Adli tıp ana bilim dalı tarafından düzenlenen maluliyet raporlarının retrospektif incelenmesi
Date
2023-01-16
Authors
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Publisher
Bursa Uludağ Üniversitesi
Abstract
Trafik kazası gibi travmatik olaylara maruz kalan kişilerde olay nedeni ile kalıcı sakatlık gelişebilmekte ve bu sakatlık hali kişinin sosyoekonomik yaşamını etkileyebilmektedir. Bu sebeple travmatik olay nedeniyle meydana gelen maluliyetin tespiti gerekmektedir. Maluliyet tespitinde olayın meydana geldiği tarihe göre farklı yönetmelikler kullanılmaktadır. Bu yönetmelikler yayınlanma sırasına göre; Sosyal Sigorta Sağlık İşlemleri Tüzüğü, Çalışma Gücü ve Meslekte Kazanma Gücü Kaybı Tespit İşlemleri Yönetmeliği (ÇGMK), Maluliyet Tespit İşlemleri Yönetmeliği, Özürlülük Ölçütü, Sınıflandırması Ve Özürlülere Verilecek Sağlık Kurulu Raporları Hakkında Yönetmelik, Erişkinler İçin Engellilik Değerlendirmesi Hakkında Yönetmelik (EEDY) ve Maluliyet Ve Çalışma Gücü Kaybı Tespiti İşlemleri Yönetmeliğidir. Olay tarihine göre farklı yönetmelik kullanılması nedeniyle aynı yaralanmalarda farklı maluliyet oranları hesaplanmaktadır. Bu çalışmada maluliyet hesabında kullanılan ÇGMK ve EEDY yönetmelikleri (cetvelleri) incelenerek aralarındaki farkların saptanması ve bu farkların giderilmesi hususunda çözüm önerileri sunulması amaçlanmıştır. Bursa Uludağ Üniversitesi Tıp Fakültesi Adli Tıp Ana Bilim Dalı tarafından 2018-2021 yılları arasında düzenlenmiş 359 olguya ait maluliyet raporları incelenerek her olgu için ÇGMK cetveli ve EEDY hükümleri dikkate alınarak maluliyet oranları hesaplanmıştır. Maluliyet oranları ortalamalarının ÇGMK ve EEDY cetvelleri için sırasıyla 16,9±24,7 ve 13,1±20,4 olduğu saptanmıştır. Ayrıca cetveller açısından maluliyet oranları arasında pozitif yönde güçlü düzeyde korelasyon (r=0,808; p<0,001) olduğu saptanmış olup EEDY cetveline göre ÇGMK cetvelinden daha fazla oran alındığı tespit edilmiştir. Sonuç olarak cetvellerden alınan oranlardaki farklılığın giderilmesi hususunda EEDY cetvelinde yer alan ayrıntılı arızalara/hastalıklara ait listelerin ÇGMK cetvelinde yer alan meslek ve yaş değerlendirmesi ile kombine edilerek maluliyeti tüm yönüyle değerlendirecek yeni bir cetvel/yönetmelik oluşturulması gerektiği kanaatindeyiz.
Persons exposed to traumatic events such as traffic accidents may develop permanent disability due to the event, and this disability may affect the socioeconomic life of the person. For this reason, it is necessary to determine the disability status due to the traumatic event. Different regulations are used in determining disability status, depending on the date of the event. These regulations are in order of publication; Social Insurance Health Affair Regulation, Working Power and Profession Loss Determination Procedures (ÇGMK), Disability Determination Procedures Regulation, Disability Criterion, Classification and Regulation on Health Board Reports to be Given to the Disabled, Regulation on Disability Assessment for Adults (EEDY) and Disability and Working Power Loss Detection Procedures Regulation. Due to the use of different regulations according to the event date, different disability rates are calculated for the same injuries. In this study, it is aimed to examine the ÇGMK and EEDY regulations used in disability calculation, to determine the differences between them and to offer solutions to eliminate these differences. Disability reports of 359 cases prepared by Bursa Uludağ University Faculty of Medicine Department of Forensic Medicine between 2018-2021 were studied retrospectively. Disability rates were calculated for each case with taking into account the provisions of RLWP scale (Regulation on Determination of Loss of Working Power and Profitability) and RAA scale (Regulation on Disability Assessment for Adults). The mean rates of disability were found to be 16.9±24.7 and 13.1±20.4 for RLWP scale and RAA scale, respectively. In addition, it was determined that there was a strong positive correlation (r=0.808; p<0.001) between the disability rates in terms of the scales and it was determined that the rate was higher than the RLWP scale compared to the RAA scale. As a result, in order to eliminate the difference in the ratios taken from the scales, we believe that a new scale/regulation that will evaluate the disability in all its aspects should be created by combining the lists of detailed disabilities/diseases in the RAA scale with the occupation and age assessment in the RLWP scale.
Persons exposed to traumatic events such as traffic accidents may develop permanent disability due to the event, and this disability may affect the socioeconomic life of the person. For this reason, it is necessary to determine the disability status due to the traumatic event. Different regulations are used in determining disability status, depending on the date of the event. These regulations are in order of publication; Social Insurance Health Affair Regulation, Working Power and Profession Loss Determination Procedures (ÇGMK), Disability Determination Procedures Regulation, Disability Criterion, Classification and Regulation on Health Board Reports to be Given to the Disabled, Regulation on Disability Assessment for Adults (EEDY) and Disability and Working Power Loss Detection Procedures Regulation. Due to the use of different regulations according to the event date, different disability rates are calculated for the same injuries. In this study, it is aimed to examine the ÇGMK and EEDY regulations used in disability calculation, to determine the differences between them and to offer solutions to eliminate these differences. Disability reports of 359 cases prepared by Bursa Uludağ University Faculty of Medicine Department of Forensic Medicine between 2018-2021 were studied retrospectively. Disability rates were calculated for each case with taking into account the provisions of RLWP scale (Regulation on Determination of Loss of Working Power and Profitability) and RAA scale (Regulation on Disability Assessment for Adults). The mean rates of disability were found to be 16.9±24.7 and 13.1±20.4 for RLWP scale and RAA scale, respectively. In addition, it was determined that there was a strong positive correlation (r=0.808; p<0.001) between the disability rates in terms of the scales and it was determined that the rate was higher than the RLWP scale compared to the RAA scale. As a result, in order to eliminate the difference in the ratios taken from the scales, we believe that a new scale/regulation that will evaluate the disability in all its aspects should be created by combining the lists of detailed disabilities/diseases in the RAA scale with the occupation and age assessment in the RLWP scale.
Description
Keywords
Adli tıp, Maluliyet, Yönetmelik, Forensic medicine, Disability, Regulation
Citation
Düzcan, A. M. vd. (2023). ''Adli tıp ana bilim dalı tarafından düzenlenen maluliyet raporlarının retrospektif incelenmesi''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 49(1), 9-16.