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PubMed1995

[Retirement pensions in Canada: the inequalities of a dualist system].

"Using data from the Survey of Ageing and Independence (N=20,036), this research examines the effect of a dual economy on retirement incomes for both men and women [in Canada]. Specifically, the analysis compares core and periphery retirees on sociodemographic characteristics, work characteristics, income characteristics and pension arrangements. Models are then estimated to ascertain what factors influence the retirement incomes for those retirees who previously worked in the core or periphery of the economy. The findings suggest that Canadian pension policy has served to exacerbate the already precarious economic position of retired women, a known outcome of their unstable labour force histories and family responsibilities. The dualist pension system has assisted in producing an underclass of retirees, the principal causalities being women who previously worked in the periphery of the economy." (SUMMARY IN ENG AND SPA)

Americas↗
PubMedDate not supplied

Demographic changes and pension reform in Italy.

The author comments on recent pension reforms carried out in Italy. He suggests that "the promise to renounce real indexing of pensions appears to be a ¿sham', used in order to make the initial pension award more generous but impossible to maintain. Equalization will be necessary and will once again unhinge the financial balance of the system, because the rate of return will be pushed above the growth of overall wages and the golden rule will be violated. Moreover, individual rates of return on contributions will again be diversified, favouring those working people whose retirement period is longer (in terms of the working life) and/or characterized by more frequent or more generous adjustments."

Developed Countries↗
PubMedDate not supplied

[Expert decisions concerning disability pensions in the area of psychiatry--in view of a court-appointed expert].

Inability of social services to provide a non-working person with the necessary minimal financial support as well as a high unemployment rate make acquiring of a disability pension appear the only means of coming to terms with existential problems. After the fairly tolerant decision policy of the Social Insurance Institution (ZUS) in the first half of the 1990s, the criteria of granting disability pensions hassince been made stricter--through replacing of the former disability pensions by the concept of inability to work. The author evaluates the theory and practice of experts' decision-making in the prospect of his over ten year experience as an expert appointed by the Regional Court of Law in Cracow. Mental disorders are rated third among disturbances most frequently indicated as the reason for deciding about long-term inability to work. Psychiatric disorders, unlike most illnesses from other domains of medicine--do not require the use of modern methods of instrumental diagnostics. The only instrument supporting the clinical diagnosis is a psychological examination--especially in regards to the assessment of the depth of intellectual deficit. In psychiatry, clinical diagnosis is of a descriptive character: "As the district psychiatrist perceives or wants to perceive the patient during the examination--so does he describe this patient in the medical documentation". It is verification of actual intensity of mental disorders during a short examination--here the examination by a Social Insurance Institution's expert physician or an expert appointed by court--that becomes a problem. Of special importance in decision making must be prescribed to medical documentation, including regularity of treatment, applied pharmacotherapy, hospital treatment and its duration, etc.

Community Psychiatry↗
PubMed1991

[The ability of elderly institutionalized pensioners in Reykjavik in maintaining and carrying out oral hygiene procedures in 1984].

In 1984 a random sample of 400 institutionalized old-age pensioners, 67 years and older, was interviewed on oral hygiene habits. Complete denture cleanliness was also studied by using a plaque detector to disclose plaque on the fitting surface of the maxillary denture. Based on the distribution of plaque a grading system using three categories (excellent, fair, poor) was applied to indicate complete denture cleanliness. About 94% of dentulous and 88.7% of edentulous respondents claimed that they were able to take care of their oral hygiene themselves. The proportion of dentulous subjects that cleaned their teeth at least once a day was 66.7%. A great majority (92.4%) of edentulous pensioners reported that they cleaned their complete dentures once a day or more often and women cleaned their dentures more frequently than men. Nevertheless cleanliness was graded excellent in only 14.4% of the complete dentures. This seems to indicate a need for increased education on the importance of a good oral hygiene and that institutionalized pensioners should receive more help with their daily oral hygiene.

Aged↗
PubMedDate not supplied

[Organization of care for citizens of pension age through systematic evaluation].

The increase in the efficiency of the process of complex care can only be looked for in the field of the improvement of the dispensatory care for the population of pension age by the family doctor. At present this form of care develops already for the citizens of old age in many towns and villages, in particular by paying periodically home visits without having been called for especially. In continuation of the accompanying care from the health protection of children and adolescents via industrial health protection the dispensatory care for the population of pension age could be continued systematically if the citizens were subjected to a serial examination in the year of entering pension age, and if the dispensatory care by the family doctor were introduced on this basis according to a care programme. The development and testing of such a model is currently worked upon at the Institute of Social Hygienics of Karl-Marx University.

Aged↗
PubMed1997

[Not giving up prematurely. Rehabilitation instead of early pensions for officials with psychosomatic and addiction problems].

Many chances for a competent psychosomatic and dependence treatment for government employed people are still being overlooked. One-sided somatic fixation, premature urge for a permanent pension and indulgence are important contributing factors. There is, however, clear evidence that a sufficient in and/or out-patient treatment has a very favourable impact on the course of illness. The different therapeutic methods and their combination in a private psychosomatic hospital, which treats many government officials, are outlined and a clinical example is presented. Physicians in the public health sector are in the a singular position of helping to avoid premature pensioning and to keep the expenses caused by premature pensioning of people in government service low by means of informed and dedicated action.

