskeletal system, skin infections, diseases of the digestive system, etc.

37-injury – the most important social hygiene problem. There are production (industry, agricultural), non-production (household, transport, street), sports. The average level is 120-130 cases per 1000 population. In men it is 1.5-2 times higher. In the structure of the general zab. 10-15%. In the structure of primary disability, injuries occupy 2nd place after CVD, 3rd place in mortality.

Organization of trauma care - stage 1 - 1 assistance, 2 - pre-hospital medical care, 3 - inpatient care, 4 - recovery treatment. A clear upward trend!

38- Cardiovascular diseases today occupy first place among the causes of disability in our country. At the same time, 4% of men receive group I disability, 60% - group II disability. For women, these figures are slightly lower. Among the causes of disability, coronary and hypertension diseases, vascular lesions of the brain, and rheumatism prevail.

With age, there is an increase in the incidence of cardiovascular diseases (except rheumatism). Women have higher incidence rates (except for myocardial infarction) than men. The increase in mortality rates from cardiovascular diseases is due to factors such as the aging of the population, improved diagnostics, and a more precise formulation of the causes of death

43. a International Statistical Classification of Diseases and Related Health Problems(English) International Statistical Classification of Diseases and Related Health Problems) is a document used as a leading statistical and classification basis in healthcare. It is reviewed periodically (every ten years) under the guidance of WHO. The ICD is a normative document that ensures the unity of methodological approaches and the international comparability of materials.

Currently in effect International Classification of Diseases, Tenth Revision (ICD-10, ICD-10). In Russia, health authorities and institutions made the transition to statistical accounting to ICD-10 in 1999.

The purpose of the ICD is to create conditions for the systematic recording, analysis, interpretation and comparison of data on mortality and morbidity obtained in different countries or regions and at different times. The ICD is used to convert verbal diagnoses of diseases and other health problems into alphanumeric codes that make data easy to store, retrieve, and analyze.

The ICD has become the international standard diagnostic classification for all general epidemiological purposes and many health care management purposes. They include an analysis of the overall health situation of population groups, as well as calculations of the incidence and prevalence of diseases and other health problems in their relationship to various factors.

The International Conference on the Tenth Revision of the International Classification of Diseases was held by the World Health Organization in Geneva from September 25 to October 2, 1989. The main innovation in the Tenth Revision is the use of an alphanumeric coding system, which assumes that in a four-character category there is one letter followed by three digits, which made it possible to more than double the size of the coding structure. Introducing letters or groups of letters into rubrics allows up to 100 three-character categories to be coded in each class. Of the alphabet of 26 letters, 25 were used. Thus, possible code numbers range from A00.0 to Z99.9. The letter U is left vacant (reserved).

ICD-10 consists of three volumes:

· volume 1 contains the main classification;

· volume 2 contains instructions for use for users of the ICD;

44. ITU- determination in the prescribed manner of the needs of the examined person for social protection measures, including rehabilitation, based on an assessment of the limitations in life activity caused by a persistent disorder of body function.

MSE is carried out based on a comprehensive assessment of the state of the body based on the analysis of clinical, functional, social, professional, labor and psychological data of the persons being examined.

MSA is carried out by the State Service for Medical and Social Expertise, which is part of the system (structure) of social protection bodies of the Russian Federation (Ministry of Labor and Social Development of the Russian Federation).

The state service of medical and social examination is entrusted with:

· determination of the disability group, its causes, timing, time of onset of disability, the need of a disabled person for various types of social protection;

· development of individual rehabilitation programs for disabled people;

· study of the level and causes of disability of the population;

· participation in the development of comprehensive programs for the prevention of disability, medical and social rehabilitation and social protection of disabled people;

· determination of the degree of loss of professional ability of persons who have received a work injury or occupational disease;

· determination of the cause of death of a disabled person in cases where the legislation of the Russian Federation provides for the provision of benefits to the family of the deceased.

PRESS RELEASE

DECISION of December 16, 2004 No. 805 On the procedure for organizing and operating federal state institutions of medical and social examination

In order to implement Article 8 of the Federal Law "On Social Protection of Disabled Persons in the Russian Federation" the Government of the Russian Federation decides:

Establish that federal state institutions of medical and social examination include the Federal Bureau of Medical and Social Examination (hereinafter referred to as the Federal Bureau) and the main bureaus of medical and social examination, which have branches - bureaus of medical and social examination in cities and regions (hereinafter referred to as the bureau).

Establish that the Federal Bureau is under the jurisdiction of the Ministry of Health and Social Development of the Russian Federation, the main bureaus of medical and social examination that have bureaus (hereinafter referred to as the main bureaus) are under the jurisdiction of the Federal Agency for Health and Social Development.

