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PubMed1995

[Disability pensions because of musculoskeletal diseases among women of different occupations].

Altogether 9,516 women, 16-67 years of age, were granted a disability pension in Norway in 1993. Musculoskeletal disease was registered as the main diagnosis for 3,730. Employment status is known for 3,125 of these 3,730 women. Analyses, based on age standardized incidence rates--SIR's, pointed to shop assistants, practical nurses and charladies as the three major occupational groups with high risk of being disability pensioned because of musculoskeletal disease. These three occupations accounted for more than one third of all women in paid employment who were granted a disability pension for musculoskeletal disease 1993. Compensation will amount to about NOK 600 million before these women reach the normal retirement age of 67 years. Prevention of musculoskeletal diseases in the labour force would appear to be potentially cost-effective. So far, prevention of work-related musculoskeletal diseases has focused mainly on the technical ergonomic aspects of the working conditions. It is recommended that more attention be given to organizational aspects, such as daily hours of work, the timing and duration of breaks, work pace and potential to influence one's own work situation.

Adolescent↗
PubMed1995

[What happens to patients not granted disability pension?].

Subsequent to a recent (1991) narrowing of the medical legibility criteria for granting disability pensions in Norway, we wanted to follow up rejected applicants with regard to main sources of income. As setting were chosen five mainly rural municipalities on the North-West coast of Norway and the city of Trondheim. The study was carried out as a historic prospective study of a sample of rejected applicants for a disability pension, mainly based on follow-up data from local social security offices. Among a sample of 146 applicants rejected in 1990/91 and 1992, 143 (87 women and 56 men) were available for the analysis in March 1994. A rather stable 20% of the sample were occupationally active throughout three years of follow-up, this percentage being slightly higher among women than among men. In spite of the initial rejection, 25% had been granted a disability pension after two years. The rest received other kinds of public social support, or had left the labour market and had no social security support (mostly women).

Adult↗
PubMed1993

Pension vesting and preretirement lump sums among full-time private sector employees.

Vesting among full-time private sector employees has increased dramatically over the past two decades. With further increases expected, it seems likely that almost all workers covered by a pension plan will eventually receive some kind of benefit. Coverage, however, remains a problem. According to the most recently available data, only 46 percent of full-time private employees in 1988 were covered by a pension plan on their current jobs, 35 percent were vested, and an additional 4 percent were vested from a previous job. Vesting rates would have been higher if some workers had not cashed out their retirement benefits when they left previous jobs, but the impact is slight; most lump-sum recipients were also vested or covered on their current jobs. Vesting is higher among older workers and among men, though the gender gap has narrowed appreciably over time. Based on trends in vesting and 1988 rates for all types of workers aged 50-59, the analysis suggests that pension receipt rates among the elderly will continue to increase over the next decade.

Adolescent↗
PubMed1993

[Restrictions in connection with disability pensions--physicians' view on the revised legislation].

In 1991, the Norwegian legislation on disability pensions was revised, narrowing the medical criteria for eligibility. From a questionnaire answered by 66 primary health care physicians attending a course in Oslo in October 1992, data were collected on doctors' attitudes and expectations regarding the revised legislation. The physicians did not believe that refusing a higher percentage of applications for disability pension would bring many applicants back to paid employment. The majority believed that lower expenditure on disability pensions would be reflected in a corresponding increase in other public expenditures. Despite this, half of the participants welcomed the revision of the law.

Adult↗
PubMed1997

[Disability pension after a factory close-down--eight years after].

A follow-up study of 97 persons who were granted a disability pension in 1987 or 1988 after closure of a shipyard showed 82 alive in 1995. The predominant diagnoses were musculoskeletal complaints, heart disease and psychiatric disorders. The 82 who were still alive were in good health and satisfied with their pension. However, if the factory had not been closed down, many of them could probably have continued in work. For many of them, and especially the youngest, the first year on disability pension was difficult. Based on today's more restricted rules, we have estimated that 25% of the applications for disablement benefit would have been refused.

Adult↗
PubMed1995

Public pensions, family allowances and endogenous demographic change.

"A tax-transfer system deals with redistribution a PAYGmong generations and corrective taxation a PAYGt the same time. Since such a policy is a government's task, we take a normative approach and pose the question: Which tax-transfer system should a government apply to maximize social welfare? The framework we consider allows for endogenous demographic aspects...: first, fertility has a great impact on a PAYG [pay-as-you-go] financed pension insurance; and second, through education human capital is accumulated.... We analyzed the optimal extent of a public pension scheme in the presence of external effects of fertility and education on the net domestic product." Pension schemes in Germany and the United States are compared.

Aid to Families with Dependent Children↗
PubMed1995

Public pension reform, demographics, and inequality.

"Starting from a simple, descriptive model of individual income, an explicit link between the age composition of a population and the personal distribution of incomes is established. Demographic effects on income inequality are derived. Next, a pay-as-you-go financed state pension system is introduced. The resulting government budget constraint entails interrelations between fiscal and demographic variables, causing an additional, indirect demographic impact on the distribution. This is shown not only to change, but in some cases even to reverse the distributional incidence of an aging population. Several policy conflicts arise. The point is re-emphasized by an analysis of the German Pension Reform Act of 1992. The study reveals that the design of the pension formula decisively drives the relation between demographics and inequality."