Ambulatory Care↗
PubMed1998

[Changes in pensioning and psychosomatic assessment].

Appropriate evaluation of a patient's handicapping or disabling conditions, of his or her capacity for work and gainful activity rank among the recurring tasks in inpatient rehabilitation. Published recently, the Beeinträchtigungsschwere-Score (BSS; a score for determining the severity of a condition) constitutes a highly practicable instrument for these purposes, well suited to the clinical setting. Particular difficulties are encountered in the assessment of patients already in the pension award process, a population where the original disease picture has been superimposed by numerous chronification factors of a psychological, social and economic nature so that a so-called invalidity pensioning career has set in. The article gives an overview of this phenomenon of invalidity pensioning career and the sequence of its various phases, setting out the use of the BSS for social-medical evaluation in an inpatient rehabilitation setting.

Adult↗
PubMed1990

Long-term sick leave and disability pensioning due to back disorders of tractor drivers exposed to whole-body vibration.

In a historical 11-year follow-up study, disability pensioning and the incidence of the first sick leave of 4 weeks or longer due to back disorders has been investigated in a group of drivers exposed to whole-body vibration (WBV), mainly of agricultural tractors. The reference group comprised workers not or only slightly exposed to WBV from the same and another company. The vibration exposure of the tractor drivers was roughly around the ISO-2631 fatigue-decreased proficiency limit. The incidence of a first long-term sick leave due to back disorders was 3 per 100 person-years in tractor drivers and 2 per 100 person-years in the entire reference group. However, the incidence was not substantially increased in tractor drivers when the referents comprised only those working at the same company, suggesting selection bias. The highest relative risk (ca. 3) was found for long-term sick leave due to intervertebral disc disorders and this risk seemed to increase with the received WBV dose. That especially the incidence of intervertebral disc disorders increased, agrees well with findings in other studies. Data on disability pensioning due to back disorders are too scarce to be conclusive, but a trend towards younger disablement in tractor drivers is evident. Exposure to WBV, together with twisted posture and prolonged sitting, are considered to be responsible for the increased incidences observed in tractor drivers.

Absenteeism↗
PubMed2006

[Quality Assurance in Rehabilitation under the German Pension Insurance Scheme].

Ten years after its introduction, the German Pension Insurance's quality assurance programme is firmly established within the rehabilitation system. Regular, substantive reporting to rehabilitation centres and pension insurance organisations has contributed to improving the quality of rehabilitation. Legal codification of quality assurance stipulations has existed since 2001. The programme is in constant development, e. g. by optimization of patient interviewing and inclusion of evidence-based clinical practice guidelines. New programmes, e. g. in inpatient rehabilitation of children and youths or in outpatient rehabilitation, are being developed together with the German health care organizations. In the field of vocational rehabilitation quality assurance had started out with a conceptual study followed by projects concerning client interviewing, evaluation of documentation instruments, and analyses relative to the most important outcome factor, namely the vocational reintegration results achieved. External quality assurance is a mayor input factor for the rehabilitation centres' internal quality management. In future, rehabilitation centres will be asked to demonstrate the appropriate use of this information. It will remain the centres' decision which method of quality management system implementation they choose. Quality assurance results of every centre are planned to be made publicly accessible in the medium term, in particular to the insureds. Moreover, the results of the quality assurance programmes are intended to clearly impact the allocation of patients as well as the remuneration of the rehabilitation centres concerned. Quality assurance and quality management will continue to play a major role in the political discussion of health care.

Germany↗
PubMed1994

Retiree health insurance and pension coverage: variations by firm characteristics.

This study examined coverage by employer-sponsored retiree health insurance using the 1988 and 1989 Employee Benefits Surveys. The effects of firm characteristics on the probability of offering retiree health insurance and pension coverage are also estimated. We find that coverage by retiree health insurance varies across occupational groups, industries, and firm sizes. In addition, we find a strong relationship between a firm's decisions to offer retiree health insurance and pension coverage, with the retiree health insurance decision being more sensitive to specific firm characteristics.

Aged↗
PubMed1985

Disability pensions due to peptic ulcer in Germany between 1953 and 1983.

In the present study, the number of disability pensions provided in West Germany between 1953 and 1983 because of peptic ulcer served as a marker of peptic ulcer morbidity. A total of 46,426 cases of disability resulting from peptic ulcer occurred, representing 0.6% of all cases of disability in West Germany during this period. Blue collar workers were affected more often than white collar workers, and men more often than women. The proportion of disability pensions due to peptic ulcer markedly declined between 1953 and 1973. This decline affected both sexes and both blue and white collar workers and was accompanied by a shift of the highest age-specific proportions from the middle to the older age groups. These findings show that the previously observed temporal variations of peptic ulcer disease do not apply only to the mortality but also to the prevalence of peptic ulcer.

Adult↗
PubMed1996

Nurses' pensions: a need for change.

