PRIMARY DISABILITY IN ADULTS DUE TO CEREBROVASCULAR DISEASES AMONG URBAN AND RURAL RESIDENTS IN THE UDMURT REPUBLIC IN 2017–2019, INCLUDING CHANGES DURING THE COVID-19 PANDEMIC IN 2019–2021
Authors:   General Bureau of Medical-Social Assessment of the Udmurt Republic, Izhevsk, Russian Federation, Mukhametgaleeva Ekaterina , Popova Natalia ,   Izhevsk State Medical Academy, Izhevsk, Russian Federation, Ivanova Maisa ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russian Federation, Popov Alexey ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russian Federation, Byvaltsev Alexey ,   Medical Center «Palladium», Izhevsk, Russian Federation, Stolbova Margarita ,   General Bureau of Medical-Social Assessment of the Udmurt Republic, Izhevsk, Russian Federation
Published: January 2024

Significance. Vascular diseases of the brain top the structure of total mortality and disability in Russia and, therefore, are considered the most important medical and social problem. The purpose of the study was to analyze statistical data on primary disability due to cerebrovascular diseases in the Udmurt Republic. Material and methods. The study used the following data: parameters of the Unified Automated Vertically Integrated Information Analysis System for Medical and Social Assessment of the General Bureau of Medical-Social Assessment of the Udmurt Republic of the Russian Ministry of Labor on the contingent of newly identified as primary disabled due to cerebrovascular diseases; Federal State Statistical Observation Form No. 7 (social security department) in the Udmurt Republic in 2017–2021; and official statistical data of the General Bureau of Medical-Social Assessment of the Udmurt Republic of the Ministry of Labor of the Russian Federation. The data were extracted from medical records, the study also used descriptive statistics, calculations of extensive and intensive parameters, analytical analysis, and comparative analysis. Results. Within the analyzed 5-year period (2017–2021), primary disability due to cerebrovascular diseases ranks first in the structure of circulatory diseases and generally equals to 48.3%, with an upward trend from 45.4% in 2017 to 51.5% in 2021. The Udmurt Republic has a lower level of primary disability due to cerebrovascular diseases than the Russian average and the Volga Federal District. A high disability rate among older people in the Udmurt Republic adds to 13.8 per 10,000 population, in general. Males dominate among the disabled, with a trend towards increasing from 59.8% in 2017 to 66.1% in 2021. The third-degree disability is the most common type of primary disability due to cerebrovascular diseases equaling to 39.9% in general. Conclusion. Primary disability due to cerebrovascular diseases ranks first in the structure of disability due to circulatory diseases in the Udmurt Republic in 2017–2021. The age structure of the patients studied is dominated by the elderly (women ≥55 years and men ≥60 years). In the sex structure of adult population newly identified as primary disabled in the Udmurt Republic in 2017–2021 men dominate (62% in general). In terms of disability severity, the third-degree disability prevails. Urban patients are dominant. The consequences of ischemic stroke lead in primary disability due to cerebrovascular pathology (73.0%). The main persistent functional disorders leading to disability due to cerebrovascular diseases include persistent neuromuscular, skeletal, and motor (static and dynamic) disorders. From 2017 to 2019, there was an almost 2-fold increase in the number patients with cerebrovascular diseases not recognized as disabled - from 4.8% in 2017 to 8.5% in 2019, which may be due to incomplete necessary diagnostic, therapeutic and rehabilitation measures and ungrounded referrals for disability examination. From 2019 to 2021, the number of citizens with cerebrovascular diseases not recognized as disabled fell from 8.5% in 2019 to 1.7% in 2021; this may be due to improvements in the regulation of disability-related issues and creation of unified approaches to the criteria for referring for disability examination within the framework of interdepartmental cooperation with medical organizations. The decrease in the number of patients with cerebrovascular diseases referred for disability examination may be associated with the COVID-19-induced epidemiological situation and introduction of a number of restrictive measures, including in medical organizations.