The number of bureaus is determined based on the calculation, as a rule, 1 bureau per 70 - 90 thousand.
people, subject to examination, 1.8 - 2 thousand people per year. Taking into account the existing socio-demographic, geographical and other characteristics of the regions, bureaus can be created based on a different calculation of the population and the number of citizens examined per year.

The main tasks of federal government agencies medical and social
examinations are: conducting rehabilitation expert diagnostics in order to determine rehabilitation potential, limitations in life activity, and the need for social protection measures; study of the causes, factors and conditions influencing the occurrence, development and outcome of disability, analysis of the prevalence and structure of disability.

The Bureau performs the following functions:

a) conducts an examination of citizens to establish the structure and degree of disability (including the degree of limitation of the ability to work) and their rehabilitation potential;

b) the doctor develops and adjusts individual rehabilitation programs for disabled people, including determining the types, forms, timing and scope of measures for medical, social and professional rehabilitation;

c) establishes the fact of the presence of disability, the group, causes, duration and time of onset
disability, degree of limitation of ability to work;

d) determines the degree of loss of professional ability to work (in percentage); -

e) determines the causes of death of a disabled person in cases where the legislation of the Russian Federation
The Federation provides for the provision of social support measures to the family of the deceased;

f) gives citizens undergoing examination explanations on medical issues;
social expertise;

g) participates in the development of programs for the rehabilitation of disabled people, disability prevention and social protection of disabled people;

h) forms a data bank within the serviced territory about citizens who have undergone

i) submits information to the relevant military commissariats about all cases of recognition of persons liable for military service and citizens of military age as disabled.

The main bureau performs the following functions:

a) considers complaints from citizens undergoing examination about the decisions of the bureau and, if found to be justified, changes or cancels the decisions of the bureau;

b) conducts, on its own initiative, a re-examination of citizens who have been examined by the bureau, and, if there are grounds, changes or cancels the decisions of the bureau;

c) conducts examinations of citizens who have appealed the decisions of the bureau, and also on
referral to the bureau in cases requiring special types of examination in order to
establishing the structure and degree of disability (including the degree
restrictions on the ability to work) and their rehabilitation potential;

d) gives citizens undergoing examination explanations on medical issues
social expertise;

e) forms, within the serviced territory, a data bank about citizens who have undergone
medical and social examination, carries out state statistical monitoring of the demographic composition of disabled people living in the serviced territory;

f) participates in the development of programs for the rehabilitation of disabled people, disability prevention and social protection of disabled people;

g) coordinates the activities of the bureau and generalizes the experience of their work in the serviced territory;

h) in the case of an examination:

develops and adjusts individual rehabilitation programs for disabled people, including determining the types, forms, terms and volumes of measures for medical, social and professional rehabilitation, and also establishes the fact of disability, the group, causes, duration and time of onset of disability, the degree of limitation of ability to work activities; determines the degree of loss of professional ability to work (as a percentage);

i) determines the causes of death of a disabled person in cases where the legislation of the Russian Federation

The Federation provides for the provision of social support measures to the family of the deceased.

The Federal Bureau performs the following functions:

a) ensures that all citizens are provided with equal opportunities to undergo examination for the purpose of being recognized as disabled in accordance with the Federal Law “On Social Protection of Disabled Persons in the Russian Federation”;

b) considers complaints from citizens undergoing examination about the decisions of the main bureaus and, if they are found to be justified, changes or cancels the decisions of the main bureaus;

c) conducts examinations of citizens who have appealed the decisions of the main bureaus;

d) conducts examinations of citizens at the direction of the main bureaus in cases requiring the use of particularly complex special types of examination;

e) conducts, on its own initiative, a re-examination of citizens who have been examined at the main bureaus, and, if there are sufficient grounds, changes or cancels the decisions of the main bureaus;

f) carries out comprehensive rehabilitation expert diagnostics using
the latest technologies, results of scientific developments in order to determine the availability
limitations in life activity, degree of loss of professional ability to work,
rehabilitation potential and need for social protection measures;

g) conducts scientific research in the established field of activity on behalf of the Ministry of Health and Social Development of the Russian Federation; carries out activities to improve the qualifications of specialists in the field of medical and social examination;

i) provides methodological and organizational assistance to the main bureau and bureau in accordance with the methodological recommendations of the Ministry of Health and Social Development of the Russian Federation, ensures the uniform application of these recommendations, as well as the legislation of the Russian Federation in the field of social protection of disabled people in the established field of activity;

j) forms a data bank on citizens who have passed a medical and social examination, carries out state statistical monitoring of the demographic composition of disabled people;

k) takes part in the study of factors leading to disability and makes proposals for the development and implementation of programs on the problems of disability and people with disabilities;

l) makes proposals to the Ministry of Health and Social Development of the Russian Federation on the implementation of the results of scientific developments, new technologies of rehabilitation expert diagnostics, best practices of the main bureaus, as well as the implementation of programs in various areas of medical and social expertise; m) submits proposals to the Ministry of Health and Social Development of the Russian Federation on the formation of a state order for carrying out research and development work on medical and social examination.