Although most hospitals provide retirement benefits to nurses, a number of factors conspire to prevent many nurses from enjoying the benefits. It is quite possible for nurses to work continually in their profession and yet be ineligible for a pension on retirement. The unique circumstances of nurses career working patterns are outlined as are characteristics of hospitals' pension plans. Action is recommended at three levels: individual, employee and professional.

Age Factors↗
PubMed1997

Depression and disability pension in Finland.

During the period 1987-1994 there has been a threefold increase in disability pensions granted to individuals with affective disorders in Finland. Possible reasons for this development include a deep economic recession, changes in the diagnostic system, and better recognition of affective disorders. Against this background, it seems relevant to ask why, over the same period, the functional capacity of depressive patients has markedly deteriorated, causing an increase in disability pensions, despite the fact that many new drugs and other treatments have become available.

Activities of Daily Living↗
PubMed2006

Sickness absence as a risk factor for job termination, unemployment, and disability pension among temporary and permanent employees.

OBJECTIVES: This study examined sickness absence as a risk factor for job termination, unemployment, and disability pension among temporary and permanent workers. METHODS: Prospective cohort study with data on employment contract and sickness absence in 1996, job termination by 1997, and employment status in 1997 and 2000 for 19,093 temporary and 41,530 permanent public sector employees. RESULTS: For women aged 40 years or less and for women over 40, a high sickness absence increased the risk of job termination among temporary employees (OR 1.52 (95% CI 1.36 to 1.71) and OR 1.70 (95% CI 1.36 to 2.13) respectively). High absence was not associated with job termination among men in temporary employment. Among permanent employees, high sickness absence predicted job termination among older, but not among younger employees. Temporary employees with high sickness absence were at the highest risk of immediate unemployment and unemployment three years later. Among older permanent employees, high sickness absence was associated with subsequent work disability pension. CONCLUSIONS: A high rate of sickness absenteeism increases the risk of job termination and unemployment among women in temporary public sector jobs. For permanent employees, secure employment provides protection against unemployment even in the case of high sickness absence.

Absenteeism↗
PubMed1990

A nested case-control study of disability pension among seamen, with special reference to neuropsychiatric disorders and exposure to solvents.

A cohort of 1,687 captains and mates from different types of ships were followed for recording of disability pension from 1970 to 1986. 199 cases were found. At date of diagnosis each case was age-matched to 4 randomly selected seamen within the rest of the cohort at risk. A strong relationship between disability pension due to neuropsychiatric diagnoses and work on tankers was found, especially when restricted to work as a mate on the tankers. These mates experience the highest exposure to organic solvents within the investigated group. The findings indicate an occurrence of chronic nervous system disorders due to long-term exposure to organic solvents.

Case-Control Studies↗
PubMed1977

Mortality among male disability pensioners.

The basic material consists of all 235 men who were granted temporary or permanent disability pension in Malmö for the first time in 1964. By the end of 1974, 111 had died; the expected mortality was 42. The most common causes of death were diseases of the circulatory system, neoplasms, and diseases of the respiratory system. The post-mortem diagnoses of the 111 deceased usually agreed with the main diagnoses at the time of the pension award.

Adolescent↗
PubMed1983

Grounds for disability pension. The younger abuser as compared with older abusers of alcohol.

Current social legislation in Sweden prescribes a great degree of restrictivity in the granting of disability pensions to young abusers of alcohol. In order to test whether this prescription is really applied, a comparison between 29 abuser applicants up to age 46 and 32 and over the age of 46 years was carried out. The total of 61 abusers represented all 78 first-time applicants with an abuse over a period of 1 1/2 years who were living in a geographically defined, mixed urban-rural region in the Swedish county of Ostergötland. The period lasted from 1st January 1978 until 1st July 1979. The participants' quality of life was examined in a multidisciplinary fashion. In line with the prescribed restrictivity, the younger group proved to be fundamentally worse, primarily in socio-psychological and psychiatric respects. In addition, they also demonstrated a greater degree of alcohol injury. Besides the legislative situation, even situational conditions were proposed as explanatory factors for the empirical findings. This is the fourth report from the research project "Abuse of alcohol - Disability pension - Quality of life".

Age Factors↗
PubMed2002

Is Swedish pension reform the right medicine for aging Europe?

Following the Second World War, the idea of the life course with distinct periods of education, work, and retirement became popular as a result of the alliance of interests of unions and management, with politicians seizing the opportunity to accommodate them. These "social partners" implemented benefit rules and created practices for using old age and disability to ease the exit of older workers. Although justifiable at the time, now those rules and practices hinder individual and employer incentives to invest in human capital and work environments that enable older workers to remain in the workforce. The article argues that the workforce environment of the coming half-century, which is relevant for persons born around 2000, is much different from that a hundred years earlier, which determined the opportunities for people born around 1900. People are healthier and live much longer and work environments are friendlier. The article argues that it is no longer justifiable to subsidize exit from the workforce around the age of 60 for healthy workers, especially in view of the coming labor shortage in Europe. It also argues that the introduction of the principles of the Swedish NDC pension reform in Europe would provide possibilities for flexible exit from the workforce and remove impediments to labor mobility in Europe, which are embedded in many of Europe's present pension arrangements.

Aged↗