[Insurance in traffic accidents].
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Accidents, Traffic↗
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[Rehabilitation after work related skin diseases].
The high incidence rates of occupational contact dermatitis, its poor prognosis, and the high social and economic impact of the disease for the affected individuals as well as for the medical insurance companies indicates a need to strive for the target of "rehabilitation instead of retirement". Here, we highlight the need and effectiveness of rehabilitation measures in individuals with work related skin diseases (mainly contact dermatitis and hand eczema). We discuss the measures for secondary individual prevention as well as tertiary prevention, which have been established in our department together with the state medical insurance companies, mainly the Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BWG: Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Service). The results of the multicentre study "Optimisation and Quality Assessment of Tertiary Prevention of Occupational Dermatoses" are presented and discussed. Both, the secondary as well as tertiary prevention measures have been successful, which has resulted in a decrease in the total annual rehabilitation costs to the BGW. A reason for this success story is the fact that in Germany these organisations are, in contrast to the health insurance companies, responsible for both acute treatment and the rehabilitation.
Dermatitis, Contact↗
[Intervention methodology for training and information for workers of the building sector].
Regarding the seriousness of work-accident in Gorizia district, various organizations as ASL 2 "Isontina" (local health agency), INAIL of Friuli Venezia Giulia (National Institute for occupational accident insurance), trade unions and trade associations created a organization called "Observatory for Working-accidents and Professional Illness Prevention". The aim of this association is the promotion of safety in working environment. Diffusing importance of safety in building trade was the first projects of Observatory. So, Observatory carried an initiative to make more aware the workers. Than, it organized training courses for building workers. Moreover, the construction of an informative pamphlet on risks in building trade was made. For some experimental investigation, Observatory works with Department of Psychology, University of Trieste.
Humans↗
[Insurance coverage for accidents on the way to work].
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Accidents, Occupational↗
[WELFARE LEGISLATION OF THE THIRD REPUBLICAN LEGISLATURE].
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Accidents↗
[Preventive medicine activities of Suva].
The Swiss National Accidents Insurance Fund (Schweizerische Unfallversicherungsanstalt, Suva) not only has to pay in case of injuries (of both occupational and nonoccupational nature) and occupational disease, an essential duty given by law (Kranken- und Unfallversicherungsgesetz, KUVG) is the prevention of work accidents and occupational disease. The Suva department for Prevention of Accidents (Abteilung Unfallverhütung) is responsible for technical measures; the occupational physicians of the Suva Medicine department (Medizinische Abteilung) are carrying for the medical prevention of occupational diseases which is the item here explained in detail. In 1977, the medical prevention was extended ot a total of 236,000 insured workers. (Of the almost 2.7 million workers and employees 1.7 million are insured by the Suva.) The legal basis, the kind of prevention done and its organization are described.
Accidents, Occupational↗
[Accidents related to physical education in school: epidemiologic and preventive approach].
Generally speaking, this category of accidents seems to cause mostly relatively mild injuries. It could explain, at least in part, why there are so few papers on this topic in the medical literature except for clinical reports usually based on hospitalized cases. The main results of a study of the 9261 physical education accidents registered within five years in primary and secondary schools in Basle and Geneva are used to illustrate their epidemiological characteristics, as well as the localization and the severity of the injuries. The sources of data are the files of the accident insurance companies. Initial operational definitions, data sources, measurement of exposure to risk and the (largely criticized) notion of individual accident proneness are constraints and conditions of a pertinent epidemiological approach which have to be carefully taken into consideration. This approach should be combined with the clinical and the ergonomical approaches in order to get the best possible pictures of the causes, mechanisms and consequences not only of accidents in general but especially of those occurring in physical activities in childhood and adolescence. Some considerations on prevention are briefly outlined here. They intend to take into account the risk factors related to the tasks, the circumstances and especially to the student himself taken as an individual involved in a growth and development dynamics.
Adolescent↗
[The legal status of medical students during practical training in hospitals (author's transl)].
The most important change in the qualification regulations in force at the present time is the provision for the practical training of medical students, which occurs not only in university hospitals but also in "teaching hospitals" outside the university. The realization of the practical year is problematic according to the actual conditions because of the difficulties and financial investment necessarily associated with it. Furthermore, the legal status of the students during the practical activities differes from that of earlier medical assistants, because according to the present law the legal provisions for employment and social insurance such as the determination of division of labour, working hours and remuneration and also for third party and accident insurance do not apply.