Age Distribution↗
PubMed1989

Utilitarian pension and retirement policies under population ageing.

The author analyzes population aging and its impact on pension and retirement policies by utilizing a simple utilitarian model for alternative types of pension finance. Findings indicate that "when specific adjustments to population ageing are necessary, changes in the retirement age are preferred to changes in pensions or contributions." A geographical focus on developed countries is implied.

Age Factors↗
PubMed1996

Aging and political decision making on public pensions.

"In this paper decision making on public pensions in a representative democracy is modeled within the framework of the well-known two-overlapping-generations (OLG) general-equilibrium model with rational expectations. The model is used to analyze the effects of aging on the economy in general and on the evolution of public pension schemes in particular, where aging is interpreted as a combination of a decrease in the rate of population growth and an increase in the political influence of pensioners. Analytical results are derived for the long run as well as for the short run by the method of comparative statics and comparative dynamics respectively. It appears that an increase in transfers to the old is not guaranteed if due to aging their political power increases."

Age Factors↗
PubMed1992

Pay-as-you-go public pensions with endogenous fertility.

A 1986 "model of public pensions is generalized to allow for endogenous fertility. We show that gifts to the old, which can be viewed as social security contributions, are always positive in the steady state. An optimal stationary allocation is sustainable if savings are zero and fertility is exogenous. However, the optimal allocation is in general not sustainable. In particular, if a government enforces a social security plan setting the pension level at the optimal gifts and individuals optimize under the pension constraint, the resulting sustainable outcome is in general different from either the optimal or Nash outcome." The geographical focus is on developed countries.

Demography↗
PubMed2002

Rehabilitation of home care workers: supportive factors and obstacles prior to disability pension due to musculoskeletal disorders.

The aim of this study was to retrospectively explore the prevalence of rehabilitation actions, supportive factors, and obstacles for rehabilitation among home care workers with musculoskeletal disorders, especially focusing on aspects related to occupational rehabilitation. All home care workers in Sweden whose disability pension was approved in 1997 and 1998 because of a musculoskeletal disorder, were selected (n = 373). Data, covering aspects of the rehabilitation process and conditions in working life 5 and 15 years prior to their disability pension, were collected from a questionnaire. The majority considered that the disorder leading to a disability pension was caused by their work, but only one-third of them had their occupational disorder formally approved. Only one-third of the study group received occupational rehabilitation. However, an approved occupational disorder was related to higher prevalence of occupational rehabilitation. In the age group 60-65, few home care workers received rehabilitation. The majority perceived good support from their supervisor and working team, but no support with regard to lowering physical demands. Modification and reduction of physical demands might improve both sustained work ability in home care work and the outcome of the rehabilitation.

Adult↗
PubMedDate not supplied

[Evaluation of outpatient rehabilitation: goals, conceptual framework and study design of a health and pension insurance joint research project].

In Germany the statutory health and pension insurance schemes are the main providers of medical rehabilitation, the majority of rehabilitation measures being given in an inpatient setting. Over the last few years, the health and pension insurance schemes have strengthened the extension of outpatient rehabilitation, and have funded a comprehensive evaluation study in this context. In this evaluation study outpatient rehabilitation in centres with different conceptual backgrounds is compared with inpatient rehabilitation in rehab clinics, indications considered being cardiology and orthopaedics. Overall, 14 rehab centres and more than 2000 patients were included in the project. The patients were interviewed and medically examined before and after the measure. A follow-up was done after six and twelve months. In addition to the rehabilitants themselves, the rehab centre physicians as well as the office-practice physicians were interviewed about the outcome of the rehab measure. One year after rehabilitation, data were collected from the relevant health and pension insurance funds concerning the benefits the patients had received. Due to the study's non-experimental design, validity of the results is confined to rehabilitants participating on an outpatient basis and who had been found medically suited for this type of rehabilitation, were capable of travelling to the rehab centre on their own within less than 45 minutes and had voluntarily opted for the outpatient setting. The findings of the study show that outpatient rehabilitants' motivation and expectations differ from those found in inpatient rehabilitation. The health economics analysis performed is restricted to the costs involved in the rehabilitation measure as such as well as the health-related benefits provided to the rehabilitants in the twelve-month study period. The issue of whether increasing outpatient rehab measures will lead to decreasing costs in the rehab system as a whole had not been considered in the framework of this project.

Ambulatory Care↗
PubMed2005

[Do psychiatric patients receive disability pension before adequate diagnostics and treatment? Evaluation of 101 psychiatric expertises done on behalf of Swiss Invalidity Insurance and the Psychiatric Outpatient Department Basel in 2002].

