[Coverage for rheumatic diseases by Social Security].

Tunis Med

Unité de Consultation de Rhumatologie, Hôpital rdgional de Ben Arous, Tunis.

Published: July 2008

Background: Lasted long disease relating to the rheumatology, constitutes a constant preoccupation because of its medical and economic repercussions.

Objective: To estimate the coverage of the long lasted disease in private sector at all levels and to compare it with that of public sector.

Methods: We report a retrospective study concerning 161 requests of coverage for long lasted disease in rheumatologic affections. Those requests were submitted to the regional medical commission of Tunis for the national social security during 2002.

Results: Rheumatologic affections represent 9% of the activity of this commission. Sciatics represents 65.8% of the cases. The requests are formulated in 75.8% by specialists. The commission asked for a medical expertise in 54.5% of the files of which 71.8% are formulated by general practitioners. The opinion of the expert is favourable in 97% of cases and the decision of the commission in 95.6% of cases. This favourable decision of the commission is either a ruling long lasted disease (89%) or a retirement for limit age, incapacity or early wear of the body.

Conclusion: Some future prospects seem to be interesting notably a revision of the list of long lasted diseases in the regime of the Tunisian CNSS.

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