Education, Medical, Undergraduate↗
Incidence and aetiology of facial injuries resulting from motor vehicle accidents in Queensland for a three-year period.
BACKGROUND: No studies have been reported on the frequency and aetiology of facial injuries due to MVAs in Queensland. This study aims to investigate the incidence, aetiology, age and sex distribution of facial injuries resulting from MVAs for a period of three years. METHOD: Cases were identified from the Motor Accident Insurance Commission, Queensland. Information including the type of injury sustained, the time, age and role of the patient in the accident were recorded and analysed. RESULTS: There was an average maxillofacial injury incidence of 4.8/100,000 per year, 53.5 per cent in males and 46.5 per cent in females. A peak incidence was found for both sexes aged 18 to 22 years. In males, 57 per cent of facial injuries occurred in this age group compared to 41 per cent in females. CONCLUSIONS: Maxillofacial injuries as a result of MVAs are still relatively high regardless of the legislation for compulsory seatbelt use. Recent advances in seatbelt systems have the potential to reduce the risk of head and face impacts. The airbag is also well established as an effective means of preventing serious head and face injury. However, more research is required to further reduce the incidence of maxillofacial injuries as a result of MVAs.
Accidents, Traffic↗
[Unusual self mutilation with the purpose of obtaining illegal insurance benefits].
In this unusual form of self mutilation the fracture of the phalanx has been carried out--upon request--by foreign person (inderect self mutilation), in order to obtain illegal accident insurance money. Short survey of the relevant literature is given and the possibilities are outlined, which facilitate at the primary wound dressing the establishment of suspicious cases.
Absenteeism↗
[5 concepts of disability].
Disablement is a measure indicating how the individual manages or does not manage to cope with the tasks life presents. Different concepts of disablement are applied: Tabular disablement is used to measure the physical resources needed by the individual to undertake an unspecified register of tasks. Medical disablement is a measure of the aggregate resources (physical, mental and social) needed by the individual to undertake an unspecified register of tasks. Occupational disablement is a measure of the aggregate resources needed by the individual to carry out his previous occupation. Economic disablement is a measure of the aggregate resources needed by the individual to carry out some kind of work for which he is fit. Social disablement is a measure of the aggregate resources needed by the individual to maintain contact with other people. The tabular and medical concepts of disablement are used in connection with compensation for non-pecuniary loss. Insurance companies and administrative bodies, when determining the amount of compensation for such losses, lay most of the emphasis on tabular disablement (accident insurance and industrial injury compensation). The courts, when assessing the compensation, attach the main weight to the concept of medical disablement (compensation for non-pecuniary loss). The insurance companies and the administrative bodies have a system that is quite easy to operate, whereas the courts have a system leaving considerable room for discretion. The concepts of occupational and the economic disablement are used when granting compensation for loss of income.(ABSTRACT TRUNCATED AT 250 WORDS)
Classification↗
The economic consequences of medical injuries. Implications for a no-fault insurance plan.
BACKGROUND: There has been little research into the actual economic consequences of medical injuries. This inhibits informed discussion of alternatives to malpractice litigation. For example, the cost of no-fault medical accident insurance has been thought to be prohibitive. METHOD: As part of a comprehensive analysis of medical injury and litigation, we interviewed a random sample of 794 individuals who had suffered medical adverse events in New York hospitals in 1984 and used their responses to calculate the cost of injuries. We then estimated the costs of a simulated no-fault insurance program that would operate as a second payer to direct insurance sources and would compensate for all financial losses attributed to medical injury. RESULTS: The estimated costs that would be paid by a simulated no-fault program were $161 million for medical care, $276 million for lost wages, and $441 million in lost household production, or a total of $878 million in 1989 dollars for the cohort of patients who were injured in 1984. CONCLUSION: Although our estimate does not include administrative costs, it nonetheless indicates that a no-fault program would not be notably costlier than the more than $1 billion New York physicians now spend annually on malpractice insurance.
Adult↗
[Prevention of medical occupational accidents].
Technical measures are not sufficient to prevent occupational accidents in patients with specific diseases. Since 1984 the Swiss National Accident Insurance Fund (SUVA) has the possibility to clarify the working conditions and medical aspects of patients presumed to suffer a special risk to occupational accidents. The actual situation and the experiences in the medical prevention of occupational accidents in Switzerland since 1984 are described.
