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Yıl:2021; Cilt: 13; Sayı: Ek 1>> Özet
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Psikiyatride Güncel Yaklaşımlar; 2021;13(Ek 1):187-199
Engelli Sağlık Kurulu Raporlarının Psikiyatrik Açıdan İncelenmesi ve Yönetmelik Değişikliği İle Ortaya Çıkan Farklılıkların Araştırılması
PK Çankaya, BB Kahraman
Ankara Eğitim ve Araştırma Hastanesi, Ankara
Çalışmanın amacı, engelli sağlık kurulu raporu için başvuran ve psikiyatrik değerlendirmesi yapılan hastaların sosyodemografik özellikleri, psikiyatrik tanıları, engel oranları, psikiyatrik açıdan bağımlılık durumları ve 20 Şubat 2019 tarihli yönetmelik değişikliği sonrası ortaya çıkan farklılıkların araştırılmasıdır. 1 Eylül 2018-31 Ağustos 2019 tarihleri arasında değerlendirilen 18 yaş ve üzeri 1315 kişinin verileri geriye dönük olarak incelenmiş, yönetmelik değişikliği öncesi ve sonrası değerlendirilen bu hastaların verileri karşılaştırılmıştır. 56.2’si erkek, %43.8’i kadın olan olguların yaşlarının ortanca değeri 46 olup, %32.8’i psikiyatrik engel oranı almıştır. Olguların %22.4’ü, %40 ve üzerinde engel oranı almıştır. Engel oranı %50 ve üzerinde olanlarda eski ve yeni yönetmeliğe göre ağır engellilik/tam bağımlılık kararları yönünden gruplar arasında anlamlı fark olmadığı saptanmıştır. Hakem hastane değerlendirmesi kapsamında başvuruların %16.1’inde ‘ağır özürlü değil’ ibaresi, %1’inde ise ‘ağır özürlü’ ibaresi ‘kısmi bağımlı’ olarak değişmiştir. Psikiyatrik olgularda işlevsellik düzeyi, hastalığın seyri doğrultusunda ve hasta özelinde çeşitli faktörlerle ilişkili biçimde çok boyutlu olarak değerlendirilmelidir. Yeni yönetmelik ile bazı hastalıklara getirilen ‘tedavi ile işlevselliği kısmen düzelen’ ara oranının ve ‘kısmi bağımlı’ tanımının karar sürecinde arada kalınan olgular için çözüm olabileceği düşünülmektedir
Psychiatric Examination of Health Board Reports of Disability and Investigation of Differences Related to Regulation Amendment
The aim of the study is to investigate the sociodemographic characteristics, psychiatric diagnosis, disability rate and psychiatric dependency status of patients who applied for the health board report of disability and the differences emerged after the regulation change dated February 20, 2019. Data of 1315 individuals aged 18 and over who were evaluated between September 1, 2018 and August 31, 2019 were retrospectively analyzed, and the data of those patients evaluated before and after the regulation change were compared. 56.2% of the cases were male, 43.8% were female. The median age was 46. 32.8% of the patients were assigned a report due to mental illness. The rate of those diagnosed with a disability rate of 40 % and above was found to be 22.4 %. When the severe disability / full dependency assessments of patients with a disability rate of 50% and above were compared according to the old and new regulations. There was no significant difference between the groups. As a referee hospital, the initial assessment of 16.1% of the applicants as “not severely disabled” and 1% of the applicants as “severely disabled” was changed to “partially dependent”.In psychiatric cases, the level of functionality should be evaluated multidimensionally in relation to the course of the diseaseand various factors specific to the patient. It is thought that the intermediate rate “partially improves with treatment” and the definition of “partially dependent” brought to certain diseases by the new regulation can be a solution for the patients who lie in between.

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