Epidemiology of disability in Ukraine (2014–2023). New challenges for the medical rehabilitation system

Abstract

Purpose. To substantiate the epidemiological component of disability in developing methodologies and models for the rehabilitation process of the population of Ukraine.Materials and methods. A retrospective analysis of disability indicators among the population of Ukraine was conducted for the period from 2014 to 2023. Statistical data from the State Statistics Service and the Ministry of Health of Ukraine were used. Methods of systematic approach, structural and logical analysis, and medical and statistical analysis were applied.Results. During the analyzed period (2014–2023), the overall disability rate in Ukraine showed a clear upward trend, reaching 77.76 cases per 1,000 population in 2022, which is 29.66% higher than the rate in 2014. The growth rates of the general disability level among the population of the regions in 2021 compared to 2014 also pointed to an increase in the overall disability level among the population, ranging from 0.69% in Kherson region to 42.91% in Cherkasy region. Primary disability indicators trended downward from 2014 to 2021, followed by a significant increase in 2022–2023. During the full-scale invasion in 2022, the primary disability rate was 4.15 cases per 1,000 population, rising to 6.95 cases per 1,000 population in 2023 – a figure twice as high as the 2014 rate. The number of servicemen newly diagnosed as disabled in 2023 was over five times higher than in 2014. Disability rates among the population of Ukraine by disease categories – such as mental disorders and neurological diseases – showed a decreasing trend until 2020, with an increase observed in 2021–2023. Disability caused by musculoskeletal system diseases exhibited a clear upward trend throughout the entire analyzed period, except in 2016 and 2020. Regarding injuries and poisonings, the highest growth rates in Ukraine were observed in 2015 (6.52%) and during 2022–2023 (47.59% and 103.57%, respectively). The highest growth rates of disability due to injuries and poisonings in 2023 were observed in Kyiv, as well as in Zhytomyr, Cherkasy, Kharkiv, and Mykolaiv regions. This trend can be attributed to the presence of hospital facilities in these regions, where the majority of the wounded were brought at certain stages of evacuation and for further treatment.Analysis of the primary causes of disability revealed that between 2014 and 2023, disability status was diagnosed in 79,896 military personnel. Notably, the number of military personnel granted disability for the first time in 2023 was nearly 4 times higher than in 2022 and over 5 times higher compared to 2014.The coverage of individual rehabilitation programs for persons with newly established disability in Ukraine between 2014 and 2023 ranged from 99% to 100%. Specifically, medical rehabilitation recommendations were provided to 401,621 individuals with disabilities in 2022 and 515,528 patients in 2023 – a 28.36% increase compared to the previous year. It is important to note that about 97% of patients required restorative therapy, 2% needed reconstructive surgery, and over 1% required orthotics among those recommended for medical rehabilitation. Conclusions. The progression of disabilities among the population of Ukraine and the growing number of servicemen with permanent incapacity highlight the need for the development and modernization of the medical rehabilitation model in Ukraine, taking into account the specific features and needs identified through the conducted epidemiological analysis.