2018-2021 yılları arasında bursa Uludağ Üniversitesi Tıp Fakültesi Adli Tıp Ana Bilim Dalı tarafından düzenlenen maluliyet raporlarının retrospektif olarak incelenmesi ve güncel yönetmelik/cetvellere göre yeniden değerlendirilmesi
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Date
2022
Authors
Düzcan, Ali Metin
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Maluliyet raporlarının düzenlenmesi Adli Tıp pratiğinde önemli bir yer tutmaktadır. Trafik kazası, iş kazası gibi travmatik olaylara bağlı maluliyet hesabında olayın meydana geldiği tarihe göre farklı yönetmelikler kullanılmaktadır. Bu sebepten dolayı, aynı olay ve aynı yaralanmalara sahip kişiler arasında olay tarihi farklı olduğu için farklı maluliyet oranları hesaplanmaktadır. Bu çalışmada maluliyet hesabında kullanılan bu yönetmelikler incelenerek aralarındaki farkların saptanması ve bu farkların nasıl giderileceği hususunda çözüm önerileri sunulması amaçlandı. Bursa Uludağ Üniversitesi Tıp Fakültesi Adli Tıp Ana Bilim Dalı tarafından 2018-2021 yılları arasında düzenlenmiş 359 olguya ait maluliyet raporları incelendi. Raporlarda yer alan tıbbi veriler ve hastane bilgi yönetim sisteminde yer alan tıbbi kayıtlar incelenerek her olgu için yaş, olay türü, ameliyat sayısı, hastane yatışı sayısı gibi olaya ait tıbbi özgeçmişi ve hangi arızalardan oran verilebileceğine ait veriler elde edildi. Her olgu için Çalışma Gücü ve Meslekte Kazanma Gücü Kaybı Tespit İşlemleri Yönetmeliği (ÇGMK cetveli) ve Erişkinler İçin Engellilik Değerlendirmesi Hakkında Yönetmelik(Engelli cetveli) hükümleri dikkate alınarak maluliyet oranları hesaplandı. Elde edilen veriler istatistiksel analiz yöntemleri ile analiz edildi. ÇGMK yönetmeliğinden alınan maluliyet oranların ortalamasının16,9±24,7, Engelli yönetmeliğinden alınan maluliyet oranların ortalamasının ise 13,1±20,4 olduğu saptandı ve aralarındaki farkın istatistiksel olarak anlamlı olduğu saptandı. ÇGMK cetvelinden alınan maluliyet oranları ile Engelli cetvelinden alınan maluliyet oranları arasında pozitif yönde güçlü düzeyde korelasyon (rho=0,808) olduğu saptandı. Oran verilerin arızaların dağılımına bakıldığında eklem hareket kısıtlılığı başta olmak üzere en sık lokomotor sistem arızalarından oran verildiği görüldü. Olgular onarlı yaş gruplarına ayrılarak incelenmesinde her iki cetvelde de yaş grupları arasında maluliyet oranı açısından anlamlı fark olmadığı saptandı.
The preparing of disability reports has importance in Forensic Medicine practices. Depending on the date of the event, different regulations are used in the determination of disability caused by traumatic events such as trafficac cidents and occupational accidents. Because of the traumatic event date is different, different disability rates are calculated between people with the same event and the same injuries. In this study, it was aimed to examine the regulations used in disability rate calculation, to determine the differences between these regulations and to propose solutions on how 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. By studying the medical records in the reports and in the hospital information management system, for each case, medical data was obtained such as age, type of traumatic event, the medical history of the traumatic event like number of operations and hospitilazations and pathologies which can be used to evaluate disability. Disability rates were calculated for each case with taking into account the provisions of the Regulation on Determination of Loss of Working Power and Profitability (RLWP) and the Regulation on Disability Assessment for Adults (RAA). The obtained data were analyzed with statistical analysis methods. It was determined that the average of the disability rates from the RLWP was 16.9±24.7, the average of the disability rates from the RAA was 13.1±20.4, and the difference between them was found to be statistically significant. It was determined that there was a strong positive correlation (rho=0,808) between the disability rates taken from the RLWP and the disability rates from the RAA. Considering the distribution of the pathologies used for evaluating disability rates, it was seen that the most common pathologies are related to locomotor system, especially joint movement limitation. It was found that there was no significant difference between the age groups in terms of disability rate in both scales (RAA and RLWP) at analysis of cases by grouping them into ten agegroups.
The preparing of disability reports has importance in Forensic Medicine practices. Depending on the date of the event, different regulations are used in the determination of disability caused by traumatic events such as trafficac cidents and occupational accidents. Because of the traumatic event date is different, different disability rates are calculated between people with the same event and the same injuries. In this study, it was aimed to examine the regulations used in disability rate calculation, to determine the differences between these regulations and to propose solutions on how 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. By studying the medical records in the reports and in the hospital information management system, for each case, medical data was obtained such as age, type of traumatic event, the medical history of the traumatic event like number of operations and hospitilazations and pathologies which can be used to evaluate disability. Disability rates were calculated for each case with taking into account the provisions of the Regulation on Determination of Loss of Working Power and Profitability (RLWP) and the Regulation on Disability Assessment for Adults (RAA). The obtained data were analyzed with statistical analysis methods. It was determined that the average of the disability rates from the RLWP was 16.9±24.7, the average of the disability rates from the RAA was 13.1±20.4, and the difference between them was found to be statistically significant. It was determined that there was a strong positive correlation (rho=0,808) between the disability rates taken from the RLWP and the disability rates from the RAA. Considering the distribution of the pathologies used for evaluating disability rates, it was seen that the most common pathologies are related to locomotor system, especially joint movement limitation. It was found that there was no significant difference between the age groups in terms of disability rate in both scales (RAA and RLWP) at analysis of cases by grouping them into ten agegroups.
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Keywords
Adli tıp, Maluliyet, Yönetmelik, Trafik kazası, Forensic medicine, Disability, Regulation, Traffic accident
Citation
Düzcan, A. M. (2022). 2018-2021 yılları arasında bursa Uludağ Üniversitesi Tıp Fakültesi Adli Tıp Ana Bilim Dalı tarafından düzenlenen maluliyet raporlarının retrospektif olarak incelenmesi ve güncel yönetmelik/cetvellere göre yeniden değerlendirilmesi. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.