To exercise their powers, federal state institutions of medical and social examination have the right to:

· refer citizens undergoing medical and social examination for examination to treatment and preventive institutions of the state and municipal health care systems, including rehabilitation, in order to clarify the clinical and functional diagnosis and professional capabilities;

· request from organizations, regardless of organizational and legal form and form of ownership, information necessary to fulfill the powers assigned to federal state institutions of medical and social examination . A bureau decision that has not been canceled or changed by the main bureau or in court, a decision of the main bureau that has not been canceled or changed by the Federal Bureau or by court, as well as a decision of the Federal Bureau that has not been canceled or changed by court are binding. relevant government bodies, local government bodies, as well as organizations, regardless of their legal form and form of ownership.

The structure and staffing of the Federal Bureau, as well as the cost estimate for its maintenance, are approved by the Ministry of Health and Social Development of the Russian Federation.

The structure and staffing of the main bureaus, as well as the cost estimates for their maintenance, are approved by the Federal Agency for Health and Social Development within the limits approved by the Ministry of Health and Social Development of the Russian Federation.

The Federal Bureau is headed by the head- Chief federal expert on medical and social examination.

The main bureau is headed by a director- chief expert in medical and social examination for the relevant constituent entity of the Russian Federation.

The appointment and dismissal of the head - the chief federal expert in medical and social expertise, the conclusion, amendment and termination of an employment agreement (contract) with him are carried out by the Minister of Health and Social Development of the Russian Federation.

The appointment and dismissal of the head - chief expert in medical and social examination for the relevant constituent entity of the Russian Federation and the head - chief expert in medical and social examination, conclusion, amendment and termination of an employment agreement (contract) with them are carried out by the head of the Federal Agency for Health Care and social development.

44. Social protection is a multi-level system of economic, legal, organizational, medical-social, pedagogical, psychological and other measures aimed at realizing individual rights and freedoms in the field of social security, guaranteeing not only survival, but also a sufficient level and quality of life.

Basic principles of social protection:

· state character, providing legal, economic and organizational guarantees for the provision of basic types of social assistance;

· delimitation of competence in the field of social protection at the federal, regional and municipal levels and expanding the rights of local authorities in providing social protection measures;

· availability, presupposing the possibility for everyone in need to receive the necessary types and forms of social assistance;

· targeting, which involves providing assistance to those in need, taking into account their individual needs;

· differentiation of measures social protection, taking into account various medical and social factors (age, gender, place of residence - city, village, helplessness, loneliness, etc.);

· complexity, providing for the combination and continuity of various types of assistance (monetary, in-kind, medical, legal, etc.);

· basing on all possible sources of financing(federal, regional, municipal budgets, funds from public associations of disabled people, charitable funds, etc.);

· participation of the population itself in the formation of state policy in the field of social protection and determination of measures for its implementation;

· interaction state, public, religious, humanitarian and other organizations.

An integral element of social protection is social assistance (social support).

Social assistance (support) is provision of the population in cash and in kind, in the form of services or benefits, provided taking into account the social guarantees legally established by the state for social security, at the expense of local authorities, enterprises (organizations), extra-budgetary and charitable funds in order to provide targeted differentiated helping citizens in need.

Among the people who need social assistance in the first place, it is necessary to name the following categories of the low-income population: single pensioners and single married couples who are not capable of self-care; elderly citizens (over 70 years old); disabled people of groups I and II; families with disabled children; mothers of many children (with 3 or more children); single mothers (fathers); orphans; persons in extreme situations (refugees, homeless people, people affected by natural disasters) and other citizens.

The right to receive social assistance is granted to needy citizens (the family as a whole or each disabled family member separately) for a certain period of time after checking income and material and living conditions, whose socio-economic situation meets the following basic criteria:

· total average per capita income is below the established regional level;

· lack of means of subsistence;

· loneliness (lack of relatives obligated by law to support them) and inability to self-care;

· the presence of material damage or physical damage due to natural disasters and catastrophes, as well as as a result of the performance of official duties.