Accidents, Occupational↗
Occupational light-vehicle use and OHS legislative frameworks: an Australian example.
Occupational light vehicle (OLV) use and associated exposures and hazards in the Australian context are described. Available insurance data indicate that the OLV injury burden, which is greater than that of other work-road users, is growing as OLV use changes incidental to workers' primary occupations and work patterns. Legislation that affects OLV users is reviewed and the shifting of the burden of responsibility for injured or killed OLV users between workers' compensation, motor accident insurance and public health systems is described. Changes to OHS regulatory frameworks are proposed to better address OLV-relevant policy and practice. These issues are relevant for many international jurisdictions.
Accidents, Traffic↗
Electric accidents in the production, transmission, and distribution of electric energy: a review of the literature.
Many work related electric accidents occurred in electric energy industries and they were very often fatal. The situation of electric accidents in electric companies worldwide is investigated by reviewing the scientific literature, to offer perspectives on the types and kinds of statistics available, the factors regarded as influencing their occurrence, their consequences, and also methodological shortcomings. Worldwide, reliable comparable data exist and indicate a downward trend in fatal electric accidents. Difficulties were encountered in compiling international statistics because of differences in how accident data were defined and recorded, variations in mandatory practices, lack of suitable data and indices, accident insurance systems, and lack of correlation between technical, financial, and medical aspects.
Accidents, Occupational↗
Chemonucleolysis versus surgical discectomy. Comparison of costs and results in workers' compensation claimants.
A retrospective review of insurance claim files was conducted to compare the costs of chemonucleolysis with surgical discectomy. Twenty-nine surgeons performed 61 chemonucleolysis procedures and 44 surgical discectomies on SAIF (State Accident Insurance Fund, Inc.--a major Oregon workers' compensation insurance company) claimants between December 1982 and April 1984. Clinical data and treatment costs were tabulated during February 1985. In this population of 105 workers' compensation claimants, the average cost/claim of the workers treated by chemonucleolysis was higher than the average cost/claim of workers treated initially by surgical discectomy. The average cost/claim was somewhat lower in successful chemonucleolysis cass than in successful surgical discectomy cases, but the average cost/claim of unsuccessful chemonucleolysis cases was much higher than unsuccessful surgical discectomy cases. In order for chemonucleolysis to be a cost effective method compared to initial surgical discectomy, it would be necessary to attain a much higher chemonucleolysis success rate than observed in this group of patients.
Adult↗
[Radiological assessment protocol in injuries of the cervical vertebrae].
Over 3000 cases of soft tissue injuries of the cervical spine are reported annually to SUVA (Swiss accident insurance). Although the majority of the patients are pain-free within 4 weeks, it appears that approximately a quarter of those injured still experience neck pain even years after the accident. The initial radiological assessment should include an AP and a lateral plain X-ray of the cervical spine, and in the case of radicular symptomatology oblique views are also recommended. Should the symptoms persist for more than 6-8 weeks after the accident, functional X-rays in flexion/extension and lateral flexion should also be performed. If no instability can be demonstrated by plain X-rays and symptoms are still present and severe enough to limit the patient's working capacity after 3 to 6 months despite conservative therapy, further neuroradiological investigations, including functional CT's, are indicated. The decision to perform these investigations should lie with an interdisciplinary spinal team. Close cooperation between the clinicians and the radiologists is of utmost importance to ensure that the optimal radiological investigation can be performed on the basis of the clinical findings.
Cervical Vertebrae↗
[Psychological sequelae of accidents. A problem in accident and liability insurance].
Active and successful management predominantly depends on good and trustful cooperation between the claims manager, the field representatives of the administration and the injured or damaged person. Only the early assessment and prompt and purposeful claims handling can minimize the risk of an unexpected claims development. In the early stage, particularly probands with acute psychological maldevelopment can still be helped effectively. The introduction of an adequate therapy is beneficial to the afflicted person and at the same time lowers the final developing costs. As early as in 1918, Horn stated that the early occupational reintegration, apart from granting compensation, positively affects the process of the psychological disturbance. In general, no substantial restriction on the quality of life occurs if the injuries of a physical and mental type have been treated successfully and if occupational reintegration has taken place. However, if a continuous performance loss remains in occupational life due to a chronic psychological disturbance and if the damaged person does not achieve his/her ability to work again, even the contribution of high compensation payments does generally not improve the quality of life.
Accidents↗