医生和社会工作者评价的比较研究,其中采用了《巴西残疾人退休功能调整指数》

Rosylane Rocha, Francisco Cortes Fernandes, J. C. Bezerra, Rui Nunes
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引用次数: 2

摘要

目的:本研究旨在评估国家社会保障研究所(INSS)内医生和社会工作者在使用经调整的巴西功能指数确定残疾方面进行的评估是否存在统计学上的显著差异。方法为此,在2013年10月至2016年1月期间,使用INSS官方数据库进行了一项分析调查,以确认通过INSS投保的工人的残疾。使用R软件(版本3.4.1.)进行分析。采用一致性指数、显著性分析和Pearson相关检验。计算了医生、社会工作者和两者评估的敏感性和特异性。Arating指数是通过将医生的评估结果除以社会工作者的评估结果得出的。结果应用R软件进行的相关分析表明,医生和社会工作者的评价没有统计学差异。然而,在评估敏感性的计算以及医生和社会工作者评估之间的评分指数和标准差的分析方面,特别是在感觉功能、家庭生活和教育、工作和经济生活领域,观察到了差异。结论本研究表明,医学专家和社会工作者进行的评估存在差异,这可以用每个专业人员对手册中定义的解释来解释。应讨论用于定义获得福利的规则的标准。我们强调,识别残疾的先决条件是,应通过国际疾病分类(ICD-10)对残疾进行表征,这是一项医学特权。
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Comparative Study on Evaluations Conducted by Medical Doctors and Social Workers in which the Adapted Brazilian Functionality Index for Granting Retirement to Persons with Disability was applied
Objective:  The present study sought to assess whether any statistically significant differences exist between evaluations conducted by medical doctors and those by social workers within the National Social Security Institute (INSS), regarding identification of disability using the adapted Brazilian functionality index to grant retirement. Method To do this, an analytical investigation was done using the official INSS database for the period from October 2013 to January 2016, regarding evaluations to confirm disability among workers who were insured through the INSS. The analysis was conducted using the R software, version 3.4.1. A concordance index, significance analysis and the Pearson correlation test were applied. The sensitivity and specificity of the evaluations made by doctors, by social workers and by both were calculated. Arating index was obtained by dividing the result from the doctors’ evaluations by the result from the social workers’ evaluations. Results The correlation analysis using the R software showed that there was no statistical difference between the evaluations conducted by medical doctors and social workers. However, differences were observed in relation to calculation of the sensitivity of the evaluations, and in the analyses on the rating index and standard deviation between the doctors’ and social workers’ evaluations, especially in the domains of sensory function, domestic life and education, work and economic life. Conclusions This study demonstrated that there is a difference between evaluations conducted by medical experts and by social workers, which can be explained in terms of each professional’s interpretation of what is defined in the manual. The criteria used to define the rules for obtaining the benefit should be discussed. We highlight that the prerequisite for identifying a disability is that an impairment should be characterized by means of the International Classification of Diseases (ICD-10), which is a medical prerogative.
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