Determination of the main target rehabilitation groups for disabled military persons to form a system of comprehensive rehabilitation of disabled persons in the Leningrad region

Authors:

Kulinich Tatyana Sergeevna – Head-Chief expert in medical and social expertise, doctor in medical and social expertise of the highest category, Main Bureau of Medical and Social Expertise in the Leningrad Region, 43 Prosveshcheniya Avenue, str.1, 93-N, 194291 St. Petersburg, Russian Federation; e-mail: kultanja@mail.ru, http://orcid.org/0009-0005-7104-4769.

Riabokon Anna Grigorievna – doctor of medical and social expertise, PhD in Medical Sciences (Cand. Med. Sci.), Main Bureau of Medical and Social Expertise in the Leningrad Region, 43 Prosveshcheniya Avenue, str.1, 93-N, 194291 St. Petersburg, Russian Federation; e-mail: ryabokon_ag@47.gbmse.ru, http://orcid. org/0000-0003-4887-4404.

Tuarsheva Svetlana Muharbievna – doctor of medical and social expertise, PhD in Medical Sciences (Cand. Med. Sci.), Main Bureau of Medical and Social Expertise in the Leningrad Region, 43 Prosveshcheniya Avenue, str.1, 93-N, 194291 St. Petersburg, Russian Federation; e-mail: tuarsheva_sm@47.gbmse.ru, http://orcid.org/0009-0002-6106-8554.

Annotation:

Introduction. The priority of the social policy of our state is to support disabled people, participants in combat operations in a special military operation (SMO), and, first of all, to provide them with comprehensive rehabilitation. The existing national standards for the rehabilitation of disabled people, draft standards for the social rehabilitation of disabled people due to military trauma do not take into account the specifics of the consequences of contusions, injuries or diseases in modern military conflicts. In order to unify approaches to a comprehensive rehabilitation program for disabled people in combat operations, it is advisable to assign each disabled person to one or several target rehabilitation groups (TRG) based on the consequences of injuries, contusions, injuries or diseases, with the subsequent formation of a contingent for certain TRG, development of stages and a set of measures for them in all areas of rehabilitation both at the regional and federal levels.

Aim. To study the medical and social characteristics of disabled combat veterans, participants of the special military operation (SVO), examined by the Federal State Institution “State Bureau of Medical and Social Expertise for the Leningrad Region” of the Ministry of Labor of Russia, to determine their target rehabilitation groups for choosing a rehabilitation standard and developing an individual rehabilitation route for comprehensive rehabilitation.

Materials and methods. The study is comprehensive. Sources of information: FGIS EAVIIAS MSE: acts and protocols of examination in the Federal State Institution “State Bureau of MSE for the Leningrad Region” of the Ministry of Labor of Russia; study period: 2023 – 2024. Research methods: analytical, statistical: extensive, intensive indicators, average values; data extraction.

Results. The article presents the results of the analysis of disability indicators among combatants in the SVO. Combatants recognized as disabled by the FSI “State Bureau of Medical and Social Expertise in the Leningrad Region” of the Ministry of Labor of Russia in the period 2023-2024, are distributed by age, group, cause and duration of disability, by belonging to the TRG based on the consequences of injuries and diseases. The contingent of disabled persons due to military injury suffered during the SVO was formed mainly by disabled persons of groups III and II in the disability structure (53,2% and 40,8%), persons of working age (91.4%), of which 39,7% were young, 51,7% were middle-aged. Military causes of disability were established in half of the cases. The consequences of injuries were mainly mineexplosive in nature. Based on the existing persistent impairments of body functions (static-dynamic, mental, sensory and their various combinations), combat invalids in most cases are classified as TRG 12.3, 12.5, 12.7 and 12.8.

Discussion. Based on the identified CRGs for disabled people injured during a special military operation, taking into account the specifics of the disability structure and clinical and functional disorders, it is advisable to divide them into 4 groups: with consequences of injuries, thermal and chemical burns, frostbite of the extremities with the formation of ankylosis, contractures and constricting scars; with consequences of craniocerebral, spinal injuries and damage to the peripheral nervous system; with consequences of injuries resulting in the absence of a limb/limbs; with consequences of injuries to internal organs, with abnormal openings of the digestive, urinary and respiratory tracts. Currently, in the Leningrad Region, a system of measures is being formed in various areas of rehabilitation for disabled combat veterans of military operations, which are carried out on the basis of rehabilitation institutions. Closer interdepartmental cooperation and coordination of persons responsible for organizing the process will allow for full and effective comprehensive rehabilitation of this contingent along the proposed rehabilitation routes, observing the continuity and sequence of all stages of rehabilitation of disabled persons.

Summary. The obtained data on target rehabilitation groups of disabled combat veterans should be used in the Leningrad Region when forming unified approaches to the rehabilitation process taking into account the recommended standards, regional rehabilitation programs for disabled people of this category, and developing measures to prevent disability. We believe it is necessary to create at the federal level standards for comprehensive rehabilitation for all target rehabilitation groups for disabled combat veterans.

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