OBJECTIVE: a) Does the psychiatric expertise confirm the claimed psychiatric diagnoses in patients applying for a disability pension due to a psychiatric (co)morbidity? b) Had the patients received adequate psychiatric treatment before being sent for the psychiatric disability expertise? METHODS: Key data of 101 psychiatric expertises done in 2002 on behalf of the Swiss invalidity insurance/Basel were analysed. RESULTS: a) 17% did not have a psychiatric diagnosis affecting the ability to work. In 50%, the ability to work was reduced by max. 30%, i. e. the prerequisites of a pension were not met. b) Patients with a psychiatric diagnosis affecting the ability to work: 50% reported to take a specific psychotropic medication, but only in 40% of them (i. e. 20% of the patients with a psychiatric disorder) the blood level was within the therapeutic range; only 35 % reported to have "some form of psychotherapy"; only 15% had been previously hospitalized. CONCLUSIONS: Many of the 101 patients applying for a disability pension had not been sufficiently diagnosed and had not received adequate psychiatric/psychotherapeutic treatment before the expertise.

Adult↗
PubMed1982

Incidence of disability pensions among slaughterhouse workers in Denmark. With special regard to diagnosis of the musculo-skeletal system.

The objective of this study was to examine whether slaughterhouse workers (SW) in Denmark have a higher incidence of disability than expected in comparison with the general population and the sub-group of the population that is gainfully employed, especially with regard to pensions awarded for incapacity related to the musculo-skeletal system. There were 122 male SW who were awarded disability pensions (medium or high level of compensation) in the 3-year period 1977-79 as compared with the expected figure, 152.3 (p less than 0.05) and 40 disability pensions awarded to female SW as compared with 30.7 (0.05 less than p less than 0.10). In men the Standardized Disability Ratio (SDR) increases with age. High SDRs are observed for diagnosis in the musculo-skeletal system for both sexes. The difference between observed and expected values does not change appreciably when the expected values are calculated on the basis of age-specific incidence rates among all actively employed people. Problems of the study design and selection bias are discussed to facilitate the interpretation of results. A possible deleterious effect of meatpacking on the musculo-skeletal system calls for further investigation.

Abattoirs↗
PubMed2002

Predictors of positive health in disability pensioners: a population-based questionnaire study using Positive Odds Ratio.

BACKGROUND: Determinants of ill-health have been studied far more than determinants of good and improving health. Health promotion measures are important even among individuals with chronic diseases. The aim of this study was to find predictors of positive subjective health among disability pensioners (DPs) with musculoskeletal disorders. METHODS: Two questionnaire surveys were performed among 352 DPs with musculoskeletal disorders. Two groups were defined: DPs with positive health and negative health, respectively. In consequence with the health perspective in this study the conception Positive Odds Ratio was defined and used in the logistic regression analyses instead of the commonly used odds ratio. RESULTS: Positive health was associated with age > or = 55 years, not being an immigrant, not having fibromyalgia as the main diagnosis for granting an early retirement, no regular use of analgesics, a high ADL capacity, a positive subjective health preceding the study period, and good quality of life. CONCLUSION: Positive odds ratio is a concept well adapted to theories of health promotion. It can be used in relation to positive outcomes instead of risks. Suggested health promotion and secondary prevention efforts among individuals with musculoskeletal disorders are 1) to avoid a disability pension for individuals <55 years of age; if necessary, to make sure rehabilitation actions continue, 2) to increase efforts to support immigrants to adjust to circumstances connected to ill-health and retirement, 3) to pay special attention to individuals with fibromyalgia and other general pain disorders, and 4) to strengthen ADL activities to support an independent active life among disability pensioners.

Activities of Daily Living↗
PubMed1993

Implications of economic transition and demographics for financing pensions in the former socialist economies.

"This paper is concerned primarily with the financing of pensions, or the old-age income maintenance portion of the social security system. While the discussion here will be limited to Hungary and Poland, most of the post-socialist countries of East and Central Europe and of the former Soviet Union face similar problems." The author suggests "a set of alternative pension financing strategies....A novel approach is to replace the payroll tax with part of a value-added tax, which may be a good short run solution to current financial crises of the pension systems in these countries."

Developed Countries↗
PubMed1994

[Future changes in the age structure and the problem of pensions in the Austrian case].

Projections of rapid demographic aging in Austria are reviewed up to the year 2050. "After the turn of the century the proportion of the population above age 60 will gradually increase from 20% to at least 30 if not as much as 40 or 50% by 2050. During the same period the population above age 80 will be multiplied by four." It is argued that drastic pension reform is needed to guarantee future pension payments and avoid a large increase in the pension contribution rate. (SUMMARY IN ENG AND FRE)

Adult↗
PubMed1998

A note on intergenerational risk sharing and the design of pay-as-you-go pension programs.

"Different versions of pay-as-you-go public pension programs may have entirely different effects on the intergenerational distribution of income risk. If the pension benefit is a fixed proportion of previous labor income, a pay-as-you-go program increases the net income risk of all generations. On the other hand, a pay-as-you-go program characterized by a fixed labor income tax rate and uncertain pension benefits provides intergenerational risk sharing."

Americas↗